Some really useful information on where to give birth…
Last week, a friend on Facebook posted a link to the BirthChoiceUK website. I’d not heard of this resource before, so clicked through and had a look.
A team of lovely people has been going through all the statistics for each hospital and midwifery centre that provides birth facilities on the NHS and has created sets of data which you can sort by local area or hospital facility.
They’ve also put in the national statistics for information, and some details on how they gathered their data.
This would be really useful information if you are currently the proud owner of a bump as it allows you to get a sense of how medicalised the birthing environment in your local establishment is likely to be*.
It’s also great if you’re just a bit nosey.
Above average interventions
Being in the latter category, I eagerly put in the details of my nearest hospital, and discovered that the caesarean rate was 36.3%.
Wait – 36.3%? That means over one in every three women giving birth there ends up with major abdominal surgery.
(Now don’t get me wrong – caesareans can be amazing, life-saving operations and we are so blessed to have free access to skilled practitioners of that operation in the UK. But 1/3 of all births ending up in this operation is very high).
Hang on, I thought – what if this is a teaching hospital and gets more of the ‘high-risk’ cases in the area? Perhaps a fairer thing to check would be the instrumental delivery rate (how many mothers and babies needed a bit of help to complete the last bit of birth – e.g. by using forceps, which are a kind of salad tong designed for helping babies out, or ventouse, which is a suction cup applied to the baby’s head).
Compare that with a hospital a few miles away (the only one in the area to achieve full Baby Friendly status). Their instrumental delivery rate is 12.8%. Go a few miles in a different direction, and you get a hospital with instrumental delivery at 7.1%.
Although you probably won’t choose your place of birth by numbers alone, this kind of stuff is useful to know.
What’s the ideal?
Clearly, there are going to be variations in the numbers of interventions used (hospitals specialising in higher risk people will need to use more medical procedures than Midwife-led units specialising in ‘low risk’ pregnancies). But what are the ‘ideal’ numbers against which each unit should be measured? How do we know what’s ‘too high’ or ‘too low’ (gut instinct aside)?
The numbers that most people use as a benchmark are those devised by the World Health Organisation (WHO). They wrote a report in the 1980s which said that countries should aim for a caesarean rate of not higher than 10-15%.
However, in 2009, WHO has said that it doesn’t think we should use these numbers any more, although countries can ‘continue to use a range of 5-15%’ (unless they choose their own number). So maybe our gut instincts aren’t such a bad idea after all…
(The idea of a minimum percentage is that if your country’s medical intervention rate was zero, that would be bad, as it would mean you didn’t have any medical facilities for specialised help where it was needed. I can’t find any research for ‘ideal’ numbers of instrumental deliveries, but if you know more, please leave a comment below).
Birth outside of hospital
Where do you find information on the statistics if you are not intending to give birth in a hospital setting? The BirthChoiceUK website has details for facilities run by Midwives (these will have very low caesarean rates listed as if you needed an operation, you’d be transferred to a hospital). It also has home birth stats by area (click the ‘Go to detailed statistics menu’ button in the region maternity statistics list).
If you are planning a home birth and want some additional numbers, then the Birthplace Study provides a useful comparison of birth outcomes at home, in Midwife-run facilities not at home, and in hospital. One of its findings was that women will have fewer interventions if they birth at home than in hospital. The study compared women with a similar risk profile (low) so that there was a smoothing of the results to ensure a more even comparison between birth location and outcomes.
I’m not aware of any statistics for Community Midwifery teams around the country, but you could always ring your local Midwives and ask them for their stats. Independent Midwives may also be able to give you their own statistical information if asked.
Other birth stats
As with community teams, if you are intending to give birth in a private hospital (or you are in America), contact them directly and ask for the numbers – by individual doctor if necessary. For extra geek points, have a look at the statistics of The Farm Midwifery Center in Tennessee, run by the world-famous Midwife, Ina May Gaskin. Their results have often been used to highlight the advantages of continuous, one-to-one care in helping to ensure good outcomes for mother and baby.
The above is just a bit of geeky enthusiasm to show you some possible places to find out more details about the birth establishments in your area. You can’t really compare academic studies with personal lists, or one hospital directly with another, as there will always be particular reasons why the numbers fall a certain way. I posted the details in case they are useful – your own local tours, chats to parents in the area and gut instinct will let you know where you want to give birth. And your baby may just decide to turn up somewhere unexpected anyway!
*There’s nothing wrong with having a more medicalised birth, if that’s what you want or need. It’s just good to know what kind of ‘vibe’ your local birth facilities are likely to have before you make a shortlist of places to visit.
Quick challenge: look up the stats for your local birth facility and post your gut instinct [polite!] reaction in the comments below. I look forward to hearing from you!