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

[Freya]

I have a query regarding someone's post about paperwork & labour/delivery.......
After having my 2nd I was given a copy of what Im guessing are casenotes from the midwife. It has all the details on it ie times, pain relief, cervical checks, bubs presentation, contraction rates etc etc Would that be a summary of the paperwork she was filling out when I was in labour? I was surprised to be given it but my OB handed it over knowing a) we move alot and b) Id probably end up having another baby.

No one likes to hear they may have a) made a bad choice based on wrong information supplied by your Dr, or b) blindly trusted a Dr who DIDNT have their best interests at heart. I would hate to have come to terms with a birth I never intended on and then suddenly via statistics discover that it was uneccesary in the first place. Same goes for accessing your own medical records. Would open up a whole can of lawsuits on OBs and hospitals for malpractice (and I consider unneccesary procedures performed on misinformed women malpractice).



Take for instance a person I know. She's in her early 20s, had an emergency csection for her first baby as she was 10 days overdue and he was over 9lbs. She laboured for 3 days/2 failed inductions, never got past 4cm and eventually he had to come out. Thats fine with her. I met her when he was 6wks old and told her that she didnt need to worry about a csection next time just because she had one first time round. She was SHOCKED about this because her hospital told her otherwise. So she was due with her second baby 11mths after #1 and they told her no VBAC/induction because of time-frame, risk of rupture blah blah. Fair enough I guess BUT she ended up going into labour on her own early, got to the hospital in established labour at 5cm with no real issues and they scaremongered her into having a csection! Gave her the "Your baby will die, youll rupture, bleed to death, stop progressing" bull. Considering a) she was in no pain bar contractions and b) her first csection was failure to progress after 2 failed inductions BUT she established labour and dialated further than she had 1st time round ON HER OWN. Pure laziness on the hospitals part and Im betting their statistics reflect this. I was horrified to hear her story afterwards. Bloody disgusting. Now she is pregnant with #3 12mths after 2 c/s and she is planning a Vba2c. No reason to think she wont get it either but she knows she'll come up against heavy opposition from the Drs here even though any reason they could possibly come up with as to why she shouldnt VBAC would be pure scaremongering again.

That is a prime example why statistics SHOULD be available on everything related to birthing, not just c/s rates.

[midi27]

Most hospitals in NSW, not sure about other states fill in a computer database with all the details that provide the stats. We then give each women a copy of this on discharge so she has it for her own record. If the hospital has the data the woman also has the right to it.
Re writing info during labour, we document timing of contractions, length & strength, maternal pulse, fetal heart & during the pushing stage we record the fetal heart at least five minutely.
It is a shame that not all hospitals request the right of the woman to birth how she wants provided it is safe. I'm glad that I work in a hospital that tries to cater for women's needs and wants, esp with VBAC & midwifery care. I feel for women who don't have choice purely because they live in a rural area with only one option for where they birth or who provides their care.

[Liz]

Interesting. I had DS in a private hospital and received no paperwork. Had DD in public (coz she was prem) and received all the paperwork.. summary of everything that happened.

I take it private hospitals don't even have to do this? Bit like doctors just keeping their own notes on your visits but we never really see our own files?

I felt really strange at the GP's yesterday when she got out Kayla's file with correspondence from the Paed in it.. it's like I was hearing/reading stuff that I never knew! They were basically summaries of our visits, but he kinda just made his observations and wrote to my GP but never really talked to me about anything. (bit different to what we're talking about.. but it did feel strange, and makes me wonder what the notes are on my first birth! even tho I was there and know what happened )

Definitely think we should have easy access to our own information as well as hospital statistics in all areas of health. If I want to know how many amputations there are due to staff infections if i was going in to have an ingrown nail removed.. I should be able to know! Just the same, I'd want to know how many c/s were performed due to intervention if I was going in to have a vaginal birth!

[Snacks]

I take it private hospitals don't even have to do this? Bit like doctors just keeping their own notes on your visits but we never really see our own files?

Hey Liz, if you want to read your hospital notes you should be able to do so under the freedom of information act. You may have to pay a small fee (I think around $30?) for the time that goes into retrieving your file, etc, but you can certainly read everything they've written about you.

[Freya]

Leanne - nope I had my first in Perth at Mercy Private and my second at Wodonga Regional (Vic) and they are who I got my notes from. Jeanine is my midwife here (and handy to as she lives right near me) and I adore her. But every midwife Ive met has been fabulous. I think Vanessa is her backup and my neighbour who lives being me (Shena, Shayna, Shea? Crud my memory sucks lol) works in the birth suite too.

[Lea79]

Shona from the UK? She's lovely too. She lives out there I know at Forest Shores or whatever the new estate is called. Bet you're getting excited, you have excellent support with Jeanine, all the best!

Leanne

[Freya]

Shona thats it lol Yep her and her hubby are lovely. Nice to hear good things about my care providers not that I was worried at all

[Lea79]

I have a query regarding someone's post about paperwork & labour/delivery.......
After having my 2nd I was given a copy of what Im guessing are casenotes from the midwife. It has all the details on it ie times, pain relief, cervical checks, bubs presentation, contraction rates etc etc Would that be a summary of the paperwork she was filling out when I was in labour? I was surprised to be given it but my OB handed it over knowing a) we move alot and b) Id probably end up having another baby.

Anna - I notice you live at Bushland Beach, did you deliver your 2nd bub at TTH? This is where I work and we give the mums as much as we can documentationwise so it can be utilised for follow up care and for their next bub if they move. We usually include perinatal data sheet, mums and bubs careplan for the entire time you are in hospital, antenatal care details and discharge summary. We dont usually include your partogram from what you have mentioned but thats great if you have that too. Its fantastic to hear you are using our new birth centre for this bub, who are your midwives? All 4 of them are excellent as you probably know by now. All the best!

Leanne