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

[Macca79]

I worry though that even if hospitals are held accountable it doesn't really mean much if they don't change. Plus if your in a regional area, as I am, your potentially stuffed if there is only one hospital in the area.

[BellyBelly]

TO vote, click the link on the first post, there is an article, scroll down and on the right is a poll.

[Liz]

Macca - I think tho even if you only have that one hospital, and if they have a high section rate, at least you can know and prepare yourself for the fight. Make it clear you're not a lemming that will just do whatever they say.

In fact knowing the statistics could in itself help fight the high rates, coz women will be more aware of what they're up against and possibly fight it more.

[maz]

Yes...regional area here to and If I had of known better, I would have had my first at the smaller lesser know hospital the other direction

UPDATE

My friend who had the c/s booked for her for tomorrow gave birth to a beautiful little boy at 7.05 this morning, via VBAC. If you have a voice...us it!! Dont think cause a DR or Ob has a degree they are necessary right. Listen to to your body and believe in yourself!!!!

[Bathsheba]

It's good to see the switch to 'yes' in this poll. Maybe people are starting to see beyond the bad phrasing of the question (poor usage of the word "shame") and see the issue clearly for what it is.... transparency or non-transparency.

[Lea79]

yep, I'm now convinced its a yes after looking more into it

[Ca Plane Pour Moi]

Girls, for those of you who think you can fight, refuse or talk your way out of surgery... you can't. Sorry to sound defeatist but BTDT and it really makes me cry to think other people believe that anyone cares about you when you're giving birth. They don't.

Listen to your body and believe in yourself... *goes off back to bed to cry again.*

But that's why the rates need publishing - it's not "who does sections and who doesn't" it's "who treats you as a human being and who doesn't" in my eyes.

[Cate5171]

You cant fight them when you numb from the neck down lol. I live in the country but the small country hospitals class you as high risk if you have had a caeser so then you are refered (by a 1800 number) to the hospital you HAVE to go to - which treats you as a number and discriminates against you. Even if they published their names you have no choice here in SA.

[chocolatecatty]

I voted 'yes'. If you had two hospitals to choose from and one had a 30% c-sec rate and the other had a 5% one, well duh, which one would you choose?


makes me cry to think other people believe that anyone cares about you when you're giving birth. They don't.

Totally disagree with you there. But that's all I'll say cos it's bedtime!

[sushee]

Girls, for those of you who think you can fight, refuse or talk your way out of surgery... you can't. Sorry to sound defeatist but BTDT and it really makes me cry to think other people believe that anyone cares about you when you're giving birth. They don't.

I have to disagree with you there Rosehip Fairy.

With Charlie, my labour stalled after many hours and I was asked to go home. I insisted I stay at the hospital, and they let me. The next morning, I asked my ob to come to the hospital and break my waters because my unborn baby had been madly kicking for 5 hours straight, and I felt something was wrong. My ob didn't want to because it was Easter, but I insisted, so he did.

When he broke my waters, it was heavily stained with meconium, and my baby was obviously in distress. My ob said 'we need to get this baby out, I'm booking the theatre for a caesar'. I looked at him, and after my initial shock, said 'no, I don't want a caesar'.

My ob, suffice to say, wasn't happy, but he'd known me long enough to know that he wouldn't 'budge' me. He couldn't perform a c/s on me without my consent. I wanted to try other options first. I said I wanted to try to birth vaginally. He reluctantly agreed.

I finally agreed to an augmentation and continuous monitoring, with the proviso that if the baby's heart rate dipped, I would agree to a caesar.

I birthed my son vaginally 4 hours later. My son's heartrate never dipped so low that it was a concern. No one would have known that Charlie was never in any real danger if I had agreed to a caesar in the first instance though.

So I do believe if you're firm about what you want, you can be heard. I just hated that I had to be firm, or that at a time when I was fearing for my son's well-being, had I had less confidence in my body, I may well have been vulnerable to having a caesar I ultimately didn't need. Even after my son's birth, my DH told me that he was shocked that I'd stood my ground, and said he'd worried that I was doing the wrong thing and putting our son in jeopardy. Hell, if I wasn't running on faith, adenalin and instinct, perhaps that very fear would have made me succumb too. At the time though, my son's well-being WAS the most important thing to me, which is why I agreed to be monitored (and give up access to an active birth). I just didn't think a 'quickie' c/s was the best course of action at that time, despite what my dr was saying. I trusted my instincts, and I felt that I (and my unborn child) just needed more time to 'get there'. So until they could prove to me that I was putting my son's life at risk by not cutting him out of my body, I was not agreeing to a c/s.

What I REALLY needed was a birth attendant who had as much faith in my body as I had, and I don't think that in general obs tend to have faith in their 'patients' bodies. I hated being the one having to 'fly in the face' of my medical professional's opinions, when what I really needed was for my team to support me. But I don't blame him either. He sees a medical solution to any problems, after all his whole job is about intervening when things go wrong (and sometimes even when things are just a little wrong!)

So I do think you can fight, refuse and talk your way out of surgery. I did. I just think having to do it while in labour is a pretty crap thing to have to endure, so I can understand why most women wouldn't do it, esp if it's their first pg.

[Ca Plane Pour Moi]

Cate, you don't HAVE to go to hospital - you can stay at home. You can rock up at a hospital locally and say you're about to push, no time to get to the aforementioned hospital.

Just because you have an appointment doesn't mean you can't cancel it!

Taking my own advice for the next time LOL.

edit:
"He couldn't perform a c/s on me without my consent." - my Obs could have; DH would have agreed if I didn't.

I'm backing out of this discussion: feeling like a COMPLETE waste of space again because I WAS bloody firm, I was bloody fighting... but why did I even have to? Why did I fail so badly that I couldn't even fight properly?

[sushee]

I don't think women SHOULD have to fight, RH, not just with their obs but with their husbands as well. My DH was crazy scared, but would not have tried to budge me, and for that I was grateful. I also think having my obs be someone who was with me from conception (he was my fertility specialist) to birth meant he knew when I got that 'look' on my face, that I wasn't going to be moved.

But you're right, why should you have had to fight? Why should any woman have to fight to be heard, when it's about their bodies and their babies?

I think you copped a really bad set of circumstances, RH and I didn't ever mean to insinuate that you didn't fight hard enough. I'm just saying it can be done, I myself have done it. But obviously with the right set of circumstances. I know you tried your level best RH, but while your experience makes you feel like a woman will never have power over her situation, I'm saying that that's not always true. It's not always true that you will have to accept anything they decide to do to you. That's why I talked about my experience. Because I think by saying a woman will NEVER have control, women will stop fighting for what they want. And that would be a tragedy.

ETA can your DH agree on your behalf for a c/s? I didn't think he could unless you were unable to consent yourself (eg in a coma). If that's true, it's bloody outrageoous!!

[Kazznazz]

I voted no because I think that every woman should have the freedom to birth the way she wants to.

Also, the way that elective c/s's are recorded and what constitutes an elective, is very wide.

I had two failed VB attempts and for the 3rd, I was advised to have a c/s for risk reasons and the fact I had developed a condition which made a c/s most advisable.

It was still listed as and elective.

We don't know the reasons behind every birth story and we should not allow others to judge, IMO.

I believe we are exceptionally lucky in this country to be able to access some of the best services in the world when specialised assistance is required before during or after birth. This is certainly not the case in some countries.
We have exceptional ante natal and post natal care available to us here in Australia and excellent facilities for women who have need of special care during labour. We also have wonderful services to help pre-term or seriously ill babies.

The language of birth should never reflect an assumption of "failure" in the event that specialised assistance is required and it is important to acknowledge that there are some very real circumstances where assistance is absolutely necessary.

It is when these undeniably valuable procedures start to become the standard form of birth management that we need to re-evaluate our approach. Medical and surgical management of pregnancy and childbirth should be available to all of us if and when problems arise.

The World Health Organisation has delivered (amongst other things) guidelines which suggest a reasonable percentage of women who will need such medical/surgical assistance; 5% - 15%.
In hospitals where these percentages are inflated by as much as 3 or 4 times what would be considered normal we need to know why this is the case.

Are women being given the support and encouragement they need during labour. Are women being assessed according to their individual progress or are they being assessed according to a model of what individual obstetricians see as ?normal? for all women?

Obstetricians are people and are subject to all the faults and failings of normal human beings. We tend to elevate them to a far higher status than that but ultimately they are just people and should be subject to the same accountability as the rest of us. Some of them are wonderful people and some are not so wonderful. Some do their job well and some not so well. Just like the rest of us.

Surely when considering the matter of whether or not we should have the freedom to give birth in the way we choose we need to know the philosophies and practices of the people who are attending us during this time.

We don?t need or want to know if a particular woman made the right or wrong choice at some point in her labour. Women don?t ?fail? during birth ? not ever. Women experience birth in the most incredible number of different and unique ways.
We do, however, need to know if the birthing institutions and attendants have the same commitment to providing what is needed to facilitate a straightforward uncomplicated birth as they have to assisting when problems arise.

We do need to know if the number of caesareans being performed appears, overall, to be a reasonable number. We need to know if there are a lot of infections occurring in a hospital. We need to know if all babies are being given complimentary feeds without needing them. We need to know if women are being slapped and told to be quiet when they are in labour (yes this happened). We need to know if women are being given honest information about all the options available to them.
We have an absolute right to know everything there is to know about the place where we are going to give birth and the people who will be with us at that time.

We absolutely need to give all women the respect and love and support they need regardless of the circumstances of their birth.

[~mamaspice~]

Okay, blonde moment here. I just worked out how to vote. I voted yes BTW.
Now it is:
622 votes for yes (43%)
611 votes for no (42%)

Sushee, thanks for your positive story. I plan to stand my ground next time too.

[Ca Plane Pour Moi]

Sushee, that's just it. I tried my best. I failed. The midwife the next day went out of her way to let me know how much I failed - she knew I would anyway.

I had about ten to fifteen people in the room when I gave birth. Aside from DH (sat at the back looking pale with midwives worried about him) I hadn't met any of these people before late that morning - when I was already 8cm dilated.

I feel so much worse because I failed. I knew and I failed. It wasn't worth the fight for me, nor was it worth the education. It just means I did my best and failed. I'd rather have just been dumb and failed. I'd rather have not known about all of this and failed, then I could blame something other than me just being a failure.

If you can fight and win, qudos to you. I'm obviously not good enough to do that. Believe me, I feel BAD about that. And would rather just not fight because then I didn't do my best and failed, maybe I could do better next time. And I know I can't.

And yup, DH can agree to a section for me. It's fine and good - they have a signature, they can chop me up now. Lucky them, they're OK. They got DH's say-so for the episiotomy - didn't even tell me they wanted to do it because they knew I wouldn't agree to it.

[sushee]

RH,

By the sounds of it, I personally think there were a lot of people who failed YOU. I don't think you failed. One person can only fight so much. And when there is that much opposition, so little support and so much control taken away from you at a time when you're in pain, vulnerable and scared, I don't think ANYONE should be thinking, let alone saying, you'd failed.

I don't think birthing the best way you could despite the odds is failing at all.

But that conversation is for another thread.

[~mamaspice~]

Okay, blonde moment here. I just worked out how to vote. I voted yes BTW.
Now it is:
622 votes for yes (43%)
611 votes for no (42%)

Sushee, thanks for your positive story. I plan to stand my ground next time too.

[sushee]

I'm glad to hear it, spice . I think the day we stop fighting, and stop informing ourselves, will be a sad day for women in general. Some of us will be forever scarred by our experiences; the rest of us have to keep fighting so that sort of thing stops happening to women.