Should c/s rates be published? Naming & shaming...

[AnyDream]

I'd like to add that an analysis of caesarean rates also needs to be done in the context of previous birthing experiences - ie a vaginal birth that is managed poorly can result in the mother requesting an elective caesarean for subsequent births (due to trauma or physical damage from things like a rushed induction, forceps delivery etc). In which case the hospital that carries out the CS may not actually be the "problem".

In my case, the hospital that traumatised me got to record that birth as a vaginal delivery - whereas the compassionate hospital that treated me well and gave me an empowered, healing birth got to record that as a caesarean delivery. The second hospital was definitely "better" than the first but that is not reflected in my own contribution to the stats.

[paradise lost]

I was just coming back to post something similar Marydean. My friend recently had an elective section and her first birth was like something from a horror film. They intervened in every way possible, kept her strapped to the bed, took ages giving pain relief then mucked up the dose, eventually giving her a foceps delivery for her "he's just too big" baby who turned out to be just over 6lbs, and caused a haematoma inside her vagina which ruptured 3 times in the following days, causing her to need 3 more surgeries and 15 units of transfused blood. The same hossie wouldn't let her even think of attempting VBAC.

To me the epidural rate speaks more than the section rate because a well-supported woman having an uncomplicated birth probably WON'T need one. The epidural rate of my hospital put me off because it made me think probably there was no good support. I have since learned they do not assign midwives for a whole shift to one woman and routinely kick dads out at 10pm unless mum is actually pushing. No wonder so many women end up having spinal anaesthesia - alone and labouring without consistent care in the night...

Routine postnatal debrief and follow-up with patient-scored performance reports would be more useful than section rates alone.

Bx

[Indadhanu]

So you can tell how a hospital is performing in line with the WHO and how many unnecesareans are being done.

But how do you know that even if a high number of c/s a performed that the majority aren't necessary? I know theres a lot of grey fuzz in whats necessary or not but unless every statistic was detailed, well naming and 'shaming' is pretty much pointless... I mean, a smaller hospital with inadequate c/s facilities who refer emergencies to other hospitals will have a very low rate... but does that mean they're better or that they're ill-equpied to deal with those situations?

I voted NO, because without all the details of every situation the numbers are pointless and I think give woman a false sense of security. A woman could go to the hospital with a 1% c/s rate and be in the 1% and have an unnecessary c/s performed.

Besides, hospitals don't perform c/s, drs do. I'd still vote NO but it'd be more accurate to propose publicising individual dr c/s rates...