Mapping Maternity Care and Birth Outcomes


High quality maternity care saves the lives of millions of women in pregnancy and childbirth. The improvements in outcomes for women over the last two centuries make clear the benefits of surgical expertise.

Even now maternal mortality ranges by over 1000 times between countries with the poorest and best outcomes further indicating the benefits of medical interventions. Within the US however there are significant variations in the delivery of surgical care without any clear differences in outcomes as measured by either maternal or infant mortality. Over the last two decades the rates of cesarean section have dropped in the mid 1990's, when effort was paid to reduce their rates, and have subsequently risen dramatically. Over the same period there have been no corresponding reductions in maternal-infant mortality outcomes. The costs of these procedures can be measured in dollars and cents.

Within this site we present publically available data to highlight this process and to bring awareness to this issue. While there is controversy as to the optimal cesarean rate, there is evidence that the current rate is higher than necessary for maternal or perinatal safety and that geographic variation does not reflect differences in women's risks, values, or preferences. We hope that this information is found to be useful in that light.

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Expenses are rising while outcomes are not improving.

These graphs show trends in the US, with some comparisons to the average for all OECD (developed) countries. The measures include the rate of cesarean sections5, the average cost of labor delivery7, infant death rate5, maternal death rate6, and low birth rate5. The markers labelled Goal for 2010 refer to the US Healthy People 20108. Costs are inflation-adjusted to 2009 dollars.

Costs vary by delivery method

These graphs indicate the average price and length of hospital stay for each of the different types of labor deliveries7. In the top graph, the gray range bars show the standard error from the mean. Costs are inflation-adjusted to 2009 dollars.

Is the rise of cesareans due to maternal choice?

Despite popular belief, the rate of maternal request cesareans is low.12

Global Costs

Costs also vary by country. This graph shows the average payments made toward physician and hospital fees8. Hover over an area to see a specific amount.

Click on any of the attribute names (blue text above) to redraw the map according to that attribute!