VIC Maternity Hospital Performances - VBAC, Induction, C/S, Tearing... Interesting...

Current Programs / Initiatives - Maternity Care in Victoria, Department of Human Services, Victoria, Australia - Current Programs / Initiatives

There are a few documents at that link but check out the Maternity Service Indicators. Some interesting stats (based on '07 results) and you can see and compare the hospitals rates.

Vaginal birth after caesarean section

* The overall statewide rate for women planning VBAC
in public hospitals has increased from 27.5 per cent
in 2006 to 30.2 per cent in 2007. This was the first
increase since 2003.

? Rates in hospitals ranged from 13.0 per cent to 77.8 per
cent. The median was 30.8 per cent. This wide variation
remains of concern and suggests undesirable variation
in quality of care on offer to women. A continued increase
in offering VBAC will be a focus for Victorian health
services in future years.

? The overall statewide rate for achieving VBAC in public
hospitals has increased from 51.4 per cent of those who
planned a VBAC in 2006 to 56.6 per cent in 2007. Rates
in hospitals ranged from 33.3 per cent to 83.3 per cent.
The median was 58.5 per cent.

? Successful VBAC rates are related to the provision
of supported decision-making in an explicit clinical
pathway. Health services are encouraged to assess
their ability to provide quality information and support
to women with a previous caesarean section.

Inductions

1. Induction of labour rates for standard primiparae ranged
from 0.0 per cent to 33.3 per cent. This wide variation
remains of significant concern, suggesting variations in
practice that are not supported by evidence and that
are likely to increase risks for women and their babies.
All health services should regularly review indications
for induction of labour and their current practices.

2. The inter-quartile range was 0.0 per cent to 7.5
per cent. Seventeen of the 41 hospitals had labour
induction rates above the statewide rate for public
hospitals of 4.8 per cent.

3. Ten of the 11 hospitals with rates above the 75th
percentile were smaller regional and rural services.

4. The statewide labour induction rate in public hospitals
for standard primiparae was approximately one-third
of the statewide private hospital rate of 13.9 per cent.

Caesareans

1. Caesarean section rates for standard primiparae ranged
from 3.4 per cent to 31.3 per cent. This wide variation
remains of significant concern, suggesting variations in
practice that are not supported by evidence and that
are likely to increase risks for women and their babies.

2. The inter-quartile range was 11.9 per cent to 18.5 per
cent. Nineteen of the 40 hospitals had caesarean
section rates above the statewide rate for public
hospitals of 14.8 per cent.

3. Eight of the ten hospitals with rates above the 75th
percentile were smaller regional and rural services.

4. The statewide caesarean section rate for standard
primiparae in public hospitals was almost half the
statewide rate for private hospitals of 26.8 per cent.

Tearing

1. The rates for 3rd and 4th degree perineal tears
in standard primiparae ranged from 0.0 per cent
to 10.7 per cent.

2. The inter-quartile range was 0.0 per cent to 6.0 per
cent. Thirteen of the 38 hospitals had severe perineal
tear rates above the statewide rate of 5.2 per cent for
public hospitals.

3. The ten hospitals with rates above the 75th percentile
included metropolitan, regional and rural hospitals.

4. The statewide rate for severe perineal tears in standard
primiparae for public hospitals was approximately
1.6 times the statewide rate of 3.3 per cent for
private hospitals.

5. As differences in rates may be associated with
differences in ascertainment and reporting, it is
important that hospitals provide training and support
to clinicians in the recognition and repair of severe
perineal tears.