Four things you should know about having a baby in the U.S.

Having a baby is one of life’s most miraculous and joyful experiences. Most moms and dads bask in a level of happiness that’s unequaled by any other event. But responsibilities and decisions involving maternity care can create challenges.

Beyond choosing the mother’s physician, one of the biggest decisions is the choice of hospital for delivery. According to a report from the 2014 Leapfrog Maternity Care Report—developed for The Leapfrog Group by Castlight Health—the right hospital can make a big difference.

4 things you should know about having a baby in the U.S.

  • The rate of early elective deliveries is declining—whether by C-section or medical induction, the rate has dropped for the fifth year in a row, from an average of 17% in 2010 when the Leapfrog study began to a 3.4% average at the hospitals reporting in the latest study. This means moms and babies are at lower risk from complications due to a baby being born too soon.
  • Considerable variance of early elective deliveries still exists, with 82 hospitals reporting a rate of 10% or more, and 17 relying on early elective deliveries 30% or more of the time, six times the Leapfrog standard. This variance reinforces the need for transparency so families can find the best-quality hospitals.
  • Episiotomies—surgical incisions made to help facilitate birth—are also declining, but there’s a huge variance. The good news: In 2014, the average episiotomy rate (11.3%) fell below Leapfrog’s standard (12%), with 65% of hospitals meeting or beating the threshold. The bad: 48 hospitals still were using the outdated and risky procedure on more than 30% of their mothers.
  • High-risk babies weighing less than 3 lbs. 5 oz. should be delivered in hospitals with neonatal intensive care (NICU) and other services. Unfortunately, the percentage of hospitals that are optimally equipped remains dangerously low, with only 24.4% of hospitals meeting Leapfrog’s standard. Women with a high-risk delivery, where there is the potential need for an NICU, should be sure to identify facilities equipped to care for their newborn.

What this means when you’re expecting

For moms and their babies, early elective deliveries increase the risk of complications, can add significantly to the cost of maternity care and should only be done when medically necessary. Babies requiring a NICU drive maternity costs even higher. It is critical that these very sick babies receive the proper intensive care. To ensure the best possible outcomes, these deliveries should occur in hospitals with well-equipped and staffed NICUs, according to the report.

The comforting news is that now technology exists to provide expectant mothers (and everyone else) with quality data compiled by measurement experts such as Leapfrog.

What else you can learn from this study An in-depth look at the quality of maternity care is just the first takeaway from this year’s Leapfrog study of over 1,500 hospitals across America. This report series, which Castlight is developing in partnership with The Leapfrog Group, will also offer many other insights and ideas for employers, employees, providers, and insurers on the path to quality care at more affordable costs.

The specific areas addressed include:

  • Maternity care
  • Medication errors
  • High-risk surgeries
  • Hospital-acquired conditions
  • Intensive Care Unit (ICU) staffing
  • Serious adverse events
  • Safety practices

To learn more about the Leapfrog Hospital Survey, and how you can participate to bring greater transparency to U.S. healthcare costs, quality, and outcomes, visit