Where you have your baby matters
Image courtesy Flickr user Howard Ignatius
If you are a Californian having a baby for the first time, choose your hospital wisely. You might even wish to move. A recent report from the California Hospital Assessment and Reporting Taskforce revealed alarming discrepancies in outcomes for low-risk pregnancies at high-performing and low-performing hospitals. For example, a healthy woman with a low risk pregnancy has just a 19 percent risk of undergoing a cesarean section at a high-performing hospital. A similar woman has a 56 percent chance of having a c-section at a low-performing hospital.
A woman at a low-performing hospital is likely to experience worse care in several other ways too. She has a 46 percent chance of getting an episiotomy, a surgical incision meant to create more room for delivery that can lead to complications later. At a high-performing hospital there is just a 2 percent chance that she'll have this procedure. She's much more likely to breastfeed exclusively before discharge at a high-performing hospital (88 percent, compared to 19). If she had a c-section for her first child, she doesn't necessarily need to have c-sections with subsequent children. Yet at a low-performing hospital she has just a 1 percent chance of giving birth vaginally with subsequent children, compared with 27 percent at a high-performing hospital.
An interesting twist in these, frankly, alarming discrepancies: of the ranked hospitals, almost all of the high-performers were in Northern California (33 in total, accounting for 88 percent). However, all of the low-performing hospitals (12 in total) were in Southern California.
My project will ask how hospital policies lead to high-performance or low-performance, if it is more profitable to be a low-performing hospital and how the ACA is affecting hospitals' treatment of pregnant mothers and newborns.