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

[BellyBelly]

AdelaideNow... MP Sandra Kanck wants to 'name and shame' over caesareans

Have a read of this article and you need the link to vote - do you think hospitals should be named and shamed for their c/s rates? No is very much ahead... hmmm this link must be circulating around the AMA and RANZCOG!!!

MP Sandra Kanck wants to 'name and shame' over caesareans
Article from: AAP

November 17, 2008 01:15pm

SOUTH Australian hospitals performing a high number of caesarean section births should be named and shamed, says Democrats MP Sandra Kanck.

SA's official figures show more than 32 per cent of all babies born were delivered by caesarean section, which is more than double the recommended World Health Organisation standard, Ms Kanck said.

"WHO guidelines recommend 5 to 15 per cent of births as a safe level," she said.

"Yet in SA the breakdown of caesarean rates are 28.4 per cent for all public hospitals, both metro and country, and 43.7 per cent for metro private hospitals."

She said rates across five private metropolitan hospitals ranged from about 35 per cent to more than 54 per cent.

"Because choice in childbirth needs to be informed choice, I urge the minister for health (John Hill) to name and shame the worst-performing hospitals."

Ms Kanck said fear of pain should not a reason for having a caesarean.

Mothers must be informed of the risks involved with surgical deliveries and the circumstances in which they should be used.

"It is vital that a caesarean is not seen as an option of convenience for either obstetrician or mother," she said.

[Marlene]

I voted!!

It's now:

Yes 35% (405 votes)
No 49% (567 votes)
Only in extreme cases 15% (180 votes)

[kristy J]

I voted NO! which seems to be in fornt in the pole so far.

i don't think its anyone elses buisness, its between the pariend and her doctor . and also there is no shame in a C/sect anyway (Sandra Kanck) my twins were an elective c/sect (tho emergancy in the end) and i think they are fantastic i really enjoyed it. if i have more i would definatly have another c/sect.

but thats just me.

[Kitt3n]

I voted yes, its just a statistic, just like anything else, and I believe we should all have the right to know such rates at our local hospital/hospital of choice.

[Liz]

I voted yes. Why go to a hospital that could potentially perform an unnecessary or preventable c/s. Don't want people being too quick with the knife thank you!

[sneakysparkle]

I voted yes. Why go to a hospital that could potentially perform an unnecessary or preventable c/s. Don't want people being too quick with the knife thank you!

my thoughts exactly!

[Liz]

Was just thinking - the way they word these things always affects how people vote I reckon. "naming & shaming"... i dunno.. why not just say "release each hospital's statistics to inform women".

I don't think the hospitals need to be 'shamed' as such.. but I think the info should be available.

[Beatrix]

i vote no


On the fact that you have absolutly no idea why these c sections are being carried out. Unless you were able to find out why ever c sect was performed the the basis the info was collected on is wrong..

by showing which hosptial has the most c sects is scare mongering.. isnt that what you call it? dont go here cause you more likely to have a c sect?



And yes i understand some c sects are performed unneccesarily

[feeb]

i vote no


On the fact that you have absolutly no idea why these c sections are being carried out. Unless you were able to find out why ever c sect was performed the the basis the info was collected on is wrong..

by showing which hosptial has the most c sects is scare mongering.. isnt that what you call it? dont go here cause you more likely to have a c sect?



And yes i understand some c sects are performed unneccesarily

I completly agree, also a tertiary hospital will have a higher cs rate as they deal with a lot of high risk pregnancys so how is that fair. Tertiary hospitals are thought to be best and safest. people go to them assuming that if something is wrong it will be dealt with according to safety of baby and mum.

Not everyone can have a vaginally birth unfortunatly, cs rates have gone up for many reasons including bigger babies due to diabetes, more multiple births etc. Yes some Drs are more cs happy than others but they r not the majority.

I had a cs and i pre emptyed it as i had knowladge of what was happening and i aggredd with mw and ob decisions at all times and would change nothing.

[*Efjay*]

i vote no


On the fact that you have absolutly no idea why these c sections are being carried out. Unless you were able to find out why ever c sect was performed the the basis the info was collected on is wrong..

by showing which hosptial has the most c sects is scare mongering.. isnt that what you call it? dont go here cause you more likely to have a c sect?



And yes i understand some c sects are performed unneccesarily

My thoughts also.

[lmbmcb]

Hi all
I would say no.
My reason being that I don't believe it would give a true account of why the C/sections are being performed.
My first 2 kids were natural deliveries at a public hospital. My next baby is going to be a ceasarean for medical reasons at a Private hospital. If I didn't have these medical reasons then I would be having a natural birth and wouldn't bother with a Private hospital. The only reason I am going private is because I want to know who is going to be performing the surgery, as my medical condition is not something I want left up to whoever is available to operate at the time, I really want to be able to choose my own surgeon. Perhaps there are others who also feel this way and I feel that this may be one reason why C/section rates are higher at private hospitals, although possibly not the only reason.

But as Kelly points out, the WHO rate is inclusive of emergencies..honestly there is no other medical reason for having a planned one except rare instances of placenta praevia.

Just out of interest, my medical reason for having a c/s is NOT placenta Praevia, and yes, I have sought several opinions on this matter and they have all said the same thing. C/s or extremely high risk delivery.For me it's just not worth the risk.
l.b.

[dlworth1]

quote;Quote:
Originally Posted by dlworth1
But as Kelly points out, the WHO rate is inclusive of emergencies..honestly there is no other medical reason for having a planned one except rare instances of placenta praevia.

Just out of interest, my medical reason for having a c/s is NOT placenta Praevia, and yes, I have sought several opinions on this matter and they have all said the same thing. C/s or extremely high risk delivery.For me it's just not worth the risk.
l.b.


Sorry hadnt meant to imply there was only ONE reason, i left off the "etc", my point is that they are for the most part rare and exceptional reasons... : )

[ShootingStar]

Kellxx, I don't know about anyone else, but your words have kind of offended me. Maybe you could think about re-wording you first post?

As for there being nothing wrong with caesareans....well as long as they're necessary! Which obviously some are, they do save lives. But you are aware that a caesarean is major surgery? That is not without risks?

Um.. im an unsure how my post offended you?? Saying that as long as mum and baby are ok at the end of the day is offending? i dont get it. I have reread my post and i dont think i needed to reword it, because its how i feel. If i did offended you, i would think you would do the right thing and pm me regarding this.

And yes i know it is major surgery, but the thing is vaginal birth is pushed to be this most beautiful pleasant easy experience when it always isnt the case. c/s are put to shame because they are major surgery, you may have a longer recovery period and the baby may need assistance once born.. but what i was trying to put across in my post is, what is most important is that mother and baby are ok and are both alive to see the next day. As i also said, in my case, my first vaginal birth was a nightmare. It put my son's life at risk. Thankful he was born before quite fast otherwise i would have had a c/s and would have totally agreed to it. As for recover, i could not walk for 3 months afterwards, nor stand for longer than 10 minutes at a time. I could not DTD without being in pain to the point my eyes watered until my DD was born. So not every vaginal birth is wonderful. I just dont see the whole negative aspect of c/s that the article is trying to portray, when the majority of the time they are there for a reason.. to save lives.

???
I have never heard of a mother, IRL, or on this forum, or any other, try a vaginal birth if they have been told it is too risky for mum or bub.

I dont know anyone who would do this to their child???

And even if some do, I doubt the numbers would be very high at all, enough to sway the c'section rates anyway....

A good friend of mine lost their child because they refused to have a c/s when they were advised it was the best option for mother and baby.. but she had her mind set on a vaginal birth. I also know of another 2 people who i dont know personally, but have lost their babies due to the same reason. It does happen, and i think these OBs give advice that a c/s is neccesary because they are trained in that area and know what they are talking about.

[Bathsheba]

QUOTE: Saying that as long as mum and baby are ok at the end of the day is offending?

I would say it could be quite upsetting... birth trauma is a very real situation and by telling a mother that she shouldn't be traumatised (by either a c/section or vaginal birth) because her baby is safe is very dismissive and will make the trauma worse. But that is off topic. If women feel fully informed then trauma is less likely to occur. A policy allowing women to be informed could reduce birth trauma.

ETA: and I would suspect that if there were less women with birth trauma there would be less women with PND. This is why being dismissive of "how a woman gives birth" can be upsetting.

[ShootingStar]

QUOTE: Saying that as long as mum and baby are ok at the end of the day is offending?

I would say it could be quite upsetting... birth trauma is a very real situation and by telling a mother that she shouldn't be traumatised (by either a c/section or vaginal birth) because her baby is safe is very dismissive and will make the trauma worse. But that is off topic. If women feel fully informed then trauma is less likely to occur. A policy allowing women to be informed could reduce birth trauma.

ok so you would prefer me saying the opposite?
ETA.. im sorry, but i dont see where i said a mother shouldnt be traumatised, nor that giving birth is easy.. If you would read what i said about my birth with my son, youll see it wasnt easy sailing for me either.

[Pretty Butterfly]

A good friend of mine lost their child because they refused to have a c/s when they were advised it was the best option for mother and baby.. but she had her mind set on a vaginal birth. .

I find it extremely sad that anyone would put a vaginal birth over the true safety of their baby.....

Actually, I find it a little disturbing.....



ETA... By true safety I mean, REAL stats, not just a Ob saying so... My ob said a c/section would be safer if Little Girl stayed breach, and that is JUST NOT TRUE....

[ShootingStar]

I find it extremely sad that anyone would put a vaginal birth over the true safety of their baby.....

Actually, I find it a little disturbing.....

As do i.. that is what i was trying to say.

[BellyBelly]

This is not about who should have what and what is the best way to give birth... can we please stay on topic? This is about if the rates should be published for consumers to see... some may not want to but many also make their healthcare choices based on things like this.