It’s Official!

The Birth Survey is officially up! Here is the press release. (Oh, and check out the button in my right sidebar. You can get your own button for your blog by going to The Birth Survey and clicking on “PR Materials”. Fellow WordPress.com users — it’s  a little tricky to add the button, because the free WP platform doesn’t have the right “trick” to just copy and paste it. But I’ll post the directions to it as a comment on this post, and will give a big shout out to Guinever for telling me how to do it — I was pulling my hair out over it!)

Dear Friends,

The Coalition for Improving Maternity Services (CIMS) has just announced: The Birth Survey Now Offers Access to Reviews of Local Maternity Care Providers and Facilities.

Many of you already know about The Birth Survey, part of the Transparency in Maternity Care Project of the Coalition for Improving Maternity Services CIMS). The Birth Survey involves an “an on-going online consumer survey that asks women to provide feedback about their pregnancy and birth care specific to the particular doctor, midwife, hospital or birth center that served them.” The Birth Survey has been collecting these surveys, and now has these reviews available on-line, for reviews from across the country!

Read the informative press release below, or find it and more information about the Birth Survey and the rest of the Transparency in Maternity Care Project here.

Sincerely,
Susan Hodges, “gatekeeper”

FOR IMMEDIATE RELEASE

CONTACT: Denna Suko, Executive Director
Coalition for Improving Maternity Services
Tel: 919.863.9482
dsuko@motherfriendly.org

Choosing a Birth Care Provider? The Birth Survey Now Offers Access to Reviews of Local Maternity Care Providers and Facilities.

Raleigh, NC (April 28th, 2009)-CIMS, the Coalition for Improving Maternity Services, a group working toward transparency in maternity care, today announced that consumer survey results rating health care providers and birth facilities are now available online.

The CIMS Transparency in Maternity Care Project: The Birth Survey is the first ever consumer ratings website dedicated solely to providing feedback on obstetricians, midwives, hospitals, birth centers, and home birth services. The consumer reviews include overall ratings and recommendations for birth facilities and care providers, and also a seven-item set of questions on providers’ interpersonal and communication skills, facility intervention rates, and information on finding good care. A national average of ratings is also displayed to provide comparison with individual ratings.

“While consumers have long been sharing information online about products and services, more data was available for the purchase of a digital camera than had ever been available to women as consumers of maternity care. The Birth Survey directly addresses that information deficit,” said Robin Elise Weiss, LCCE, author of The Complete Illustrated Guide to Pregnancy and member of The Birth Survey Committee.

The Birth Survey is a user-friendly, free Website where mothers who have given birth within the last three years can provide detailed, anonymous feedback about their experiences. The survey questions are based upon the Mother Friendly Childbirth Initiative, an evidence-based model of high quality maternity care. Additionally, the interpersonal and communication questions are based upon an AHRQ survey, which represents a well known set of questions currently used by doctors and hospitals.

More than 17,500 ratings for providers and 6,500 ratings for facilities have been submitted since the national launch in August 2008. Now, parents-to-be can retrieve the pooled reporting on local providers and facilities.

The national averages of the consumer feedback collected indicate that midwives were rated more highly than the physicians. For example, 58 percent of respondents would recommend their doctors to family and friends, compared to 90 percent who would recommend their midwives. Across all providers, 77 percent of women reported that they had their questions answered completely, and 73 percent felt they were as free as they wanted to be in making their own decisions about their care. Averages, however, varied widely between individual providers.

The Website ratings pages also provide links to hospital and birth center obstetric intervention rates, such as c-section, for facilities in nine states. This information is part of The Birth Survey’s nationwide campaign to make facility-level intervention data available to the public. This kind of public reporting supports informed choice
and fosters transparency, which improves outcomes.

Consistent with a new series of government Public Service announcements that encourage consumers to get involved in their health care and ask questions of their care providers, The Birth Survey offers links to information on how to choose and evaluate providers, including the “CIMS Ten Questions to Ask.” B y offering more than a conventional five-star rating, The Birth Survey offers information that is vital for women to make more informed decisions.

“A woman who looks at a list of names from her insurance company is often choosing a provider on nothing but blind luck. Where and with whom to give birth are important health care decisions. Research shows that both provider and location have a significant impact on birth outcomes. CIMS wants expectant parents to ask questions of their providers and facilities, and have access to more information about their local options,” said Elan McAllister, founder of Choices in Childbirth in New York City and Co-chair of the The Birth Survey committee.

The Birth Survey is an ongoing project. In the summer of 2009, free-text responses will be displayed on the website, and in 2010, detailed information on patients’ experiences with prenatal, labor, birth and postpartum care will be added to the website as searchable custom reports.

###

For more about The Birth Survey, to view intervention data for each
state, the survey results, or to take the survey, log on to
http://www.thebirthsurvey.com <http://www.thebirthsurvey.com/> .

About the Transparency in Maternity Care Project: The Coalition for Improving Maternity Services CIMS) through the Transparency in Maternity Care Project developed The Birth Survey so families can share information, learn about the choices and birth experiences of others, and view data on hospital and birth center intervention rates and practices. It is also designed to help providers and facilities improve the quality and transparency of their care. At the heart of the project is an on-going online consumer survey that asks women to provide feedback about their pregnancy and birth care specific to the particular doctor, midwife, hospital or birth center that served them. Responses are made available online to other women in their community who are deciding where and with whom to birth. Paired with this experiential data, are official statistics from state departments- of-health listing obstetrical intervention rates at the facility level.

About the Coalition for Improving Maternity Services: The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs. For more information, log on to http://www.motherfriendly.org/.

Denna L. Suko
Executive Director
Coalition for Improving Maternity Services (CIMS)
1500 Sunday Dr Ste 102
Raleigh, NC 27607
Tel: 919.863.9482
Fax: 919-787-4916
dsuko@motherfriendly.org

Bet she will!

What if you found out your doctor and nurses had a bet going on as to when you’d give birth, if you’ll end up with a C-section or episiotomy, etc.? Do you think that would have some bearing on the kind of care you receive? If your doctor thinks that all first-time moms and most subsequent moms need an episiotomy, what do you think your chances are of coming through childbirth uncut? If your doctor has you marked out for a C-section, do you really think he’ll try to ensure that you will have a vaginal birth, just because that is what you wish?

No, I don’t really think that doctors and nurses really have a betting pool on their patients (although, years ago, I did hear of a Las Vegas hospital or nursing home that had to fire some of its employees, after it was discovered they were betting on when their terminal patients would die), but does it really matter whether the doctor has money riding on it or not, if he has prejudged you as needing a C-section?

This is more than just a thought-provoking post. This post was inspired by numerous posts I’ve read recently that have come together in my mind in a new way. The main “other post” I read was by a woman who feels like she was railroaded into an unnecessarean. Of course, I only have her point of view to go on, and can’t ask her doctor’s opinion. While she has some legitimate beefs with the care she received, if her perspective is correct, she did fit several risk profiles (including being overweight and having diabetes and having a 9lb+ baby — although these in and of themselves do not require a C-section), and she may have been unaware of something that happened in labor from a clinical perspective, so it is also possible that her cesarean was indeed necessary and kept her baby safe. She does not think so, and is planning a home VBAC if she gets pregnant again, because of the care, or lack thereof, she received at the hospital.

But in reading her birth story, she relates that the doctor had strongly encouraged her to choose a C-section before she went into labor, and even said that she’d end up with a C-section anyway. It didn’t matter that she wanted a vaginal birth; it didn’t matter that she wanted to give birth without any medication at all. Her doctor grudgingly allowed her to go into labor (as if he really had a choice to force her into an elective C-section), but there was a thread running through her birth story of consistent undermining of her wishes and desires to have a vaginal birth. So while I was expecting the story to end more along the lines of, “so I ended up having a vaginal birth despite my doctor,” I was not too surprised to see the doctor keep pushing a C-section, and the woman finally consenting, without any indication of a real medical reason. (Although, again, she may have been unaware of something that had happened to indicate a C-section.) The actual diagnosis given was “failure to progress,” with the explanation being that she was too fat for the baby to descend into the pelvis, and the baby was also too big to descend lower into the pelvis and dilate the cervix. Of course, I would have just suggested that she be given more time, as long as the baby’s heartbeat was fine, but that suggestion would not have been taken well. You see, the doctor had determined that she ought to have a C-section before she even went into labor. So, the doctor was ultimately proven right. Or was he?

The fact that she ended up with a C-section does not necessarily indicate that the C-section was necessary to save either her or her baby’s life or health, any more than the fact that I give my kids peanut butter and jelly sandwiches for lunch when they ask for pizza is an indication that PB&Js are necessary for them. Reading her birth story indicated to me that the doctor had made his mind up to perform a C-section on her, and he had a “don’t bother confusing me with the facts” attitude. So, no, I don’t really trust that the doctor did what was medically indicated. Rather, I think he decided that she should have a C-section, and chose every opportunity he could to force-feed her a C-section, until she finally gave in and submitted to it. That is certainly the impression she has.

The other stories are mainly L&D nurses’ stories of patients they’ve taken care of — they advocated for them to have a vaginal birth and some succeeded, while others did not. Some of the stories make my blood boil, because the doctors just don’t care. Sometimes they are knife-happy; other times they are just selfish and want to go home and stay home, and not have to be called back out to catch the baby later; and sometimes they have just marked out a woman for a C-section, and jump at the earliest opportunity to coerce her into one by telling her that her body has failed. Hearing these stories from mothers who have gone through this experience, but may miss clinical reasons that truly indicated a C-section, so feel like their C-section was unnecessary, but are wrong, is one thing; hearing these stories from experienced L&D nurses who can unequivocally say, “I know her C-section was unnecessary,” is another.

So much depends on your care provider’s philosophy! Do not underestimate how important it is to choose your midwife or doctor and birth-place wisely!!

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One organ, two functions

I’ve been kicking around this idea for a while — and I will admit that it first started in my mind because of the pro-breastfeeding people’s argument that people should not be embarrassed or offended by breastfeeding in public because, after all, nursing is a natural function of the body! I agree with that. However, breasts are also sexual. I’ve yet to see any breastfeeding advocate say that it is perfectly all right for men to expose themselves in public as long as they are urinating. If anybody reading this is of that philosophy, feel free to leave a comment! :-)

But on another blog I read the blogger was relaying her irritation about the “breasts are for sex [not breastfeeding]” mentality, and said the same thing could be said for vaginas. I like my response, so I’m going to paste it in this post, too.

I sometimes get a kick out of the “organs used for sex” mentality, because it only seems to apply to women. Why is it that we never talk about how that the penis is used for both sex and urination? Should men have a tube cut into their bladder to preserve their penises from the non-sexual function of peeing?? Why is it that only women’s sexual/practical organs must be preserved for purely sexual use???

What say you? :-)

Scars that Run Deep

As Cesarean Awareness Month draws to a close, here is a very deep and thoughtful post on the phrase that makes so many C-section moms shudder — “At least you have a healthy baby — that’s all that matters.” She delves deeper into that phrase, and why it is so hurtful to so many women.

Thanks to Nursing Birth for the link.

Birth and ear infections

This is anecdotal, and as far as I know, there is no research into this topic. I don’t expect there to be research into it, either, because of the prevailing medical opinion from doctors (who often think the “MD” after their name stands for “minor deity”).

I wonder how many babies and children have ear infections because of their difficult births. Seriously.

When MJ told me the story of her second child’s birth, or rather, what happened afterwards, because of the birth, she said that her son “took a baseball bat to her tailbone on the way out.” Her tailbone was literally broken during the birth, but she didn’t know it until months afterwards. She had had an epidural of course, same as with her first birth. When giving birth to her first child (different hospital, different state, different everything), they wouldn’t top off her epidural when she was pushing because they wanted her to be able to feel what she was doing. With her second, they gave her a second dose, and she said that she thought it was more helpful to her to be numb, because then she wasn’t distracted by the pain, and could concentrate on pushing. While that’s certainly possible, I wonder if it was worth it, all things considered.

One blogger likened pushing with an epidural to getting a shot of lidocaine at the dentist’s office. You move your mouth, or you think you’re moving your mouth, but you’re not really sure, because you can’t totally feel it. You’re doing your best, but you’re still numb so you don’t know if it’s really right. (And considering the number of words I’ve slurred, or the food or liquid I’ve spilled when my mouth was still numb, it’s pretty obvious that many times it does not work just right.) I like this analogy, but have never had an epidural, so don’t know its accuracy from experience.

So my friend was nice and numb, which is what she wanted at the time, but I think she also was in a bad position for birth, and didn’t know it. Had she been able to feel, she probably would have realized she was uncomfortable (or perhaps in a downright painful position), and would have made an adjustment so that she was more comfortable. The fact that the tip of her tailbone broke is evidence to me that she was not in a good position. Of course, having an epidural, she was pretty much sitting on her tailbone in a C-position or lying supine, which makes it difficult for the tailbone to flex outward, which it naturally does when a baby’s head passes it. In her case, I think her position made it impossible for the coccyx to move, so it broke.

She didn’t feel it then, but she sure did over the course of the next several months when she couldn’t sit comfortably except with the donut ring (and sometimes not even then)! So I wonder if it was really even worth it for her. Not that one can travel backwards in time anyway, but if I wonder if I were to go to her when she was pregnant and tell her that if she got an epidural her tailbone would break and she’d be unable to sit comfortably for any length of time for six months after the birth, if she’d still get an epidural. But that’s neither here nor there. What happened happened. Enough background.

This baby had multiple ear infections in his first year of life, and he had no risk factors for it. He was exclusively breastfed (even when he started eating baby cereal for his first solids, his mother mixed breastmilk in it); he did not go to day-care, nor was he around a lot of other little children. His older brother was 3, but he didn’t really go to a lot of friends’ houses and bring back germs, etc. But he still had one infection after another, at an average rate of one infection a month. The pediatrician eventually referred him to an ear nose and throat doctor, who recommended ear tubes. Of course. She actually had the surgery scheduled, when I mentioned chiropractic.

My older sister started getting ear infections as a teenager after being thrown from a horse. She got no help from a medical doctor (the first time he looked in her ears, he said they were too infected and he couldn’t see anything; two weeks of antibiotics later, he looked in her ears and said they were clear so he couldn’t see anything). My mom had trouble with her back (a swing fell underneath her years previously), and was seeing a chiropractor, and mentioned the ear infections to him. Although she had to go frequently for the first few weeks, after that she was just on maintenance visits, and never had another ear infection. This was after having many multiple infections.

So, I mentioned this possible course of treatment to MJ. She was naturally skeptical, but decided that she really needed to exhaust all alternatives before choosing what was possibly an unnecessary surgery for her son. She had plenty of reason to be concerned about the infections — her older son also had many ear infections as a child, and was delayed in speech because of it, and she didn’t want her younger son to be likewise affected. But she decided to give it a try.

When she told the pediatrician and the ENT (she had to cancel the tube surgery), they pooh-poohed it, said it wouldn’t work, she was wasting her time and money, her son (who had an active ear infection at the time) would never get any better without the surgery, etc., etc., etc. A week or two after starting chiropractic adjustments, his ear infection was cleared up (without antibiotics), and he never had another one.

These ear infections started within a few months of his birth. There was nothing physical that happened to him that would account for a messed up neck or back causing an ear infection — he wasn’t crawling, rolling over, falling off of stuff, bumping his head into walls, etc. But one thing he did have was a difficult birth — as evidenced by his breaking his mother’s tailbone on the way out. The chiropractor said that he often saw cases like this, and he said it was many times due to the manipulations doctors do to babies in getting them out — both vaginal and Cesarean births. In fact, he said that oftentimes babies born by C-section are even worse, because doctors will pull these babies out by the head, putting a great deal of stress on the head and neck area, much more than in a vaginal birth, in which mothers are pushing their babies out, rather than having their babies pulled out of them.

Makes sense to me!

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Vitamin D and C-sections?

This was an interesting article — a midwife’s take on the recently released study that showed that women who had C-sections were more likely to have low vitamin D. She points out some flaws and potential faults in the study. Quite interesting reading!

I also blog here…

In addition to my sometimes neglected personal blog (if you’re interested in my kids, gardening, and insight and discussion on frugality and other non-birth related topics), I also blog occasionally at the Independent Childbirth Educators blog, so be sure to check it out and subscribe to it (because the other writers have great insight as well).

I also have recently joined a new blog called Grassroots Conservative Network, and will be writing there as well, so feel free to check it out. If you’re conservative, then you’ll enjoy it; and if you’re not conservative, then you may enjoy the argument. :-)

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