did you know that the c-section rate can range from 15.9 up to 34.9 percent just within one
city this is actual published data on the rate of cesarean birth at the hospitals in metro atlanta
and only if you're familiar with the atlanta area will you realize something interesting about this
list there is something huge missing the hospital system where most of the babies that are born
in the metro atlanta area they didn't agree to participate in this survey 25 000 babies are born
at this one hospital group in one year so why are they keeping this information hidden now before i
jump in any further let me do a quick intro my name is alice i am a doula i'm a child birth
educator with over 17 years of experience helping families during pregnancy and birth and i've
attended births in nearly all the hospitals in the metro atlanta area and many of the hospitals
in the metro seattle area there is one thing that i've noticed kind of makes me crazy and
it's because there are things that hospitals seem to be hiding from their patients so in this video
we are going to tackle these three things that hospitals seem to be hiding about childbirth and
try to provide information about how you can go about finding out this information on your own
so the first on our list i already started discussing it it's the rates of important
procedures so to the top procedures that a lot of people care about when they're thinking about
the place that they're giving birth is caesarean rate and episiotomy rate so for this reason
hospitals they collect this data and i was able to make this graph of the caesarean rates in
metro atlanta because hospitals have submitted their data to a non-profit organization called
the leapfrog group now this is an amazing organization it surveys hospitals for important
information like c-section rates and episiotomy rates and they also put together a safety
report card and give hospitals grades like abcd on their website you can view the whole hospital
report card you can dive in into the individual data on each topic you can do a search by city
state zip code you can even look up a particular hospital by name
it's an excellent resource but it's kind of useless if your hospital doesn't choose
to participate so we can only speculate why hospitals aren't participating and i think
the real question here is how can we get this information if our hospital doesn't participate
so i made a few phone calls to try to get this information on this particular hospital to see
can we find can we figure it out yes could you um connect me with someone in labor and delivery
hi i am trying to track down some information do you have access to the current c-section rate
okay as you can see this wasn't super successful and i would say if i was thinking about having
birth at one of these hospitals my next step would be to talk to my provider directly and see if they
can get rates for their particular practice and if they can't even give an estimate then i personally
would probably be concerned like that's a red flag and if it's something that's important that i know
then maybe i need to look for another practice okay let's move on from these rates and let's
talk about number two who's actually going to be involved in your care now when you receive
prenatal care you have an idea about who's going to be involved right you are probably
part of a practice that might have different uh physicians might have different midwives but do
you know the whole story are there going to be residents involved in your care how about medical
students will you have a medical student that's going to be observing your birth from the corner
or is there going to be a student nurse that's going to be shadowing your nurse so if you're
getting care through a practice that is part of a major medical school then you are likely going to
have the opportunity to receive part of your care from residents here's the thing about that is that
often you aren't given this information upfront if you are going to be seen by a resident you
might see them in your prenatal appointments and you can have the opportunity to ask how
they will be interacting um what i have seen a lot of hospitals that have a major medical
school involved the resident actually does most of the interaction with you when you're in labor
this has brought up seriously this memory of this very new i think very young resident
at a birth that i was at where um he was trying to describe the risks or of breaking
breaking your water and how it increased the risks of infection and he said well the
the baby is surrounded by a big water balloon and after the water balloon breaks it's sort of like a
vacuum where your vagina can suck in bacteria and i just looked over it there was at the nurse and
we both and she gave me the hugest eye roll and we couldn't stop laughing about the um the vacuum
vagina after the water breaks so your care could look a little different from what you are wanting
or what you are imagining um i have certainly seen non-teaching hospitals where they have
student nurses come and it is an awkward situation if you are not prepared for it what this can look
like is you're in labor you are meeting your nurse and your nurse has someone else with them
who's a student nurse and your nurse says to you um i have a trainee today meet rebecca um is it
okay if she shadows and takes part of your care part in your care well you're in labor you've
got a lot going on and it's super awkward to right then say no please don't have rebecca but if you
don't want to have care from a student or have a student involved you actually do have a right to
make your preferences known so it's something to think about and i would love to share a real
experience that was actually in a comment on my video on this channel about vaginal exams so i had
a commenter share that during her birth experience she had a student that did a vaginal exam that was
actually very painful and this is not the first time that i have heard this that students they're
learning so they might be learning on you and if i have worked with families that are totally okay
with this they're in the spirit of supporting the profession and the people that are learning
and i have definitely had people who would prefer not to be the one that is being learned on the
not to be the one who um is one of the first vaginal exams done by a medical student so who
are who will be taking care of you is a little bit hidden sometimes so something for you to
ask if this is something that you want to find out ask your care provider ask about nurses residents
students and how they will interact with you and what your options are okay let's go to number
three number three is the one that's been driving me crazy since the very beginning of my doula work
and that is hospital policies so hospitals make policies about certain things around childbirth
you know other medical procedures other things that how the hospital works and these policies
they're so confusing um they are often not something that you can get access to
even in labor they are not something that is necessarily even um
said the same way from nurse to nurse or doctor to doctor
sometimes they almost feel like they're being made up sort of on the fly because they are not
um they don't seem very rigid sometimes now here's a perfect example uh eating and drinking and labor
so your hospital might have a policy about this they might have a policy that they restrict intake
to clear fluids only during or after you reach active labor which it's not evidence-based so
it bothers me that they might have that policy but it's very common to have that policy so
you in labor might save your doctor hey can i keep eating after i'm in active labor and your doctor
or your nurse might say yeah that's okay and someone else who's giving birth next door with a
different nurse and a different doctor might have a completely different answer to this question
so it's like what is the wiggle room here how solid is this policy how flexible is this policy
who wrote the policy can i get an can i get any information about it and some of these really
do impact your care like for example eating and drinking if you know that you want to
go unmedicated if that is your preference low intervention you're probably going to want to
eat and drink in labor and you're likely going to want to be at a hospital that supports that
but how do you find that out right so again good first step is to go to your provider
and say are there any hospital policies that i should be aware of if this is my goal
that's going to come into play in me trying to reach this goal or what's important to me is this
are there any hospital policies that you're aware of that will prevent me from doing that
so another policy might be if you can get in the shower with an induction um what kind of
monitoring do they have how do they do their intermittent monitoring how do they do what is
their policy for continuous intermittent that can really affect your experience and might make you
change where you want to give birth or change your ideas about it so a lot to think about as we are
preparing for birth now i have got a playlist for you that i've taken my must watch before birth
videos and put them all into my favorite playlist that you can get to
right here and leave me a comment if you have a hospital policy or something that you feel like
your hospital is hiding from you and we might even tackle a part two of this topic thanks for joining
me today don't forget to hit the subscribe button for more videos put them out every week bye guys