Childbirth Connection

Exposing Variation in Maternity Care Quality, Health Outcomes, and Value

The average cost of hospital charges for hospitalizations related to Pregnancy, Childbirth & The Puerperium for all payors rose 200% from 1993 to 2008. The greatest dollar increase in average charges was incurred by Medicare, rising from an average of $4,727 in 1993 to $13,690 in 2008, an increase of $8,963. The greatest percentage increase in charges were incurred by private insurance, rising 220% over this time period.

Nationwide Trends

Major Diagnostic Category 14, Pregnancy, Childbirth & The Puerperium

The average hospital charge for women hospitalized with a primary diagnosis of Previous C Section rose 170% for all payors from 1993 to 2008.

Average Hospital Charges for Diagnosis “Previous C Section” over time.

Just as infants reach developmental milestones, like rolling over or crawling, at different times, every baby reaches the "developmental milestone" of readiness for birth at a slightly different time. The most reliable sign that the baby is ready to be born safely is labor beginning on its own at full-term.

Full-term has traditionally been defined as any time between 37 and 42 weeks of pregnancy, with your estimated due date at 40 weeks near the middle of this window. (You can find an estimated due date calculator on the Resources Page of this section.) However, more and more research shows that babies born between 37 weeks and 38 weeks and 6 days, whether labor started on its own or was induced, face a higher risk of several health problems than babies born from 39 weeks on. For this reason, labor induction or planned cesarean surgery should never be used before 39 weeks unless there is a clear medical reason. (The Best Evidence: Induction of Labor page describes the medical reasons for induction of labor.) Although the risk of stillbirth or newborn death is very low, this risk begins to rise around 41 weeks and rises significantly after 42 weeks. To prevent these rare deaths, most caregivers will offer induction of labor between 41 and 42 weeks.

Availability of Birth Centers

This animated chart of the United States shows the number of Hospitals and Birth centers across the United States. Color value indicates the number of facilities in the state (as a percent of the national total). Scroll over the States to see the rate of count of birth centers, number of hospitals allowing Vaginal Birth After Cesarean (VBAC), the number banning VBACs, and the number whose policies and staffing result in a de facto ban of VBACs. Texas has the highest rate of birth centers (2.88), followed by Florida (1.31), and California (1.09).

In 2008, 32% of babies born in the US were delivered by Cesarean.

http://www.cdc.gov/nchs/fastats/delivery.htm

The Value of Healthy Childbirth

In order to understand the data, it helps to understand the populations of each state. In 2011, the most populous states were California (36.96 million), Texas (24.78 million), New York (19.54 million), and Florida (18.53 million).

Birth center data is from www.birthcenters.org. Unless otherwise indicated, all data is from http://www.hcup-us.ahrq.gov/