I was curious about the c-section and episiotomy rates for the closest hospitals to me, so I looked them up. These are (as far as I can tell) all of the hospitals within a 20-mile radius of me that have maternity wards. Episiotomy and cesarean section were the two interventions that I most wished to avoid in birthing my son back in September 2013, so I wondered how the hospitals in my area stood on those. 
2012 c-section rates come from CesareanRates.com.  Episiotomy rates come from the Leapfrog Group; I believe the statistics were last gathered in Fall 2013, but I’m not sure. The Leapfrog Group recommends that hospitals have an episiotomy rate no higher than 12%.
I listed the number of births and NICU level because I imagine the hospitals with more births are larger hospitals with higher level NICUs, and are therefore more likely to see high-risk births. When a hospital was reported as being a level III center, I attempted to call them and ascertain whether or not they were also a IIIC, sometimes known as a level IV.
Hospitals with the Lowest C-Section Rates
(1) Centegra Hospital – McHenry — 22.1%
(2) Evanston (NorthShore University Health System) — 26.0%
(3) Sherman Hospital — 26.9%
(3) VHS Westlake Hospital — 26.9%
Hospitals with the Highest C-Section Rates
(1) Gottlieb Memorial Hospital — 39.2%
(2) St. Alexius Medical Center — 35.9%
(3) Advocate Lutheran General Hospital — 35.8%
(4) Alexian Brothers Medical Center — 35.6%
Hospitals with the Lowest Episiotomy Rates
(1) Vista Medical Center East — 4.1%
(2) Elmhurst Memorial Hospital — 5.1%
(3) Evanston Hospital — 6.1%
(4) Centegra Hospital – McHenry — 6.8%
Hospitals with the Highest Episiotomy Rates
(1) St. Alexius Medical Center — 34.6%
(2) Alexian Brothers Medical Center — 26.2%
(2) Presence Resurrection Medical Center — 26.2%
(4) Northwest Community Hospital — 22.8%
Hospitals That Did Not Report to the Leapfrog Group
– Advocate Condell Medical Center
– Advocate Lutheran General Hospital
– Advocate Sherman Hospital
- The national average for cesarean sections was 32.8% in 2011. This is the most recent figure I can find. Not sure why 2012 data has not been reported.
- The Illinois average for cesarean sections was 31.7% in 2011, just 1.1% below the national average.
- Of the 18 hospitals with maternity wards within the 20-mile radius of where I live, 8 had rates higher than the already-too-high national average. 1 was just barely below the national average (32.6%) but higher than the Illinois average. 1 was just barely below the Illinois average (31.4%).
- 8 hospitals had rates below 30%.
- The state of Alaska, where I grew up, has a cesarean rate of 22.6%. The state of Utah, where I went to college, has a cesarean rate of 23.1%. The only hospital in my area with a cesarean rate that rivals the averages in these states is Centegra Hospital of McHenry. If these states can have such low average cesarean rates, I don’t see why Illinois hospitals seem unable to follow suit.
- 15 of the 18 hospitals reported their episiotomy rates to the Leapfrog group. Of these, 7 had rates that met the Leapfrog group’s target recommendation of 12.0% or less.
- The hospitals with the four lowest episiotomy rates all had c-section rates lower than 30%.
- The hospitals with the four highest episiotomy rates all had c-section rates higher than 34%.
- Three of the four hospitals with the lowest cesarean rates also had episiotomy rates at or below Leapfrog’s target of 12%. The fourth, Advocate Sherman Hospital, did not report its episiotomy rates to Leapfrog.
- Three of the four hospitals with the highest cesarean rates also had episiotomy rates higher than Leapfrog’s target of 12%. The fourth, Advocate Lutheran General Hospital, did not report its episiotomy rates to Leapfrog.
- Only the hospitals in the Advocate medical group did not report to Leapfrog.
I delivered at Highland Park (NorthShore University Health System) 16.65 miles away from where I live because I had a doctor there that I liked and trusted, one who will be done with his residency and out of the area very soon. Highland Park Hospital was in the middle of the pack on both c-sections (31.4%) and episiotomy (15.5%) rates. Had it not been for my doctor and my trust in him, I likely would not have delivered at Highland Park. Northwest Community Hospital is the closest hospital to my home, so if I’d had a true emergency while at home (such as a prolapsed cord), I likely would have wound up there.
If I were to become pregnant again while still living where I currently live, the hospitals I would be most likely to deliver with would be Centegra Hospital — McHenry and Evanston Hospital (NorthShore University Health System). Advocate Sherman Hospital could be a possibility if I could learn their episiotomy rate.
The hospitals I would stay far, far away from are St. Alexius Medical Center aka Alexian Brothers Women & Children’s Hospital, Alexian Brothers Medical Center, Northwest Community Hospital, and Presence Resurrection Medical Center. These hospitals all have episiotomy and c-section rates that are far higher than what they should be. Depending on its episiotomy rate, Advocate Lutheran General Hospital might also be a hospital to stay away from. Alexian Brothers Women & Children’s Hospital is by far the worst of these with a ghastly 34.6% episiotomy rate and the second-highest c-section rate at almost 36%. If you deliver vaginally at St. Alexius, you have a more than 1 in 3 chance of having your perineum cut. That’s just terrifying.
 In case you are not familiar with the story of the birth of my son: he was a vacuum-assisted vaginal delivery, direct occiput posterior. My son was 9 lbs 5 oz, 22.5 in, and 9 days past his due date. I was only in the second stage of labor for 16 minutes and sustained a shallow 2nd degree perineal tear which was less painful and healed much better than the episiotomy that I had for my daughter in 2006. My son received a 9 on both of his Apgars. Though a few bullying and demeaning comments were made to me by nurses at Highland Park, overall I had a wonderfully supportive team and it was a good experience.
 It needs to be stated that this represents the total cesarean rate. If I could, I would instead look at primary c-section rates (c-sections performed on women who have never had a c-section before) plus CBAC rates (cesarean birth after c-section), as this could change the picture considerably. For example, a VBAC-ban hospital could have a low primary c-section rate that is being offset by its near 100% CBAC rate. Besides, from a purely selfish perspective, as a woman who has never had a cesarean, what really matters to me is a hospital’s primary c-section rate.