how important is c-section rate at hospital?

[steph410]

this is how my OB is. so maybe the rates of the hospital are pretty important in my case. i just hired a doula, so i'm hoping that will help things too.

Originally Posted by Janine But if you have an OB who is the type that comes in just to catch the baby at the end, then the hospital staff and policies are going to be the dominant influence.

[Bethan_77]

Oh, and if your ob won't answer the rate question, it's time to find a new OB. He or she should know his personal rate and that of the practice. You should know the main reasons for the surgeries, and the rates of primary csection vs secondary. If he gives you an answer like, "I only do sections when I have to" or I only give occasional episiotomies, and only when the woman needs one" without numbers, run. I just an account of a woman whose OB smiled and said, "I don't want to do a csection on you, because then I wouldn't be delivering your second child.". Yeah, she got cut.

[songbird516]

I had a friend call my ob's office and ask for me! Turns out it was pretty low at 17%. If you have fast labors I wouldn't worry about the hospital rate too much- I would be more concerned with their policies about after baby is born.

[luvsviola]

IMO, it is the wishes and intentions of the doctor, not the hospital. Your doc is the one that makes the decision, so if you have a doc you trust, you are good to go.

[kej]

[QUOTE=steph410;11269217]this is how my OB is. so maybe the rates of the hospital are pretty important in my case. i just hired a doula, so i'm hoping that will help things too.[/QUOT

A doula can make a big difference. Mine helped me successfully through a VBAC. Use her knowledge to help you make informed decisions. Don't be afraid to ask the doc to leave the room while you discuss things with your doula, to ensure you aren't pressured into things. It is your birth and your body.

[Mama'sPocket]

I don't think the hospital rate is as critical as the person that delivers you. IF you have had two children naturally at the hospital, then you are probably fine to deliver there again. Choose where you are comfortable

[rohirette]

I see so many people saying that it is the doctor and not the hospital. Let me try to address why I feel hospital policies can shunt you towards surgery as quickly as your doc's.

1) Nothing by mouth- depending on your individual makeup, you may get exhausted after a long labor. Could make the difference in having energy to continue, or not.

2) continuous fetal monitoring. Can make getting an epidural absolutely necessary, if the positions you should be in to cope with pain in labor are anything other than in the bed, laying/semireclined. In turn, pushing can be less effective. Can absolutely lead to a section

3) Nurses- are they literally holding you in bed when you want to stand/walk? Are they aggressively offering pain relief when you've indicated that you want to go without it? Are they generally negative? Those who have not had these experiences are fortunate, but one nice story doesn't change that you may deal with a nurse, or two shifts of nurses, who may not be interested in helping you go outside of hospital policy for 12 -24 hours.

4) Laborist model- a number of hospitals have docs in shifts, and whoever is around when you are crowning delivers you. "Your" doc may very likely not even be on the premises and therefore can't enforce their policies.

ETA #s 1 & 2 can be countermanded by an OB, but if they aren't there at the start/during the middle of your labor, they won't be.

[cwieberdink]

Originally Posted by luvsviola IMO, it is the wishes and intentions of the doctor, not the hospital. Your doc is the one that makes the decision, so if you have a doc you trust, you are good to go.

Only if the mom lets the doc make the decision. The decision really belongs to the birthing mom.

[FinnegansMom]

Originally Posted by rohirette I see so many people saying that it is the doctor and not the hospital. Let me try to address why I feel hospital policies can shunt you towards surgery as quickly as your doc's. 1) Nothing by mouth- depending on your individual makeup, you may get exhausted after a long labor. Could make the difference in having energy to continue, or not. 2) continuous fetal monitoring. Can make getting an epidural absolutely necessary, if the positions you should be in to cope with pain in labor are anything other than in the bed, laying/semireclined. In turn, pushing can be less effective. Can absolutely lead to a section 3) Nurses- are they literally holding you in bed when you want to stand/walk? Are they aggressively offering pain relief when you've indicated that you want to go without it? Are they generally negative? Those who have not had these experiences are fortunate, but one nice story doesn't change that you may deal with a nurse, or two shifts of nurses, who may not be interested in helping you go outside of hospital policy for 12 -24 hours. 4) Laborist model- a number of hospitals have docs in shifts, and whoever is around when you are crowning delivers you. "Your" doc may very likely not even be on the premises and therefore can't enforce their policies. ETA #s 1 & 2 can be countermanded by an OB, but if they aren't there at the start/during the middle of your labor, they won't be.

I totally agree with this. it's for sure a mix of both.
I have a midwife that has a really low c section rate of 8%, in the hospital with the lowest c section rate in the state of 17%. it was really important to me so we are driving a bit to and from each appt even though there are several hospitals in the next town. Having a doula can help you with decision making, but won't be able to change hospital policies...

[Lisa_delo]

Originally Posted by rohirette I see so many people saying that it is the doctor and not the hospital. Let me try to address why I feel hospital policies can shunt you towards surgery as quickly as your doc's. 1) Nothing by mouth- depending on your individual makeup, you may get exhausted after a long labor. Could make the difference in having energy to continue, or not. 2) continuous fetal monitoring. Can make getting an epidural absolutely necessary, if the positions you should be in to cope with pain in labor are anything other than in the bed, laying/semireclined. In turn, pushing can be less effective. Can absolutely lead to a section 3) Nurses- are they literally holding you in bed when you want to stand/walk? Are they aggressively offering pain relief when you've indicated that you want to go without it? Are they generally negative? Those who have not had these experiences are fortunate, but one nice story doesn't change that you may deal with a nurse, or two shifts of nurses, who may not be interested in helping you go outside of hospital policy for 12 -24 hours. 4) Laborist model- a number of hospitals have docs in shifts, and whoever is around when you are crowning delivers you. "Your" doc may very likely not even be on the premises and therefore can't enforce their policies. ETA #s 1 & 2 can be countermanded by an OB, but if they aren't there at the start/during the middle of your labor, they won't be.

I completely agree with the above!!

Here are some questions my Doula sent me to ask my OB -(some won't apply to you, but others may)

1. What is the best way for me to avoid a repeat cesarean?
2. For my first two births, I was moving around all the time. Is that going to be possible this time?
3. What kind of time lines effect me? How long will I have to labor before you start talking cesarean?
4. How successful are your VBAC clients? What is your cesarean rate?
5. I tend to go into labor early, how does that change how often you want to monitor?
6. What kind of requirements will the hospital ask of you because I'm VBAC.

Basically, I want you to have a dialogue with him about natural birth, VBAC, and how it applies to you. This is your birth and your body. It is totally appropriate for you to want to know how he expects to effect it.

If you can print out your birth plan from the first time around and ask him what you would need to adjust for this birth at this hospital. But, I would have the conversation first.

I met him on Friday and asked him all those questions, he was fine with me and seemed to like the fact that I had come prepared lol

He has an OK c-section rate ( compared to most OB's here in CA, not as low as other ones in other states). The hospital doesn't have the best at all. Which does worry me. Which is the other reason I have a Doula. I amy still change providers before I deliver I am still trying to go through all my options, the thought of another C-section scares me to death and I will do everything I can to avoid it.