I’ve read several pro-natural-birth L&D nurses’ blogs; and one of the recent ones mentioned that her hospital’s “official” statistics state that their epidural rate is 75%. Sounds pretty good — national average and all that. But she questions that, because she suspects it to be more like 90%. In fact, she said that she hasn’t had a patient in recent memory that went without an epidural. And she’s in training to be a CNM, and would like to be involved in home births, so you know she’s ready and willing to help women go without epidurals if they want them. But all of her patients have had epidurals. And her hospital says that only 75% of women giving birth there have epidurals. Yeah, right. Another L&D nurse commented on that entry and said that her hospital’s stats are similar — and are also similarly misreported. She said the only women who don’t have epidurals are those that arrive too late to get one (and they’re usually irritated by not being able to get one).
In a recent post, I discussed a recent article that purports to show that only 4% of C-sections are unnecessary. The study’s author looked at hospital discharge data, which doctors fill out in order to get paid, for reasons behind the Cesareans. Hospital discharge data… billing insurance companies. The information is available! Hospitals have to know how many epidurals they do in order to properly bill insurance companies! Anything that can be billed to insurance companies will be billed to them. (In fact, some insurance companies have a policy that if you, the patient, find that you were billed for an item or service you did not get, and you contest it, they will reimburse you 50% of the money they saved by being wrongfully billed. So check your itemized statement. Some people have been charged for pacifiers their babies were given that they had repeatedly requested not be given to their babies; others have been double-billed for two sets of IVs or other paraphernelia that they didn’t receive/use at all, or only one was used, but two were charged.)
So how do hospitals arrive at their stats? It’s probably not by billing — although surely there are some whiz-bang computer nerds who could easily bang out a program that looks at what patients were billed for, and calculate percentages. There probably already are programs like that. I’m thinking it’s done more by sticking a wet finger in the air, and trying to come up with a number that sounds good — something that will not scare women who don’t want an epidural, but also that won’t scare women who do want an epidural. And 75% sounds pretty good — 3 out of 4 get an epidural, but 25% go natural, so that must mean that the nurses have plenty of experience helping unblocked women. And if they’re lying? Who’s to know?
It frustrates me to know that these stats are available, but they’re being hidden. Insurance companies have to pay for the anesthesiologist and all the paraphernelia involved in an epidural, which means that hospitals have to bill for them, which means they have to know just how many they do. Hmm, maybe we should ask Hospital Billing for birth stats, instead of the L&D desk.