Comments on: Ohio Hospital Compare includes (some troubling) data on c-sections

By: Tweets that mention Birthing Beautiful Ideas | Ohio Hospital Compare includes (some troubling) data on c-sections -- Topsy.com

Thu, 07 Jan 2010 06:07:44 +0000

[...] This post was mentioned on Twitter by Michelle Potter, Kristen O. Kristen O said: Ohio Hospital Compare includes (some troubling) data on c-sections. http://birthingbeautifulideas.com/?p=1225 #cesarean [...]

By: Jessica

Jessica — Thu, 07 Jan 2010 00:24:35 +0000

This is an interesting report, I wish they had included all the other cesareans so we could have a more accurate view of the true rates. I would love to see a survey of all the women who left the state to have a birth safely away from the surgery happy hands of Ohio’s OBs. I had a birth center VBAC after an Inv T in MI in 2007 because none of the care providers (OBs or home birth midwives) in NW Ohio would assist me.

By: BirthingBeautifulIdeas

BirthingBeautifulIdeas — Wed, 06 Jan 2010 16:16:50 +0000

@Mrs. Spit – No, they didn’t report any information on induction rates and reasons, although they did mention that inductions are associated with higher c-section rates. It makes me wonder if the state does have a lot more data on maternity care in Ohio that they simply haven’t reported yet. Perhaps they felt as if c-section infection rates, c-section rates for first time moms, etc. were some of the best ways to characterize a hospital’s performance measures in terms of maternity care. (For what it’s worth, the website also reported on pre-term infants who were delivered at hospitals with Level II NICUs and mothers of pre-term infants who were given steroids before their babies’ births, so the maternity-relevant performance measures weren’t solely related to cesarean section.)

By: BirthingBeautifulIdeas

BirthingBeautifulIdeas — Wed, 06 Jan 2010 16:09:01 +0000

I’m guessing the 6.9% rate includes c-sections for fetal distress, “failure to progress,” failed inductions, and “suspected macrosomia.” There might be a few patient-chosen elective c-sections in there, and there could also be some doctor-directed elective c-sections (like the ones for suspected macrosomia, or “big babies”). There could be other reasons for the c-sections in that group, of course, but a 6.9% rate seems very, very good, especially when compared with the other hospitals in the state.

As far as their reasons for not reporting the other data, my guess is that it is simply very difficult to get hospitals to give reports on lots and lots of information. (And they might be reporting overall cesarean rates to the CDC anyway.) I haven’t looked yet into why the state of Ohio chose to report (or even to collect) this data as opposed to other hospital performance measures, but I’m glad that they are at least reporting some of it!

I also wonder, however, if they do have info available on the overall c-section rates per hospital, especially since they remarked about the 50%+ cesarean rates in some individual hospitals. Nonetheless, I like how the state used the info on first cesareans to shed light on how maternity care providers need to do a better job of “managing” these first births so that women can avoid all of the complications that come with c-sections (including FUTURE c-sections).

By: Mrs. Spit

Mrs. Spit — Wed, 06 Jan 2010 16:07:45 +0000

Did they post anything on induction rates and reasons? There can be some good reasons for induction (Past 42 weeks when you are sure of dates) and some very stupid reasons – a lot of very stupid reasons.

I wonder . . .

By: Jenny

Jenny — Wed, 06 Jan 2010 15:39:11 +0000

I was going to ask you about this – I checked out the study when I saw you Twitter it and at first I said “whoo hoo” MVH low c-section rate but then I realized all the stuff it was missing. So is the 6.9% at the Valley basically for elective c-sections since it doesn’t include breech births etc? I wondered why they don’t report the rest of the information as I would think that it would be relevant too.