2019 Edition — Maternity Care in California

A Bundle of Data

Jen Joynt, Independent Health Care Consultant


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Nearly half a million babies were born in California in 2018, representing one in eight of all births in the US. While the number of births has declined since 2000, childbirth remains the number one reason for hospitalization in California.

Maternity Care in California: A Bundle of Data provides an overview of the delivery of maternity care in California, using the most recent available metrics, and compares the state’s performance on these metrics by demographic groups, over time, and provides a comparison to national numbers.

Key findings

  1. The majority of California births occurred in a hospital and were delivered by a physician. Over the past decade, the percentage of births attended by midwives has increased.
  2. Medi-Cal covered 45% of all in-hospital births in California in 2017. Nearly 60% of Medi-Cal births occurred in nonprofit hospitals.

  3. One in four in-hospital births in California were low-risk, first-birth cesareans (c-sections). Rates for Black women were six percentage points higher than the Healthy People 2020 goal (23.9%) while rates for Latina and white women met this goal. While critical in some circumstances, c-sections can pose serious risks for baby and mother.

  4. While the national maternal mortality rate has increased, California has made significant progress in reducing maternal mortality rates overall, and for all race/ethnicity and age groups. However, Black women continued to have significantly higher maternal mortality rates than other groups.

  5. Significant racial/ethnic disparities existed across a variety of maternal quality measures in California, including prenatal visits, preterm births, and maternal and infant mortality rates. For many of these measures, Black women and infants fared worse than their peers in other racial/ethnic groups.
  6. In a recent survey, more than one in five California women who gave birth in 2016 or 2017 reported symptoms of prenatal or postpartum depression.

The full report, as well as all the charts found in the report, is available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Maternity Care in California.