Montana birth stats revisited

In September I posted twice about local birth statistics.  You can read them here and here.  Since the CDC released a preliminary report for 2006, I thought I should review some interesting data from 2004 and 2005 (source).

Montana (state-wide) cesarean rates:
2004 – 25.3%
2005 – 25.7%
2006 – 28% (preliminary estimate)
I find it interesting that 85% of Montana cesareans in 2004 and 86% of cesareans in 2005 took place in counties with 100,000 or more residents.  Granted, high-risk pregnancies would transfer to larger hospitals and might be more susceptible to cesarean delivery.

Montana (state-wide) VBAC rates:
2004 – 1.4%
2005 – n/a
2006 – n/a (yet?)
I’m not sure why the CDC didn’t provide the 2005 VBAC figures.  Could it be that VBAC is so rare that it was statistically insignificant to report?

Only 16 VBACs took place at Missoula’s Community Hospital in 2006.  That was about 1% of their live birth population.  Yikes!  Double yikes when you consider that Community is one of a small handful of hospitals across the state that still allow VBACs.

Place of delivery (2005):*
57 of 1850 births in Missoula County took place outside of a hospital.  And I’m not sure that the Birth Center was even up and running at that time.  This accounts for 3.1% of the live birth population.  This slim percentage is at least twice the national average, from what I’ve heard.
44 of 240 births (18.3%) in nearby Ravalli County took place outside of a hospital.  Now I call that statistically significant!
The state out of hospital rate was 2.5%.

Although Montana’s cesarean rate is a few percentage points below the national average (estimated at 31.1% in 2006), it still greatly exceeds the recommended level of 10-15% established by the World Health Organization.  Cesarean rates above 15% reflect an abuse of the life-saving medical procedure.  Cesarean surgery is a major abdominal surgery with its own tangible list of risks.

* Data obtained from Montana’s Department of Health and Human Services

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3 responses to “Montana birth stats revisited

  1. Data obtained from Public Citizen’s Health Research Group Publication entitled
    Unnecessary Cesarean Sections, published in 1994. Data obtained is from 1992.

    Montana -overall cesarean rate was 20.7%. Live births 10,886.
    The Missoula Community Hospital that you referred to did 321 cesarean sections that year with a rate of 22.8%.

    Montana-The state VBAC rate that year was 27.6%. The Missoula Community Hospital had a VBAC rate of 29.3%. That number represents 53 births, as compared to 128 repeat cesareans in that hospital alone.

    At any rate…compare the VBAC rate from 1992 to 2004….a little over a decade later…and you can see that this has nothing to do with size of hospital
    or whether there is a NICU present. Women are giving birth in a very different birthing climate, and they need to know it.

    The Community Hospital in Poplar did not do enough cesareans to be reported (meaning less than 4…all year). Sheridan Memorial in Plentywood had a 12.6% cesarean rate.

    The women of Montana had much better birthing options in 1992 then they do now.

  2. Hi Becky,
    As far as I know, the national VBAC rate is not tracked. Perhaps it’s not “important” enough, or maybe it’s that hospitals don’t send data that is categorized enough. The cesarean rates provided by the CDC – I believe – include primip and multipara numbers. What is the primary cesarean rate? What is the ERCS rate? What is the RCS rate? What is the VBAC rate? All of these numbers would be important to me.

    This might be a good question to ask on the ICAN yahoo list. I’m sure there are people more knowledgeable than I who can give you a better explanation for WHY the VBAC rate isn’t tracked more closely or in a more transparent fashion.

    ~ Kimberly

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