Are Episiotomies Still Done? Episiotomy Rates in Los Angeles. What You Need to Know.
BY: REBECCA BELENKY OF LOS ANGELES BIRTH
Episiotomies are still happening in Los Angeles—sometimes far too often. While evidence shows the procedure should be rare, rates vary widely depending on the hospital. Some facilities report less than 1%, while others are over 30%. This post highlights where episiotomies are most common in LA, why the numbers matter, and how you can protect yourself from unnecessary intervention.
The use of episiotomy, (a surgical cut made at the vaginal opening during the final moments of a vaginal birth), is a stark example of how hospital culture varies from place to place, even in the same city. Once a routine procedure in birth, research now shows that episiotomy is rarely necessary and can increase risks of severe tearing, infection, and long-term pelvic floor issues. The Leapfrog Group, a national leader in hospital quality reporting, recommends that episiotomy rates stay at or below 5%. Unfortunately, some Los Angeles–area hospitals are still performing episiotomies at much higher rates.
LA-Area Hospitals With Higher Episiotomy Rates
According to the most recent data:
Whittier Hospital Medical Center (Whittier) — 36.5% episiotomy rate and a 37.6% cesarean rate (well above the SoCal average)
Garfield Medical Center (Monterey Park) — 28.0% episiotomy, 30% cesarean (for low-risk, first-time births)
USC Arcadia Hospital (Arcadia) — 11.1% episiotomy
Emanate Health Queen of the Valley (West Covina) — 9.8% episiotomy
Desert Valley Hospital (Victorville) — 9.6% episiotomy
Providence Cedars-Sinai Tarzana Medical Center (Tarzana) — 7.4% episiotomy
CHA Hollywood Presbyterian Medical Center (Los Angeles) — 6.9% episiotomy
For comparison, hospitals like Cedars-Sinai Medical Center and Los Angeles General Medical Center report episiotomy rates below 1%.
Below is a graphic that breaks down these figures. The contrast is quite profound.
My Perspective on Episiotomies as a Doula
Over the years, I’ve only witnessed a few episiotomies. Looking back they felt justified and necessary. There was informed consent and it was treated as a last resort for a vaginal birth. Thankfully, people having babies at a hospital with a very low episiotomy rate can feel quite confident their provider uses episiotomy as a tool only when truly necessary.
But what about the people giving birth at hospitals where the rate is 10, 20, or even 36 percent? Thirty-six percent! I was shocked finding this data because it is so different than my client’s experience. For people birthing at these hospitals there is a real concern they would get an unnecessary episiotomy without realizing how far out of step their hospital is from evidence-based standards.
I suspect many families go into labor at these facilities not knowing the statistics—and without realizing how different their birth experience might be compared to hospitals just a few miles away. For example: let’s look at Whittier Hospital compared to PIH Whittier, just about 3 miles away from each other.
If we break the numbers down more, it means that out of 100 vaginal births at Whittier Hospital, around 36 will have an episiotomy. While at PIH Whittier, ONE person will have an episiotomy, while 99 people did not have an episiotomy. I mean I just cannot even believe these statistics. I find them SHOCKING, There is nothing fundamentally different about these people, the difference is in the OB/GYNs who are in charge of their care.
PIH Whittier’s cesarean rate is even lower than the CA state average at 23.6%.
Whittier Hospital is MUCH higher cesarean rate at 37.6%.
There is something very wrong going on.
Why These Numbers Matter
The difference between 0.8% and 36.5% isn’t just a number—it reflects how providers approach birth. High episiotomy rates often point to outdated practices, lack of patient consent, or a hospital culture that prioritizes provider convenience over patient health. Families deserve transparency and the ability to make informed choices about where and how they give birth. Chances are if you are birthing at a hospital with a high rate or with an OB who uses episiotomy often, you will not receive care that is grounded in an evidenced-based approach. You will probably find a doctor who has outdated methods of care all around, and a fundamental belief that the body needs assistance to birth.
How to Avoid an Unnecessary Episiotomy
If you’re planning a hospital birth in Los Angeles, here are some ways to reduce your risk:
Find your hospital’s rate. Leapfrog and CalHospitalCompare are good starting points.
Consider switching facilities if you are planning to birth at a hospital with a higher than average rate.
Talk to your provider. Ask directly: What is your episiotomy rate? Under what circumstances do you perform one?
Include your wishes in your birth preferences. Make sure your support people understand your wishes. Partners can be key in communication.
Consider doula support. Doulas help you advocate and communicate YOUR wishes for your birth.
Explore upright positions, warm compresses, and perineal support. These techniques can help protect tissues, keep an impatient provider busy, and preserve the perineum.
Final Thoughts
As a doula in Los Angeles, I see very few episiotomies at the hospitals that I frequent—but the data make it clear that those delivering in high-rate hospitals, this is a very real risk. Episiotomy should be the rare exception, not the rule. By knowing your hospital’s statistics, asking the right questions, switching providers if you are not comfortable and having strong support, you can greatly reduce the chance of experiencing an unnecessary episiotomy.
If you’d like more resources on this topic check out the Evidence Based Birth Protecting the Perineum series—or if you want support as you prepare for your own birth—you can learn more about Los Angeles birth doula support.
Rebecca Belenky is a Los Angeles–based doula, childbirth educator, and lactation educator who has been supporting families since 2014. Through her practice, Los Angeles Birth, she offers compassionate, trauma-informed care that helps parents feel informed, grounded, and confident through pregnancy, birth, and postpartum.
