The study included 15,574 women at 79 birth centers across the U.S. between the years of 2007 and 2010. This is a respectable sized study. About 80% of the women were married and about 3/4 of them had at least some college education. Half of them were having their first baby, while the other 50% had given birth previously.
Here's the awesome part of the study - 94% of the women planning a birth center birth had a vaginal birth! This means that only 6% of these women had a cesarean section. It's true, they were all low-risk. But in the hospital, the rate of cesarean section for low-risk women is 27%! Read this paragraph again. I'll give you a minute...
There were no maternal deaths ("I would have died if I would have had my baby out of a hospital!") and the stillborn/newborn death rate was very consistent with other birth places. In other words, these babies likely would have died regardless of where they were born.
Interestingly, the rate of cesarean birth in the hospitals has dramatically increased over the decades, while it has remained stable - and low - in the birth centers between 4.4%-6%. The women in this study saved more than $30 million simply by birthing in a birth center instead of a hospital.
According to Rebecca Dekker, "The National Birth Center Study II shows that when women receive midwifery-led care in birth centers, preventable C-sections are prevented... Legislation is needed to align payment methods and regulations so that we can better promote the proliferation of birth centers." In other words, if you are low-risk, hire a midwife, birth out of hospital, and demand that insurance cover midwifery care at a birth center!
For years I have said that birthing in the hospital is like eating at the Olive Garden. Before I go any further, let me just say that I worked for Darden Restaurants at the Olive Garden for nearly 4 years. They are a fabulous company to work for. Seriously. I got vacation, insurance, incentives. Sometimes I still miss it. It's also still one of my favorite places to eat. With that being said....
When you walk in, you are welcomed by the hostess. Hopefully you don't have to wait too long for a table. You have a lovely meal, but if you camp out, your server starts getting nervous. Because of all the refillable items, the server's section only consists of 3 tables in order to give great service. If he/she is going to make any money, they've got to turn those tables. When one table hangs out, it hurts the profits of both the server and the restaurant, and the lobby starts filling and backing up, especially if several tables are "camping out."
When you are birthing at the hospital, you simply cannot labor in a room for hours upon hours, or sometimes days. The lobby (triage) is filling up and your table (room) is needed. Even the best care providers working in the hospital will tell you to "come in pushing" because they know that women are much more likely to have things done to them to speed things along once they are in the hospital - things that interfere with and interrupt the natural process.
One of the most significant points worth repeating from the study is that low-risk women have a 6% c-section rate at a birth center, but in the hospital, they are more than 4 times as likely to have a c-section, at 27%! Some of the reasons for higher c-section rates when mom plans a hospital birth include:
* We need your table - i.e. Failure to Progress - Mom has "failed" to progress within her time limit imposed by the hospital.
* High rate of induction and not allowing labor to start on its own - A first-time mom is twice as likely to have a c-section when her labor is induced.
* The use of epidurals and IV drugs do affect the course of a woman's labor. These are not options in a birth center.
* Baby is more likely to have heart decelerations with pitocin and other drugs in mom's system, causing care providers to worry more - not just about the baby but also about lawsuits. The what-if factor is huge and a lot of cesareans are performed as a direct result.
* We cannot ignore the money factor. C-sections make more money.
* We cannot ignore the time factor. The more time the OB is in the hospital, often, his lobby is full over at his office. Ever wonder why you wait for 3 hours at your OB appointment? He/she is aware they are getting further behind the longer you are taking to have your baby. They don't have time to wait around. (I actually get this one. I am super selfish with my time. I can't stand to wait - on anything - and know I'm getting behind with other things. I would make a terrible midwife for this reason.)
Personally, I believe at the root of choosing hospital birth is the desire for an epidural. I believe that if women (and men) weren't so afraid, they wouldn't ignore this evidence about the safety of out-of-hospital birth. Education takes the fear away.
"You CAN have an amazing birth!" - Birth Boot Camp
Now, go enjoy a delicious meal at the Olive Garden and tell them Banned From Baby Showers sent you!
No comments: