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

[*Efjay*]

i vote no


On the fact that you have absolutly no idea why these c sections are being carried out. Unless you were able to find out why ever c sect was performed the the basis the info was collected on is wrong..

by showing which hosptial has the most c sects is scare mongering.. isnt that what you call it? dont go here cause you more likely to have a c sect?



And yes i understand some c sects are performed unneccesarily

My thoughts also.

[Trillian]

I just want to remind everyone that this isn't a c/s vs vaginal birth debate.

[rufalina]

I have no issues with public knowledge of statistics, but maybe what would be better than just a blanket c-sect rate, would be a breakdown of births i.e. vaginal, emergency c-sect, c-sect for medical reasons, elective c-sect??? and per hospital, but also by surgeon???

So for the name and shame I did vote No because I dont think it will achieve what it sets out to do.

I chose a hospital with both a birth centre, and a high c-sect rate. They also have a no vaginal breech birth policy. But were open with stats when I was discussing my birthing there, and I went in with open eyes, knowing what their policys were.

[BellyBelly]

OoOeeer it's now equal!



Yes
43% (603 votes)
No
43% (603 votes)
Only in extreme cases
13% (194 votes)
Total votes
Total of 1400 votes

[Ellibam]

How do they justify a difference like that - 43% and 5% between two neighbouring hospitals?

that is why it has been brought to the media's attention because there are huge difference and that is what needs to be addressed!!

[Beach Mama]

I hesitantly voted yes, because I think the information needs to be out there for women who are making choices about where to birth their babies. Having said that, I also have a problem with "name and shame"... Having had 2 c/s, one that may not have had to happen, I have more of an issue with epiduals and inductions and the lack of information about the cascade of intervention with those than with c/s themselves. "Name and shame" has implications that I disagree with and I think the c/s rate is only one aspect of hospital policy that most educated women would look at when choosing a hospital to birth their babies in.

[ShootingStar]

I also voted NO.
There is nothing wrong with having a c/s.. i kinda dont understand why they have even published an article like this. At the end of the day all that matters is that mother and baby are fine. No matter how you give birth whether vaginally, c/s, with drugs or without, you are still giving birth and that baby is not going to love you any more or less because of the way you brought them into the world.. they will love you unconditionally for giving them life.

[BellyBelly]

So no-one would be concerned at a hospital with a 60-70% c/s rate? You wouldn't question that and what's going on there? Because some of our Obs/hospitals have rates that high. I'd definitely choose a hospital with a 20% rate over 70%, if I birthed in hospital again.

[Liz]

Yeah, it's not a statistic that you can just blindly go by tho. Like you said Kelly, if the rate is 60-70% I'd want to know why. If it is because all the high risk cases are transferred there, then that's something you can take into account.

This is probably a dumb question.. but are the statistics available already if you want to know? Is this about publishing an article and naming the hospitals? or is it simply about making the information available? I guess I should have asked before voting huh. hehe.

I guess ideally the rate should be 100% coz all the vaginal births should be with midwives at home! heheh.

[BellyBelly]

The WHO's 15% is all cases of things going wrong. Studies also show maternal request c/s are actually very low... and I think the inductions are the main thing causing the c/s.

[Tobily]

Yeah, it's not a statistic that you can just blindly go by tho. Like you said Kelly, if the rate is 60-70% I'd want to know why. If it is because all the high risk cases are transferred there, then that's something you can take into account.

This is the thing - the large, public tertiary hospitals that get all the high risk and tough cases aren't the ones with the caesareans rates through the roof.

The hospitals with 50-80% c/s rates (and there are many) are private hospitals. They are hospitals where every birth is overseen by an obstetrician.

This is probably a dumb question.. but are the statistics available already if you want to know? Is this about publishing an article and naming the hospitals? or is it simply about making the information available? I guess I should have asked before voting huh. hehe.

All public hospitals are required to disclose their c/s rate.
About 10 years ago (coincidentally when the c/s rate started to rise) private hospitals in QLD began burring up about this being on the public record and they no longer have to disclose. The only indication a woman can get up here is to look at the rate of ALL private hospitals lumped in together, which can be found in the state perinatal data, or rely on the honesty of the hospital/obstetrician. I can tell you right now that the hospitals and OB's that are sporting those rates are NOT telling them to anyone who asks. Why should they? There's no one telling them they have to.

For everyone who doesn't understand why this matters, let's put it another way.

If you were wanting an elective caesarean, and the hospital you were planning to birth at wouldn't tell you how many caesareans they do, or wouldn't tell you whether you could have one until you were due, or already in labour would you not feel that critical information that you need to make an informed decision about where to birth was being with held from you?

For a woman who wants a natural birth, this information is absolutely imperative. In the work I do, I often see women who have obliviously booked into a hospital or taken on an OB with a caesarean rate that I know is going to make their natural birth an uphill battle all the way. There is little point planning for a natural birth, engaging a doula and then walking through the doors of a hospital with an 80% caesarean rate.

I'm sorry I really can't understand how anyone could object to women being able to access this information. It just baffles me.

[Indadhanu]

But they could all be legitimate necessary caesareans... I know, I know, they probably aren't, but on numbers alone you have no way of knowing if the dr is pushing the scapel willy-nilly or if they're genuine medical emergencies.

Of course, there is a plus to it, and that is that if you choose/need a c/s you could choose a hospital with a high rate... at least you know that they kind of know what they're doing LOL

[ShootingStar]

Honestly, when it comes to having my babies, i am not concerned on how many c/s have been had or given at a particular hospital, all i care is that both my baby and myself come out alive and healthy. If theres a doubt in the doctor/midwife/OB's mind that something could happen to myself or my baby with me giving birth vaginally, thats big enough reason for me to elect for a c/s.

Vaginal births and their recoveries can be just as bad, in my case worse, than those of a c/s.

[dlworth1]

I guess the term "name & SHAME" might be wrong..There is no shame in having had or even chosing a C/S if it is truely an informed choice that is RIGHT for you, (although Im really not sure why women would choose to be sliced open with its associated risks for mother & baby, which are 3x higher than the risks of vaginal birth) and there is no shame in doctors who are using this life saving technology APPROPRIATELY! I think each OB should be required to do an annual report of their statistics and outcomes. I mean FFS even our primary school has to publish an annual report including outcomes. why are these OB's so special, that they dont think women are capable of reading and comparing information, after all we do it all the time , for fridges, cars, schools, TV's etc, etc, etc and those things arent even as important as our births.

But as Kelly points out, the WHO rate is inclusive of emergencies..honestly there is no other medical reason for having a planned one except rare instances of placenta praevia.

[Liz]

Hmm.. the more I think about it.. I'd rather see statistics on interventions.. as the c/s statistics could well be genuine emergencies - caused by intervention! Unnecessary inductions/augmentations, epidural use etc etc etc.

[jessicakate]

So no-one would be concerned at a hospital with a 60-70% c/s rate? You wouldn't question that and what's going on there? Because some of our Obs/hospitals have rates that high. I'd definitely choose a hospital with a 20% rate over 70%, if I birthed in hospital again.

Kelly I don't think that you would have to question what is going on there. I think it would be pretty obvious that a majority of women going to that hospital are electing to have c/s's. Just because that hospital does have a high c/s rate doesn't mean that you couldn't go there and have a v/b. I think it would be a matter of having a good relationship with your ob, and having a plan as to how you were going to approach the birth. speaking from my own labour and birth (vb without epi) I couldn't have had a more positive experience, and I am sure that the private metro hospy that I went to would have a high rate of c/s's. Even if they had a 70% c/s rate I would go back there again.

Many women are making a choice to have c/s's these days, and I don't think the beaurocracy (sp) of a hospital should have the choice in telling a woman that they are not allowed to have a c/s. therefore if we are going to be naming and 'shaming' hospitals for giving women what they want (whether you or I or anyone agrees with their decision or not) then we are also going to be 'shaming' the women for the decision that they have made. I am all for hospitals providing information on all of their practices from birthing through to medical operations, but I don't think that the hospital or the women involved should be shamed or feel shamed for making a choice.

[Trillian]

This is the last time I am going to come in here and say this: Can we please all stay on the topic because this is NOT a vaginal v c/s birth debate. If anything is posted off topic or not relevant to the discussion then it will be removed.

[Tanya]

I voted yes... simply to help aid those who wish to make informed choices. Hard to do if no-one gives the facts.