Cesarean Rates – With a Grain of Salt

Note: This post is not about your medically necessary cesarean, or even one you chose. The author of this post respects all births and philosophies.

As more education and advocacy spreads about high rates of cesareans many natural birth advocates will encourage women to ask for their doctor and/or hospitals cesarean rates. Sometimes it is hard or impossible to find these rates as they are not always maintained by each physician, hospital, or even in public records. It is usually easier to find your state or region’s cesarean rates.

What is a woman to do when she searches and cannot find anything but internet reviews and anecdotal accounts?  What if she asks her obstetrician and they say they do not know what their cesarean rate is? What happens when a woman finds out that the hospital she has chosen to birth at or the obstetrician she is using has a 30%, a 60%, a 25% rate of cesareans? What does it all mean?

Information is always useful. But consider a few things.  If your state or regions cesarean rate is 30% but a certain hospital has a cesarean rate twice that — it could give you pause. Or you may consider if they only accept high risk women and are staffed by all or mostly high risk women’s specialists. Perhaps your provider is a large supporter of women who are attempting VBAC (vaginal birth after cesarean) and this skews their overall cesarean rate because there is always the chance a previous cesarean will result in another cesarean for the same woman. Large hospitals may not have accumulated statistics any more recent than a few years ago or even longer.

A rate will not guarantee you will have the information about choosing a hospital or provider.

Some suggestions for finding out deeper information are to ask these questions:

  • Ask your ob/gyn if they can provide a recent cesarean experience concerning their philosophy on birth. Was it due to a time limit? Was baby or mother not faring well?
  • If the birth facility itself has a seemingly high cesarean rate ask if this is due to specialists, high risk situations, hospital policies, or something else?
  • Has the doctor or facility implemented any measures since the most recent statistics that could help lower the chance of an unnecessary cesarean? Such as welcoming doulas, adhering to ACOG recommendations about reducing non medical inductions and considering active labor as beginning at 6 cm instead of the outdated 4 cm, utilizing midwifery care, and updating the tools provided to laboring women?
  • Does your hospital or doctor keep current on certain methods that can reduce unnecessary surgery by providing peanut balls for women with epidurals, having wireless monitoring for mobility, water labor options, etc.?
  • Does your hospital or doctor support VBAC?
  • Does your provider speak with compassion and understanding when you ask these questions or are they defensive or minimizing your concerns?

I hope some of these questions have helped to show that a rate is not always just a rate. Again, information is useful. It is a good starting point to ask more questions to make sure your provider or place of birth is in line with what you want for your birth options. Ultimately labor and birth is an unknown and you can only do the best with the information you have at the time.

Happy birthing!

All Rights Reserved, Knoxville Doula, Kimberly Sebeck 2016

 

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