Childbirth Quality Data Seriously Lacking

Cheryl Clark, December 11, 2014

California is in the forefront of publicly reporting data points for childbirth, but other states lag far behind, and there is only one publicly reported national maternity measure posted on the federal Hospital Compare website.

Her obstetrician was making her nervous, seeming to pressure her into a C-section she didn't need or want, my friend suspected. She'd given birth naturally to her first child, and she'd heard absolutely no reason why she couldn't repeat that with her second.

"At my most recent appointment, he said the baby was measuring big, meaning that by 40 weeks the baby could be a whopping 7.5 pounds. And then he expressed concern about 'how that would affect me down there.' "

Her first baby, at 8 pounds, came out just fine, and she knows a normal baby might weigh up to 10 pounds. So she pushed back.

She'd asked the hospital's labor and delivery department for that doctor's C-section rate for women who'd previously delivered naturally, but was declined. She was told "don't worry. He's a good doctor," which infuriated her even more.

So, she asked me, how could she get information she needs to avoid an obstetrician who might just like to cut, as she knows some doctors do.

She can't, I explained.

Hospitals know these numbers, but keep them hidden. Arguably, attributing deliveries to specific physicians can be difficult because many doctors may be involved in decisions during a labor. Risk adjustment, too, is imperfect.

But that doesn't help healthcare consumers or payers.

Welcome to a new era of consumer demand for hospital quality data dealing with childbirth, the most common discharge diagnosis in the country.


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