Connecticut Maternity Care Worst to First 2010

We're back!

2010-02-08T19:19:00.000-08:00

After a little bit of a hiatus, we are pleased to announce our second official Worst to First Meeting, which will be held at the Panera Bread Co. at 228 S. Main St. (route 25) in Newtown.

If you would like to attend this meeting, please contact Michele at michele@ctworsttofirst.com or Danielle at Danielle@ctworsttofirst.com.

Hope to see you there!

The VBAC Numbers are out!

2009-11-14T08:46:00.000-08:00

Connecticut Hospital Repeat Cesareans Vs. VBAC Statistics 2007

Hospital	VBAC	Repeat Cesarean	Total Previous Cesarean Births
Bridgeport Hospital	3.29%	96.71%	334 Deliveries
Bristol Hospital	7.06%	92.94%	85 Deliveries
Charolette Hungerford Hosp	0%	100%	67 Deliveries
Danbury Hospital	9.06%	90.94%	265 Deliveries
Day Kimball Hospital	0%	100%	54 Deliveries
Greenwich Hospital	7.23%	92.77%	166 Deliveries
Griffin Hospital	9.43%	90.57%	106 Deliveries
Hospital of Central CT	4.31%	95.69%	209 Deliveries
Hartford Hospital	2.0%	98.0%	500 Deliveries
Hospital of St. Raphael	5.52%	94.48%	163 Deliveries
John Dempsey (UCONN)	7.06%	92.94%	85 Deliveries
Johnson Memorial Hospital	14.29%	85.71%	28 Deliveries
Lawrence & Memorial	2.26%	97.74%	221 Deliveries
Manchester Memorial	15.13%	84.87%	119 Deliveries
Middlesex Hospital	1.26%	98.74%	159 Deliveries
Midstate Medical Center	2.5%	97.5%	120 Deliveries
Milford Hospital	6.85%	93.15%	73 Deliveries
New Milford Hospital	6.98%	93.02%	43 Deliveries
Norwalk Hospital	4.76%	95.24%	210 Deliveries
Rockville General	14.58	85.42%	48 Deliveries
Sharon Hospital	5.26%	94.76%	19 Deliveries
Saint Mary's Hospital	5.26%	94.74%	114 Deliveries
Saint Francis Hospital	7.41%	92.59%	324 Deliveries
Saint Vincent's Medical Ct.	0%	100%	157 Deliveries
Stamford Hospital	6.98%	93.02%	387 Deliveries
Waterbury Hospital	10.56%	89.44%	180 Deliveries
William Backus Hospital	9.23%	90.77	130 Deliveries
Windham Community Hosp.	4%	96.0%	50 Deliveries
Yale New Haven Hospital	9.95%	90.05%	583 Deliveries
Total	6.06%	93.94%	4,999 Deliveries

These can also be located on the Hospital Statistics portion of our website.
http://ctworsttofirst.com

The Rituals of American Hospital Birth

2009-10-27T10:16:00.000-07:00

While doing some research for a birth trauma article, I came across a very interesting article about the rituals of hospital birth in America, and the psychological effects it has on women (as well as the staff).

Many know first hand just how traumatic and violating a hospital birth can be. Doctors and other hospital staff attend births day in and day out--becoming desensitized in the process. The mother is treated as a mere compartment for a child to emerge from. Here are a few excerpts from the article that sum this up nicely:

The rising science of obstetrics ultimately accomplished this goal by adopting the model of the assembly-line production of goods as its template for hospital birth. Accordingly, a woman's reproductive tract came to be treated like a birthing machine by skilled technicians working under semiflexible timetables to meet production and quality control demands. As one fourth-year resident observed:

We shave 'em, we prep 'em, we hook 'em up to the IV and administer sedation. We deliver the baby, it goes to the nursery and the mother goes to her room. There's no room for niceties around here. We just move 'em right on through. It's hard not to see it like an assembly line.

The hospital itself is a highly sophisticated technocratic factory; the more technology the hospital has to offer, the better it is considered to be. Because it is an institution, the hospital constitutes a more significant social unit than an individual or a family. Therefore it can require that the birth process conform more to institutional than personal needs. As one resident explained,

There is a set, established routine for doing things, usually for the convenience of the doctors and the nurses, and the laboring woman is someone you work around, rather than with.

The most desirable end-product of the birth process is the new social member, the baby; the new mother is a secondary by-product. One obstetrician commented,

It was what we were all trained to always go after--the perfect baby. That's what we were trained to produce. The quality of the mother's experience--we rarely thought about that.

Many women report feeling a lack of control once they are in the hospital--I know I did.

Routine obstetric procedures are highly symbolic. For example, to be seated in a wheelchair upon entering the hospital, as many laboring women are, is to receive through their bodies the symbolic message that they are disabled; to then be put to bed is to receive the symbolic message that they are sick. Although no one pronounces, "You are disabled; you are sick," such graphic demonstrations of disability and illness can be far more powerful than words. One woman told me:

I can remember just almost being in tears by the way they would wheel you in. I would come into the hospital, on top of this, breathing, you know, all in control. And they slap you in a wheelchair! It made me suddenly feel like maybe I wasn't in control any more.

The intravenous drips commonly attached to the hands or arms of birthing women make a powerful symbolic statement: they are umbilical cords to the hospital. The cord connecting her body to the fluid-filled bottle places the woman in the same relation to the hospital as the baby in her womb is to her. By making her dependent on the institution for her life, the IV conveys to her one of the most profound messages of her initiation experience: in American society, we are all dependent on institutions for our lives. The message is even more compelling in her case, for she is the real giver of life. Society and its institutions cannot exist unless women give birth, yet the birthing woman in the hospital is shown, not that she gives life, but rather that the institution does.

The article talks about how women are repetitively being told--without words--that they are dependent on the hospital: the often awkward and exposing hospital gown, the ID bracelet, IV, the bed, etc.

The message that she is "defective" is also conveyed to her, that her body needs help to birth a baby.

She is also reminded in myriad ways of the potential defectiveness of her birthing machine. These include periodic and sometimes continuous electronic monitoring of that machine, frequent manual examinations of her cervix to make sure that it is dilating on schedule, and, if it isn't, administration of the synthetic hormone pitocin to speed up labor so that birth can take place within the required 26 hours. All three of these procedures convey the same messages over and over: time is important, you must produce on time, and you cannot do that without technological assistance because your machine is defective.
...Consider the visual and kinesthetic images that the laboring woman experiences--herself in bed, in a hospital gown, staring up at an IV pole, bag, and cord, and down at a steel bed and a huge belt encircling her waist. Her entire sensory field conveys one overwhelm-ing message about our culture's deepest values and beliefs: technology is supreme, and the individual is utterly dependent upon it.
...Internalizing the technocratic model, women come to accept the notion that the female body is inherently defective. This notion then shapes their perceptions of the labor experience, as exemplified by one woman's story:
It seemed as though my uterus had suddenly tired! When the nurses in attendance noted a contraction building on the recorder, they instructed me to begin pushing, not waiting for the urge to push, so that by the time the urge pervaded, I invariably had no strength remaining but was left gasping and dizzy....I felt suddenly depressed by the fact that labor, which had progressed so uneventfully up to this point, had now become unproductive.
Note that she does not say "The nurses had me pushing too soon," but "My uterus had tired," and labor had "become unproductive." These responses reflect her internalization of the technocratic tenet that when something goes wrong, it is her body's fault.

Many families seem comforted by hospital rituals. They welcome the interventions, feel safer with them and put more faith in the machines than their own bodies. Some women opt for elective cesarean sections or prefer them to vaginal birth because of the "control" factor, fear of the pain from a vaginal birth or countless other reasons. Others may find this hard to understand--a major surgery is not scary? How and why would anyone ever choose that over a vaginal birth--a natural process? The article explains this well, how people tend to conform to rituals--no matter how absurd it may seem--in times of stress.

When humans are subjected to extremes of stress and pain, they may become unreasonable and out of touch with reality. Ritual assuages this condition by giving people a conceptual handle-hold to keep them from "falling apart" or "losing it." When the airplane starts to falter, even passengers who don't go to church are likely to pray! Ritual mediates between cognition and chaos by making reality appear to conform to accepted cognitive categories. In other words, to perform a ritual in the face of chaos is to restore order to the world.
Labor subjects most women to extremes of pain, which are often intensified by the alien and often unsupportive hospital environment. They look to hospital rituals to relieve the distress resulting from their pain and fear. They utilize breathing rituals taught in hospital-sponsored childbirth education classes for cognitive stabilization. They turn to drugs for pain relief, and to the reassuring presence of medical technology for relief from fear. One woman expressed it this way:
I was terrified when my daughter was born. I just knew I was going to split open and bleed to death right there on the table, but she was coming so fast, they didn't have any time to do anything to me...I like Caesarean sections, because you don't have to be afraid.
When you come from within a belief system, its rituals will comfort and calm you. Accordingly, those women in my study who were in basic agreement with the technocratic model of birth before going into the hospital (70%) expressed general satisfaction with their hospital births.

The institution that is the hospital is overwhelming. If women who want to birth there, who find a hospital birth inviting or optimal give themselves over in such a huge way upon arrival--imagine what it does to women that don't feel that way.

Unfortunately, many of us know that all too well.

From The Big Push for Midwives

2009-10-13T05:32:00.000-07:00

PBS Global Health Watch Report: High Rate of Home Birth in the Netherlands Results in Reduced Costs, Superior Outcomes
Report Follows Landmark Dutch Study on the Safety of Home Birth

WASHINGTON, D.C. (October 9, 2009)—In the second segment of PBS' The NewsHour with Jim Lehrer series on health care reform that aired on Wednesday, senior correspondent Ray Suarez reports that “for the Dutch, a huge cost saver starts the day you’re born.” He goes on to note that the majority of Dutch babies are born at home in a nation where the infant mortality rate is 25% lower than in the United States . Suarez’s report is consistent with a recent study of more than 500,000 births in the Netherlands , which found that planned home birth with trained midwives is as safe as hospital birth.

"Reports and research coming out of the Netherlands confirm what those of us in the medical community who pay attention to the evidence have known for many years,” said Stuart Fishbein, MD. “Planned home birth with trained midwives not only reduces costs, but it also results in significant reductions in the cesarean section rate as well as in the rates of low birth weight and preterm births.” Low birth weight and prematurity are two of the leading causes of infant mortality and racial and ethnic disparities in birth outcomes in the United States .

Two types of midwives practice in the United States, Certified Nurse-Midwives and Certified Professional Midwives. While Certified-Nurse- Midwives practice primarily in hospital settings, Certified Professional Midwives are required to undergo specialized clinical training in out-of-hospital settings, including private homes and freestanding birth centers. More than half the birth centers nationwide are owned or staffed by CPMs, who also deliver the vast majority of babies born at home each year.

"What we've learned from the Netherlands and other countries is that expanding access to out-of-hospital maternity care by providers with the type of training that Certified Professional Midwives receive benefits mothers and babies,” said Katherine Prown, PhD, Campaign Manager for The Big Push for Midwives. “The research shows that we could make significant improvements in birth outcomes and in lowering health care costs here in the United States by implementing very basic policy measures, such as closing the gap in federal Medicaid law that neglects to include CPMs as eligible providers.”

David A. Anderson, a professor of economics at Centre College with a research specialization in the costs of out-of-hospital maternity care, calculates that a 5% increase in both the rate of home births and births that take place in freestanding birth centers would result in an annual savings of more than $9 billion. Even at the current rate of 1% out-of-hospital births, simply covering the services of Certified Professional Midwives and freestanding birth centers under Medicaid would result in hundreds of millions in savings to the nation’s health care system each year.

The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in Medicaid. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushfor midwives. org
#####

The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800 | Washington, D.C. 20037-1434 | TheBigPushforMidwiv es.org

Connecticut Hospital Cesarean Section Numbers for 2007

2009-09-28T08:09:00.000-07:00

Over the weekend we really worked hard on locating some numbers we needed in order to come up with percentages that are much easier to understand over the number of cesarean sections taking place at hospitals across the state. Some of these numbers are staggering.
While our goal is to reduce the cesarean rate here in the state to the 10-15% the World Health Organization recommends, there are some hospitals in the state we feel will have a very hard time working to those numbers.

The hospitals with the exceptionally high rates, I have highlighted in Red. (Over the national average of 31.8%)
The hospitals which currently hold ban's on VBAC (Vaginal Birth after Cesarean) are in blue.

Hospital Name ______ Cesarean % ____ Total # of Births
Bridgeport Hospital ....... 39.07% ............ 2592
Bristol Hospital ......... 29.01% ........ 693
Charlotte Hungerford Hospital 37.25% ..... 459
Danbury Hospital ............ 30.21% ................... 2446
Day Kimball Hospital ......... 25.82% ................. 577
Greenwich Hospital ............ 34.20% ......... 2188
Griffin Hospital ............ 32.45% ......... 761
Hartford Hospital ............... 38.17% ......... 4071
Hospital of St. Raphael ........ 32.15% .......... 1440
John Dempsey Hospital (UCONN) 43.35% ........ 850
Johnson Memorial Hospital ........ 28.99% ........ 300
Lawrence & Memorial Hospital ....... 38.70% ......... 1739
Manchester Memorial Hospital ....... 27.76% ...... 1078
Middlesex Memorial Hospital ..... 37.50?% ..... 1176
Midstate Medical Center ........... 30.69% ......... 1082
Milford Hospital ........... 36.45% .................. 557
New Milford Hospital .............. 35.37% .............. 294
Norwalk Hospital .......... 32.12% ......... 1616
Rockville General Hospital ........... 26.53% ............ 441
Saint Francis Hospital ........ 31.23% .......... 2895
Saint Mary's Hospital ........ 29.74% ....... 1298
Saint Vincent's Medical Center ... 44.50% ....... 1211
Sharon Hospital .......... 31.78% ......... 236
Stamford Hospital ..... 37.99% ....... 2638
The Hospital of Central CT ..... 30.94% ......... 1975
Waterbury Hospital ..... 36.00% ...... 1311
William W. Backus Hospital ..... 30.40% ......... 1046
Windham Community Memorial ... 29.38% ......... 439
Yale New Haven Hospital ..... 34.91% ....... 4557

Also I would like to add, that The Hospital of Central CT told us that this information was not available to the public when we contacted them for the information. Waterbury Hospital was unable to tell us the statistics saying they were not public knowledge, Greenwich Hospital ignored our request and only gave us the primary cesarean statistics even after clarification of what we wanted, Bristol Hospital never responded to us after they asked what the statistics we being used for, Midstate Medical Center never replied to our request, it was like pulling teeth trying to deal with most of these hospitals. Mind you these listed above are the only that contacted us back out of every hospital in the state that provides maternity care.

Episiotomy Statistics!

2009-09-26T09:23:00.000-07:00

After much patience with the department of health care access in Connecticut we obtained some of the statistics we have been looking for. While we do not have the percentages at this point in time because we still have some pieces of missing information, we do have the number of cesarean sections, episiotomies, and forcep/vaccum/breech deliveries (which is apparently counted as one statistic and number in CT's recordings).

Today I am posting the Episiotomy rates.
The numbers I am putting in blue we consider to be high and will be addressed to lower.

Bridgeport Hospital - 191
Bristol Hospital - 24
Charlotte Hungerford Hospital - 53
Danbury Hospital - 61
Day Kimball Hospital - 65
Greenwich Hospital - 269
Griffin Hospital - 80
Hartford Hospital - 168
Hospital of St. Raphael - 74
John Dempsey Hospital - 11
Johnson Memorial Hospital - 36
Lawrence and Memorial Hospital - 120
Manchester Memorial Hospital - 55
Middlesex Memorial Hospital - 91
Midstate Medical Center - 187
Milford Hospital - 44
New Milford Hospital - 64
Norwalk Hospital - 163
Rockville General Hospital - 66
Saint Francis Hospital - 248
Saint Mary's Hospital - 77
Saint Vincent's Medical Center - 96
Sharon Hospital - 30
Stamford Hospital - 517
The Hospital of Central Connecticut - 96
Waterbury Hospital - 155
William W. Backus Hospital - 56
Windham Community Memorial Hospital - 5
Yale New Haven Hospital - 224

These are some huge episiotomy numbers!

Two Hospitals

2009-09-24T05:51:00.000-07:00

We have successfully obtained statistics from two hospitals here in Connecticut so far.
One being Stamford Hospital, and the other is Griffin Hospital in Derby.

I don't like the numbers from either, but I do give Griffin props for their VBAC rate.

Stamford Hospital
2007
Cesarean Section - 39.04%
Episiotomy - 20.50%
VBAC (Vaginal Birth after Cesarean) - 1.62%
Out of 1766 births

2008
Cesarean Section - 43.35%
Episiotomy - 24.88%
VBAC (Vaginal Birth after Cesarean) - 1.74%
Out of 2355 births

Griffin Hospital (Derby, CT)
2007
Cesarean Section - 30.6%
Episiotomy - 16.1%
VBAC (Vaginal Birth after Cesarean) - 18.3%

2008
Cesarean Section - 34.8%
Episiotomy - 16.3%
VBAC (Vaginal Birth after Cesarean - 10.4%

Some of these statistics are alarming, and the worst part of it all is, women are not being given this information when they choose to have a baby at these hospitals. Another reason for a push for a type of Mothers Information Act here in Connecticut.

Like Pulling Teeth

2009-09-17T11:24:00.000-07:00

This week I have been following up with all the hospitals in Connecticut, a total of 29 hospitals, I have received the statistics I requested from one, and the other hospital that actually replied to me said those type of statistics aren't available to the public. Which in turn really makes me think about the issue and run around pregnant women would and are getting when they try to obtain statistics and information about hospitals that they may potentially be delivering at.
I fully believe that hospitals should be required to disclose this information when asked. While they are required by law to report them to the state, not all people know what office to contact to obtain this information.
Many people give up when the hospital meets them with closed doors, and they do not know about something called the "Freedom of Information Act" meaning, you contact and put in a request for the information you are looking for, and they provide you with the information.

But all in all, these hospitals seem to think that consumers, and women in general are stupid.
I am looking forward to meeting with the ones who haven't gotten back to us, or told us that information isn't available to the public, especially when I do stroll in with their statistics.

Atleast You Have a Healthy Baby

2009-09-11T10:49:00.000-07:00

One of the goals of the Connecticut Maternity Care Worst to First Campaign is to improve maternal birth experiences by opening more options in hospitals.

Today, something was said to me, which has been said before, but it doesn't piss me off any less when I do hear it. I am the mother of two boys, both born via cesarean section. One a completely unnecessary cesarean, and one that was very necessary. But it doesn't change that both experiences hurt, physically and emotionally. Now unless you have walked in someone's shoes through an experience like this, you shouldn't really try and comment about it, or think twice about what may come out of your mouth.

Having a healthy baby, or a baby born safety does not have any kind of connection to how your birth experience went, or if you were hurt (emotionally or physically) by the experience.
A healthy baby isn't all that matters. Birth is a fundamentally important event in a mothers life, and a woman's birth experiences will be with her for life, so when you have a negative experience, it is much harder to get over. You look at your beautiful babies, and how they make you smile, but in the back of your head you always have the experience of their birth, good or bad.

Some women can easily move on from their experience, some will be haunted by it till the day they die. But no one should ever try and disregard ones experience just because a healthy baby is the end result.

CT Worst to First Upcoming Event!

2009-09-08T20:17:00.000-07:00

CT Worst to First will be holding a meeting on Wednesday, September 30th at 7 PM at Panera Bread Co. in Newtown located on 228 S Main St (route 25). We will be meeting face to face for the first time in hopes to really get things going.

If you are interested in joining us to help this cause, please contact either danielle@worsttofirst.com or michele@worsttofirst.com.

Hope to see you there!

Why is this an imporant issue?

2009-09-06T06:37:00.001-07:00

Many people wonder when a grassroots organization like this pops up, why is this even an issue?
My answer always echos something along the lines of
"How important is it to you to have the birth you want?"
"How important is it to you to have a healthy baby?"
"How important is it to you to have a safe birth?"

Many women do not equate medical interventions in pregnancy and birth to complications, but the reality is in most cases where heavy intervention is uses, such as non medically necessary labor inductions, the complications that come of it, in many cases such as fetal distress, are caused by these interventions. It is a pretty simple equation, and path that the interventions take place in.

My favorite explanation of the cascade of interventions is in The Business of Being Born. The famous Ricki Lake birth flick that ACOG went crazy over. Anything that is going to take money out of the pockets of OB/GYN's they are going to boycott of course, but I bet you they all watched it at some time or another!

Now, these people in this video are not just anyone. They are professionals in the birthing community, people with medical degrees, and have researched this extensively. But we still want to believe that all these interventions are the safest.

Which is why we are challenging all the local hospitals to lower their intervention rates.

Welcome to the Connecticut Worst to First Campaign blog.

2009-09-05T18:51:00.000-07:00

Connecticut Worst to First is partnering up with New Jersey Worst to First in an effort to eventually make this a national campaign. Connecticut Worst to First's membership includes Danielle Elwood, chapter leader of ICAN (International Cesarean Awareness Network) CT and ICAN Northeast Regional Coordinator, and Michele Demont (birthcut.com).

Both are cesarean mothers and were drawn towards advocating change in maternity care after the unnecessary cesarean births of their first born, which resulted after the typical cascade of hospital interventions. They now want to help change the way birth is viewed and managed in the United States, hoping to help other mothers and babies avoid the same needless and excessive intervention.

The goals of Connecticut Worst to First are:

lower the cesarean rate in Connecticut from the current 34.6% as of 2007, to a cesarean rate of no higher than 30% for the year 2010, in each hospital state wide.

Episiotomy rates of no higher than 5%.

Alternative birthing positions other than the classic lithotomy position.

Full informed consent to hospital procedures and protocols

lowering epidural rates

lowering rates of vacuum and forceps use

These goals are set to be reached for the year 2010. Consider giving a helping hand to the newest grassroots effort in Connecticut. Together, we can make a difference.