What is this? This is the rate at which women have a vaginal delivery after having had at least one C-section. Higher rates are better.

Why does it matter? A VBAC has the benefits of a vaginal delivery: aquicker recovery and less pain, fewer days in the hospital and a lower chance of infection. A VBAC also means one fewer scar on the woman's uterus.

What factors might affect the numbers? Most experts say women can consider labor and a vaginal delivery after one C-section. But because a VBAC could risk tearing a prior C-section scar, some hospitals and doctors might resist this out of concern for the mother’s health or their own liability. As with C-sections, there are cultural differences among hospitals but no firm proof that these explain the variations in rates.

What is this? The baby is delivered through incisions in the mother's abdomen and uterus. Lower rates are better.

Why does it matter? A C-section increases the mother's pain, recovery time and risk for infection. It may complicate future pregnancies. There is a small risk the scar could rupture or that the placement of the placenta will cause severe bleeding. C-section babies are slightly more likely to have breathing problems and be at risk for a few common chronic conditions than babies delivered vaginally.

What factors might affect the numbers?

These are rates for a mother’s first Cesarean section. Experts say preventing a first C-section will protect a mom against ruptures and severe bleeding that may occur with a second or third C-section.
Large hospitals, including teaching hospitals, often have higher C-section rates. They say it’s because they handle more premature and other high-risk deliveries.
There is no definitive reason for the big differences between hospitals. A mother’s age, patient choice or fear of malpractice lawsuits may help explain high rates overall, but have little effect on the gaps between hospitals. Researchers are looking at cultural differences among hospitals, time pressures and the impact of fetal health monitors on C-section rates.

What is this? Sometimes pregnant women or their doctors schedule an early delivery for convenience or to make sure the doctor who has been seeing the mom will handle her delivery. Lower rates are better.

Why does it matter? Many medical societies, child advocacy organizations and employer groups say hospitals should not schedule deliveries before 39 weeks to avoid complications, and because babies need the last two weeks for brain, lung, and other vital organ development.

What factors might affect the numbers? Most hospitals are trying to eliminate this practice and many have. Most hospitals above 0 are in the single digits. Hospitals say this reflects their goal of reducing, if not ending, early elective deliveries.

What is this? A cut made to enlarge the vaginal opening during birth. Lower rates are better.

Why does it matter? Most experts recommend natural tearing when needed. An intentional cut may prolong a mother's recovery and lead to urinary incontinence and muscle problems in the anus.

What factors might affect the numbers? Doctors may perform an episiotomy to speed a delivery if a baby is in distress. Some doctors say that younger obstetricians don’t perform episiotomies or that it’s more acceptable at some hospitals than others.

What is this? The percentage of babies fed nothing but breast milk from birth to hospital discharge, among mothers who say they want to breast-feed. Higher rates are better.

Why does it matter? Breast-feeding helps protect babies against allergies, Sudden Infant Death Syndrome and some illnesses. It may protect the mother against some forms of cancer and postpartum depression.

What factors might affect the numbers? Hospitals can help mothers with breast-feeding, but they can’t control whether they succeed. Larger hospitals -- those that perform 1,100 births or more per year -- are beginning to report this measure to a national accrediting group and appear to be making a greater effort to collect this information than some smaller hospitals.

Procedure: Region:

Where did we get the numbers? These rates (table 31) were collected by the state Department of Public Health for 2010, the most recent year available.

Where did we get the numbers? Our numbers are from The Leapfrog Group, which monitors healthcare quality and safety through voluntary hospital surveys. Leapfrog shared its latest numbers on 11-30-13.

Where did we get the numbers? Our numbers are from The Leapfrog Group, which collects the information through voluntary hospital surveys. Leapfrog shared its latest numbers on 11-30-13.

Where did we get the numbers? WBUR collected this information directly from hospitals across Massachusetts. In January, The Joint Commission, a national hospital accreditation group, will begin collecting this information from hospitals that perform 1,100 or more births a year.

Measures: