The rates for Caesarian-section births vary widely by hospital in New Jersey, but health-care advocates and childbirth experts agree on one thing: Those rates are too high – and getting higher.

The Garden State joined Florida, Kentucky, New York and Texas as the top five states in the nation with the highest number of C-sectiondeliveries, says the Leapfrog Group, a non-profit organization that issues report cards on hospital safety.

Certainly, there are situations which call for a surgical rather than a vaginal birth: cases of multiple births, for example, or when the mother has high blood pressure, or the fetus is showing signs of distress. Other indications include breech births, irregular hearts in either mother or baby, and problems with the placenta.

But although advocates have been lobbying for years to reduce the frequency of the procedure when it’s not medically recommended, rates continue to remain at unhealthy levels.

In Leapfrog’s most recent report, only nine of the 47 hospitals that deliver babies in New Jersey and which submitted data met the group’s standard of performing no more than 23.9 percent C-sections.

That was down from 11 hospitals the previous year.

In the study, Christ Hospital in Jersey City reported the lowest C-section rate (14-percent) and CentraState Medical Center in Freehold the highest (42.1-percent).

The wide disparity in hospitals’ approaches to birth suggest that more factors than health are at play. Patient demand, a doctor’s time constraints and a fear of malpractice – all these and more have a role.

The work Leapfrog does is significant, serving to heighten public awareness that an all-too-common procedure has real-life implications for both mother and child.

Mothers who deliver by C-section typically take longer to heal, face longer hospital stays and sometimes encounter problems during subsequent pregnancies. Leapfrog’s report also noted that infants born by C-section face a greater risk of developing medical problems such as diabetes or asthma down the road.

Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, had these realities in mind when she urged the state to do better when it comes to reducing the incidence of unwarranted C-sections.

“The hospital where an expectant mother delivers should not be the determining factor of whether or not she has a surgical birth,” Schwimmer said.

Hospitals in other states have been successful in driving down the rate of unnecessary C-sections. In Newport Beach, Cal., for example, Hoag Memorial Hospital Presbyterian reduced its rate from 38 percent to just under 33 percent in just three years, largely by closely monitoring the procedures and exerting pressure on doctors to modify their behavior.

Only a team effort will bring a about a similar response in our state, but the results will be well worth it. Raising consumer awareness is the first step.