The Leapfrog Group released its 2023 Maternity Care Report, which measures hospitals on three maternity medical interventions: cesarean sections (C-sections), episiotomies and early elective deliveries. The report found that while hospitals are making significant improvements in reducing episiotomies and steadily reducing early elective deliveries, the average rate of Nulliparous, Term, Singleton, Vertex (NTSV) C-sections increased significantly during the COVID-19 pandemic. The report uses final hospital data from more than 2,300 hospitals (representing 74% of U.S. hospital beds) who voluntarily submitted to the 2022 Leapfrog Hospital Survey and is the only source to publicly report these measures by hospital.
NTSV C-sections refer to mothers with first-time pregnancies that have reached at least 37 weeks of gestation and have a single baby in the head-down position, making this population least likely to need a C-section. From 2015, when Leapfrog first publicly reported this measure, to 2020, progress on reducing C-section rates was slow and showed limited improvement. More than half of reporting hospitals met the standard (23.6% or lower) in 2020, but now, three years later, only 42.3% meet the standard.
The two other measures included in Leapfrog’s 2023 Maternity Care Report, episiotomies, and early elective deliveries, showed improvement:
- Episiotomies, defined as an incision made in the perineum to make the vaginal opening larger during childbirth, is on average, below Leapfrog’s standard for the first time, with an average national rate of 4.6%. Since 2012, episiotomies have declined by 63%.
- Early elective deliveries, defined as scheduled C-sections or medical inductions performed without a medical reason before 39 weeks, have dramatically declined from over 17% in 2010 to 1.8% in 2022. The Leapfrog standard is 5%.