HEALTH & WELLNESS
cutting down on c-sections NEW JERSEY CESAREAN DELIVERY RATES ARE ABOVE NATIONAL AVERAGES WRITTEN BY LINDY WASHBURN
New Jersey hospitals performed worse— not better— in lowering the rate of Cesarean deliveries for newbornsinthe most recent report on the quality of maternity care.
Only nine of 48 hospitals where babies are delivered brought the rate of such surgery down to the national goal level, said the report. That compares with 15 hospitals that had reached the goal set by the federal Healthand Human Services Department ayear earlier.
Some of the busiest hospitals for childbirth— such as Hackensack Meridian Health Hackensack University Medical Center— have C-sectionrates of more than 40 percent, far above the national and state averages.
The state“ can and must do better to reduce C-sectionrates,” says Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute.“ Now is the time for hospital leadershiptoprioritize maternal and child health throughout New Jersey.”
No one says the goal should be zero C-sections. Surgical births are sometimes necessary for the healthofthe mother and baby. The government saidhospitals should strive to do no morethan 23.9 percent of birthsvia C-section.
Hospitals separated by less than
NEW JERSEY’ S C-SECTION RATE HAS REMAINED STUBBORNLY HIGH FOR YEARS.
5miles can provide vastly different childbirthexperiences. For example, Holy Name Medical Center in Teaneck has aC-section rate of 16.2 percent, compared with Hackensack’ s rate of 41.0
percent.“ The hospital where an expectant mother delivers her baby should not be the determining factor of whether or not she has asurgical birth,” Schwimmersays, notingthe wide gaps among New Jersey hospitals.
More than 100,000 babiesare born eachyearinNew Jersey, and about 40 percent of their deliveriesare covered by Medicaid, the state insurance program for low-income people.
C-sections cost morethan vaginal childbirthand result in longer hospital stays. For themother, the procedure carries ahigher riskofcomplications such as infection or the formation of blood clots. And babies born without being squeezed through thebirth canal have ahigher risk of respiratoryproblems and lack exposure to the mother’ s bacteria, which can help their developing immune systems.
New Jersey’ sC-section rate has remained stubbornlyhigh for years.
The state ranked fourth— behind Mississippi, Louisiana and Florida— in 2016, with an overall rate of 36.1 percent, according to the federal Centers for Disease Control.
New Jersey mothers are also twice as likely as the national average to die in the year after giving birth.
Their deathsmay be related to the unusually highrate of surgical deliveries, experts say. That issue— and the highest-in-the-nation mortality gap between black babies and white babies— are among the health care priorities of Gov. PhilMurphy’ s administration.
“ This data should be awake-up call that improving maternal healthinNew Jersey requires transparency” and new ways to make hospitals more supportive to mothers and babies, says JillWodnick, achildbirth educator at Montclair StateUniversity. She led agroup marking New Jersey’ sfirst Maternal Health Day earlier this year.
Women crave information that allows them“ to understand the quality of maternity care” and the facilities available at various hospitals, she says. In California, for example, consumers can searchbyZIP code for information about the birth practices and quality metrics at their hospitals.
Use of this information, combined with therightfinancial incentives, could lead“ New Jersey to see vast improvementsinits maternal and infant health outcomes, across all races,” Schwimmer says. ●
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10 FALL 2018 |( 201) FAMILY