AJC Watchdog: First Alert

Keeping watch on those who hold the public trust and money

Northside Hospital tops the charts for c-sections among Atlanta hospitals, AJC finds

Northside Hospital in Atlanta had the highest c-section rate among metro area hospitals in 2014, with 40 percent of babies delivered by cesarean, according to an analysis by The Atlanta Journal-Constitution.

While Northside topped the rankings, five other metro Atlanta hospitals had c-section rates of 35 percent or higher, the AJC found. Those five hospitals are Eastside Medical Center, Gwinnett Medical Center, Northside Hospital Forsyth, DeKalb Medical Center and WellStar Kennestone Hospital.

North Fulton Hospital had the metro area's lowest c-section rate, at 18 percent.

The AJC calculates c-section rates using reports filed by the state's hospitals with the Georgia Department of Community Health.

To see c-section rates for every metro Atlanta hospital, check out the AJC Hospital Checkup website. The website offers information ranging from infection rates to labor and delivery stats.

In Georgia and across the country, about a third of deliveries are by c-section, which represents a 60 percent increase since 1996. Last year, The American College of Obstetricians and Gynecologists said c-section rates had climbed too high and urged doctors across the nation to be cautious about using them. This in-depth AJC story from last year explored the c-section trends.

Northside Hospital, which delivers far more babies than any other metro Atlanta hospital, says its vast obstetrics operation attracts many women with high-risk pregnancies who are more likely to need a c-section.

The AJC Hospital Checkup site also tracks each hospital's rate for "early elective deliveries."

In recent years, it became commonplace for doctors to schedule c-sections or inductions before the 39th week of pregnancy, primarily for convenience. These are not cases where a woman goes into labor early, or where an early delivery is medically necessary. Instead, these elective deliveries were scheduled to work around a family's commitments or to make sure a woman's favorite doctor would handle the delivery.

Doctors and other experts have pushed back against this practice, saying it's important to wait until the 39th completed week of pregnancy before delivering because important brain and lung developments are taking place. The stakes are so high that many hospitals are working to eliminate early elective deliveries. The AJC is tracking how hospitals are doing, using data collected by federal health officials.

Piedmont Henry Hospital posted the metro area's highest rate of early elective deliveries at nine percent, according to the most recent federal statistics. At WellStar Douglas Hospital, the rate was 8 percent. The rates cover births from April 1, 2014 to March 31, 2015. Ten metro Atlanta hospitals reported zero early elective deliveries during this time period. 

 Piedmont Healthcare said it has been working for several years to reduce early elective deliveries at its hospitals.

"We’ve been very successful – achieving sustained rates of zero at four of our five hospitals," Piedmont Healthcare said in a statement. "There are many influencers for c-section rates, including patient preference. This is an ongoing conversation as to why our rates are sometimes higher than state and national averages, and what we can do to help impact this."

Piedmont reports more recent data on early elective deliveries and c-section rates on its quality website.

The March of Dimes, which has worked hard to educate pregnant women, doctors and hospitals about the risks of early deliveries, said there has been a quick response in Georgia with significant drops in the early elective deliveries at many hospitals around the state.

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About the Author

Carrie Teegardin is on the investigative team. She is a graduate of Duke University and has won numerous national journalism awards.