California

 

NTSV Cesarean Birth Rate Dashboard: California

The Healthy People 2020 target of 23.9% not yet met.

Preliminary 2017 data show that California's NTSV cesarean rate is on track to meet the Healthy People 2020 target of 23.9 percent.   

What does NTSV mean?

How does this state compare to the United States?

How does this state rank among other states?

 

About this state dashboard

Centers for Disease Control and Prevention (CDC) National Center for Health Statistics provided a special report on state-level final data to CesareanRates.org. These include maternal morbidity cases, maternal conditions and characteristics of labor and delivery not currently accessible in CDC WONDER. Our organization is publishing these alongside national numbers to inform the public, policy makers, public health experts and the obstetric and midwifery community about state-level progress toward Healthy People 2020 goals for childbirth.

 
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Defined by the World Health Organization Maternal Morbidity Working Group (MMWG), 2013. 

 
 
 

Maternal Morbidity, CA, 2016

All births: 488,827

Maternal transfusion: 815

3rd- or 4th-degree perineal laceration: 3,739

Ruptured uterus: 89 

Unplanned hysterectomy: 168

Admission to intensive care unit: 547

Unknown: 57

Maternal Morbidity, U.S., 2016

All births: 3,945,875

Maternal transfusion: 11,494

3rd- or 4th-degree perineal laceration: 25,463

Ruptured uterus: 976

Unplanned hysterectomy: 1,342

Admission to intensive care unit: 5,003

Unknown: 5,362

More available on CDC WONDER, including data on age, race and other characteristics.

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Characteristics of Labor and Delivery

 

Final Route of Delivery, CA

Overall cesarean rate in 2016: 31.9 percent

Final Route of Delivery, U.S.

Overall cesarean rate in 2016: 31.9 percent
 

Birth Attendant, CA

Birth Attendant, U.S.

SOURCE: CDC WONDER
 

VBAC v. Repeat Cesarean, CA

8.3 percent Vaginal Birth After Cesarean rate (excludes unknown)

VBAC v. Repeat Cesarean, U.S.

12.4 percent Vaginal Birth After Cesarean rate (excludes unknown)
 

Compare to other states:

 

Epidural/Spinal Utilization, CA

64.9 percent

Epidural/Spinal Utilization, U.S.

73.5 percent
 

Cesarean with Trial of Labor, CA

29.6 percent attempted a trial of labor before a cesarean birth (excludes unknown).

Cesarean with Trial of Labor, U.S.

25.3 percent attempted a trial of labor before a cesarean birth (excludes unknown).
 

Induction of Labor, CA

14.3 percent

Induction of Labor, U.S.

24.5 percent
 

Labor Augmentation, CA

17.3 percent

Labor Augmentation, U.S.

21.0 percent
 

Maternal Health Characteristics

History of a Prior C-section, CA

16.5 percent

History of a Prior C-section, U.S.

15.3 percent
 

Chronic Hypertension, CA

Chronic Hypertension, U.S.

Source: CDC WONDER
 

Pregnancy-Associated Hypertension, CA

Pregnancy-Associated Hypertension, U.S.

Source: CDC WONDER
 

Tobacco Use, CA

Tobacco Use, U.S.

Source: CDC WONDER
 

Diabetes, CA

Diabetes, U.S.

Source: CDC WONDER
 

Tools for Promoting Maternal Safety

Several organizations offer free quality improvement solutions online, including condition-specific toolkits and larger scale data collection and analysis protocols.

 

Hospital level:

Patient Safety Movement Foundation: Optimizing Obstetric Safety Actionable Patient Safety Solutions (APSS)

Council on Patient Safety in Women's Health Care: Maternal Safety Bundles

California Maternal Quality Care Collaborative: Toolkits and Maternal Data Center

 

State or regional level:

State Perinatal Quality Collaboratives

Maternal Mortality Review Committees: General information and standardization of data collection


California Hospital C-section and VBAC Rates

California is advanced compared to other states in the areas of the collection, publication and use of maternity data.

 

Cal Hospital Compare + Yelp

CalHospitalCompare.org (formerly CHART) has been renamed a few times over the years but has always featured up-to-date maternity data. One feature worthy of exploration and replication in other states: VBAC Policy reporting. The Hospital Quality Institute surveys all birthing hospitals in the state for a Yes/No as to whether VBAC is routinely made available at their hospital.

This information is on Yelp as a result of a partnership with California Health Care Foundation and adds the element of consumer reviews of facilities and satisfaction with their experiences. It is the only existing option for patients to receive up-to-date data and read reviews on the same page.

UCSF Birthing Center’s Yelp page selected as an example.

 

CMQCC’s Maternal Data Center

The California Maternal Data Center was launched in 2012 and sets the standard for robust, near real-time data collection. Two other states—Oregon and Washington—now have hospitals using the MDC.

For many performance measurement projects, people can get away with using what is called “administrative data,” or discharge data. However, some quality and performance metrics require that these data be linked with birth certificate and hospital records in order to understand more about the patient. All of this has to be completely deidentified in order to comply with HIPAA. The MDC devised a secure, HIPAA-compliant system of delivering rapid cycle data and near real-time feedback to hospitals for the purpose of helping them do quality improvement work.

 

California Office of Statewide Planning and Development

Hospital discharge data sets are publicly available to download for free. You can find aggregated data on AHRQ quality indicators conveniently available to download in Excel or as a PDF.