How Your Hospital Rates
By SHAYDANAY URBANI
No single indicator can tell you which are the best hospitals for having your baby. A prospective mother may want to examine several factors, experts say: the rates of cesareans, episiotomies and vaginal births by mothers who have previously had cesareans.
In general, the best hospitals will have lower rates of cesareans and episiotomies — incisions of the vagina to ease difficult deliveries — and higher rates of vaginal births after C-sections.
A cesarean is sometimes necessary for mothers carrying twins or babies in breech positions or facing other complications. But it is major surgery that carries risk to both mother and baby.
“Looking at cesarean births at hospitals is helpful because it indicates to mothers how likely it is that they will have a surgical birth,” said Katy Kozhimanil, a University of Minnesota professor. But she added, “It would be misleading to say that lower rates of C-sections are always better, because it depends on the population that a hospital deals with. Some hospitals are dealing with higher-risk populations, who may require a cesarean section.”
Episiotomies, which involve risk including infection, are no longer standard delivery procedure. “Routine episiotomies used to be really common,” said Kozhimanil. “Now the evidence is really clear that routine episiotomies are not recommended.”
Vaginal births after cesareans, called VBACs, are a strong indicator of how committed a hospital is to vaginal births, Kozhimanil said. “This is important information for mothers who have already had a C-section.”