Methodology:
The Leapfrog Group is an independent nonprofit that monitors the quality and safety of health care and powers the Newsweek Best Health Care series. Best Maternity Care Hospitals are hospitals that meet Leapfrog’s tough standards for excellence in maternity care: hospitals that have low rates of C-section, episiotomy, and early elective deliveries, and follow important protocols to protect moms and babies. Though these are standards aligned with medical research and best practices, not all hospitals achieve them. Newsweek’s Best Maternity Care Hospitals are an elite group of hospitals demonstrating the highest performance in the United States.
To be considered for the list, hospitals had to demonstrate that they fully met Leapfrog’s standard for all of the following measures:
Early Elective Delivery
Data strongly demonstrates that early elective deliveriesscheduled cesarean sections or medical inductions performed prior to 39 weeks of gestation without medical necessitycarry risks to both babies and mothers. Early elective deliveries can result in neonatal intensive care unit (NICU) admissions, longer stays and higher costs to both patients and payers.
For this measure, a lower rate is more desirable. Leapfrog’s target for all hospitals is 5% or less.
NTSV C-Section
Cesarean sections (C-sections) carry serious risks of infection or blood clots, and many women experience longer recoveries and difficulty with future pregnancies. C-sections can also cause problems for babies, like breathing difficulties that need treatment in a newborn intensive care unit (NICU). To measure a hospital’s rate of C-sections, Leapfrog uses one standardized, endorsed measure that reflects the percentage of first-time mothers giving birth to a single baby, at term, in the head-down position. This measure allows for a fair comparison on C-section rates among very different hospitals.
For this measure, a lower rate is more desirable. Leapfrog’s target for all hospitals is 23.9% or less.
Episiotomy
An episiotomy is an incision made in the perineum (the birth canal) during childbirth. Although episiotomies were once routine in childbirth, medical guidelines today recommend an episiotomy only in a narrow set of cases. Episiotomies have been clearly linked with worse perineal tears, loss of bladder or bowel control, serious infections, and pelvic floor defects.
For this measure, a lower rate is more desirable. Leapfrog’s target for all hospitals is 5% or less.
Newborn Bilirubin Screening Prior to Discharge
To ensure a safe delivery for mom and baby, hospitals must take some standard precautions for their patients. Leapfrog assesses whether a newborn has been properly screened for a high bilirubin level. If a high level is not caught, the newborn faces a high risk of brain damage and various disabilities.
Leapfrog’s target rate is 90% or greater, meaning that at least 90% of babies are screened for jaundice.
Appropriate DVT Prophylaxis in Women Undergoing Cesarean Delivery
Mothers that deliver via C-section are sometimes at risk for a pulmonary embolism, where one or more arteries in the lungs become blocked by a blood clot. Hospitals must take care to reduce this risk using standard prevention protocols.
Leapfrog’s target rate is 90% or greater, meaning that techniques to prevent blood clots are used for at least 90% of mothers delivering via C-section.
