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My Birth Center Statistics


Forum: Natural Childbirth

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  #1  
November 6th, 2008, 10:06 AM
Husher's Avatar B & E complete me.
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Cesarean Deliveries: Of the women starting labor at the birth center, the Cesarean rate was 5%.

VBAC: Nine out of fourteen women were able to achieve a VBAC in 2006 for a 64% success rate.

Vacuum/Low Forceps Delivery: There were 2 vacuum assisted births for a rate of 0.1%.

Transfer Rate: The transfer rate during labor from the birth center to the hospital was 21%. The most common reason for transfer was a need for labor augmentation.

Electronic Fetal Monitoring: There is no electronic fetal monitoring at the birth center.

Pitocin for Induction or Augmentation: The percentage of birth center clients having pitocin induction was 5% and augmentation with pitocin was 23%. Pitocin is administered at the hospital only, never at the birth center.

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The one that bothers me the most is the transfer rate. What do you ladies think? This birth center is on the grounds of a hospital and services both women who want to birth at the center and at the hospital. The total Cesarean rate, including those who choose to birth at the hospital is 18%.

Feel free to share your statistics too. I'd love to see how they compare.
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  #2  
November 6th, 2008, 10:51 AM
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yeah, the transfer rate sounds kinda high. If they had said the transfers were due to wanting pain meds I would be okay with it, but transfer for labor augmentation indicates to me that it's for "failure to progress" scenarios which shouldn't be THAT common, kwim? It makes me wonder how much they do to naturally help progress labor. Maybe ask them what they do to encourage progression and at what point they decide it needs to be "augmented"

18% cesarean including hospital is pretty good considering the national average though.
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  #3  
November 6th, 2008, 10:56 AM
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I have an appointment tomorrow so I am definitely going to ask about that. All of the midwives I have met with so far seem to be extremely into the natural way of things, not just in childbirth so it confuses me as to why it would be so high. I am wondering if it could be as simple as even though augmentation is the most common reason, it may not be that much more than asking for pain meds, etc. I am definitely anxious to find out a bit more about this.
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  #4  
November 6th, 2008, 11:04 AM
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My question would definitely be some of the reasons behind the transfer rate.
Some woman do have a "change of heart" and maybe decided they wanted epidural, etc. Another possibility could be breach or transverse position not being able to change before/during labor or any unexpected medical emergency. You'll have to let us know what you find out. Other than the transfer rate I think the statistics seem rather favorable.
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  #5  
November 6th, 2008, 11:48 AM
moon~maiden's Avatar Cheryl~ birth truster
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very interesting...can't wait to hear what they say!
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  #6  
November 6th, 2008, 12:14 PM
mgm78's Avatar Zoe's mom Meredith
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My birth center will not transfer you for pain meds. They had a 20-something % hospital birth rate, but half of those were predetermined before the woman went into labor (breech or other high risk reason determined prior to due date) and the actual transfer rate was 12% i believe. They are across the street from the hospital. The national average for c-sections now is 33% i last heard. and 97% for epidural!!!!!! My birth center does not have fetal montioring (they periodically use a doppler) and they do not have vaccuum or forceps.
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  #7  
November 6th, 2008, 12:25 PM
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Quote:
My birth center will not transfer you for pain meds. They had a 20-something % hospital birth rate, but half of those were predetermined before the woman went into labor (breech or other high risk reason determined prior to due date) and the actual transfer rate was 12% i believe. They are across the street from the hospital. The national average for c-sections now is 33% i last heard. and 97% for epidural!!!!!! My birth center does not have fetal montioring (they periodically use a doppler) and they do not have vaccuum or forceps.[/b]
It sounds like you have a great one! I can't wait to get in there tomorrow and get some clarification. Either way it's my best option since there are only two within an hour from where we live. The other one DH doesn't want to go to as he feels this is the best of both worlds having the hospital nearby. The other one is pretty far from the nearest hospital I believe, but is actually about 10 minutes closer to our house.
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  #8  
November 6th, 2008, 04:48 PM
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The transfer and pitocin rates do seem a little high. It could be the mindset of even one midwife who works there though. I've heard some stories through this board of midwives who work through a hospital that are a little less dedicated to the natural birth process. I think you know what you're up against though, and are well informed, so being pushed into something shouldn't be a problem.
I think the transfer rate at my birth center is somewhere under 15%, which includes pre-labor transfers. They seem to have an excellent VBAC rate. They post pictures and stats of each baby born that year and they will put next to it if it's a water birth or VBAC. They must have at least 2 VBACs a month.
It sounds like this place is a great choice though, thier rates still aren't bad at all, and the c-section rate is great!
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  #9  
November 7th, 2008, 07:11 AM
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I'm a little concerned about that c-section rate. 18% is rather high. For a midwife who is attending low risk births in a center, I really think it should be under 10%. My homebirth midwives (though I was attended in the hospital for being a vbac), have a c-section rate of about 5%. Another midwife in the state has a vbac rate of about 8-9% and she only attends hospital births (used to attend birth center births until her center was shut down for financial reasons). There is also a perinatologist/midwifery group in my state wtih a c-section rate of under 5% which is incredible!

The vbac rate is nothing to brag about either. With proper support a vbac rate should be over 70%. My midwives attend a lot of vbacs and their rate is well into the 90s.

Overall, it sounds MUCH better than you will get at any hospital so I'm not trying to be overly critical! I'd be curious in the % of women who opt for pain relief considering that transfer rate.
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  #10  
November 7th, 2008, 07:41 AM
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Quote:
I'm a little concerned about that c-section rate. 18% is rather high. For a midwife who is attending low risk births in a center, I really think it should be under 10%. My homebirth midwives (though I was attended in the hospital for being a vbac), have a c-section rate of about 5%. Another midwife in the state has a vbac rate of about 8-9% and she only attends hospital births (used to attend birth center births until her center was shut down for financial reasons). There is also a perinatologist/midwifery group in my state wtih a c-section rate of under 5% which is incredible!

The vbac rate is nothing to brag about either. With proper support a vbac rate should be over 70%. My midwives attend a lot of vbacs and their rate is well into the 90s.

Overall, it sounds MUCH better than you will get at any hospital so I'm not trying to be overly critical! I'd be curious in the % of women who opt for pain relief considering that transfer rate.[/b]
The c-section rate is 5% for those who chose to birth in the birth center. It's 18% total for those women who also choose to birth in the hospital. The birth center has a midwifery practice that services both women who want to use the birth center for birthing and those who want to birth in the hospital or who risk out of birthing at the birth center. I hope that makes better sense.
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  #11  
November 7th, 2008, 11:34 AM
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I don't think it's a horrible c-section rate but I would expect that midwives can do better whether in a birth center or a hospital. What's going on in the hospital to lead to over twice the c-section rate? I guess my concern is that whether midwives serve women in or out of the hospital, their overall c-section rate is 18% which means that if a woman needs to be in the hospital she is MUCH more likely to need a c-section. The World Health Organization suggests that a c-section rate fall between 10-15%. The overall c-section rate exceeds this. My midwives will do either home or hospital birth (women can either choose the hospital up front or get risked out of home birth for reasons like vbac.

I think I would just ask why the women in the hospital are having so many more c-sections. They may be higher risk than the typical birth center woman but if they birth with midwives they shouldn't be *that* high in risk. Around here, women are risked out of homebirth with a vbac or suspected "big baby."

I would just ask a little more about. It may turn out to be that the hospital has a lot of policies and restrictions that inhibit natural birth (like IVs, standard pitocin augmentation, no eating/drinking in labor, staying in bed with monitors, etc). Might be worth looking into just in case!
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  #12  
November 7th, 2008, 11:51 AM
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I'm curious to see what they say about the transfer rate. That's definitely one that I would wonder about. I haven't looked at the statistics of the birth centers in our area. I'm going to do that now though. Seeing your stats makes me wonder what they are like around here. Can't wait to hear how your appointment went.
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  #13  
November 7th, 2008, 01:35 PM
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That overall c/s rate actually seems pretty good if that is for the whole hospital! The transfer rate seems a bit high to me, but it may that more women may choose to birth there and then not prepare because 'the hospital is right there if I need it'. So it may be the women asking for it as opposed to the midwives advising it. Yay for birth centers though!
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  #14  
November 8th, 2008, 04:18 AM
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I asked the midwife about the transfer rate and the c-section rate yesterday. She said that although the most common reason for transfer was a need for augmentation this is not really more common than the other reasons they transfer for and is certainly not all 21% of the women. She said if there is meconium they are required to transfer and some women do end up requesting to be transferred if they themselves feel like they want a little extra help getting things going. She said they encourage natural labor for as long as possible with different positions and other natural methods for as long as the mother can handle it and as long as there is no danger to either the mother or the baby. She said there is no set number of hours or anything like that before they decide to transfer and they take each mother's situation into account separately. As far as the c-section rate among the women cared for by the midwives she told me that many women come to them looking for VBAC's but either decide on their own later in pregnancy that they would prefer the c-section or that they already know coming into a pregnancy that they will be having a section but like having midwives for their care instead of OB's because of the personal care they receive.

I think both of these answer my questions satisfactorily but now we just have to wait and see if the hospital is even going to keep the birth center open. Ugh!
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  #15  
November 8th, 2008, 09:32 AM
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I'm glad that you were able to get some answers as to the transfer and c-section rates. They definitely sound like good responses to me. Did you ask about the possibility that they may be shutting the birth center down?
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  #16  
November 9th, 2008, 06:56 AM
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It sounds like your place is good to me Hope you enjoy!
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  #17  
November 9th, 2008, 05:30 PM
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That's still a little weird that the most common reason for transfer is augmentation. Overwhelmingly with midwives and birth centers, the biggest reason is pain management.

The c-section rate explanation sounds good though.
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