5 findings on maternity care safety in US hospitals

Childbirth is the main reason women with private insurance between ages 19 and 44 in the U.S. are hospitalized, according to the Leapfrog Group, which laid out several points on the quality of maternity care provided to women in its 2017 Maternity Care Report released Tuesday.

Castlight Health analyzed Leapfrog's 2016 data by hospital to put together this year's report, which mostly showed improvements nationwide.

Here are five findings from this year's Maternity Care Report.

1. Early elective deliveries (performed by induction or Cesarean section prior to 39 completed weeks with no medical indication) reached their lowest point since Leapfrog started reporting the metric in 2010: It reached 1.9 percent in 2016, down dramatically from 17 percent in 2010. Leapfrog recommends EEDs be performed in no more than 5 percent of low-risk deliveries.

2. Similarly, the rates of episiotomies have also declined, falling from 13 percent in 2012 to 9.6 percent in 2016. However, it is still higher than Leapfrog's target episiotomy rate of 5 percent.

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3. The rate of first-time mothers of a single baby at term with a head-down position having C-sections sat at 25.8 percent in 2016, down only slightly from 26.4 percent in 2015, the first year Leapfrog started tracking this metric. Leapfrog would like to see this rate at 23.9 percent or lower.

4. Quality of care provided to mothers did not vary much between teaching and non-teaching or urban and rural hospitals, Leapfrog found. Maternity quality performance data was nearly identical when comparing those types of hospitals. "This year's Leapfrog data underscores that many of the conventional assumptions for how to pick a 'good' hospital do not bear out — rates among teaching hospitals that may care for 'sicker' patients are similar to those at non-teaching hospitals. Rates at urban hospitals are similar to those at rural hospitals," Neel Shah, MD, an associate professor at Harvard Medical School, said in the Leapfrog report.

5. While improvements have been made nationwide, individual hospitals still have room to improve. Only 45 percent of reporting hospitals met Leapfrog's target rate for episiotomies, and 37 percent met Leapfrog's standard for C-sections.

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