55: Simple inter-hospital comparison of cesarean delivery rates is inappropriate as a marker of care quality

Contemporary approaches to monitoring quality of care in obstetrics often focus on comparing hospital cesarean delivery (CD) rates, with the implication being that higher CD rates are a marker of poor quality. Our group previously developed a risk prediction tool for nulliparous women who may require intrapartum CD. Five key predictors were identified (maternal age, maternal height, BMI, fetal abdominal circumference and fetal head...