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U.S. News Special Report: Half of Mothers Get a C-Section in This Louisiana Community

New report dives into high C-section rates in the U.S. and highlights ways hospitals can improve maternal health

U.S. News & World Report Logo. (PRNewsFoto/U.S. News Media Group)

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U.S. News & World Report

Sep 25, 2019, 09:30 ET

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WASHINGTON, Sept. 25, 2019 /PRNewswire/ -- The C-section rate varies widely across U.S. hospitals, counties and states, yet was the highest in one particular community in 2017, marking it as America's C-section capital, an analysis by U.S. News & World Report finds.

The editorial package released today shows that in Rapides Parish, Louisiana, the C-section rate among low-risk births was 47.3% in 2017, the latest year for which county-level federal data is available, while the overall C-section rate was 50%. Maternal health experts say the vast majority of women whose deliveries are considered low-risk can safely give birth vaginally, while the federal government says the rate of first-time cesareans among a similar group of women should be no more than 23.9% by next year. Nationwide, research indicates mothers who undergo a cesarean rather than a vaginal birth are more likely to suffer from severe pregnancy-related health issues, both immediately and in future pregnancies.

"Though Rapides Parish may have recently seen the highest low risk C-section rate in the country, this maternal health issue extends far beyond Louisiana," said U.S. News reporter Gaby Galvin. "Piecing together data, insights from national maternal health experts and the often-overlooked experiences of mothers, we sought to understand why low-risk C-sections happen so frequently in America – and why it's so challenging to bring that rate down."

U.S. News' analysis explores why half of childbirths in Rapides Parish ended in surgery – a complex, systemic issue that advocates say should be addressed at both the state and local levels – and highlights successful efforts to curb low-risk C-sections in other communities.

Key takeaways include:

  • Although patient health may be a contributing factor to high C-section rates, research indicates patient characteristics alone can't explain the wide variation in rates across the U.S. Health experts say provider practices and hospital cultures can tend to drive the number of low-risk C-sections performed. In some places, such as Louisiana, data on C-section rates for specific hospitals can be hard to come by, making it difficult for pregnant women to recognize potential red flags for their care.
  • High cesarean rates are a systemic issue in health care. Maternal health experts tell U.S. News that efforts to bring down the low-risk C-section rate will need to come from both public and private sectors, such as hospitals that voluntarily adopt best practices for labor and delivery and government and insurance agencies that enact changes to payment policies.
  • Efforts to improve maternal health care are paying off. The California Maternal Quality Care Collaborative rolled out its C-section "toolkit" for providers in May 2016. The toolkit addresses hospital culture and ways to support vaginal birth, how to manage abnormalities during labor without defaulting to C-sections and how to use data to push for a reduction in low-risk C-sections. Three years later, the impact of the collaborative and its partners is measurable.

The editorial package on C-section rates is accompanied by analysis, reporting and commentary from experts on the frontlines of this issue.

  • Questions in America's C-Section Capital
  • Commentary: The Rise of C-Sections and What It Means
  • States With the Highest C-Section Rates in the U.S.
  • Photo Essay: Women from Rapides Parish Share Their Stories

"U.S. News' in-depth analysis explores one of the most sensitive issues in maternal health care that is prevalent across America," said Kim Castro, editor and chief content officer of U.S. News. "This report underscores the divide in care across the country and how hospitals have the opportunity to grow in their level of care and learn from best practices."

This new report is part of the Healthiest Communities platform, which features in-depth reporting and analysis on public health issues in nearly 3,000 communities. Developed in collaboration with the Aetna Foundation, an independent charitable and philanthropic affiliate of CVS Health, Healthiest Communities includes comprehensive data covering the full spectrum of factors that influence population health. Healthiest Communities is part of U.S. News' expanding civic journalism initiative, which measures government performance locally and globally and includes their Best States, Best Countries and Cities platforms.

About U.S. News & World Report

U.S. News & World Report is the global leader in quality rankings that empower people to make better, more informed decisions about important issues affecting their lives. A digital news and information company focused on Education, Health, Money, Travel, Cars and Civic, USNews.com provides consumer advice, rankings and analysis to serve people making complex decisions throughout all stages of life. More than 40 million people visit USNews.com each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C.

SOURCE U.S. News & World Report

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