Navelgazing Midwife alerted her friends to the article Births on cue: C-sections soar in S. Florida in the Miami Herald. I periodically babble about how I don’t think the general public will really care about the c-section rate until it crosses the 50 percent mark. When there is a greater than fifty percent chance that their friend, partner or sister will leave the hospital with vaginal bypass surgery, the general public will be shocked.
The fifth horseman of the apocalypse just rode into to Miami-Dade County and is cantering around Kendall Regional Medical Center.
Last year, for the first time, more babies in Miami-Dade County were born by cesarean section than were born vaginally, according to state records, and Broward’s not far behind, with a rate of 43.7 percent — both far above the national average.
At Kendall Regional Medical Center in Southwest Miami-Dade, seven out of 10 babies were delivered by C-section, a rate that University of Miami obstetrician Gene Burkett called “just astounding.”
Douglas Richards, a professor of obstetrics-gynecology at the University of Florida says c-sections are fast, easy, pain-free and make women so happy!
Traditionally, many doctors have warned against cesareans because of the risks anytime a patient is cut open. ”Definitely surgery always has a chance of a serious complication,” said Douglas Richards, a professor of obstetrics-gynecology at the University of Florida.
Still, in recent years, such warnings have been muted. ”The risks and benefits are much more balanced than they used to be,” Richards said. “Cesareans have become so safe and relatively easy for women.”
He means in particular planned C-sections — ”no rushing around, the baby doesn’t have to come out right away.” Improved anesthetics allow patients to rebound quickly. “They’re happy and pain-free and walking around the first day. Many go home after 48 hours.”
The article also features the cliché motherblamer quotes from various “experts,” such as too old, too fat, multiples and more.
Hospitals with rates higher than 50 percent were:
South Miami (59.9)
Jackson Memorial (50.4)
Holy Cross (51.6)
Hospital PR Clean-up?
Many of the hospitals didn’t want to discuss cesareans. Kendall Regional spokesman Peter Jude acknowledged the AHCA numbers were correct and said the hospital is “first and foremost committed to the well being and health of our mothers and infants. There are a number of factors patients and physicians consider when determining the delivery method.”
Berrios at South Miami said her hospital has been designated a center for high-risk cases and was close to an infertility clinic, where many of the patients had various risk factors, including multiple fetuses.
Jackson Memorial’s rate is high because the hospital gets most of the high-risk births for the entire county, said Burkett, noting that he had just been notified a woman carrying a fetus with heart problems was on her way from the Virgin Islands.
While supporting many reasons for C-sections, Richards in Gainesville emphasized he didn’t want to appear to be endorsing rates of 50 percent to 70 percent. ”That’s pretty astounding.” He noted one reason “not to have a more liberal cesarean policy is that babies born without labor tend to have more respiratory problems.”
Still, when Richards and three other ob-gyns were asked whether there was an upper limit on how high the C-section rate could go, in South Florida or the nation, none wanted to venture a guess. ”We just don’t know,” Berrios said.
Dr. Zulma Berrios might like to know that doctors have the power to curtail the c-section rate lest they be left looking like incompetent, ignorant boobs. You can call her at (305) 669-1523.
Peter Jude is Kendall Regional’s spokesperson. His number is (305) 228-5451.
Warn Your Floridian Friends! Tell Them They Have Options.
The Birth Place run by CPM Jennie Joseph
Baby Love Birth Center run by Samantha McCormick
The Florida Midwives Web site gives women a place to search for a midwife.
The Birth Survey results are live and women can search for reviews on physicians and midwives.
File a Complaint Against Your Hospital for Unnecessary Cesarean or VBAC Ban
For directions from the JCAHO regarding how to file a complaint, call:
1-800-994-6610 between 8:30 a.m. - 5:00 p.m. Central Standard Time.
Start with an e-mail to firstname.lastname@example.org or fax the Office of Quality Monitoring at (630) 792-5636
Mail: Office of Quality Monitoring
Joint Commission on Accreditation of Healthcare Organizations
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
Name and Shame
In April, when Beth Israel Deaconess Medical Center in Boston experienced a MRSA outbreak, BIDMC CEO Paul Levy wrote about it on his blog, Running a Hospital, before the media caught wind of the story. His hospital has a 42 percent c-section rate and while the MRSA outbreak which affected more than 30 mothers and newborns could happen anywhere, the high c-section rate makes women more vulnerable to nosocomial infection and should be reduced immediately.
In a follow-up post, Levy wrote about deciding to post about the MRSA outbreak:
In so doing, I show us for what we are in real time, warts and all. This makes us vulnerable to nasty anonymous commenters in the blogosphere, as well as to people who think they benefit from embarrassing us and making us uncomfortable. And, even a few of my board members have said, from time time, “Transparency is one thing, but did you have to post that?”
The truth is, hospital administrators should feel uncomfortable and should harness those feelings of guilt and shame to make positive changes in their hospital, like telling their OB/GYN staff to stop performing so many unnecesareans and unethically turning low-risk women into high-risk patients with each unnecessary cut of a scalpel.