Hospital Rates...wdyt? — The Bump
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Hospital Rates...wdyt?

I am debating between returning to the freestanding birth center, an hour away, where I had DS (where obviously intervention rates are incredibly low, they do not perform c-sections or medical inductions there, the transfer rate is less than 10%) or the local hospital (which is just 10 minutes away). I did take the hospital tour a few weeks ago and wasn't totally impressed by the well, hospital setting, but they do seem to support "natural" birth and the nurse told me all 3 of her patients that morning had delivered naturally- but of course that term changes based on who is using it. There are pros to the hospital of course, like distance, convenience, they seem to be cool with eating/drinking lightly, heplocks, etc... but I called the hospital rate person today to get more info that the nurse didn't know,on my midwife's recommendations (who is awesome and says I need to be where I feel most comfortable. As of right now, I'm thinking that's the birth center)

My hospitals rates:

C-section rate: 25% (lower than national average, but still higher than recommended)

Vbacs: Yes, they are allowed (yay!), 4% of previous c-section moms did a trial of labor. 11/18 women delivered vaginally after a previous c-section. She did not seem to think the rates were increasing, but rather staying the same, since the new ACOG guidelines came out. But maybe it's just too soon. Success rate is 61%.

Episiotomy: 6% rate

3rd-4th degree tearing/episiotomy: less than 1%

Now for the biggie- induction rate: 40%! (this does NOT include labors that are augmented or "sped" up. This is strictly inductions.)

The woman I spoke to said they are trying to keep inductions low and that they do follow the ACOG guidlines with regards to inducing but I don't see how they could and still have that high of a rate. Or am I nuts? And she said a week over your due date is when they will induce, not 42 weeks.

I still need to talk to my doctor and like my MW says, I don't need to decide today but this just makes me feel uneasy about delivering there. And I don't think a doula is a possiblity, I have to double check, but my MW said as of 7 or 8 months ago, they do NOT allow doulas at this hospital- another red flag? Any thoughts or opinions are appreciated :)

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Loss #1 2008, Loss #2 2010, Loss #3 2011, Loss #4 2012, Loss #5 2012
Loss #6 2014 Loss #7 (chemical) 2014

~DS Born! 2009~
~DD Born! 2013~
~DD due! 2015~





Re: Hospital Rates...wdyt?

  • Are you going for a vbac?

    Is this hospital or the birth center your only options? I would just hate for you to get to 39w and your doctor who you think is on your side flip on you- which I've seen so much lately (online). I also worry about your 2nd labor going faster and the birth center being so far away. Good luck with your decision. Oh, and to me the no doulas is a red flag, but maybe your "friend" could be there if that's where you choose to deliver. I'm hoping you have an option C though.

  • It seems like the only statistic that is worrisome is the induction rate. However, that has to do with the doctor not the hospital. The doctor is the one that will schedule an induction and possibly try to pressure you into one not the hospital. If you are going to have the same MW at the hospital that you would at the birth center, which is how it sounds to me, than the induction rate doesn't really matter.
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  • imagestar173:

    Are you going for a vbac?

    Is this hospital or the birth center your only options? I would just hate for you to get to 39w and your doctor who you think is on your side flip on you- which I've seen so much lately (online). I also worry about your 2nd labor going faster and the birth center being so far away. Good luck with your decision. Oh, and to me the no doulas is a red flag, but maybe your "friend" could be there if that's where you choose to deliver. I'm hoping you have an option C though.

    Sorry, no, not going for a vbac- I had a vaginal birth with my son. I just look at the fact that they support/allow vbac as a good sign. And yes, I agree with the doctor changing her mind thing which I too read a lot on the bump. Thanks for your input.

    image
    Loss #1 2008, Loss #2 2010, Loss #3 2011, Loss #4 2012, Loss #5 2012
    Loss #6 2014 Loss #7 (chemical) 2014

    ~DS Born! 2009~
    ~DD Born! 2013~
    ~DD due! 2015~





  • imageSharon21:
    It seems like the only statistic that is worrisome is the induction rate. However, that has to do with the doctor not the hospital. The doctor is the one that will schedule an induction and possibly try to pressure you into one not the hospital. If you are going to have the same MW at the hospital that you would at the birth center, which is how it sounds to me, than the induction rate doesn't really matter.

    They are two different people at two different places. Sorry if that wasn't clear...

    image
    Loss #1 2008, Loss #2 2010, Loss #3 2011, Loss #4 2012, Loss #5 2012
    Loss #6 2014 Loss #7 (chemical) 2014

    ~DS Born! 2009~
    ~DD Born! 2013~
    ~DD due! 2015~





  • imageManderlin923:

    imageSharon21:
    It seems like the only statistic that is worrisome is the induction rate. However, that has to do with the doctor not the hospital. The doctor is the one that will schedule an induction and possibly try to pressure you into one not the hospital. If you are going to have the same MW at the hospital that you would at the birth center, which is how it sounds to me, than the induction rate doesn't really matter.

    They are two different people at two different places. Sorry if that wasn't clear...

    Well then I would be worried. I would definitely ask the OB/MW that you would see at the hospital what their induction rate is and if they would allow you to go past 41 weeks if you and baby are both healthy. The induction rate at the hospital could be inflated because of just a couple of doctors that are induction happy.

  • How can they not "allow" doulas?! I've never heard of that. Crazy!
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  • imageStacieJane:
    How can they not "allow" doulas?! I've never heard of that. Crazy!

    i remember reading someone else on this board say something similar and several people advised her to just have the doula there, but not tell the docs ahead of time who she was. they usually don't object to having your sister or best friend in the room along with your husband or partner, so it's kind of an "ask forgiveness, not permission" situation, where you just have them there and let the docs assume it's a family member/friend until it's too late.

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  • At our hospital tour the nurse said they have more women induced than not! I couldn't believe it! She said most of them were elective too... around 39 weeks women can choose to be induced. It almost made me change hospitals, but I talked to my doctor about it and she said she does not advise it, but that it is common for women to ask. WEIRD! I delivered DD #1 in another state and the doctors wouldn't even consider induction until after 42 weeks... and both are award-winning nationally recognized hospitals. Crazy...
  • imageManderlin923:

    The woman I spoke to said they are trying to keep inductions low and that they do follow the ACOG guidlines with regards to inducing but I don't see how they could and still have that high of a rate. Or am I nuts? And she said a week over your due date is when they will induce, not 42 weeks.

    Automatic induction at 41 weeks for no other medical reason is not along ACOG guidelines, and I would ask why they aren't following them.  ACOG says induction should not be performed before 39 weeks, but also says a pregnancy is not post-term until 42 weeks.

    Also, I second the "ask forgiveness, not permission" advice about the doula.  However, for me, a hospital that did not fully support having a doula would be a red flag for me.

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