@halfthetree The high C-section rates are concerning. My local hospital is very nice, not a teaching hospital, and we still are above 40%. My metro area hospitals combined sit at 37%.
Curious, what is considered a "good" c/s rate, I guess what constitutes to be above necessary? My hospital is 32.1%.
Me: 26 DH: 27 Married 6-15-13 DS born 4-9-15 Septate Uterus BFP 10/12/16--EDD 6/24/17
@JackieMarie1989 I think you have to take into account the rate of home births, the presence of a birth centre or not, and then look at elective cesarean section incidences and emergency cesarean sections. Obviously I have no official, reliable stats, but an OB who sections HALF of his patients is not the one to see if you want to avoid interventions. That's the guy to go to if you want an elective but your OB won't do it.
I think the target is under 25%, including elective and emergency. (From consumer reports, not entirely sure of the reliability of that).
@JAGinMI oh it's terrible. Absolutely no regard for each individual mother baby dyad, only on getting that baby out before 5pm! Ive attended births where they actually offered sections because they were getting crowded. I will never birth at our hospital unless there is a necessary reason to, not after the garbage I've seen.
I have been to births that were beautiful and totally empowering there, but it all depends on the nurses and attending.
@JackieMarie1989 The c section rate for the entire country here is 15%. I think its the lowest in the world of industrialized nations. Midwife led care is so great!!
I'm sure the factors that go into the rate of c-sections are complex and well beyond my understanding and I'm not claiming to be an expert, but the research I did turned up the following -
According to the World Health Organization the optimal c-section rate is 10-15%. This is based on their study of maternal, neonatal, and infant mortality associated with c-sections. According to the WHO, as the rate approaches 10% mortality is reduced and no benefit is seen beyond that. They studied the rate up to 30% because they didn't have good data higher than that. There's more to it (they looked at complications, explained how socioeconomic factors fit in) if you want to read: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/
You can try to look up numbers by state and hospital. When I googled and clicked around, I was able to find a report (albeit a 5 year old one) from our state department of health and human services that covered c-section rates among other birth data.
When we were thinking of doing a home birth, I wanted to see people's personal reasons for choosing the care provider they did.
In case someone out there is searching, here were some of my deciding factors: 1- She has experience suturing (if I tear like I did with DD I don't want a hack job down there) 2- Her transfer rate is approximately 6%. It's not unheard of but she also won't put us at risk if she feels we need interventions. 3- In addition to her doula, montrice, and MW training she is also a Level II EMT. She carries oxygen, drugs to stop hemorrhage, and some mild pain relief. 4- She has been the primary MF on about 350 births and has attended close to 600 total. This means she has seen some shit. She also helps train the new MWs at the practice. As an educator, I respect someone who is confident enough in their skills to train someone else. 5- She has attended many births in my neighborhood and been a doula at my local hospital. If something goes sideways, she already has established relationships there.
Jumping in because I only recently decided that I really want a midwife! I'm a FTM so this isn't even anything I even thought about before now. All along I thought I would just go to see the lady who has been my gyno for a few years now. I do really like her, but I really hate the hospital she's affiliated with and it only recently occurred to me that I have more options!
Why do you want to have your baby with a midwife? I want more personalized care and low intervention if possible.
Birth center or home birth? I found a practice that has both OBs and CNMs on staff and they are affiliated with a beautiful new women's hospital close to my house. I want to give birth in a hospital because I think it will ease my nerves in case anything goes wrong.
How far along are you in planning for the birth? So far I've only requested an appointment. I still have my last appointment at my RE scheduled for next week so I really haven't done much planning at this point.
Will the rest of your care (prenatal, baby checkups) be with the midwife as well? I honestly don't know. I hope for this but because I have an autoimmune disorder I might be considered high risk. GTKY: white, dark or milk chocolate? I love all chocolate! I don't discriminate
***BFP & Child Warning***
Me: 34, DH: 38 ~ TTC since 2014 IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs IVF ER (July 2016) = 7 PGS normal embryos FET #1 (Sept 2016) = BFP! DD born 5/30/17 FET #2 (April 2019) = BFN FET #3 (July 2019) = BFP! DS born 3/27/20
My choice this time is largely because of my previous experience. I sawa CPM with my last pregnancy as there are no CNM's who deliver at home in my area. Unfortunately, I was unable to keep anything down while I was in labor, and when fatigue kicked in, my labor stalled. CPM's are not permitted to administer them in my state, so I made a non emergent transfer to the hospital for an IV. Pain meds were a happy side effect. I was able to have an uncomplicated vaginal birth once the IV kicked in. -Why do you want to have your baby with a midwife? I prefer the more holistic approach, and I truly believe that she helped me to have a healthier pregnancy.
-Birth center or home birth? I was not pleased with some of my experience with a hospital birth for
DD. They would not let me use a birthing stool and instead strongly
encouraged me to stay on the bed, and someone kept telling me to "push
twice as hard as you can with every contraction!" I wish I could go back
in time and make that person leave.I would prefer a birth center, but I do not have that option.
-How far along are you in planning for the birth? I haven't, and other than asking my mom to come take care of DD, I likely wont.
-Will the rest of your care (prenatal, baby checkups) be with the midwife as well? All of my prenatal and postnatal care with be with her. She will also follow up with the baby until 12 (or is it 15?) weeks. I particularly love this because she will come to my house for these visits for about 2 weeks.
-GTKY: white, dark or milk chocolate? Dark chocolate all the way!
New MW question: I just got my insurance verification back and it says "pre determination is required for a home birth". Does anyone here know what that means?
New MW question: I just got my insurance verification back and it says "pre determination is required for a home birth". Does anyone here know what that means?
How is your billing handled? Did the MW submit? Did you ask about her typical process?
My MW uses a billing service that specializes in insurance homebrtih coverage. They work out all of the coding in such a way that my insurance covers everything (e.g. Facility fees, outpatient visits, nursing care) without ever telling them it's actually a homebirth. First rule in billing was to never call up the insurance and ask them about homebirth lol.
I think pre determination would be like a prior authorization. Mine declined me for my last birth, but evidentially if you bill them enough, they get annoyed and start to pay for things. I've been billing for almost a year, and there are only 2 infant checks left for them to cover.
Re: Midwifery births
Married 6-15-13
DS born 4-9-15
Septate Uterus
BFP 10/12/16--EDD 6/24/17
Obviously I have no official, reliable stats, but an OB who sections HALF of his patients is not the one to see if you want to avoid interventions. That's the guy to go to if you want an elective but your OB won't do it.
I think the target is under 25%, including elective and emergency. (From consumer reports, not entirely sure of the reliability of that).
Ive attended births where they actually offered sections because they were getting crowded.
I will never birth at our hospital unless there is a necessary reason to, not after the garbage I've seen.
I have been to births that were beautiful and totally empowering there, but it all depends on the nurses and attending.
<a href="http://lilypie.com/"><img src="http://lagm.lilypie.com/3Fc1.png" width="200" height="80" border="0" alt="Lilypie Angel and Memorial tickers" /></a>
In case someone out there is searching, here were some of my deciding factors:
1- She has experience suturing (if I tear like I did with DD I don't want a hack job down there)
2- Her transfer rate is approximately 6%. It's not unheard of but she also won't put us at risk if she feels we need interventions.
3- In addition to her doula, montrice, and MW training she is also a Level II EMT. She carries oxygen, drugs to stop hemorrhage, and some mild pain relief.
4- She has been the primary MF on about 350 births and has attended close to 600 total. This means she has seen some shit. She also helps train the new MWs at the practice. As an educator, I respect someone who is confident enough in their skills to train someone else.
5- She has attended many births in my neighborhood and been a doula at my local hospital. If something goes sideways, she already has established relationships there.
DS #1 born 05/25/2012
BFP#2: 06/12/2013 ---- loss
DS #2 born 4/08/2014
BPF#4: 2/1/2016 --- 2/23/2016 suspected molar pregnancy--- 3/15/2016 D&E - diagnosis MM
BFP#5 - 9/22/2016
* formally bornmommy
How long are you going to attend births for? I've gotten calls for June already!
Why do you want to have your baby with a midwife?
I want more personalized care and low intervention if possible.
Birth center or home birth?
I found a practice that has both OBs and CNMs on staff and they are affiliated with a beautiful new women's hospital close to my house. I want to give birth in a hospital because I think it will ease my nerves in case anything goes wrong.
How far along are you in planning for the birth?
So far I've only requested an appointment. I still have my last appointment at my RE scheduled for next week so I really haven't done much planning at this point.
Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
I honestly don't know. I hope for this but because I have an autoimmune disorder I might be considered high risk.
GTKY: white, dark or milk chocolate?
I love all chocolate! I don't discriminate
Me: 34, DH: 38 ~ TTC since 2014
IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
IVF ER (July 2016) = 7 PGS normal embryos
FET #1 (Sept 2016) = BFP! DD born 5/30/17
FET #2 (April 2019) = BFN
FET #3 (July 2019) = BFP! DS born 3/27/20
-Why do you want to have your baby with a midwife?
I prefer the more holistic approach, and I truly believe that she helped me to have a healthier pregnancy.
-Birth center or home birth?
I was not pleased with some of my experience with a hospital birth for DD. They would not let me use a birthing stool and instead strongly encouraged me to stay on the bed, and someone kept telling me to "push twice as hard as you can with every contraction!" I wish I could go back in time and make that person leave. I would prefer a birth center, but I do not have that option.
-How far along are you in planning for the birth?
I haven't, and other than asking my mom to come take care of DD, I likely wont.
-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
All of my prenatal and postnatal care with be with her. She will also follow up with the baby until 12 (or is it 15?) weeks. I particularly love this because she will come to my house for these visits for about 2 weeks.
-GTKY: white, dark or milk chocolate?
Dark chocolate all the way!
Does anyone here know what that means?
My MW uses a billing service that specializes in insurance homebrtih coverage. They work out all of the coding in such a way that my insurance covers everything (e.g. Facility fees, outpatient visits, nursing care) without ever telling them it's actually a homebirth. First rule in billing was to never call up the insurance and ask them about homebirth lol.