You asked for information on laws in New York and Massachusetts on the reporting of childbirth-related information by hospitals and other facilities. You also want us to compare these to Connecticut's laws.

SUMMARY

New York and Massachusetts each passed legislation in 1989 requiring hospitals to provide information to maternity patients, at the time of pre-admission, on a variety of childbirth-related procedures and outcomes. This information includes annual rates and percentages of cesarean sections, both first-time and repeat; subsequent vaginal births; births using anesthesia, forceps, spinals, epidurals, or episiotomies; deliveries by nurse midwives; breech births; and use of birthing rooms. (The New York law applies to hospitals and birthing centers; the Massachusetts law only to hospitals.)

Connecticut does not have a law of this nature. The Connecticut Department of Public Health (DPH) does not collect hospital data concerning cesarean sections. The Office of Health Care Access does not routinely report this data but was able to provide acute care hospital data on cesarean sections, upon request of this office, for a previous OLR Report (2008-R-0509).

Connecticut law does establish a birth defects surveillance program in DPH (CGS §§ 19a-56a, 56b). The program monitors the frequency, distribution, and type of birth defects occurring in the state on an annual basis. DPH must establish a system for collecting information on birth defects and other reproductive outcomes. The DPH commissioner has access to identifying information in hospital discharge records for purposes of establishing the system. Data collected must comply with state and federal privacy and confidentiality regulations. (see http://www.ct.gov/dph/cwp/view.asp?a=3138&q+396758).

NEW YORK

New York's “Maternity Information Act, enacted in 1989, provides expectant parents and the public with information about the hospitals they are considering for the birth of their babies. The law directs the New York State commissioner of health to require that every hospital and birth center distribute a maternity information leaflet directly to each prospective maternity patient at the time of pre-admission and, upon request, to the general public. The pamphlet contains state-reviewed information giving the rate that various maternity-related procedures are performed at the hospital and other information the commissioner deems appropriate. Hospitals and birth centers may also choose to distribute additional explanatory material along with the required leaflet.

Specifically, the law requires hospitals with obstetric services to make public in the leaflet their annual rates (or percentages) of:

1. cesarean sections, both primary and repeat;

2. women with previous cesarean sections who have had a subsequent successful vaginal birth;

3. deliveries in birthing rooms;

4. deliveries by certified nurse-midwives;

5. births utilizing either external or internal fetal monitoring;

6. births using low- and mid-forceps delivery;

7. births using breech vaginal delivery;

8. vaginal births using analgesia;

9. vaginal births using anesthesia including general, spinal, epidural and paracervical, listed on the basis of vaginal and cesarean births;

10. births involving inducing labor;

11. births involving labor augmentation; and

12. births involving episiotomies.

The leaflet must also include information on whether (1) birthing rooms are available for use in the facility and (2) rooming-in is available in the facility, on the basis of 24 hours a day or during daytime.

A copy of the New York law (N.Y. Public Health Law Sec. 2803-j) is attached.

MASSACHUSETTS

A 1989 Massachusetts law (Chapter 155 of the Acts of 1989; Mass, General Laws, chapter 111, sec. 70E) requires that every maternity patient, at the time of pre-admission, receive complete information from an admitting hospital concerning a variety of childbirth-related procedures. Specifically, this information includes the annual rate or percentage of:

1. primary, repeat, and total cesarean sections;

2. women who have had a cesarean section who have had a subsequent successful vaginal birth;

3. deliveries in birthing rooms and labor-delivery-recovery or labor-delivery-recovery-postpartum rooms;

4. deliveries by certified nurse-midwives;

5. deliveries which were continuously externally monitored only, continuously internally monitored only, continuously monitored both internally and externally;

6. deliveries involving intravenous, inductions, augmentation, forceps, episiotomies, spinals, epidurals, and general anesthesia; and

7. women breastfeeding upon discharge from the hospital.

A copy of the Massachusetts law is attached.

JK:ts