Massachusetts' Wicked High Cesarean Rates

The most frequent reason that Cesareans are performed at Melrose-Wakefield Hospital in Melrose, Massachusetts is because the baby is too large or due to the shape of the woman’s pelvis, according to a medical official interviewed by the Melrose Free Press. The hospital’s Cesarean rate was released this month— 43.7%. It is the second highest in the state and one of six Massachusetts hospitals with a rate over 40%.

Bernard Logan, chief of Obstetrics and Gynecology for Hallmark Health System told a Melrose Free Press reporter that most medical organizations do not declare an ideal C-section rate as they did “in the past.” He claims that with the lower rates, there might have been some Cesareans that should have been performed but were not.

According to Logan, Hallmark Health officials have realized over the past four years that they have a higher C-section rate than most other Massachusetts hospitals yet Logan cites excellent outcomes for mothers and babies.

“We have not heard any concerns from our patient population that they thought they were rushing into a cesarean section,” he said. “We are only trying to get the best outcome for the mother and baby.”

Melrose-Wakefield Hospital instituted a ban on VBAC in 2004.

Logan explained the high c-section rate as resulting from a combination of many “clear cut indications”:

As far as standard, non-emergency C-sections go, Logan said there are “clear cut indications that there’s no doubt about,” which indicate an expectant mother should deliver by C-section. Those indications could be anything from the baby presenting feet-first in a breech position to the mother suffering from extensive internal bleeding.

The most frequent reason for a C-section, Logan said, is simply because the baby is too large to be delivered vaginally, or because the shape of woman’s pelvis makes it safer and easier to deliver by C-section.

“The feeling of the physician staff and practice staff is if we could have a safe vaginal delivery, that’s our aim, but if there’s any risk to the mother or baby, we’re more apt to go for a cesarean section for the safety of both,” Logan said.

Also, older expectant mothers are more likely to have medical conditions such as high blood pressure or diabetes, Logan said, which could also make it more likely that a C-section would be performed.

 [Emphasis mine]

Thirty-two of the 50 Massachusetts licensed maternity facilities documented in the report had a Cesarean rate of 30% or higher. According to the Free Press article, the Massachusetts c-section rate increased from 20% to 33.7% between 1997 and 2007 and Dr. Lauren Smith, medical director of the Massachusetts DPH, said the increase isn’t necessarily because of more elective C-sections.

The full listing of Massachusetts Cesarean rates is listed at the bottom of this post.



File a Complaint Against Hallmark Health System for Unnecessary Cesarean or VBAC Ban

Examples— If you were denied a VBAC or if you were sectioned for a suspected large baby and the baby weighed less than 8 lbs., 14 oz. at birth

From Hallmark Health System’s Web site:

HHS is surveyed by the JCAHO (Joint Commission on Accreditation of Healthcare Organizations) every three years. The JCAHO provides hospitals with survey guidelines and standards that must be achieved in order to become and remain a successfully accredited organization. The process focuses on systems critical to the safety and quality of care, treatment, and services provided by the hospitals. HHS received accreditation in June 2003 and will be surveyed again in 2006. The survey for 2006 will be unannounced but any member of the public wishing to communicate a quality of care or safety concern about HHS is welcome to contact the JCAHO at the following:


Fax: Office of Quality Monitoring

(630) 792-5636


Mail: Office of Quality Monitoring

Joint Commission on Accreditation of Healthcare Organizations

One Renaissance Blvd.

Oakbrook Terrace, IL 60181


Or for directions from the JCAHO regarding how to file a complaint, call:

1-800-994-6610 between 8:30 a.m. - 5:00 p.m. Central Standard Time.



Massachusetts Cesarean Support and Midwifery Resources


International Cesarean Awareness Network


ICAN of Eastern Massachusetts


Massachusetts Midwives Alliance


Massachusetts Friends of Midwives


Massachusetts Friends of Midwives—Advocacy Blog


Birth Network of Greater Boston


Massachusetts (Nurse) Midwives


Massachusetts Coalition for Midwifery


Other Resources

The Mommy Uprising – Article by Tina Cassidy in Boston Magazine

Birth by the Numbers

Eugene R. Declercq, PhD, Professor of Maternal and Child Health, Boston University School of Public Health


Cesarean Section Rates by Licensed Maternity Facility

From Table 13 of the Massachusetts Births 2007 report published by the Mass Department of Public Health in February 2009.


South Shore Hospital - Weymouth                              44.3

Melrose-Wakefield Hospital - Melrose                        43.7

Caritas Holy Family Hospital & Medical Ctr-Methuen 42.9

Beth Israel Deaconess Medical Center - Boston         42.0

Metrowest Medical Center- FUC- Framingham           41.8

Caritas St. Elizabeth’s Medical Center of Boston        40.4

Brockton Hospital - Brockton                                          39.9

Caritas Good Samaritan Medical Center - Brockton        39.7

Caritas Norwood Hospital - Norwood                             39.7

Milford Regional Medical Center - Milford                        38.9

Tufts-New England Medical Center Hospital - Boston    37.7

Emerson Hospital - Concord                                          37.5

Newton Wellesley Hospital - Newton                            37.2

Falmouth Hospital - Falmouth                                        36.3

Sturdy Memorial Hospital - Attleboro                             35.9

Winchester Hospital - Winchester                                 35.3

Harrington Memorial Hospital - Southbridge                  35.2

Saints Memorial Medical Ctr.-St. John’s Campus - Lowell  35.2

Brigham And Women’s Hospital - Boston                       34.1

Charlton Memorial Hospital Fall River                             33.7

Lawrence General Hospital - Lawrence                          33.5

Morton Hospital - Taunton                                              33.5

Massachusetts General Hospital - Boston                      32.7

Beverly Hospital - Beverly                                               32.4

Jordan Hospital - Plymouth                                             32.1

Lowell General Hospital - Lowell                                     32.0

St. Luke’s Hospital New - Bedford                                   31.7

Baystate Medical Center - Springfield                             31.4

Martha’s Vineyard Hospital - Oak Bluffs                          31.1

Berkshire Medical Center - Pittsfield                               30.9

Boston Medical Center - Boston                                     30.9

North Shore Medical Center - Salem Hospital - Salem    30.4

Anna Jaques Hospital - Newburyport                             29.5

Cape Cod Hospital - Barnstable                                     29.5

Cambridge Hospital - Cambridge                                    29.1

Nantucket Cottage Hospital - Nantucket                        29.1

Baystate Mary Lane Hospital - Ware                              28.9

Saint Vincent Hospital - Worcester                                 28.7

Other Hospitals                                                              28.6

Fairview Hospital Great - Barrington                              27.8

Mercy Medical Center - Springfield                                 27.7

Mount Auburn Hospital - Cambridge                              27.5

Cooley Dickinson Hospital - Northampton                      27.3

UMASS Memorial Medical Center - West - Worcester     27.3

Leominster Hospital - Leominster                                  24.7

North Adams Regional Hospital - North Adams              22.5

Franklin Medical Center – Greenfield                              21.2

Holyoke Hospital - Holyoke                                            19.2

Heywood Memorial Hospital - Gardner                          18.8

Tobey Hospital - Wareham                                            17.1

Home, En route & Dr. Off.                                               1.2

Cambridge Birth Center – Cambridge                             0.0

North Shore Birth Center - Beverly                                 0.0


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