Six of nine maternity units in San Diego County are rated “high performing” in the latest report on routine maternity care from U.S. News and World Report, but three of the largest in the region did not make the cut.
Sharp Mary Birch Hospital for Women & Newborns, Sharp Chula Vista Medical Center and Scripps Memorial Hospital La Jolla are the three left out of the high-performing group.
All three — each generally well respected in the areas they serve — were said to have lower rates of deliveries to women delivering vaginally after a previous cesarean section than the state average. Often called “VBAC,” this measure is meant to identify those hospitals working hardest to make sure that previous C-sections do not unduly influence subsequent deliveries.
As the American College of Obstetricians and Gynecologists (ACOG) notes, VBAC “is associated with decreased maternal morbidity and a decreased risk of complications in future pregnancies,” leading to a focus on allowing women to at least attempt such a delivery after a previous C-section.
VBAC and overall C-section rates are the most heavily weighted of the 10 different factors that U.S. News uses to build its composite ratings. All three hospitals were said to have C-section rates somewhat higher than the 22 percent average for hospitals nationwide that were rated high-performing, according to the publication’s methodology.
Other factors such as the rate of newborn medical complications or the frequency with which a hospital performs episiotomies, a surgical widening of the birth canal, are performed. The demographic makeup of deliveries was also considered. Mary Birch and Scripps La Jolla were said to have lower percentages of non-white deliveries than average.
At Mary Birch, Sharp operates the largest birthing center in California with 7,436 deliveries in 2021, the most recent year for which state data was available. In a statement, the medical provider said that it is actively working on the topics that U.S. News uses to make its ratings.
“Sharp HealthCare has active programs in place to reduce the number of C-sections and increase VBAC rates, but many factors, such as high-risk pregnancies, can have an impact on those numbers,” Sharp said. “It’s important to know that all pregnant mothers who present to our hospitals are carefully evaluated for the safest mode of delivery.
“Not reflected in the US News & World Report maternity ranking are patient safety and recovery rates. Our patients who do undergo C-sections and episiotomies experience outcomes that are well within industry standards.”
Scripps expressed similar sentiments in its own statement.
“Scripps Memorial Hospital La Jolla is a tertiary referral center, which means it receives the highest risk patients,” Scripps said. “These higher risk patients tend to have a higher maternal age, which along with other complicating factors lead to higher cesarean section rates.
“Scripps offers vaginal birth after cesarean section (VBAC) to all our patients for whom this is safe, but the patient decides their preferred delivery option and our team respects their decision. The makeup of the catchment area for Scripps La Jolla likely accounts for non-white births being moderately lower than other areas of San Diego County.”
Hospitals whose maternity care is listed as high performing include: UC San Diego Health La Jolla and Hillcrest hospitals, Kaiser Permanente hospitals in San Diego, Scripps Mercy Hospital in San Diego, Sharp Grossmont Hospital, Scripps Memorial Hospital Encinitas and Palomar Medical Center Escondido.
