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

[Tobily]

I'm confused too, because why dont people prepare a birth plan and give it to their OB, midwife, birth attendant, support people etc, so if they cannot speak on their behalf due to pain or tiredness they can speak on their behalf about their request and have them listened to. Furthermore, it should be mandatory and mentioned at the pregnant womens first visit to the hospital or shared care or OB to have a birth plan whether you do public or private hospital births. And personally thank god for Belly Belly who I found on the Web when pregnant with my first child so I was able to prepare myself with all the information and birthplan etc.

Belle while a birth plan is good tool it is not, and should never be used as, a substitute for making choices (about caregivers and birth places) that are congruent with how you want to birth.

I get very nervous when I hear birth plans being talked about like they're a sort of "insurance policy" or first line of defence against the things you don't want. In fact, they are a last defence. Your very first defence is making smart choices to minimise the likelihood of your having to deal with these things blindsiding you in the birthing room. And you cannot make those choices in an informed way without having some idea of what your odds are of having those interventions with the obstetrician or hospital you are using.

And it is often not a matter of just having these things on your birth plan and they are automatically respected either. There is a massive power differential at play in hospitals and women and their partners are not on their own turf. This means they are usually less confident in their decision making, less assertive with "authority" etc...lots of issues for many people here.

At my parenting class before my first birth I was given the stats of rates of c/s both emergency and elective at my private hospital. Pity they dont seem to do the same thing in the public sector.

Belle this actually fairly unusual. The public sector is more transparent because they are run by the government and by extension tax payers. So the Health Department requires that public hospitals disclose their stats. There is no such onus on private hospitals.

[*Belle*]

Belle while a birth plan is good tool it is not, and should never be used as, a substitute for making choices (about caregivers and birth places) that are congruent with how you want to birth.

I get very nervous when I hear birth plans being talked about like they're a sort of "insurance policy" or first line of defence against the things you don't want. In fact, they are a last defence. Your very first defence is making smart choices to minimise the likelihood of your having to deal with these things blindsiding you in the birthing room. And you cannot make those choices in an informed way without having some idea of what your odds are of having those interventions with the obstetrician or hospital you are using.

And it is often not a matter of just having these things on your birth plan and they are automatically respected either. There is a massive power differential at play in hospitals and women and their partners are not on their own turf. This means they are usually less confident in their decision making, less assertive with "authority" etc...lots of issues for many people here.



Belle this actually fairly unusual. The public sector is more transparent because they are run by the government and by extension tax payers. So the Health Department requires that public hospitals disclose their stats. There is no such onus on private hospitals.

Tobily I was merely trying to point out that the more you look into preparing yourself for the birth the better of you are, for example selecting a hospital based on recommendation and research, preparing a birth plan and at the first visit to the hospital or carer to include the stats of c/s which is being discussed in here. Everyone who has prepared a birthplan may view the use of it differently. Choice was not the issue I was getting at at all. As I said my first post was personal about my choice and after reading the whole thread I am entitled to move my decision to saying the information should be made available as people in here have made valid posts as to why. My last few posts in this thread I have been trying to put that point across about more information as I think its good to help others so pregnant women can be made aware of the information they want so they can think about where to have the birth and their carers, afterall when you are pregnant you do think about these things. Im lucky that North Shore Private hospital is prepared to offer that information at their parenting classes.

[Matryoshka]

The title of the article is judgemental, there's no shame in a c/s, nor do i feel shame in high rates of c/s.

I vote no, because i think if you are after a vaginal birth, then choose to birth at home or in a birth centre, then there's the least likely opportunatey of an unnecessary c/s.

[Snacks]

Yes, but for what purpose?

For the very purpose of 'getting the birth you want'. If I want an intervention-free birth, I will not go to a hospital where the c/s rate is abnormally high.

i think if you are after a vaginal birth, then choose to birth at home or in a birth centre, then there's the least likely opportunatey of an unnecessary c/s

That's not fair! I can't afford to birth at home (can't afford the pvt midwife who's services wouldn't be covered under my health fund), and the closest birth centre to me is a good drive away and very popular. Why don't I have the right to choose to birth in a hospital AND have a low or intervention-free birth?
This is kind of academic because I am fortunate enough to have had and currently have low risk pregnancies, so I can go through the public system and see midwives. This is my way of minimising intervention. However, were I to need the services of an OB because of a higher risk pg, then I would want to choose a place where my desire for low intervention would be respected. Surely I have that right?

[Matryoshka]

For the very purpose of 'getting the birth you want'. If I want an intervention-free birth, I will not go to a hospital where the c/s rate is abnormally high.

That's not fair! I can't afford to birth at home (can't afford the pvt midwife who's services wouldn't be covered under my health fund), and the closest birth centre to me is a good drive away and very popular. Why don't I have the right to choose to birth in a hospital AND have a low or intervention-free birth?
This is kind of academic because I am fortunate enough to have had and currently have low risk pregnancies, so I can go through the public system and see midwives. This is my way of minimising intervention. However, were I to need the services of an OB because of a higher risk pg, then I would want to choose a place where my desire for low intervention would be respected. Surely I have that right?

Well then then wouldn't you want epidural rates, vaccuum rates, forceps rates etc publicised (dont know if they already are).

I was just trying to say that the only way to really secure an in control birth, low risk of "intervention", is birthing at home, b/c. And yes, money is an issue in other states (not here in WA - home birth is free.) But thats a separate issue, agree ALL choices should be publicly funded - c/s and homebirth.

[Snacks]

Well then then wouldn't you want epidural rates, vaccuum rates, forceps rates etc publicised (dont know if they already are).

Well, sure. That'd be interesting reading too The fact is, that many unnecessary ceasareans wouldn't occur if dr's didn't intervene with the above in the first place. So yes, I'd want to know those things, but the c/s rate would give me a fair idea without knowing those things, KWIM?

I was just trying to say that the only way to really secure an in control birth, low risk of "intervention", is birthing at home, b/c.

I hear you, but do you not think that is something to remedy? We CAN achieve a low-intervention birth in hospital if we are educated, aware and well supported. In order to educate ourselves we need to get our hands on information. The information should be freely available.

[Pretty Butterfly]

I vote no, because i think if you are after a vaginal birth, then choose to birth at home or in a birth centre, then there's the least likely opportunatey of an unnecessary c/s.

So because I've had 5 great, natural drug free vaginal births, I should have to pay for a private midwife or drive hours away to a birth centre?????

Just so some silly Ob doesn't push me for a unnecessary c/section????

Wouldn't it be better for ALL women if we stood up and looked into why and where this is happening??

I should have EVERY right to know if the hossy I walk into is knife happy, and if the Ob is too..... if you dont wanna know, then dont.

It really is very simple. I cant believe in this day and age ANY woman would say no to any information on childbirth... astounding. .
But they shouldn't stop the rest of us from getting it.

[maz]

Now what Id like to know...if its 'extra work' and 'extra expenses' ...how can it be???

Dont these guys use computers and have 'codes' that tick boxes. Are all our files in hospitals on computer. I know when I booked in for my c/s that it was all done on the computer and the admin asked if it was elective or medical elective c/s. what's the big friggen deal if they have to hit one more friggen key on the keyboard.

I have no doubt in my mind that the boards of hospitals have enough statistics about their c/s rate's compared to vaginal births to take to their monthly meetings. How else would they be able to work out their expenses and medicare repayments?????

I think a birth plan is a good idea...is a friggen start in the right direction of being in control of birthing the way you want...and its a hell alot better then going in all doey eyed. I had no birth plan with my first 2 and fell flat on my arse...yet thanks to BB and the advice I recieved here..I had one and it made my 3rd emergency c/s a hell of alot better. So lets not condem and make it sound so negetive when infact its actually positive!

[Ellibam]

hoobley its a game of chinese whispers!!!
quite a few of us get it but a few that just pop in cos it seems to be the "in thing" arent reading any of this right.
my mum is a m/w of 30+ yrs and she sits down every month and has to do the hospitals statistics.
my IM m/w has to put in her statistics to( and she goes in to te detail we want even though her tranfer rate is about 4% and c/s rate is 3 women in 7yrs doing four births a month)
so why cant private hospitals here in adelaide give out there stats??
(the public ones it is available to anyone who looks)

[Pretty Butterfly]

What happens to a woman who is sent back to a regional community after a traumatic birth (having had to travel hundreds of km's to birth), where there is NO maternal health care reasonably available to that woman (and there are many women in this situation).

Would it not be better for that woman to birth via c/s if she wants? And wouldn't there be a higher incidence of this type of c/s in those areas?

?

I dont see how sending her back after a "traumatic" birth is worse than sending her home after a C/section, if she has no care afterwards????

And I cant see how if you had to travel 100kms away, a c/section would be better if there is no medical need? A vaginal birth where your up immediatly and can leave asap, or major surgery? I would of thought it a no-brainer....