Canadian Births: "where" is more important than ever

Canadian Births: "where" is more important than ever.  "Where" as in: where in Canada you are giving birth-
Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut. The percentage of women getting an epidural while in labour is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island. 

Isn't that strange?  That women who live on the East Coast of Canada have suddenly developed a problem giving birth vaginally?  Or that women in Quebec have strangely lost their ability to push their babies out without help of a vacuum or salad tongs?  How could this be?  Is it the water?  Maybe something in the air that they breathe?  Or could it be that doctors and hospitals in those areas are more scissor happy than in other areas of Canada? hmmmmmmm....

Personally I like the part of the article where the  SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.“We have some good guidelines but there is no money for implementation,” 
ARE they freakin' joking?!  No money to implement guidelines that will save hundreds of thousands of women from needless surgical deliveries, and save multitudes of babies from suffering respiratory distress and other life threatening problems due to the over used of medical interventions like epidurals, inductions and caesarean sections?!  No money to implement a set of guidelines that by lowering the surgical birth rate would effective cut the cost of giving birth by at least 50%?!?   HELLO!?  Is there a mathematician in the house?

*insert smiley banging head against a brick wall* 

Obstetrical interventions

Procedures for delivering babies vary markedly across Canada

New data show wide regional disparities in C-sections, epidurals and forceps deliveries

Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut, newly released data show.
Similarly, the percentage of women getting an epidural during delivery is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island.
These are just a few striking examples of how the medical procedures women are subjected to during childbirth vary markedly between regions.
“The bottom line is that there are a lot of obstetrical interventions in Canada,” said Gisela Becker, president of the Canadian Association of Midwives.
“As for the variations, there are a whole bunch of reasons,” she said.
Those reasons include everything from more women giving birth over the age of 40 through to the fragmentation of care, and from overcautious risk managers through to doctors with ingrained habits.
“It’s really hard to figure out what the correct rate of intervention should be,” said Dr. André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada.. “There are a lot of factors that come into play.”
What is certain, though, is that the variations that exist are too great and suggest some inadequacies in care, he said.
Dr. Lalonde noted that the SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.
“We have some good guidelines but there is no money for implementation,” he said.
There were about 374,000 hospital births in Canada last year, according to the Canadian Institute for Health Information.
Of those, 18.5 per cent were delivered by C-section and 81.5 per cent were vaginal births. The cesarean rate rose to 23.7 per cent among women over the age of 35.
Ms. Becker, a midwife in Fort Smith, NWT, said that while there are cases where surgery is required, the “World Health Organization says that a C-section rate over 15 per cent is not acceptable.”

HERE to read the entire article at the Globe & Mail

The High Cost of Caesarean Sections

Almost weekly now we are reading news stories in North American main stream media about our appalling maternal and infant mortality rates in Canada and the US, which I've written about many times:

*"Canada’s reputation for low infant mortality takes stunning decline"

*Canada gets a "C" for infant mortality

*Amnesty blows the whistle on Maternal Mortality rates in the US

*"Emotional Impact of Caesareans"

This week is continuing the tradition with yet another article on the High cost of Caesarean Sections- both in loss of life and financially.  You have to wonder if the Medical Machine is ever going to wake up and realize that THEY are the problem right now.  Study after Study has been done to show the increased risks that come with Caesarean Section births, especially elective C/Sections. More and more women and babies are suffering from needless trauma, and horrifyingly our maternal and infant mortality rates just keep climbing.  Various medical organizations have pointed fingers at North America's high preterm birth rates and an increase in multiple births due to fertility treatments as reasons for the decline, but they refuse to accept that the biggest reasons are the use of chemical inductions, epidurals and C/Section.

Do I sound like a broken record?   I really hate sounding like a one hit wonder.  But I'll keep roaring from my soap box and hopefully someone will listen. Even if it's just a pregnant first time mom who needs to hear the truth.

(as usual the highlighted areas are my own)

The high cost of caesareans

By Timothy R. B. Johnson and Judy Norsigian June 28, 2010

FOR A symbol of what ails the US health system, look no further than hospital delivery rooms, where costly caesareans, many for non-medical reasons, are inching closer to a majority of all births.

 

Even though caesareans are associated with higher rates of complications than vaginal births, they are becomingly increasingly common. Problems range from infections, including the more serious antibiotic-resistant ones, to blood clots, prematurity, respiratory problems for the baby, and more complications with subsequent pregnancies. There is even a small but measurably higher risk of death for the mother.

Between 2000 and 2006, while the Massachusetts caesarean rate climbed from 16th to 10th highest among all states, the state’s ranking on neonatal mortality has slipped from 4th best to a tie for 9th. Six hospitals in the state have caesarean rates greater than 40 percent for first time mothers, yet none of these hospitals is designated as a high-risk center. So much for the argument that high-risk pregnancies are the reason for these rates.

There are also cost consequences for taxpayers — the caesarean rate for Massachusetts mothers on Medicaid is increasing at a faster pace than among privately insured mothers. Nationally, in 2008, average hospital charges for an uncomplicated caesarean section were $14,894, while such charges for an uncomplicated vaginal birth were $8,919.

What can we do to lower the caesarean rate? Considerable media attention has focused on how extreme obesity can raise the risk of having a caesarean, but more emphasis is needed on these system-based approaches:

■More hospitals need to institute policies that restrict the induction of labor, unless there is a good medical reason. Unfortunately, labor is now sometimes induced solely for the convenience of the physician or the mother, and labor induction increases the likelihood of a caesarean section in many women. Almost all the recent increase in late preterm (34 to 36 weeks) births was related to planned caesareans carried out too soon, and the rise in premature and low-birth-weight babies has required more expensive hospital-based care to address the medical problems of these infants.

■Obstetricians and hospitals should follow the new National Institute of Health recommendations to offer the option of vaginal birth after a caesarean for those women who want to avoid repeat surgery. As noted in a recent NIH press release, “Although as many as 60 percent of hospitals in some states routinely prohibit vaginal delivery by women who have had a caesarean section, that practice is out of step with current medical research.’’

Expanding this option would require that the American Congress of Obstetricians and Gynecologists amend a recommendation that hospitals have 24/7 presence of an anesthesiologist if they choose to offer vaginal births after a caesarean. Because of this recommendation, many hospitals concerned about liability refuse to allow them. Yet those same hospitals find it acceptable to call in an off-site anesthesiologist when mothers need an emergency caesarean for any other reason.

■Hospitals could expand access to nurse-midwifery care. In Boston, statistics for hospitals that care for women facing the same risk of complications show that hospitals with nurse-midwifery services tend to have lower caesarean rates than those without a significant midwifery presence.

 HERE to read the entire article