Planning a birth always means deciding where to give birth. Knowing the cesarean rate for a given birth place can be a concern and a decision-making factor in the location of birth but, frustratingly, the numbers can be hard to come by.

That’s why I have crunched them for you, using data from the State of Oregon Vital Statistics, Final method of delivery by county and facility. One caveat with these numbers is that since these are the numbers of where the birth finally took place, births that were planned for home or birth center and needed to transfer, are counted in the hospital numbers. Not all transfers to a hospital will result in a cesarean, but some will. In this way, I was not able to determine a cesarean rate for the home births or birth center births because a cesarean cannot take place AT the birth center or at home. 

Even with that said, I definitely thought there were some surprises in here. 

1. Legacy Emanuel Medical Center has by far the highest cesarean rate at a whopping 38%. Now, they do have the highest level of NICU (level 4, OHSU also has a level 4 NICU). NICU level can draw higher risk pregnancies, which can also lead to a higher percentage of cesarean births. Perhaps Emanuel gets more of the home birth/birth center transfers, but I’m not sure if that can truly account for this high of a cesarean rate. Emanuel, if you have someone who can speak to this (with numbers, of course, please let me know!
2. OHSU’s cesarean rate is 5 percentage points lower than Emanuel’s, while also having a Children’s Hospital and the same high level NICU (level 4).
3. Kaiser Sunnyside has a level III NICU, but maintained a much lower cesarean rate, 26%, than its fellow level III NICU hospitals. Providence St. Vincent and Providence Portland also have level III NICUs, but 33% cesarean rates (7 percentage points higher than Kaiser Sunnyside). 
4. Kaiser Westside had the absolute lowest hospital cesarean rate in the area at 22%. 
5. Hillsboro Medical Center (formerly Tuality Hospital) had the highest percentage of Vaginal Births After Cesarean (VBAC) as a fraction of their overall births, but OHSU and Providence St. Vincent were nearly tied in the absolute number of VBACs that happened at their facilities.