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Oregon hospital attempting to reduce rate of cesarean births

An article published earlier this week details the steps Oregon Health & Science University is taking to reduce the number of women undergoing cesarean sections for delivery of their babies.  The hospital’s current rate of cesarean–about 1 in 3–is on par with the national average.  Care providers at the hospital, in an attempt to reduce that number, are allowing for some attempted vaginal deliveries of certain types of breech babies, VBACs after one and two cesareans, and nonvertex twins.  This seems to be a step in the right direction, and a great option for mothers that would feel safer in the hospital.  But what about the implication that certain types of births should take place in a hospital as opposed to at home?  This hospital seems to be opening the door for women who otherwise wouldn’t be able to have a chance of a vaginal delivery in the hospital, but, of course, some women will still to choose to birth at home for many and varied reasons.  It is ICAN’s belief that a woman’s choice of care provider and location of birth should be respected.

What are your thoughts?

9 Comments

  1. Amanda says:

    I definitly agree with choice of location being respected. Although, I truely love the fact that women should be allowed to VBAC after more than one c/s. And some women, based on other conditions, should be able to do that in the hospital enviroment to reduce the risk of dangerous complications.

    However, if it were safe to birth at home. I would. The enviroment is under my control. No needles, no monitors, no invasions. BUT the risk to me would be too great and I can;t even express how much I want to know what its like to actually push my baby out of me. Then again, my greatest fear of birthing in a hospital is being bullied into a c-section in the hospital at the slightest implacation of blip or anything that something may be going wrong. Also, the hospital could use my fears to force me into my csection whereas a home birth would not have that occur

  2. MKJ says:

    A step in the right direction indeed! I think that Amanda’s great points about the various fears associated with different birth locations are beginning to be addressed by the hospital described here, and I certainly hope that other hospitals will follow suit. By making the commitment to reduce the C-section ratio, the hospital is showing its commitment to try to alleviate some of the fears that we may have about hospital births. In addition to hoping that other hospitals catch on, I also hope that this leads to efforts to reduce other potential fear factors including induction.

  3. Selena says:

    While I’m happy that OHSU is offering this service I’m not happy about their negative stance on home birth. I had a HBA2C in Oregon last year and I know I would have most likely ended up with another csection had I chose a hospital provider. My baby and I were perfectly healthy but we went into the 42nd week and no hospital would have allowed that. I just wonder how many restrictions they put on women who want a vbamc and how many will actually be successful. I resent that they think I should not have had the choice to have a home birth.

  4. Lauren says:

    Wow, vaginal delivery for BREECH!! Holy Moley!! That’s awesome!! So happy to hear a hospital that doesnt consider vaginal delivery of breech and death sentence for mother and baby! But having my baby at home would still be my choice, all though, for my pain-sensitive friends who reeaally want the epidural, I might recommend this hospital! But the option to birth at home should never be taken away from any women any where. Some women just like to be at home and thats their business!

    I was a HBAC who went almost to 43 weeks too Selena!! No doctor would have allowed that! So, it was homebirth or nothing for me. Really glad I chose homebirth and got to have my VBAC!!

  5. I did not read the other responses yet, but I don’t really believe that it is implying that the births should be done in a hospital – just that it is now an option when it wasn’t otherwise. From the experience I’ve had discussing VBA(m)Cs & HBA(m)Cs, a hospital delivery is hardly ever something I even hear mentioned. So for me, this is comforting, when the implication I feel exists with having a VBA(m)C is usually that it most be done at home. That’s just my take on it.

  6. So after reading the responses & re-reading the article, I am interpreting it differently. According to the article, they are not removing home birth as an option, so I don’t see it as being taken away or as a negative thing. They are adding an option for those who would not like a home birth. Sometimes, I feel like there is a level of hypocrisy to birth choices when it comes to subjects like this. We would like to be able to choose where we are most comfortable, to do what we know our bodies were made to do (safely), and to have support for those decisions. So offering another option, to those who want it, is great, in my opinion.

    I believe women who want a home birth will still do so. I don’t think this is going to sway them. I do think this may sway women who think home birth is their only option for a VBAC, breech delivery, twin delivery, etc. into considering the hospital, but isn’t it nice to be able to attempt a vaginal birth in a hospital, if you are not comfortable with a home birth, versus having no choice but consent to a c-section? I think so.

  7. Selena says:

    Don’t get me wrong, I do think it’s great that they are offering vag twin/breech and vbamc. I guess as someone who is local to this hospital and knows some of their history of being anti home birth it colors how I feel and interpret the statements on home breech/twin/vbamc made in the article.

  8. I can understand that. Without knowing the back-story/history, I just interpret it differently. I enjoy reading the different viewpoints.

  9. This is a good step in the right direction, but how much difference is it *really* making in VBAC and breech access? Sounds like they are only permitting “Cinderella” VBACs and breeches…..those in which every little requirement is met JUST SO or to the O.R. with you. Look at the stats cited…..only a few women have qualified for vaginal breech over the last several MONTHS.

    I wonder how many VBA2Cs they have had? Not many, I bet. Theoretical access is better than no access….but what we really need is MEANINGFUL access, not Cinderella Access.

    The political climate for homebirth in OR is better than in most states, but is facing new restrictions, esp on VBAMC. This hospital used to be a great place for homebirth transfer but is now considered hostile to it by a lot of midwives. So that’s why some people are doubting how much difference these new rules will actually make, and the motivations of the doctors in ostensibly offering them.

    They wonder if it’s just the latest bait and switch tactic……sure you can have your VBA2C or vaginal breech in the hospital!…..until at the last minute, something doesn’t qualify for all their guidelines and back to the O.R. you go.

    I would like to assume it’s all in good faith and with the best intentions and will make a difference in the c/s rates, but time will tell. Still, it’s a step in the right direction, so let’s celebrate that….and then hold them to this commitment.