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Member Research & Reports

Member Research & Reports

Minnesota Finds Maternal Diagnosis Does Not Explain Variation in U.S. Cesarean Rates

In 2011, cesarean delivery was the most common inpatient surgery in the U.S., making up 32.8 percent of all deliveries and more than 1.3 million births. But while cesarean delivery is common, cesarean rates vary 10-fold across hospitals in the U.S. The reasons for the variability are not well understood.

[Photo: Dr. Katy Kozhimannil]

Using data from 2009-2010, a new study from the University of Minnesota School of Public Health looked at more than 1.4 million births in more than 1,300 hospitals, across 46 states, and adjusted rates for maternal diagnoses, socio-demographics and hospital characteristics including size, location and teaching status.

“On average, the likelihood of cesarean delivery for an individual woman varied between 19 and 48 percent across hospitals,” said Dr. Katy Kozhimannil, lead author of the study and assistant professor in the School of Public Health. “We found that the variability in hospital cesarean rates was not driven by differences in maternal diagnoses or pregnancy complexity.”

Study findings were recently published in PLOS Medicine.

Key findings of the study include:

The authors state that their findings highlight the potential roles of hospital policies, practices, and culture in determining cesarean rates.

“Women deserve evidence-based, consistent, high-quality maternity care, regardless of the hospital where they give birth, and these results indicate that we have a long way to go toward reaching this goal in the U.S.,” Dr. Kozhimannil said.

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