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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 xx
Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
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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.
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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.
Kelly xx
BellyBelly Member
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.
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.
Last edited by Tobily; November 20th, 2008 at 02:04 PM.
2013 BellyBelly RAK Recipient.
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
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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.
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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.
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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.
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I agree with Liz. While knowing c/s rates for hospitals is interesting, I'd be more interested in knowing the rates of inductions etc.
Also if c/s rates are going to be published then it would be very useful to know why those c/s occurred: how many were emergencies, elective etc.
I'm leaning towards voting for 'yes' but I don't agree with the 'name and shame' title without further information.
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Thats exactly it Liz... by the time an Ob may be done with you (not targeting Obs, but they are the only ones who do interventions), that c/s may be absolutely necessary. Like the baby gone into distress after that induction or whatever.
I reckon the Ob who is currently trying to sue me for $900k (payable in 7 days thanks or will go to the Supreme Court) for what a BB member said (and post removed) should be named and shamed. Some are in it for the money folks. Shocking??? Not really. They have to protect their wallets.
Kelly xx
Registered User
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.
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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.
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I voted yes... simply to help aid those who wish to make informed choices. Hard to do if no-one gives the facts.
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just to be clear I was not debating vaginal v c/section. I was simply stating that to me the c/s rates do not mean that the hospital is good or bad, therefore they shouldn't have to be published as part or a "name and shame" campaign which would or course shame the mother too. However all public hospitals should have to provide detailed information about their practices and procedures so that women can find a hospital that suits them best.
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I voted "no" on the "shaming" aspect of the question. While there's no harm in information being available forums such as this one allow women to research and discuss hospitals and make informed decisions.
The hospital I gave birth at has a very high c-section rate, I knew that in advance and I spoke to my ob my about it because I was worried. He told me the figures are distorted because they include all the women who have chosen elective c-sections, of which there are a high number on the Gold Coast.
As it turned out, the number of emergency c-sections at my hospital was very low compared with other hospitals. My doctor never even suggested it to me, it never came up in conversation again after I asked about it on our first consultation.
Perhaps hospitals with high c-section rates are simply honouring a woman's right to choose the birth she wants, not forcing c-sections on unsuspecting women.
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I just checked out a chart on infant mortality rates... and yes, much safer to give birth in all of the Scandinavian countries who have low C/section rates, more in line with World Health Organisation recomendations.
If C/sections are the "safest" means of having a baby you'd think that the countries that have the most c/sections would have the best mortality rates... why is the opposite the case?
ETA: sorry Trillian... I hope I haven't been out of line in this thread. I'm just trying to work out if high c/section rates equate with safety... delete my post if I'm OT. I was just trying to compare country of birth to hospital of birth.... drawing a comparison. I'm not suggesting that all c/sections are unsafe.
Last edited by Bathsheba; November 20th, 2008 at 03:41 PM.
Registered User
I agree that more important than the CS rate is the intervention rate. There are loads of unnecessary interventions which do lead to an emergency CS, but there are also loads of VBs with high intervention. A CS is an intervention.
I am concerned at the hospitals that choose to CS because the staff want to go play golf, or have dinner reservations and I would be wanting to see that stats on that, But I am more concerned about interventions than the actual CS rate. I think I will vote for the extreme circumstances, as I believe these will be the ones CSing for golf or dinner.
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