Happy Groundhog Day!

This post has nothing to do with Groundhog Day, although I do like the movie! It’s six weeks until spring, which is March 20 officially, and I have no idea whether it will be warm or a cold (most likely a mixture of the two) until then.

The idea for this post struck me, though, a couple of weeks ago when I was adjusting the thermostat in my house, the day after receiving my latest gas bill. My gas bill is extremely low in the summer, because we only have a gas water heater, and just “normal” water is fairly warm coming into the water heater, so it takes very little energy to get it and keep it hot. (After all, when it’s 100 degrees outside, it takes little energy to increase the water temperature to 120 degrees; and we tend to take cooler showers and just generally use less hot water in the summer.) Several months last year, the gas bill was around $10 or less. The winter is a different story, because we have both gas and electric heat; and I prefer to use the gas because it’s cheaper and more efficient. But the gas bill can be as much as $100, depending on how cold it gets and how warm we keep it inside.

There is, obviously, an “average” that can be determined by adding up my gas bills for 12 months and dividing by 12, but the bills are usually either really high or really low — there is never an “average” that I can depend on. But my average may be different from your average, depending on a whole range of reasons.

My sister-in-law’s electric bill averaged $600 a month in the winter last year, because the house they rented in Michigan was poorly insulated, it was obviously cold, electricity is not very efficient for heating anyway, and my brother-in-law liked it warm when he was home.

There is individuality in a lot of things that affects “average” — including in birth. Here are some factors that may affect what a person’s heating bill is during the winter:

  • the location of the house (the North vs. the South, or how high up a mountain it is)
  • the size of the house
  • how well insulated the house is
  • how warm you want your house
  • the type(s) of heater(s) you use — electric, gas, propane, wood-burning; central heating, ceramic heaters, radiators…
  • how efficient your heater is
  • how often you run your heat (do you turn it off while you’re gone, or leave it on all day?)
  • how cold it is outside
  • how many cold days you have
  • how much the form of energy costs that your heater runs on

A researcher can look at heating bills across the country, and get a “national average” for how much it costs to heat a home for a month in the United States… but that doesn’t do a lot of people very much good. I daresay that Hawaii and Florida have very low heating bills in the winter; while Alaska has very high ones. Also the length of “winter” varies, with some areas of the country able to wear short sleeves year-round, while other areas have to dress warmly for most of the year.

Just so, researchers can look at maternal and child health across the country and get a “national average” for various risks, but that is just a snapshot, and has limited usefulness. There are people who do not fit into “average” well if at all, and may need more or less care than “average”. Just as it is of limited usefulness to know that the average household’s heating bill is [making up a figure here] $300, if you live in Miami or Juneau, so it is of limited usefulness to know that the “average” American woman is low risk, if you’re high risk. Or to know that the “average” woman won’t have a C-section (because the rate is still in the low 30%, most women will not have a C-section), if you end up having a C-section against your will and/or unnecessarily.

So, when you have someone tell you about “risk” or “average” or “likelihood” of something happening, you need to also think of the extenuating circumstances — just like with heating bills. You may be at low risk for a C-section medically speaking, but if you choose a knife-happy OB with a 75% C-section rate, the odds are high for you to end up with a surgical birth. Contrariwise, you may have several risk factors, and be under close observation while in labor, and be at high risk for a C-section, yet avoid the knife if you choose a care provider with a low C-section rate (if you can find one).

Just as different areas of the country have different levels of heating bills, with the Northeast having much higher ones than the Southwest, so different areas of the country, and different hospitals within the same area, and different doctors at the same hospital, may all have different levels of interventions including C-sections. Don’t look at national statistics to find out your local risks! Talk to local women who have given birth with the same care provider(s) you’re thinking of using, to find out your local average. In one sense, that’s the only average worth knowing. Yes, national statistics are important; but they are made up of local ones, so it makes sense for each woman to find out for her own area what her local statistics are. Small changes locally can add up to big changes nationally!

Finally, bookmark the link to The Birth Survey, which is set to release its national statistics sometime in the spring. (If you’ve given birth in the last 3 years and haven’t yet contributed your experience to the project, please do!)

At the heart of the project is an on-going, online consumer survey, The Birth Survey, that asks women to provide feedback about their birth experience with a particular doctor or midwife and within a specific birth environment. Responses will be made available online to other women in their community who are deciding where and with whom to birth. Paired with this experiential data will be official statistics from state departments of health listing obstetrical intervention rates at the facility level.

I eagerly await the nationwide release of the information (New York City’s information is already available, from the pilot project).

One Response

  1. Clever. I see where you’re going with this. Studies and stats only go so far. They measure what has already happened but are not by nature predictive. There is always more to the picture.

    I have another train of thought that I’ll come back to later.

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