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The incidence of cesarean deliveries has risen from 21% of all births in 1996 to 33% in 2011. This trend has been attributed to changes in maternal, fetal, societal, and healthcare-related factors, only some of which reflect actual clinical risk. Recognizing the additional cost to the healthcare system of cesarean versus vaginal delivery as well as the potential role of hospitals in reining in the cesarean rate, health-policy researchers sought to quantify hospital-level variation in frequency of cesarean delivery.
From a national sample of 1050 hospitals, records of 593 hospitals with ≥100 deliveries in 2009 were analyzed. Hospital-wide rates of cesarean deliveries ranged from 7% to 70% (mean, 33%). Among women with low-risk pregnancies (fu…