Use of Episiotomy and Forceps During Childbirth Down, C-Section Rates Up

AHRQ News and Numbers, April 28, 2011

Use of episiotomy, a surgical incision to widen the vaginal area during childbirth, fell by 60 percent between 1997 and 2008, according to the latest News and Numbers by the Agency for Healthcare Research and Quality (AHRQ). However, the proportion of hospital stays of women who delivered via cesarean section (C-section) increased by 72 percent during the same period.

AHRQ's analysis also found that from 1997 to 2008:

• The use of forceps to aid delivery declined by 32 percent, from 14 percent to 10 percent.
• The number of hospital stays for childbirth fell by 300,000 between 2007 and 2008—from 4.5 million to 4.2 million. In comparison, the annual number of childbirth stays had been increasing by an average of 2 percent a year starting in 1999.
• The average childbirth stay involving C-section with no complications cost hospitals an average of $5,700 and $7,600 when there were complications. By comparison, a vaginal childbirth stay without complications cost hospitals an average of $3,400 and $4,400 when there were complications.
• Forty percent of all childbirth stays were billed to Medicaid, 53 percent to private insurers, 4 percent were uninsured, and the rest were charged to other payers.
• Roughly 36 percent of all childbirth hospital stays in 2008 occurred in the South compared to 16 percent in the Northeast. The West and Midwest accounted for 26 percent and 23 percent, respectively, of childbirth stays.

This AHRQ News and Numbers is based on data in Hospitalizations Related to Childbirth, 2008. The report uses data from the 2008 Nationwide Inpatient Sample, a database of hospital inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 95 percent of all discharges in the United States and include patients, regardless of insurance type, as well as the uninsured.

For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.