In the latest U.S. News & World Report report on routine obstetric care, six of the nine maternity facilities in San Diego County are rated as “high performing,” but three of the area’s largest facilities are rated low. could not be obtained.
Three were removed from the high-performing group: Sharp Mary Birch Hospital for Women and Newborns, Sharp Chula Vista Medical Center and Scripps Memorial Hospital La Jolla.
All three hospitals have generally good reputations in their respective regions, but they say they have lower birth rates than the state average for women who give birth vaginally after a previous C-section. The measure, often referred to as “VBAC,” aims to identify hospitals that work the hardest to ensure that past C-sections do not unduly influence subsequent births.
As the American College of Obstetricians and Gynecologists (ACOG) points out, VBAC is “associated with decreased maternal morbidity and reduced risk of complications in future pregnancies,” so if a woman has had at least one previous pregnancy The focus is on being able to attempt such a delivery later. -section.
VBAC and overall C-section rates are the most weighted of 10 different factors that U.S. News uses to construct its overall rating. According to the magazine’s methodology, the C-section rates at all three hospitals are slightly higher than the average of 22% among hospitals rated as excellent nationwide.
Other factors also play a role, including the rate of neonatal complications and how often hospitals perform episiotomy, a surgical procedure that widens the birth canal. The demographics of the deliveries were also considered. Mary Birch and Scripps La Jolla reportedly have lower than average rates of non-white births.
At Mary Birch, Sharp operates California’s largest birthing center, with 7,436 births in 2021, the latest year for which state data is available. The health care provider said in a statement that it actively addresses the topics used by U.S. News to make its ratings.
“At Sharp Healthcare, we have an aggressive program in place to reduce the number of C-sections and increase VBAC rates, but many factors can impact these numbers, including high-risk pregnancies ” Sharp said. “It is important to know that every pregnant woman who visits our hospital is carefully assessed for the safest method of delivery.
“Patient safety and recovery rates are not reflected in U.S. News & World Report obstetric rankings. In fact, patients who undergo a C-section or episiotomy experience outcomes that are within industry standards. ”
Scripps expressed similar sentiments in its own statement.
“Scripps Memorial Hospital La Jolla is a tertiary referral center, which means we receive the highest-risk patients,” Scripps said. “These high-risk patients tend to have older maternal age, which, combined with other complicating factors, leads to higher rates of caesarean delivery.
“While Scripps offers vaginal birth after cesarean section (VBAC) to all patients when it is safe, patients decide which delivery option they prefer and our team will respect that decision. The composition of Scripps-La Jolla’s watershed likely explains the somewhat lower number of nonwhite births than other parts of San Diego County.
Hospitals listed as high-performing for obstetric care include UC San Diego Health La Jolla Hospital and Hillcrest Hospital, Kaiser Permanente Hospital in San Diego, Scripps Mercy Hospital in San Diego, Sharp Grossmont Hospital, and Scripps Memorial Hospital Includes Encinitas and Palomar Medical Center Escondido.
First Published: December 10, 2024 5:18 PM PST
