Exploring Cesarean Rates in San Francisco Bay Area Hospitals and Midwifery Practices

A title slide with the words C-Section Rates at SF Bay Area Hospitals

Cesarean section rates vary widely across the San Francisco Bay Area, with hospitals reporting rates ranging from 19% to over 28%. Understanding cesarean rates is crucial for expectant parents when choosing where to give birth. The difference between 19% and 28% may not seem like a big difference, but let’s consider a group of 100 birthing people: 19 of those folks would have had a cesarean section if they went to Hospital A or 28 if they’d gone to Hospital B where the rate is higher. If we consider that roughly 7,500 babies are born in San Francisco each year (as of 2021), that difference would amount to 675 additional cesarean births in this one city alone!

Please don’t get me wrong. Cesarean births are sometimes medically necessary. According to the World Health Organization, in the least developed countries in the world, the cesarean rate is about 8% and in the most developed countries, the rate is about 27%. It is very likely birthing people and babies in the least developed countries die unnecessarily because of their inability to access cesarean birth in time. However, the opposite is undoubtedly true as well: some birthing people are having cesarean births because of factors that have nothing to do with health and safety. It is important to remember that cesarean sections are major abdominal surgeries that carry real risks and discomforts.

Midwifery practices generally boast lower cesarean rates compared to hospital-based care. Statistics show that midwifery-led care results in a 30% reduced risk of cesarean births among first-time birthing people and a 40% reduced risk among people having a second baby or beyond. This makes sense, as our training focuses on holistic, individualized care that prioritizes informed decision-making and supports individuals in ways that are oriented towards utilizing fewer interventions. OBGYNs, on the other hand, spend about three-quarters of their education learning surgical procedures, such as cesarean birth.

To help parents consider childbirth options in the San Francisco Bay Area, we’ve taken the most recent data about our local hospitals’ cesarean rates and organized them below. If you’re reading this in other areas in California, you can research your local hospitals at CalHospitalCompare.org.

Cesarean Birth Rates by Hospital in the San Francisco Bay Area

This data was collected from CalHospitalCompare.org and reflects births from July 2022 – June 2023.

Facility NameCesarean Section Rate
State Average24.6%
Alta Bates (Berkeley)19%
CPMC Van Ness Campus (San Francisco)*22.8%
Highland Hospital** (Oakland)20.8%
John Muir Medical Center (Walnut Creek)24.7%
Kaiser Permanente** (Oakland)21%
Kaiser Permanente** (Redwood City)23.7%
Kaiser Permanente** (San Francisco)28.1%
Kaiser Permanente** (San Leandro)19.2%
Kaiser Permanente** (Santa Rosa)22.6%
Kaiser Permanente** (Walnut Creek)25.7%
Marin Health Medical Center (Greenbrae)19.1%
San Francisco General Hospital**20.9%
Lucile Packard Children's Hospital Stanford (Palo Alto)26.8%
UCSF (San Francisco)21.5%

Notes:

*CPMC Van Ness is home to two birthing teams. The CPMC-Mission Bernal team is staffed largely by midwives and the CPMC-Van Ness Geary team is staffed largely by OBGYNs. The two teams have different approaches to labor and birth care. However, the latest statistics seem to lump these two practices together. Unfortunately, the cesarean rate data is not available for each team separately. If you are considering birth at the CPMC Van Ness Campus, keep in mind the different teams and their approaches.

**Not open to all insurance types. Kaiser Permanente is open to Kaiser members, while Highland Hospital and San Francisco General Hospital are intended for Medi-Cal/uninsured populations.

Why Understanding Hosptial Cesarean Rates is Important

Knowing the cesarean rate of your chosen hospital is essential for making informed decisions that center around your birthing preferences. High cesarean rates can be a result of a variety of factors, including hospital policies, provider practices, and the overall culture surrounding childbirth. For some individuals, avoiding an unnecessary cesarean may be a strong preference, making it a priority to seek out hospitals with lower cesarean rates and supportive care practices.

In contrast to hospital-based care, community midwifery practices often boast lower cesarean rates and focus on holistic, individualized care. Community midwives prioritize physiological birth and offer continuous support throughout the labor and birthing process, resulting in higher rates of vaginal births and lower rates of unnecessary interventions. The graph below shows the cesarean rate of each facility compared to the percentage of deliveries by midwives. While the availability of midwifery support is not the only factor influencing cesarean rates, it is interesting to note the general trend.

Chart showing trend of lower facility cesarean rate by increasing rate of deliveries by midwives

I hope this information on cesarean birth rates in the San Francisco Bay Area was useful as you consider your birthing options. I hope to update this information on an annual basis so that families can easily compare their choices. If you’re interested in learning more about our approach to midwifery care in San Francisco, please visit our services page or sign-up for a Meet the Midwife session. Wishing you a safe and supported journey to parenthood.

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