Guide to Avoiding Unnecessary Cesarean Sections in New York

April 21, 2010

Sidney Wolfe, M.D.
Public Citizen Health Research Group

Full report as a pdf
Statements from press conference

Introduction
Objectives
Methods
About New York
Variations in Cesarean Sections, VBACs, and Midwife Availability by County and by Hospital Within Each County
Healthy Outliers: Two New York Hospitals that Have Bucked the Trend
Factors Possibly Associated with Variation in Rates
What is Driving Cesareans in New York?
How a Woman Can Avoid an Unnecessary Cesarean in New York State
What Health Departments and Hospitals Can Do to Reduce Unnecessary Cesareans
New York Hospital Birth Statistics by County

Methods

Because the state maintains updated hospital-specific data that are easily retrievable, we compiled our own database using these data and examined how cesarean sections (overall and primary) and VBACs vary by level of care, county, and among hospitals.

The state has a total of 231 hospitals, of which 155 perform deliveries. Three of the latter have closed since 2007, so we did not include them in our study. We thus collected data for the remaining 152 hospitals that perform deliveries and are still operating

Some of these perform few deliveries, so their numbers are subject to great fluctuation and are not reliable over time. We therefore excluded from our database any hospital that reported fewer than 30 births or fewer than five cesarean sections over the course of the year. These two exclusion criteria overlapped exactly and were met by nine hospitals. The sample on which our analyses are based focuses on the remaining 143 hospitals.