The Transparency Gap in Maternity Care—and How to Advocate for Yourself
Why It Feels So Hard to Get Straight Answers
Unlike most medical specialties, maternity care data isn’t easy to access. Much of it is state-level or voluntarily shared by hospitals.
The Leapfrog Group posts hospital maternity metrics, but only from facilities that opt in (Leapfrog Maternity Report).
The CDC’s mPINC survey tracks hospital breastfeeding practices, yet its detailed results stay internal (CDC mPINC).
How We Still Know the National Rate
Families often ask, If hospitals don’t post their data, how do we know the U.S. cesarean rate?
Because every birth certificate includes “method of delivery.” States send those records to the CDC’s National Vital Statistics System (NVSS), which aggregates all births nationwide.
That’s how we know the C-section rate was 32.1 percent in 2022 and 32.3 percent in 2023 (CDC Data Brief; NVSR 2023).
What’s missing is facility-level transparency—knowing whether your chosen hospital performs closer to 20 percent or 50 percent.
Access Isn’t Equal
Choice also depends on insurance and geography.
Medicaid covers roughly 41 percent of U.S. births, often limiting hospital options (NVSR 2023).
Meanwhile, maternity-care deserts keep growing as rural units close (March of Dimes 2024 report).
Your Research Roadmap
Check Leapfrog for voluntary hospital rates.
Ask directly: “What’s your cesarean rate for first-time, full-term, head-down births?”
Request breastfeeding-support info (mPINC).
Know your rights to a medical interpreter under ACA §1557 (HHS OCR letter).
Simple Advocacy Scripts
“I don’t feel like I’m being heard. Please note that in my chart.”
“Can you explain the benefits, risks, and alternatives?”
“Could we have a moment to decide?”
After hours: ask for the house supervisor or patient advocate.
Why Listening Saves Lives
The CDC’s Hear Her campaign reminds us that listening saves lives (Hear Her).
Pregnancy-related deaths are often preventable, yet biases and communication gaps persist—especially for women of color.
It can take 17 years for new evidence to become standard practice (Implementation Science review).
Until transparency improves, informed advocacy is our best protection.