Maternal care quality fluctuates across hospitals in same region

The rates at which women received episiotomies, a surgical cut to the perineum to aid in vaginal deliveries, and C-sections differed significantly among hospitals in the same city and region, according to the Leapfrog Group's 2018 Maternity Care Report.

The analysis stems from Leapfrog's 2017 Hospital Survey, which includes data from nearly 2,000 hospitals.

Here are five report insights.

1. Episiotomies are often considered medically unnecessary procedures and have been linked to numerous complications for mothers, according to the report. Although the rate of episiotomies declined in 2017, they still are performed in hospitals across the U.S.

2. In the Los Angeles area, the report found two hospitals 12 miles apart had episiotomy rates of 1.7 percent and 22.7 percent. In the Chicago area, one hospital had an episiotomy rate of 3.4 percent while a hospital 9.1 miles away had an episiotomy rate of 20.2 percent. The report found a similar trend in Dallas, where the episiotomy rate was 2.8 percent at one hospital compared to 18.4 percent at a hospital about 10 miles away. 

3. The survey found only 2 in 5 hospitals reporting to the 2017 Leapfrog Hospital Survey fully met the standard for C-section rate among low-risk, first-time mothers.

4. The survey found only 1 in 5 hospitals that elect to deliver very low birth weight babies meet Leapfrog's standard for high-risk deliveries. The standard includes treating large numbers of high-risk babies, having outstanding outcomes and giving mothers steroids before a baby's birth.

5. Early elective deliveries, which are induced or C-sections performed before 39 completed weeks gestation without medical necessity, have been declining. The rate of early elective deliveries is now down to 1.6 percent among reporting hospitals, the report stated. The majority (91.4 percent) of hospitals fully met Leapfrog's standard of 5 percent or lower for early elective deliveries.

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