Belly Up

* bellies * birth * babies * breastfeeding *


Tuesday, February 1, 2011

Any Menie Moe? Choosing Your Hospital

Most of us wouldn't buy a car, or even a large appliance, without at least a passing glance at a Consumer Reports or the regulated sticker affixed to a product listing things like gas mileage, general features or energy efficiency. However many couples don't even do this much research when choosing where they will deliver their child.  I tend to believe that this is not because they don't care, but rather that this info is not as readily available since hospitals don't have a sticker stating their c-section rates or policies on the door at the entrance to L&D.  Nor do the hospital childbirth classes generally cover this material.

Where you choose to birth will make the most impact on what kind of birth you can expect.  The reality is that most couples, for a variety of reasons, will give birth in a hospital. Luckily there are good hospitals...but there are also plenty of less than great hospitals out there too who will be happy to bill your insurance and provide a place for your baby's arrival.  Luckily, while it is true that figuring out which hospital is a good fit for your choices is not as easy as reading a sticker, it's not rocket science either.

First of all it is easy to access the primary c-section rates of hospitals, at least here in Texas.  A quick google search will tell you that in the DFW area the rates for primary c-sections (meaning low risk, 1st time moms carrying head down singletons) run from 14% to 35%  depending on the hospital  If a hospital has a primary c-section rate of 40% you can safely assume its total c-section rate (which adds in repeat c-sections, twins, breeches and higher risk moms) is closer to 70%.  Unless you know some reason why only 30% of the women that birth at that particular hospital are capable of vaginal birth (recent epidemic of rickets maybe???), then that a huge red flag.  The vast majority of women that walk into that hospital to deliver, are rolled out with a scar on their uterus due to major abdominal surgery...though if you are having a c-section this is where to go!

After finding a hospital that is not likely to perform surgery simply for convenience, profit or perhaps just due to routine procedures that just happen to steer women toward surgical birth, you can further narrow your search.  I don't want to assume all my readers will want the same thing, however, a good rule of thumb is that if a hospital supports natural birth, VBACs and commonly works with doulas, then they are usually more open to working with moms whatever their choices.  Hospitals with rigid rules and routine procedures that everyone gets, needed or not, are more bureaucratic and less flexible....sort of like giving birth at the DMV! (my apologies to anyone working at a governmental agency, but really they are not usually very user friendly)

The next step is to talk.  Join a local pregnancy group, call a doula, call a friend, call a nurse who works at any given hospital.  You will get the goods this way much more reliably than most any other means.  This goes without saying, take the tour.  Better yet, take the tour and ask obscure questions.  Ask if they have a squat bar or a birthing tub, even if you have no desire to ever use either one.  The answers, and sometimes just the look on the guide's face, to the more off beat questions will sometimes tell you more than finding out if each room is equipped with an I-Pod dock (though that can also be a helpful bit of info!).

More in the next post....

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