# Birth Injury Marketing — open data

Four files, all CSV, all free to reuse with attribution including commercially (CC BY 4.0).
No registration, no email, no rate limit. If you need a different cut — by year, by
geography, by facility type — write to kevin@birthinjurymarketing.com and we will produce it and
tell you what it cannot support.

## Files

  counties.csv        3,144 rows. Births 2021-2024, lawyer establishments, delivering hospitals.
  states.csv          51 rows. The same, rolled up, plus gap counts.
  hospitals.csv       4,658 rows. Obstetric service status per facility.
  outcome-audit.csv   The published-vs-withheld audit of every CMS obstetric measure.

## The one convention that matters

A withheld value is written as the literal string WITHHELD. It is never an empty cell
and never a zero. If you sum a column containing WITHHELD your tool will error, which is
deliberate: those values are absent, not low, and averaging past them produces a number
that looks real and is not.

## The finding you should know before using hospitals.csv

For the 2024 reporting period CMS publishes ZERO hospital-level scores for all three
obstetric OUTCOME measures — PC-02 Cesarean Birth, PC-07a and PC-07b Severe Obstetric
Complications — across all 4,426 reporting hospitals. Every value is withheld under
footnote 4 ("Data suppressed by CMS for one or more quarters") or footnote 5 ("Results
are not available for this reporting period").

Those three columns in hospitals.csv are therefore WITHHELD for every row. They are
included so that the absence is explicit rather than inferred from a missing column.
Only SM-7, a structural attestation rather than an outcome, carries data — and it should
never be described as an outcome measure.

See https://birthinjurymarketing.com/intelligence/outcomes/ for the full audit.

## Known limits

- Births are by mother's county of residence, not place of delivery.
- NAICS 541110 counts establishments (locations), not firms or attorneys, and does not
  distinguish practice area. It is not a measure of legal capability.
- CMS coverage is hospitals in CMS quality reporting. Freestanding birth centres are absent.
- Territories (PR, GU, VI, AS, MP) are excluded from every national figure.
- Nothing here links a clinical measure to a legal one, and neither should you.

## Sources

  Census Bureau, Vintage 2024 county population estimates (components of change), released June 2025
  Census Bureau, County Business Patterns 2023, NAICS 541110 Offices of Lawyers, released May 2025
  CMS Care Compare, Maternal Health · Hospital, reporting period 1 Jan – 31 Dec 2024
  Retrieved 2026-08-24.

## Cite as

Birth Injury Marketing. "Births, obstetric delivery capacity and legal services capacity
by U.S. county." 2026-08-24. https://birthinjurymarketing.com/data/

Full methodology, including every join and the three datasets we tried to get and could
not: https://birthinjurymarketing.com/methodology/