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

[canberramomma]

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....

Well, you have just illustrated m point exactly. It is of absolutely no benefit for women and children to publish these figures per region as every region, as with every birth, has many different variations!

[sushee]

I was thinking about this in the shower, and I think I've nailed down what's been bothering me.

It's the term 'choice'. I touched on it before but will speak more plainly.

What it sounds like to me is that those who are going on about 'choice' are actually talking about wanting to choose a c/s. They talk about their birth choice like it should be beyond criticism (even if the criticism isn't at all directed at them), and over and over again feel the need to defend themselves.

Yet what about those women who actually wish to choose a VB? Who wish to choose a hospital that will less likely to introduce interventions? Who wish to be informed of their birth choices? What about their right to choose? By saying you don't need it when a woman is saying she wants that information, you're effectively inhibiting HER birth choices.

If anyone here is truly advocating choice, why it is you then object to women having access to information that will assist them in making that very choice??

Because I see the opposite of what you're fearing happening with the introduction of measures to make hospitals accountable - women will have a true, informed choice, be it to have a c/s or to have a vb.

So you can't have it both ways. You can't talk about wanting choice, but then say other women shouldn't have access to information that will assist them in making their birth choice.

[Ca Plane Pour Moi]

I foresee one BIG problem.

The hospital "uses up" the amount of sections they are "allowed" by management for the month by day 2 (or maybe 1 - surgeons like chopping you up, admin like nice statistics).

A woman attends on day 3 and is going to die without a section. This rarely happens, the surgeons know, so they didn't leave a space for her.

What to do? The woman die so they can have more sections allowed by the top brass? Or be told off and fined because their section rate is now "too high"?

[sushee]

If an ob purposely ignores a woman in obvious need of a emergency c/s woman simply because he/she is worried about the hospital statistics, I reckon he/she deserves to be sued for malpractice. Because at that point, when a woman actually needs a c/s, is when he's supposed to be doing his job, and not performing unnecessary c/s on women who didn't actually want them, but was coerced into one.

To me, if this makes a Dr think twice about pressuring a woman to have a c/s when there is every possibility that she wouldn't need one at all, I think that's a hell of a positive outcome. If obs go back to peforming c/s on women who need them to save her or her baby, I think that's another positive outcome.

I loved birthing in a birth centre. If, by some miracle, I ever fell pg again, I'd be booking myself into one so fast your head would spin. But if I couldn't get into one, I would choose a hospital birth over a homebirth. I don't want to birth at home, I don't want to have my teenagers in the next room watching tv, or wanting to have their friends over (this actually happened while I was in labour).

So I would want to attend a hospital that had low intevention rates, because I would want a vb. So would it be helpful to me if I could then find out which hospitals had low intervention rate? I think so.

[Ca Plane Pour Moi]

Sushee, I'd love to find a hospital that had low intervention rates. Just one. Anywhere in the world. Because I don't believe they exist.

[sushee]

Aw hun I don't blame you after what you've been through. Perhaps I should have said 'a hospital that had a comparatively lower intervention rate'.

[Ca Plane Pour Moi]

. I would love rates to be published too, but I don't think it will affect anything. Rates in the UK are published (as has already been mentioned) and it doesn't stop scalpel-happy surgeons. But I know a hospital is paid more for a section than for a happy woman here. In Australia, they get more money from more women, yes? So the management will do all they can to attract women - which may include stupid limitations on C-sections. I'd give birth at the end of the month in that type of hospital!

I don't see why anyone who wants to know about the quality of care should be denied a hospital statistic. You can ask for infection rates, for morbidity statistics, for how long you have to wait for an appointment, for how much it will cost... why not how many operations are performed on what percentage of patients with a condition (such as pregnancy... yes, now a medical condition as defined by a hospital!).

ETA - just looked at my own records on the computer. I saw my computer maty notes, from which stats will be pulled. Apparently I had a live birth. And no drugs administered whatsoever. Quite interesting reading. So someone doesn't put the details on the computer and bam, your targets are met. And I was only in under a midwife, no Obs. Best check these are my records and they've not confused me with... an imaginary patient because no bugger is allowed to not have drugs in here.