Here is an excerpt from her article and you can plainly see how where you go to give birth can play a huge role in your outcome.

Advocate Good Shepherd Hospital in Barrington—35 percent (1,724 births 601 C-sections)

Advocate Medical Center in Oak Lawn—35 percent (4,233 births 1520 C-sections)

Resurrection Saint Joseph Hospital, Chicago—34 percent (1895 births 647 C-sections)

Advocate Condell Medical Center Libertyville, 30 percent (545 births 165 C-sections)

University of Chicago Medical Center, 29 percent (2,013 births 585 C-sections)

Advocate Illinois Masonic Medical Center, Chicago, 29 percent (2,931 births 866 C-sections)

Northwestern Memorial Hospital, Chicago, 28 percent (11,958 births 3,418 C-sections)

Elmhurst Hospital, 26 percent (1,426 births 374 C-sections)

Evanston Hospital, 26 percent (3,590 births 966 C-sections)

Adventist Hinsdale Hospital, 26 percent (2,252 births 588 C-sections)

Swedish Covenant Hospital, Chicago, 25 percent, (2,464 births 618 C-sections)

West Suburban Hospital, Oak Park, 20 percent (2,175 births 453 C-sections)

University of Illinois Medical Center, Chicago, 14 percent (2,893 births 433 C-sections)

Some notes about the three hospitals with the lowest cesareans:

• UIC is one of the few hospitals in the area that supports vaginal birth after 2 cesareans (VBA2C).  Most hospitals in the area view women who have had multiple cesareans as too risky for vaginal births and schedule them for repeat cesareans.
• West Suburban and Swedish Covenant both have alternative birthing centers on the premises used by midwifery practices that support natural childbirth and evidence based maternity care.  Women birthing in these birth centers aren’t forced to having labors conform to a curve or else face called cesareans for: “Failure to Progress”, “Arrested Labor,” or “Cephalopelvic Disproportion- CPD.”

if your hospital is not listed here, leave a comment and I’ll crunch the numbers and post your hospital’s rate.  Or you can check out the report yourself and leave it in the comments.

2008 Illinois Hospital Profiles

It does make a difference where you choose to give birth.

I spoke with a woman last weekend who would love to have a home birth but her insurance won’t cover one.  And the homebirth practice she was considering would cost her close to $7,000.  So then I asked her about going with a group of midwives who have an alternative birthing center.  She informed me that the only maternity reimbursements that her insurance provides are for MD’s.  She is healthy and low-risk and cannot even consider maternity care from a midwife.

I have heard of women whose coverage wouldn’t apply to the birth  if they were “allowed” to go past 41 weeks.  So in order to make sure that the birth was covered by their insurance they must undergo a costly, invasive, medical induction that increases their chances of a cesarean simply becasue their insurance policy arbitrarily states that it must be so.

So now we turn toward Texas where a judge recently ruled that Medicaid is not required to reimburse birthing centers for their facility fee when a woman using Medicaid gives birth there.  Medicaid will continue to reimburse hospitals (at a much higher cost) when women birth there, but the more cost effective option of the birthing center is being denied any reimbursement.  Also this ruling is not limited to Texas; it would apply nationally. Once again a medical plan is not even giving women  a choice when there exist several good options.  I’m not advocating that all low-risk women must give birth in a birthing center, only that if they have that option in their area they should be able to consider it.

If you would like to communicate your opinion about this ruling you can go here to do so: Consumer Letter to Congress

Childbirth Connection has great information on evidence-based maternity care and an excellent discussion of how current reimbursement practices actually encourage more intervention and less tolerance of supporting normal physiologic birth.  Pages 59-67 of their report Evidence-Based Maternity Care: What It Is and What it Can Achieve adress these concerns specifically.

As a childbirth educator and a doula I see my role as helping women to see the full range of options they have in various cincumstances so that they can make an informed decision about their care.  Unfortunately, the reality is that unless these women happen to be of certain means, their options are in reality much more limited than they appear at first glance.