Blue Cross and Blue Shield Designated Hospitals Report Lower C-section Rates and Improved Health of Mothers and Children

C-section Rate Surpasses Healthy People 2020 Federal Goal

Chicago – The Blue Cross Blue Shield Association (BCBSA) reports that Blue Distinction® Centers for Maternity Care achieved a 32 percent lower cesarean section (C-section) rate for first-time mothers compared to hospitals that are not in the program. The Blue Distinction Centers average C-section rate of 23.7 percent surpasses the Healthy People 2020 federal goal to reduce C-section rates for first-time, low-risk mothers in the U.S. to 23.9 percent by 2020.

In order to qualify for a Blue Distinction Centers for Maternity Care designation, a hospital has to achieve a C-section rate of 27 percent or lower, among other patient health outcomes and quality measures that are reviewed.  Compared to other hospitals, Blue Distinction Centers also have 70 percent fewer early (37-39 weeks) elective deliveries and 53 percent fewer episiotomies. 

For low-risk pregnancies, cesarean delivery can pose a greater risk of maternal morbidity and mortality than vaginal deliveries due to complications that can occur, including hemorrhage, blood clots and/or major infection. There are also long-term risks associated with cesarean deliveries if a woman has more children. With each subsequent cesarean delivery, the incidence of placental abnormalities, such as placenta previa and placenta accreta, increases and can lead to adverse neonatal outcomes and even perinatal death. 

In addition to higher complications for babies and mothers, C-sections that are not medically necessary also add cost to the health care system. For commercially insured Blue Cross and Blue Shield (BCBS) members, the average cost difference between vaginal and cesarean deliveries was $4,157 ($13,325 versus $17,482), according to a Blue Cross Blue Shield Health of America Report

Nearly four million babies are born in the U.S. annually, making childbirth the most common reason for hospitalization. BCBSA announced the national designation in 2016 to help prospective parents find hospitals that deliver quality, affordable maternity care. Today, BCBS companies across the nation have recognized more than 1,080 hospitals for quality maternity care.

“Working in collaboration with medical experts, we’ve been able to create an innovative program that offers parents an objective source of information to help find quality care for new mothers and their children,” said Kari Hedges, senior vice president of commercial markets and enterprise data solutions for BCBSA. “Blue Distinction Centers for Maternity Care are proving to provide better, higher-quality maternity care nationally. We are pleased to see that the program is helping to make health care work better for everyone.”

The program selection criteria also considers a hospital’s implementation of consistent maternal safety bundles developed by the Council on Patient Safety in Women’s Health Care, a multi-stakeholder group, in which the American College of Obstetricians and Gynecologists (ACOG) is a core partner, that drives cultural change to improve women’s health. The bundles consist of best practices for providers to implement, to prevent or respond promptly to common pregnancy-related conditions, such as hemorrhage and hypertension, which can often lead to adverse outcomes or death. 

“ACOG applauds the Blue Distinction program’s focus on improving maternal outcomes,” said Hal Lawrence, M.D., ACOG executive vice president and CEO. “Minimizing the rate of primary cesarean is one of the nine maternal safety bundles and is an important part of lowering the high U.S. maternal morbidity and mortality rate. This program’s incentives for collaboration across care teams encourages and recognizes the need for consistent standards and improved systems to provide better care for women and their babies.”   
Since 2006, the Blue Distinction Specialty Care program has recognized hospitals for delivering quality specialty care safely and effectively based on objective measures developed with input from the medical community. It has helped patients find quality providers for their specialty care needs in the areas of bariatric surgery, cardiac care, cancer care, knee and hip replacements, spine surgery and transplants. Research shows that, compared to other facilities, those designated as Blue Distinction Centers demonstrate better quality and improved outcomes for patients. On average, Blue Distinction Centers+ are also 20 percent more cost-efficient than non-Blue Distinction Center+ designated health care facilities.

For more information about the program, and to see a complete list of facilities designated as Blue Distinction Centers and Blue Distinction Centers+ for Maternity Care, please visit

About Blue Distinction Centers 
Blue Distinction Centers (BDC) met overall quality measures, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable healthcare. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.