Current research in maternal healthcare clearly indicates that the hospital you deliver in may be the largest risk factor in your birth. With national cesarean rates soaring and maternal mortality higher than in any developed country in the world, it’s never been more important to walk into your birth educated and informed.
For most pregnant women, deciding on a hospital is secondary to choosing their preferred provider. Most obstetricians and midwives only practice at one local hospital. Once an expectant mother is in their care, the decision of where to deliver in is made for them.
But when it comes to US maternal care, it pays to be skeptic. The US does not currently have a universal standard of maternity care. This means that if you plan to avoid a cesarean delivery, it is critically important to evaluate your hospital to determine whether giving birth there will increase your risk of having major surgery.
Understanding the Numbers Game
Only about half of the hospitals that deliver babies in the United States publicly report their data. And of those hospitals, more than half have C-Section rates above the acceptable range. And what is an acceptable range? The US Department of Health and Human Services have set a national target rate of 23.9% for low risk, first-time mothers. The World Health Organization (WHO) raised the bar even higher by stating that cesarean rates over 10% have no effect on maternal or fetal outcomes.
In 2016, Consumer Reports analyzed data from over 1,300 hospitals and uncovered some startling statistics.
The percentage of C-Section rates among large hospitals ranged from 51% on the high end to 7% on the low end. This is concrete evidence that some women are having major surgery unnecessarily.
How Can I Evaluate My Hospital?
If your hospital publishes their C-Section rates, it’s as simple as asking your provider, “What is the cesarean rate at my hospital?”. It’s important to note that even though your provider’s personal rate may be low, he or she may not be the one managing your labor when you are admitted to the hospital. Asking for their personal rate and the hospital rate will give you more clarity when making your final decision.
If your hospital does not publish their C-Section rates, there are still ways of accessing information. Local doulas are a fantastic resource because they attend many births but have no conflict of interest. Reach out to these women in your community. They are often more than happy to share their experiences and perspective and can be a valuable resource for you.
Nothing Changes until Something Changes
Over the past 80 years, Americans trust in the medical profession has plummeted from 75% to less than 34%. When trust begins to wane, people begin to ask questions and evaluate long-held positions and thoughts. Recent trends have shown that now is the time to question the medical establishment and demand more transparency.
The best way to help affect change in your area is to choose a hospital that values women by actively implementing policies that are evidenced based and patient centric. Birth is a business, and you can make a bold statement by choosing to birth at a facility that cares just as much as you do about the outcome of your birth.
It is your responsibility to educate yourself about the risks associated with your birth. You owe it not only to yourself and your baby, but to your future daughter, your sisters and your friends. Change won’t happen overnight, but until something changes, nothing changes.
