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

[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.

[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.

[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.

[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.

[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.

[sangie]

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.

[BellyBelly]

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.

[lmbmcb]

Hi all
I would say no.
My reason being that I don't believe it would give a true account of why the C/sections are being performed.
My first 2 kids were natural deliveries at a public hospital. My next baby is going to be a ceasarean for medical reasons at a Private hospital. If I didn't have these medical reasons then I would be having a natural birth and wouldn't bother with a Private hospital. The only reason I am going private is because I want to know who is going to be performing the surgery, as my medical condition is not something I want left up to whoever is available to operate at the time, I really want to be able to choose my own surgeon. Perhaps there are others who also feel this way and I feel that this may be one reason why C/section rates are higher at private hospitals, although possibly not the only reason.

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.

Just out of interest, my medical reason for having a c/s is NOT placenta Praevia, and yes, I have sought several opinions on this matter and they have all said the same thing. C/s or extremely high risk delivery.For me it's just not worth the risk.
l.b.

[dlworth1]

quote;Quote:
Originally Posted by dlworth1
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.

Just out of interest, my medical reason for having a c/s is NOT placenta Praevia, and yes, I have sought several opinions on this matter and they have all said the same thing. C/s or extremely high risk delivery.For me it's just not worth the risk.
l.b.


Sorry hadnt meant to imply there was only ONE reason, i left off the "etc", my point is that they are for the most part rare and exceptional reasons... : )

[Pretty Butterfly]

TBH i think the problem is too many risks are taken with some mothers trying to have vaginal births when they are high risk that something could happen to them or the baby. .

???
I have never heard of a mother, IRL, or on this forum, or any other, try a vaginal birth if they have been told it is too risky for mum or bub.

I dont know anyone who would do this to their child???

And even if some do, I doubt the numbers would be very high at all, enough to sway the c'section rates anyway....

[dlworth1]

???
I have never heard of a mother, IRL, or on this forum, or any other, try a vaginal birth if they have been told it is too risky for mum or bub.

I dont know anyone who would do this to their child???

And even if some do, I doubt the numbers would be very high at all, enough to sway the c'section rates anyway....

It happens quite a lot. what about those who choose to vaginally birth a breech baby...they are told all sorts of s@#t to try and get them to choose CS. Twins? Homebirth? over 35yrs? IVF ? the reasons they are often given (without much basis in fact ) go on and on

[Pretty Butterfly]

I'm sorry, maybe preggy brain, but I dont get it???

I know some Ob's try to scare you into a c/section, they tried with me, as Little Girl was frank breach. BUT I know it is still actually safer to birth a perfect frank breach, with a trained middie or Ob, than have a c/section.

I thought the oringinal poster was saying that MUMS are choosing to birth vaginallly, even though they are high risk, and shouldn't be. That she thinks more c/sections should be done??

Maybe I missunderstood....