May 2014 Moms

Just found out my hospital has a 47.5% C-section rate and only a 3.6% success rates for VBACs

IBackBevoIBackBevo member
edited January 2014 in May 2014 Moms
My OB delivers at the Women's Hospital of Texas which basically handles about 10,000 or so births a year. I just read where their c-section rate was about 47.5%. I am wanting to go for a VBAC and I feel like this is a bit of a warning sign that they aren't going to be supportive.  I also think that because of my experience having DS1 there.  This rate is probably slightly increased because I know alot of high risk patients are sent there, but that still seems high.  To me, a rate this high seems like it is more of an indication that the hospital is being overly cautious or is c-section happy. Any thoughts?  Does this rate seem high to you?

As an aside, I very much felt this way with DS1 who I had at that hospital.  When he started having heart rate decels, the L&D nurse made the call that I could not be induced and I never even got the chance to try labor.  I asked for an ultrasound and she said it would not tell us anything...which I find strange because when I had been in that hospital on ante partum, DS has had heart rate decels and they did an ultrasound and determined everything was fine.  I feel like the nurse just didn't want to mess with me. 

I also didn't really care for my post-partum care.  The only time I felt like I got excellent care was when I was in ante-partum with pre-e.  I also have heard that a lot of the really good nurses who used to work at Texas Women's have gone to Texas Children's Women's Pavilion because they pay more.     

Would this make you want to look for a new OB who delivers somewhere else?  I really would like to stay with my current OB, but I have to admit that I am not looking forward to using this hospital again.  My overall experience there with DS1 was mediocre at best.     

Edit: I also just found out that they require 1 hour of monitoring of the baby after birth in the nursery.  WTF?!?!!!  And if my experience with DS is any indication, that 1 hour may turn into a lot more.  \

EDIT2: I just found the vbac rate - an abysmal 3.6%!  Ben Taub, another hospital in the area, has a vbac rate of 25.58%!  LBJ, which is a hospital my DH has worked at before, has the best rate at almost 30%. (I would not deliver there, though, because I think it may be military...) The 3.6% is well below what the state average is...well below.
IF DX: DOR & Fragile X pre-mutation carrier
2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
BFP from supps ~ DS#2 due May 2014

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Re: Just found out my hospital has a 47.5% C-section rate and only a 3.6% success rates for VBACs

  • Is it known for a great NICU or great with high risk pregnancies? If so, they may get a lot of high risk moms and babies who need c-sections more frequently.

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  • Whoa, that seems extremely high. 

    Mine has a 10% c-section rate. I chose this place because it had a lower rate than every other hospital in the area (it is a birthing center in a hospital). They also have fairly high successful VBAC rates (near 80%), and I would definitely ask about that at yours since you're aiming for one. I would personally look somewhere else, but there's a lot of factors at play that you know best. 


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  • that is super high.  But I agree I'd look into the HR dept and NICU cause that could explain at least a good potion of that stat.  But yikes...holy high.
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  • That rate seems alarmingly high to me.  That's almost half!  Do you know the rate of your actual OB?  

    Are you considered high risk for any reason?  I think I've read in recent posts that you're not fully committed to the VBAC...did this new information push you one way or the other.  

    I don't think it could hurt to at least explore other options.  Your local ICAN chapter can direct you to the doctors/hospitals in your area with the best VBAC rates.  Good luck, it's a lot to deal with but you still have plenty of time if you do decide to make a change!
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  • That is high. My hospital had a 40% rate and I wish I'd known sooner.  This time around (#2), I am going with a midwife at a hospital that promotes natural birth.

    So to answer your question, yes, I would look elsewhere.
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  • Is it known for a great NICU or great with high risk pregnancies? If so, they may get a lot of high risk moms and babies who need c-sections more frequently.
    I mean, Houston is the 4th largest city in the US and has the largest medical center in the world so people come here from all over...and Texas Women's is the largest hospital for births in Houston so they definitely get a lot of high risk patients.  However, this still seems really high to me.  It is almost half of their births!  I doubt that half of their 10,000 a year births are high risk.  And there are many other hospitals in the area that have excellent NICUs and would be where high risk patients would go, too, so it isn't like they are getting all of the high risk patients.  In fact, I would say that Texas Childrens is probably even better known for their NICU.   
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • Empireceo said:
    That rate seems alarmingly high to me.  That's almost half!  Do you know the rate of your actual OB?  

    Are you considered high risk for any reason?  I think I've read in recent posts that you're not fully committed to the VBAC...did this new information push you one way or the other.  

    I don't think it could hurt to at least explore other options.  Your local ICAN chapter can direct you to the doctors/hospitals in your area with the best VBAC rates.  Good luck, it's a lot to deal with but you still have plenty of time if you do decide to make a change!
    I don't know my OB's rate, but I plan to ask at my next appointment.

    I am not currently high risk (not even seeing an MFM), but was with DS due to pre-e.  My BP is staying down with this pregnancy and I have no other signs of pre-e so I have no reason at this point to think I will be.

    I am about 90 percent committed to a vbac. I am still a little up in the air on whether to vbac or have a rcs just due to the convenience of a planned rcs, but if I do try for a vbac (and hire a doula, etc.) then I want the best shot possible at it. 

    The main advantage for a RCS for me is that I can more likely guarantee that my DH will have time off around the birth if I go the RCS route.  He is a physician and has to plan his time off months in advance. Since I had DS early, he was back to work the first day I was home from the hospital.  Recovering from bedrest, pre-e and a c-section while trying to pump and with a 4.75 pound baby who wouldn't latch and had to be fed every 2 hours due to weight issues was horrible.  And this time I will also have a 20 month old.  But that is the only real advantage for having a RCS and still not guaranteed if I have to deliver before 39 weeks.    
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • IBackBevo said:
     This rate is probably slightly increased because I know alot of high risk patients are sent there
    This is what I thought after i read your first sentence.  I looked it up and our Women & Newborn Hospital has 42.2 percent rate significantly higher then any other area hospitals but I will speculate it's for the same reason.

    That being said when in L&D with Beb she was having a little trouble working her way out my narrow hips.  Which worried the L&D nurse who used the term Cesarian over and over.  Since I was induced by my OB she was well aware of my wishes to deliver vaginally and told the nurse to cool her jets, she would keep monitoring the progress and we would only do a c/s if it was absolutely necessary.  I am super thankful to her for that, if it had gone another way I would probably be OB shopping.  GL!

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  • Continuous monitoring and 24 hour limit after rupture of membranes is standard practice for most hospitals, although some are more relaxed about deviations from that then others. I wouldn't take that as an indication that they're not VBAC friendly. I would see if you could find the VBAC success rate. It also may be that some of the OBs that deliver at that hospital allow for elective CS, which could up the rate. Can you find the RCS rate? Do you know your OB's section rate?
  • edited January 2014
    Well can you find out what their VBAC rate is? Typically that type of hospital has higher than average csection rates because like you said, they get a lot of high risk cases from the entire state. But 47.5% does seem very high. I'm delivering at Brigham and Women's hospital in Boston. Similarly to yours it has a great NICU, handles 8000 births a year and deals with high risk cases from all over New England. Their csection rate, however, is 25.9% not the highest in the state, but close. I actually expected it to be higher. They also have a VBAC rate of 16.3% which is the 3rd highest in the state. So even though they do a lot of csections they also do a lot of VBACs
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  • Huh. I never thought to look this up. My hospital had a 30% c-section rate in 2011 (the year DS was born) and 6% VBAC rate. I'm surprised the C-section rate isn't higher, to be honest, especially since they have such a well-known NICU.


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  • I don't know about Women's Hospital of Texas, but my sister did her OB clinicals at Texas Children's Women's and loved it. I'll ask her what her thoughts are about the two.
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  • Holy moly that seems crazy!  I would totally switch.  From what you wrote, it seems like the only reason you'd be staying there is b/c that's where your OB delivers.  I'm sure you know that you will only actually see your OB for a fraction of the time that you're in the hospital.  Doesn't seem worth it to me.  I'm sure if you look/ask around you can find another Dr you like at another hospital.  Although if you do end up staying there, I'd highly recommend getting a doula who and help  you fight the good fight with the nurses and hospital policies. 

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  • mmks said:
    Holy moly that seems crazy!  I would totally switch.  From what you wrote, it seems like the only reason you'd be staying there is b/c that's where your OB delivers.  I'm sure you know that you will only actually see your OB for a fraction of the time that you're in the hospital.  Doesn't seem worth it to me.  I'm sure if you look/ask around you can find another Dr you like at another hospital.  Although if you do end up staying there, I'd highly recommend getting a doula who and help  you fight the good fight with the nurses and hospital policies. 
    I am definitely planning to get a doula this time.

    And you are correct.  If it were not for my OB, I would not be staying at this hospital.  The main reason I want to stay with my OB, though, is that she is pretty good about letting me have my way.  She is really, really nice and she knows I do my research and have a good gut instinct on things. Every problem I had in my first pregnancy was the result of someone else (the on call doctor at the hospital, another doctor in the practice, a stupid nurse in L&D, etc.).  And she truly listened to me.   Also, if I do end up with a RCS, she is an excellent surgeon...I know this because she did my first.   I am very hesitant to switch because just in terms of the doctor, I doubt I will find a better one.  I just wish every other person in her practice and at this hospital was to her level. 
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • OMG!  I just found the vbac rate - an abysmal 3.6%!

    Ben Taub, another hospital in the area, has a rate of 25.58%! 
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • IBackBevo said:
    OMG!  I just found the vbac rate - an abysmal 3.6%!

    Ben Taub, another hospital in the area, has a rate of 25.58%! 
    Oh man, that's crazy low, for both actually.  
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  • The information you've discovered would make me want to change my provider and hospital, yes. 
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  • Empireceo said:
    IBackBevo said:
    OMG!  I just found the vbac rate - an abysmal 3.6%!

    Ben Taub, another hospital in the area, has a rate of 25.58%! 
    Oh man, that's crazy low, for both actually.  
    The highest in the entire city was only about 30% and it was at a hospital I would not go to. Ben Taub had the second highest in the City of Houston as of the year of reporting. I don't have stats on Texas Childrens because it so new.
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • If you want a VBAC get the eff away from that hospital !
  • IBackBevo said:
    OMG!  I just found the vbac rate - an abysmal 3.6%!

    Ben Taub, another hospital in the area, has a rate of 25.58%! 

    That's bad. I would discuss it with your Ob at your next appointment. Tell her what the csection vs VBAC rates are at the hospital and explain you're concerned your chances of a successful VBAC are not good there. Maybe she has some insight as to why the rates are what they are. Ask if she can recommend someone at Ben Taub. Also you don't have to switch right away if you like where you are now, with DD I switched Ob in my third trimester.
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  • That's so high.Mine has 20% I thought that was high!Id go elsewhere
  • Ok, so just spoke to my sister and she had one she highly recommended and two she said to avoid. I'll PM you their names :)
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  • Ok, so just spoke to my sister and she had one she highly recommended and two she said to avoid. I'll PM you their names :)
    Thanks so much!
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • Just to make you feel better, look up hospitals in NJ. There isn't a hospital anywhere near me with less than 40-something%. If there are better options, I'd definitely investigate switching to another. (They're all just as awful by me)
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  • Just to make you feel better, look up hospitals in NJ. There isn't a hospital anywhere near me with less than 40-something%. If there are better options, I'd definitely investigate switching to another. (They're all just as awful by me)
    Oh, there are waaayyy better options.  On my local ICAN page, they are saying Ben Taub or Texas Childrens are the most vbac friendly.

    The only problem is that I will have to switch OBs.  So I basically have to choose between the hospital I want to be at and the OB I like. My plan as of right now is to interview a couple of vbac friendly OBs and then decide what I want to do.
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • IBackBevo said:



    Just to make you feel better, look up hospitals in NJ. There isn't a hospital anywhere near me with less than 40-something%. If there are better options, I'd definitely investigate switching to another. (They're all just as awful by me)

    Oh, there are waaayyy better options.  On my local ICAN page, they are saying Ben Taub or Texas Childrens are the most vbac friendly.

    The only problem is that I will have to switch OBs.  So I basically have to choose between the hospital I want to be at and the OB I like. My plan as of right now is to interview a couple of vbac friendly OBs and then decide what I want to do.


    My question is this ... Who has more say over what happens? Your doctor or the hospital? I feel like if I trust that my doctor will help me avoid a c-section, the hospital rate doesn't matter as much. Or is that insanely naive
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  • Just to make you feel better, look up hospitals in NJ. There isn't a hospital anywhere near me with less than 40-something%. If there are better options, I'd definitely investigate switching to another. (They're all just as awful by me)
    Oh, there are waaayyy better options.  On my local ICAN page, they are saying Ben Taub or Texas Childrens are the most vbac friendly.

    The only problem is that I will have to switch OBs.  So I basically have to choose between the hospital I want to be at and the OB I like. My plan as of right now is to interview a couple of vbac friendly OBs and then decide what I want to do.
    My question is this ... Who has more say over what happens? Your doctor or the hospital? I feel like if I trust that my doctor will help me avoid a c-section, the hospital rate doesn't matter as much. Or is that insanely naive
    This is just the he way it works in my practice, i don't know about others.  But, your OB may not deliver your baby.  if you go into labor while another doctor from your OB's office is on call they will make those decisions. 

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  • danabsd said:
    Just to make you feel better, look up hospitals in NJ. There isn't a hospital anywhere near me with less than 40-something%. If there are better options, I'd definitely investigate switching to another. (They're all just as awful by me)
    Oh, there are waaayyy better options.  On my local ICAN page, they are saying Ben Taub or Texas Childrens are the most vbac friendly.

    The only problem is that I will have to switch OBs.  So I basically have to choose between the hospital I want to be at and the OB I like. My plan as of right now is to interview a couple of vbac friendly OBs and then decide what I want to do.
    My question is this ... Who has more say over what happens? Your doctor or the hospital? I feel like if I trust that my doctor will help me avoid a c-section, the hospital rate doesn't matter as much. Or is that insanely naive
    This is just the he way it works in my practice, i don't know about others.  But, your OB may not deliver your baby.  if you go into labor while another doctor from your OB's office is on call they will make those decisions. 
    What basically happened to me last time was that a nurse and the on call doctor (who was a jerk and not even from my practice) made the call on my c-section.

    So, yeah, I think the hospital matters.

    Everyone I am talking to on my local ICAN board is basically telling me to RUN away from Texas Women's Hospital.  They are saying Texas Children's for VBA1C or VBAC2C and Ben Taub for VBAC3C or VBAC with multiples.  Apparently, Ben Taub will pretty much let anyone VBAC (probably why they have the highest rate in the state for last year), but you don't labor in private rooms and it generally is not as nice of a hospital.
    IF DX: DOR & Fragile X pre-mutation carrier
    2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
    BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
    Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
    BFP from supps ~ DS#2 due May 2014

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  • Hrm, I just looked up the CS rate for my hospital and its much more reasonable (20%). But, of course, the OB practice I need to be at to deliver at Methodist Willowbrook isn't exactly ideal. I love love love my OB but the practice itself isn't anything to write home about.

    I'd look into who you'd need to switch to to change hospitals, but I wouldn't immediately ditch your OB if you're happy with her until/unless you find a better one.
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  • I didn't read through all the responses but here's my 2 cents. The biggest, most advances hospital in our area (out of 5 hospitals) takes on the most high risk & has the best NICU as well. C/S rate is less than 20% with a >90% VBAC success rate. I would run as far & as fast as I could from your OB & hospital. And it's absolutely ridiculous they require monitoring during the golden hour. The above mentioned hospital, where I delivered, is very evidence-based & does not separate mom & baby at all unless there's medical need. And everyone rooms in & you must request baby to go to the nursery.

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