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

Thats a good point. So many women wonder what the hell happened at their birth, feel disappointed and more women are getting post traumatic stress disorder and PND after birth... we need to start taking more responsibility for ourselves and our decisions, we research so many other things when we are making a purchase, why isn't birth as important?

There is a BB poll, where I asked how you choose your Ob, the #1 response was word of mouth. I notice that alot, people will ask around who they had and pick them. Along with the "My ob was brilliant, he saved my baby when it was an emergency!" -- well what created the emergency in the first place? Alot of babies are born in 'emergencies' these days. We know that simply having a doula at your birth reduces c/s by 50% based on many studies around the world, they all match up, that's gotta be saying something, thats massive - and its NOT a reduction from having medical care... hmmmmm....

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-- well what created the emergency in the first place? Alot of babies are born in 'emergencies' these days. .

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This is so true. I think society has put upon us a fear of birthing - so we hand ourselves over to the medical institutions to care for us, because we are not informed as to how to take care of ourselves..... and many of us do not seek this information, we simply go along to our monthly/fortnightly/weekly appointments and smile when the ob says "yep everything is fine".

I know 5 other people who are due at around the same time as me. Not one of them had any idea what a doula was, and all of them think i am some weird freak for planning a homebirth. None of them have done any investigations as to what happens to them, one didnt even know about the stages of labour! I mean c'mon!!!!!!!!

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I vote no. Naming a hospital because they perform high c sections is an indication of what again??? Majority of the mothers to be ....have knowledge of both options and do their research as a result...the option they choose is based on a number of factors....and it is between the patient and the Doctor.

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I totally agree, the hospital has no say in whether you have a c-section or a natural birth. I made my choice with my obgy and told the hospital that's what was going to happen. I admit that it is not the nicest experience however, I got two healthy babies delivered safely....and that is all that should matter. So i feel that if you feel that you are not being informed or feel that you are being pressured into a c-section....find another dr!!!

This is a good question.after having 2 boys naturally i found out at my 42 week check up at the hospital (yes 42 weeks) that i was breach with my daughter and had to have an emergency c section as i was going into labour.i had top wait 3 hours for a postion to come up for me to get into have the procedure.after having my daughter and coming out to the ward it made me realise just how many ladies had accually had the proceedure (alarming).i was devistated to find out i had to have a c section.after having 2 natural labours and now a c section personally i would note choose to have a c section.you might get away with the pain but it takes a long time for you to recover after having it done and i could not even get up to attend to my daughter for the first 2 days and according to the nurses they were amazed when i got up on the 3rd day and tried to attend to her.statistics dont need to be put out as you do not know how many are elective c section and how many are emergency.please ladies consider all your options.you may not get as much pain during the childbirth/labour process with the c section but you do pay a price in other ways.i wish i could have been able to attend to my daughter myself in the first couple of days not relying on everyone else and trying to breastfeed a newborn lying on your back is a definate task.

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So i feel that if you feel that you are not being informed or feel that you are being pressured into a c-section....find another dr!!!

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Which would be fine if you actually had other information readily available to alert you to the fact that you weren't being informed! People who are aware of things don't tend to get information fudged, because they can either tell that it's happening, or the other person won't even try.
The majority of women clearly don't have all the information that would help them make informed decisions. And the majority of voters in this present poll don't even want all the information! Which tells me that there's a lot of women who will 'just trust what the medicos say'. Like professionals never make mistakes or follow policy over customer/patient welfare...ha!

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I totally agree, the hospital has no say in whether you have a c-section or a natural birth. I made my choice with my obgy and told the hospital that's what was going to happen.

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I'm sorry, in your case that might be true but in many it's not. I have a cousin who is now a paediatrician and she told me when she was doing obs and gynae they were FREQUENTLY told to advise a section when it was getting lat either in the evening or the week... It's not a comfortable truth but it IS the truth, NOT ALL women who have sections needed or wanted them. I'm not talking about breeches or twins which without a willing and skilled careprovider ARE better delivered surgically, i'm talking about healthy women having normal labours who are subjected to unnecessary interventions. My cousin even told me at one hospital the Obs joked about the "tea-time push-along" - at 4pm they reviewed all labouring women to see who they could augment and get the babies out before 8pm shift-change. How many sections a day came about because of that? How many sections that women neither wanted nor would have NEEDED if they had been able to labour normally?

This is not ABOUT it being "right" or "wrong" to elect a c-section, this is about women having a REAL CHOICE in who they choose to go to for their births. If i want a natural birth i should be able to find a place to get that (fortunately i have already discovered i live in that place - my home!), just as if a woman wants or needs a c-section she should have access to the stats about where to get that.

I don't understand why people don't want the information out there. If YOU don't want to know you needn't look, but why can't i know? Why can't another woman making different choices have access to the information that would help her do that? What does it cost one woman if another wants to know how her hospital stacks up statistically?

Bx

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So i feel that if you feel that you are not being informed or feel that you are being pressured into a c-section....find another dr!!!

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easier said then done in the public sector of hospitals as you get what your given and not everyone has the money to go private.

And such a comment yet again emthasises the need to find out the statistics so you can PICK your own hospital!

I ended up having an emergency caesar a few months ago at one of Melbourne's private hospitals. In our pre-natal classes, the nurse running the sessions went through all the hospital statistics in detail. VBAC vs Emergency Caeasar vs Elective Caesar. They also broke down the number of births that were forceps or vaccum delivery which we all found really interesting. I don't really understand why other hospitals are so secretive about this information. I feel that when parents are selecting hospitals, they should be able to have access to this information. Having said this though, I don't agree with the notion of "naming and shaming". As many people on this thread have said, we have no way of knowing the particular circumstances surrounding each birth.

does it really matter. if you want a home birth you're gonna try a home birth if you want a drug free hospital birth go for it if you want an elective ceaser thats your choice who cares how a baby is delivered as long as mum & bub come out ok. i think to much pressure is put on women and thy're made to feel a failure if they didn't have a natural drug free birth for eg. a woman at my work had an emergency c after 24hr labour and one of our co workers said "well ive had 4 kids and never had a c or an epidural i can't understand why anyone should have to it's the easy way out". as i said earlier who cares how they are born as long as they are healthy.

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does it really matter. if you want a home birth you're gonna try a home birth if you want a drug free hospital birth go for it

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But it's more likely you'll GET a homebirth if you stay at home, does it not follow that you're more likely to get a drug free vaginal birth if you go to a place where they are commonplace? How likely is a woman to get a drug free vaginal birth in a hospital where over 90% of women who go there have an epidural? And if you DID want a vaginal drug free birth, given the choice would you go to a hosital where 55% of women achieve that, or one where less than 10% do?

Bx

I can't understand why time after time women are coming into this thread and saying that by asking hospitals to be accountable for the amount of c/s they do above and beyond what is acceptable is somehow an attack on their choices?

If you had a c/s out of choice, great for you, no one is attacking your right to choose. If you had an emergency c/s, well it really wasn't a choice, was it?

The TRUTH is, many women is coerced into a c/s they wouldn't normally need. We see it here on BB ALL THE TIME. Your baby is too big. You'll put your baby in danger if you have a VBAC. Your pelvis is too small. You're too overdue. You're high risk. There are too many stories where mothers are made to feel like they're putting themselves and their babies at risk by not listening to what their doctors say. Please don't pretend it's not true, because we all know that it is. Yet if you scratch the surface on the majority of these cases, none of those reasons are valid!

I had a Dr who said he was low intervention, and even he suggested at 39w that I should have a c/s, simply because I was complaining I was over it all. If I were a new mum, who had never given birth vaginally before, imagine how good that would have sounded?

And let's not ignore the fact that in my antenatal class, 8 out of 10 women were planning a c/s, variously because they believed it would be 'safer' for their babies, or they'd been told their babies were too big, or they were told that a c/s would be less painful. Why is it that that sort of information is perpetuated day after day after day, yet we as women think it's okay for us not to be informed about it?

My sister gave birth to 2 children vaginally in Singapore, then was told by her Australian ob that her pelvis was too small to deliver her 3rd baby. So she had a c/s ('elective' it said on her forms) and guess what? Her baby was not so big after all that she couldn't have delivered her naturally. My sister is hugely upset that she was scared into making a decision that was incorrect in the end. Again her story is NOT isolated. Women here on BB get it all the time, too. So imagine how many women are being told fibs like that out there.

If you don't care about whether your hospital performs far more c/s then necessary, I think it's your prepogative to ignore any stats they're asked to divulge. If, however, you WOULD like to know how your hospital compares to other hospitals, I think you should have a right to know. I would want to know, so why shouldn't I have access to that sort of information?

I don't think many are reading anyone else's posts or responses Sush... everyone is coming in with their experiences and thats it.

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But why did your labour end in c/s? Was there intervention that some women would prefer not to have? That's the thing women need to be able to make these decisions and they should be informed of what is the norm at their chosen hospital/obs.

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Hi Tanya,
I had been pushing for a couple of hours and Johanna was going into distress and I was tired. The medical intervention was required in my case.

Jodi

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I don't think many are reading anyone else's posts or responses Sush... everyone is coming in with their experiences and thats it.

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here here :clap:....many people arent thinking outside the box....

From some of the responses i don't even think people are reading the FIRST post!

Jodi, i have more questions (which you absolutely needn't answer if you don't wish to):
Was your labour artificially augmented (drip or gels or AROM)?
What position did you push in?
What, if any, pain relief did you use?

Bx

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If you don't care about whether your hospital performs far more c/s then necessary, I think it's your prepogative to ignore any stats they're asked to divulge. If, however, you WOULD like to know how your hospital compares to other hospitals, I think you should have a right to know. I would want to know, so why shouldn't I have access to that sort of information?

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SNAP!!!!!!!!!!!!!!

Absolute RIPPER of a post Sush! I agree wholeheartedly.

Information should be made available. Simple as that. Its up to a woman to choose. But just because one half of the population believes their c/s is valid doesn't mean that the other half shouldn't be entitled to that information. I don't necessarily believe that every ob or every hospital is pro c/s but I think that there are plenty of situations where women haven't been informed enough. And try and remember just because you had a good experience doesn't mean everyone will, shouldn't others be allowed to make the decision for themselves and not just because a few people are happy with the current climate.

I vote no to naming & shaming the hospitals, but yes to naming & shaming the dr's. They are the ones who decide to give c-sections. I agree with FionaJill about finding out why the c-sections were done before naming & shaming as some c-sections are a necessity (I have had 2 c-sections because I can not give birth naturally). But definately name & shame dr's who do it because it's convenient!!

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From some of the responses i don't even think people are reading the FIRST post!

Jodi, i have more questions (which you absolutely needn't answer if you don't wish to):
Was your labour artificially augmented (drip or gels or AROM)?
What position did you push in?
What, if any, pain relief did you use?

Bx

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No I laboured naturally. The position I was pushing in was laying on my back. I didn't have any pain relief until the epidural. They were going to try a forceps delivery but on the way to the operating room Johanna backed up and went breech after being on the verge of crowning :o. The staff said that this was the first time a baby had actually done what she had done.

Jodi

Thanks for that Jodi! I know a mw who has a pic of a little boy who has the internal monitor clip screwed firmly into his buttock - he was born head down, so did the reverse move to your DD during labour!

Bx

I voted yes to naming the hospitals. I take exception with it being called naming and shaming, a c-section is not a shameful thing, and this phrase insinuates this IMO.

I think that a c/s rate is a piece of information that we should be able to know when making a decision on which hospital to birth in - although in reality most times it's geography which dictates this anyway. We do tours of the hospital to see their bed setup on ward, look at the facilities and ask about the menu. If we are very proactive we ask about their induction policies, synto policy, cord cutting policy, work out how far we can push the packet until we have to start digging our heels in.

Why should the c/s rate be off limits to us? Personally I would prefer to birth in a hospital with a 20% c/s rate than one with a 70% rate. I know this doesn't mean my situation won't end up in a c/s, but it gives a good indiction TO ME about the general attitude of the maternity policies.

I would also prefer to try to avoid being in the unlucky 20% than try to shoot to be in the 'lucky' 30% - just makes statistical sense to me.


Regardless of your reasons for not wanting to know personally, the question strikes me of why would you want to hide it? Why keep it unknown? I can not see a benefit of keeping it secret.

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The TRUTH is, many women is coerced into a c/s they wouldn't normally need. We see it here on BB ALL THE TIME. Your baby is too big. You'll put your baby in danger if you have a VBAC. Your pelvis is too small. You're too overdue. You're high risk.

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i was one of these woman....I so regret listen to the doctor at the time and taking his word for gold....his words were

its hospital's policy

still echo in my head.

And as a result of his actions I had NO CHOICE but to deliver my last 2 children via c/s also. If I had known about the 'hospitals statistics' I would have made sure I went to the other town's more natural birth friendly..and LOW rate of c/s deliveries in the first place

I definately think these figures should be available to women but shaming come on!!!
I really think as a country we need to start taking some responsibility for ourselves it becomes way to easy to play the blame game eg Mcdonalds is causing obesity! We are an educated race of people, we need to go into our births as we would any major event in our lives, well informed and aware of all the outcomes. The only person i blame for my 1st birth is myself i went in and handed my body over to the hospital, if i'd done my homework i would have known better.
I cant help to notice also that all the women on here who have had CS feel they have to "explain" WHY they had a CS (which i am finding myself at the moment with the looming posibility of an elective CS) i think articles like "naming and shaming" cant help but to make women feel like they have to explain why they arent birthing naturally.
I think the days of CS being conceived as a wonderful, painless, easy way "out" were well in truly but to bed in the 80's, that is not the perception of anyone i know.

I think if hospitals only did medically necessary c/s, their stats would reflect that, and there would be no need for any explanation about why those c/s were actually done. If their stats show they're doing c/s 40% over and above the average percentage of c/s considered medcially necessary, I think you may deduce that the most of the rest probably WEREN'T medically necessary.

ETA I actually think people are getting too hung up on the word 'shaming'. It's about making hospitals more accountable. And btw, I do think the myth that a c/s is a more painless way of having your baby is alive and well, it's just that fewer women would admit to it. But out there in the wide world, it still exists. Just in my antenatal class and my aquanatal classes, I found women who still believed it.

I would be curious to find out how many women had unnecessary c sections but were told they had no choice. I was told my baby was 'stuck' and had an emergency c section and forceps to pull my baby back out (he was too low I was told). Also my labour had stopped. I was given two bags of Syntocin and had no idea till after DS was here that the drug was most probably the reason labour had halted. I feel I trusted my OB too much, I took everything that was said as gospel truth. Homebirth for us next time round.

Macca you will LOVE it :D

Sushee i think the word "shame" is the problem too, people aren't reading past it, it's a red flag. And sadly i agree, i know MANY women who went for a section because they thought it was a less painful option, or rather, as one put it "If you have drugs for labour you're a wimp, but no-one calls you a wimp for having morphine after surgery".

Bx

Narrow minded people are seeing 'shame' and rather then think just go of on a tanjet!

I find it most annoying that it is seen as the easy way out...im pretty sure I started a thread about c/s post birth here...

https://www.bellybelly.com.au/forums...ever-knew.html

maybe this might help those who think a c/s is easy

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ETA I actually think people are getting too hung up on the word 'shaming'.

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Sushee i think the word "shame" is the problem too, people aren't reading past it, it's a red flag.

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Narrow minded people are seeing 'shame' and rather then think just go of on a tanjet!

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Not at all. It's just making a point of the state of our tabloid-like news reporting. Shouldn't have said it was shaming full stop. It's not narrow minded to take offense to that.

People are still able to read past it and respond to the actual concept.

The question of whether or not c/s is necessary or needed or painful wasn't on question for the original topic, so people shouldn't feel bad for not responding to the digressed conversation in the meantime (and yet still have read the thread ;)).

I have private cover but deliberately went to a public hospital because the c-sect rates are lower there. I did end up with a c-sect in the end (it's a long story - 42wks +2 days long!) but I truly believe if I was in a private hospital I would have gone straight to c-sect rather than experiencing a 'natural' (after being induced over 3 days) labour first. I strongly believe the statistics should be available. Not for naming and shaming but so that women can be informed. As all things related to pregnancy and childbirth, parents have the right to be informed and therefore make informed decisions about their care. That's my five cents!

Can we then all agree that using the word 'shaming' does not properly depict the issue at hand, and agree that it's about making hospital more accountable, and move on?

Because I agree that the word was used in a tabloid-like context, so let's not allow it derail the conversation. Because from some of the posts I've read, some people haven't been able to get past that word. I'm happy to talk about the media though and their poor choice of words in a seperate thread. :)

This whole subject makes me mad. Im a mum to Zoe who is now 3, almost 4. I delivered her via c-section at 38wks due to a few pregnancy complications. I do not think that having a c-section is the "easy way out" and that it is less painful than a vaginal birth at all.. If it was safe for me to deliver vaginally I wouldve I didnt elect to have her the way I did. As for those mothers who do elect for a caesarian well...so be it it is their choice, their body,their baby - they are all warned of the possible risks and complications before the birth. I dont see how c-sections can be considered a possible health risk. My obstertrician told me that delivering by c-section was less stress for the baby and I agree. Zoe arrived without a peep and was an absolute angel.
As for making it public to the community about the caesar rates in hospitals... what a joke..no body needs to know, its no ones business but our own. If you have a good obstertrician then youre in safe hands, they follow you through the pregnancy journey and makesure the safest and best way for delievery of your baby iis..they know what theyre on about.

zoesmummy,

no one is asking the hospital to publish names, just their stats.

And there are loads of other stats too that say that a vaginal birth is safer for mother and baby in MOST circumstances. There are lots of stats that say it's better for baby to travel down the birth canal as it squeezes fluid out of baby's lungs. There are lots of anecdotal evidence to say that obstetricians will not warn women of all the potential complications assocoated with a c/s, but WILL tell them they're safer/better off having a c/s. Some obs even tell the mother it's better for her baby because her baby will be less stressed, but the stats reflect that it's not actually better for her baby at all. A health risk is anything that exposes someone to increased danger that they normally wouldn't be exposed to, so c/s (and any surgery) carries a health risk.

And the topic, by the way, remains whether women should be allowed to access information on their hospital's STATISTICS on their c/s rate. I'm not sure how that's an invasion on any one person's privacy.

:think: lucky for me then I suppose that back in my mum's day that c/s were seen what they were for

MAJOR SURGERY

and not for the lets keep up with the jones situation its seem to have come to:rolleyes:

I agree that the media shouldn't have titled it this was ...bit also its not saying Shame c/s,...its saying shame the hospitals and doctors doing these procedures. People are taking there own empathese on the wording of the matter. its also the people who have come in and said no to the question....without actually have had a c/s and knowing later that if the facts were there that perhaps there could have been an not another method used.

As for making it public to the community about the caesar rates in hospitals... what a joke..no body needs to know, its no ones business but our own.

but so do you think that there is going to be alist of peoples names saying jo blow had a c/s for her own purposes...comeone that is breaching all the privacy laws that have been put in place. We can find out the rates of patients who die from surgury related issues ,how many people have cancer treatment and even to how many people have lap band surgery...but we cant find out the % of births that are c/s related....come one..why should one thing be different to the other

It is very easy to say yadda yadda when you havent walked in another person's shoes.
In a world were so much usless information is feed to us...you'd think any information involving the birth of your unborn child would be made knowledge.

The question at hand here is not what is best for baby/mum etc, the question is if statistics should be published as to what c/section rates are in our Australian hospitals.

I can readily obtain the info as to what nationalities/religious groups live in any area, I can obtain stats on which banks are most popular, hell i can even obtain stats on which phone companies have what share in the market.

So with all of this freedom of information, why on earth should we not be allowed to access THIS information?

After reading alot of these posts, i'm thinking that what we all really want is HONESTY from the medical profession - no scare mongering - just the real facts about the process of becoming a mum!

There are so many wives tales out there, and just as many medical scare-stories going around that of course women think that pregnancy/labour/birth is dangerous! A good friend of mine is pregnant for the first time and I have had to tell her "dont read any pregnancy books, dont listen to people talk about it their bad experiences - nothing!" because she is paranoid about EVERYTHING that happens - she thinks every little pain is a miscarriage or something wrong with bub... all because of the stories and rubbish shes been told! Shes one of the ones who is sure to be scared into having a c-section or other unnecessary intervention!

What women need is the TRUTH about pregnancy, the TRUTH about labour and the TRUTH about birth (not the scary one-in-a-million rare complications and problems)!

If we were all totally and honestly educated with the truth, then perhaps less women would be choosing c-sections in the first place, and docs would be less able to scare us into making bad decisions.

I vote a a great big NO.

Firstly, I agree with those that point out that you are not told why the CS is performed. Of course some hospitals will have a higher rate of CS because not all hospitals are able to do them. If you have a high risk pregnancy you will be sent to a hospital that has the facilities and so those hospitals will naturally have a higher rate. The statistic will be skewed before you even start.

I also have to agree that the stigma attached to CS doesn't need any further promotion either. I am currently 30 weeks pregnant and have been diagnosed with vasa praevia, a condition that, unless things change in the next 4 weeks, will require a planned CS. When I tell people I am having a CS I am either grilled about why, given a disapproving look and a tsk tsk or lectured about having an 'elective CS'. Now I feel I have to give a full explanation of my condition every time someone asks in order to avoid the harrasment.

Because my CS is planned and not emergency, it is referred to as 'elective' even though I would have given anything to have a natural birth and have no choice. So even dividing the CS's into 'elective' and 'emergency' won't give an accurate picture.

This all leads to the main principal, it is no-one's business but mine how I have my baby. There is evidence to support the assertion that a natural birth is better for the baby, just as there is evidence to suggest that CS is better. As long as my child is healthy and happy it should be no-ones business but mine how my child is born, and while we're at it, whether it is breast or bottle fed. When judging people for the choices, take a moment to think about the possible reasons behind that choice. Sure, some peoplemay make the decision lightly, based on fear or vanity, but who are we to judge what a valid reason truely is. More importantly, why make every woman suffer because you disagree with the reasons for a decision made by a few.

Some say that hospitals 'encourage' CS for their own convenience. Well this may happen and if you think this has happened to you, there are avenues for complaint. If you are worried about the attitudes of hospital staff when choosing your hospital, if you are lucky enough to have a choice, most maternity wards have a time you can tour through and ask questions. Ask your friends where they went and what their experiences were like, or, get on a forum. If you can afford it, hire a private midwife or doula to attend your birth.

Pregnancy and child birth are all about what's right for you and your child, other people judging you for your decisions or the outcome of your child's birth is an unnecessary added stress.

:)
I voted no, only because the wording for the article was poor..to say to "Name and shame' the hospital seems quite harsh when we dont have the facts as to why these caesareans are being performed.

I think it is more important to have more education on the subject to better inform mothers to be..so that they are making the right choice for their individual cases.

i think it should be made public, freedom of information.

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Some say that hospitals 'encourage' CS for their own convenience. Well this may happen and if you think this has happened to you, there are avenues for complaint.

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and many times those complaints can fall on deaf ears or you just get a 'we are so sorry letter in the mail'

:rolleyes: I think im over this discussion....it seems to be falling on deaf ears

I don't want to repeat my post from page 8 but suffice to say, I'm still amazed that women think asking hospitals to make known their black and white STATISTICS known is somehow an attack on a woman's birth choice. At what point did this particular thread start becoming about people thinking that by wanting to know these statistics, that somehow it means that people are judging you?

I honestly don't care how you decide to have your baby. My concern has never been about the women who knowingly choose to have a c/s, whether they medically need it or not. Your body, your choice. The women I AM speaking about are the women who were scared or coerced into thinking they HAD to have a c/s. Can anyone else see the difference, or are some of the posts that said just that (including mine on page 8) somehow invisible to some of the posters here?

And to say that you think it's better to make a complaint after the fact instead of informing yourself before you actually get to that point is completely mind-boggling.