Interventions

C-Section & Episiotomy Rates in the North/Northwest Chicago Suburbs

I was curious about the c-section and episiotomy rates for the closest hospitals to me, so I looked them up. These are (as far as I can tell) all of the hospitals within a 20-mile radius of me that have maternity wards. Episiotomy and cesarean section were the two interventions that I most wished to avoid in birthing my son back in September 2013, so I wondered how the hospitals in my area stood on those. [1]

2012 c-section rates come from CesareanRates.com. [2] Episiotomy rates come from the Leapfrog Group; I believe the statistics were last gathered in Fall 2013, but I’m not sure. The Leapfrog Group recommends that hospitals have an episiotomy rate no higher than 12%.

I listed the number of births and NICU level because I imagine the hospitals with more births are larger hospitals with higher level NICUs, and are therefore more likely to see high-risk births. When a hospital was reported as being a level III center, I attempted to call them and ascertain whether or not they were also a IIIC, sometimes known as a level IV.

Hospital # Births Cesarean
Rate
Episiotomy
Rate
NICU Level
1 Adventist GlenOaks
Hospital
380 34.2% 8.2% II
2 Advocate Condell
Medical Center
2540 34.6% NR II+
3 Advocate Lutheran
General Hospital
4122 35.8% NR IIIC
4 Advocate Sherman
Hospital
2823 26.9% NR II+
5 Alexian Brothers
Medical Center
2301 35.6% 26.2% II+
6 Centegra Hospital
– McHenry
842 22.1% 6.8% II
7 Elmhurst Memorial
Hospital
1395 28.2% 5.1% II
8 Evanston Hospital 3357 26% 6.1% IIIC
9 Gottlieb Memorial
Hospital
732 39.2% 15.1% II
10 Highland Park
Hospital
1183 31.4% 15.5% II
11 Northwest Community
Hospital
2997 35.2% 22.8% III
12 Northwestern Lake
Forest Hospital
1590 32.6% 14.0% II+
13 Presence Resurrection
Medical Center
945 34.3% 26.2% II+
14 Presence Saint
Francis Hospital
761 28.9% 7.6% II+
15 St. Alexius
Medical Center
2984 35.9% 34.6% III
16 Swedish Covenant
Hospital
2079 27.1% 14.6% II
17 VHS Westlake
Hospital
1012 26.9% 12.0% II
18 Vista Medical
Center East
1045 29.3% 4.1% II

Observations:

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“Operating Room Services”

I went over my hospital bill. By far the largest charge on the bill is a $4,292 charge for “operating room services.” This confused me as I obviously did not have a c-section.

I asked my doctor about it at an appointment yesterday. He said that, when I got to pushing and my son was having decels into the 70s, and did not seem to be coming out (there had been one pop-off on the vacuum extractor), they had told the c-section team to get ready. Considering that my son was out 5-10 minutes later, pretty amazing that they charge so much for just a few minutes of c-section prep that was ultimately not needed.

Categories: Hot Doctor, Interventions, Labor & Delivery | Leave a comment

Posterior?!? WHAT?!?

I just received a copy of the hospital records for my induction, labor, and birth of Constantine. Turns out that the little brat did come out posterior. How come nobody told me this? Do they not realize that birthing a 9 lb 5 oz posterior baby vaginally makes for some serious bragging rights, and that this is the female equivalent of bragging about penis size?

I’ve modified all past posts to reflect this.

Anyways, here’s some interesting notes from my records:

  • They had thought he was in occiput anterior position with a “compound presentation” (hand, arm, or foot by his head). It wasn’t until after he was out that they realized he was “direct occiput posterior.”
  • The vacuum was applied when he was at a +5 station. I almost had that little troll out on my own. I’m betting I would have delivered with an intact perineum if he hadn’t been posterior or if I’d had more time to push, but they wanted to vacuum him out due to decelerations into the 70s.
  • It took three pulls and one pop-off to get him out with the vacuum.
  • My bishop’s score on the morning of induction was 3-4. The initial examination by my hot doctor found that I was dilated to 1.5, posterior (cervical position), firm, 50% effaced, and -3 station. His attending’s exam a few hours later bumped me up to a 2 and 60% effaced, but still a -3 station. A bishop’s score of less than 5 means that the induction is likely to fail, so I think I was right to fear going through with the induction.
  • One note says “will offer pudendal block.” Not sure why they decided against trying to talk me into that, but they never mentioned it. I would have declined.
  • The plan was definitely to start me on magnesium sulfate during the active phase of labor. Not sure why they decided against it (maybe because I blitzed from a 3 to a 7 in two hours and they realized things were moving fast enough that I wouldn’t need it?).
  • These records say “oligohydramnios” all over them. That just annoys me. I was a 6.3! That was normal. Low end of normal is still normal. Grrr.

I’m glad that I pulled a copy of these for my records. I’ll have to ask Sark some questions about my delivery next time I see him.

Categories: Interventions, Labor & Delivery | 2 Comments

Down with “natural” childbirth

As I’ve mulled over my birth recent experience, I think I’ve arrived at the conclusion that I dislike the expression “natural childbirth.” Here’s why.

I see natural childbirth blogs and Web sites with descriptions such as the following, from Natural Childbirth Stories: “Births the way nature intended. No pitocin. No epidural. Just the beauty (and intensity!) of the human body at work.” Hmm.

“Natural childbirth” is what I was shooting for when I started this journey, and I fought tooth and nail for it. In the end, I wound up with interventions which would not be considered “natural” by most NCB advocates, namely, Pitocin and the vacuum extraction. I think these interventions were medically indicated and absolutely necessary. Still, they probably disqualify me from the natural childbirth club.

But what is “natural childbirth” anyways? “Giving birth the way nature intended.” As someone with Rh-negative blood who pair-bonded with someone with Rh-positive blood, if I “gave birth the way nature intended,” I’d probably only be able to have one healthy pregnancy. Nature apparently intends for about 15% of women to have limited childbearing abilities. Modern-day obstetrical intervention has corrected that. Yet most NCB advocates would probably not discourage Rh-negative women from obtaining the recommended Rhogam injections, and would not say that your childbirth was no longer “natural” on that account.

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Categories: Interventions, Labor & Delivery | 2 Comments

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