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2011 Pennsylvania Cesarean Rates, by hospital

4/21/2014

0 Comments

 
http://www.cesareanrates.com/pennsylvania/

WHERE DO VBACS OCCUR IN THIS STATE?There is no indication as to whether these VBACs were planned or unplanned. While it can be assumed that hospitals with higher numbers "allow" VBAC in their facility, it is best to speak with both your doctor and an administrator at the hospital for information on their VBAC policy.

(Excuse the formatting below, I haven't figured out how to tidy it up yet. But you can scroll, all hospitals are listed alphabetically. Paoli, Lankenau, and Bryn Mawr are all listed under Main Line Health Hospitals.)

2011

Facility

Total Repeat CS

Total VBAC

VBAC Rate

Abington Memorial Hospital

744

95

11.3%

Albert Einstein Medical Center

351

129

26.9%

Altoona Regional Health System

96

14

12.7%

Armstrong County Memorial Hospital

97

11

10.2%

Berwick Hospital Center

9

1

10.0%

Bloomsburg Hospital

31

5

13.9%

Bradford Regional Medical Center

48

0

0.0%

Butler Memorial Hospital

46

6

11.5%

Carlisle Regional Medical Center

60

2

3.2%

Chambersburg Hospital

167

22

11.6%

Charles Cole Memorial Hospital

28

0

0.0%

Chester County Hospital

273

52

16.0%

Childrens Hospital of Philadelphia

36

0

0.0%

Clarion Hospital

37

0

0.0%

Clearfield Hospital

22

2

8.3%

Conemaugh Valley Memorial Hospital

136

31

18.6%

Crozer Chester Medical Center

269

32

10.6%

Delaware County Memorial Hospital

184

52

22.0%

Doylestown Hospital

205

8

3.8%

Dubois Regional Medical Center

118

7

5.6%

Easton Hospital

60

2

3.2%

Elk Regional Health Center

27

1

3.6%

Ellwood City Hospital

31

4

11.4%

Ephrata Community Hospital

81

22

21.4%

Evangelical Community Hospital

142

27

16.0%

Excela Health Westmoreland Reg Hospital

197

20

9.2%

Geisinger Medical Ctr

211

34

13.9%

Geisinger Wyoming Valley Medical Ctr

220

26

10.6%

Gettysburg Hospital

72

1

1.4%

Good Samaritan Hospital

114

9

7.3%

Grand View Hospital

189

8

4.1%

Grove City Medical Center

27

1

3.6%

Hahnemann University Hospital

74

52

41.3%

Hamot Medical Center

343

61

15.1%

Hanover Hospital

71

1

1.4%

Hazleton General Hospital

117

5

4.1%

Heart of Lancaster Reg Medical Center

90

24

21.1%

Heritage Valley Beaver

87

19

17.9%

Heritage Valley Sewickley

147

14

8.7%

Holy Redeemer Hospital & Medical Center

424

29

6.4%

Holy Spirit Hospital

113

67

37.2%

Hospital of The University of PA

411

131

24.2%

Indiana Regional Medical Center

61

6

9.0%

J C Blair Memorial Hospital

28

2

6.7%

Jameson Memorial Hospital

66

4

5.7%

Jennersville Regional Hospital

52

21

28.8%

Lancaster General Hospital

624

101

13.9%

Lehigh Valley Hospital

324

75

18.8%

Lewistown Hospital

64

13

16.9%

Lock Haven Hospital

18

2

10.0%

Lower Bucks Hospital

207

8

3.7%

Magee Womens Hospital of UPMC Health Sys

852

182

17.6%

Main Line Hospital Bryn Mawr

190

17

8.2%

Main Line Hospital Lankenau

439

25

5.4%

Main Line Hospital Paoli

389

16

4.0%

Meadville Medical Center

44

0

0.0%

Memorial Hospital Inc Towanda

32

0

0.0%

Memorial Hospital York

66

4

5.7%

Millcreek Community Hospital

23

1

4.2%

Milton S Hershey Medical Center

273

43

13.6%

Montgomery Hospital

154

40

20.6%

Moses Taylor Hospital

289

38

11.6%

Mount Nittany Medical Center

143

25

14.9%

Nason Hospital

52

13

20.0%

Nesbitt Memorial Hospital

155

18

10.4%

PA Hospital of the Univer of PA Health Sys

684

119

14.8%

Phoenixville Hospital Company LLC

111

20

15.3%

Pinnacle Health Hospitals

468

22

4.5%

Pocono Medical Center

106

10

8.6%

Pottstown Memorial Medical Center

98

5

4.9%

Punxsutawney Area Hospital

20

0

0.0%

Reading Hospital & Medical Center

384

82

17.6%

Riddle Memorial Hospital

160

4

2.4%

Robert Packer Hospital

30

5

14.3%

Sacred Heart Hospital

49

13

21.0%

Saint Vincent Health Center

158

31

16.4%

Schuylkill Medical Ctr-S Jackson St

111

14

11.2%

Sharon Regional Health System

24

8

25.0%

Shenango Valley Medical Center

50

14

21.9%

Soldiers & Sailors Memorial Hospital

28

0

0.0%

Somerset Hospital

30

3

9.1%

St Clair Memorial Hospital

166

5

2.9%

St Joseph Medical Center Reading

85

13

13.3%

St Lukes Hospital Allentown

208

39

15.8%

St Lukes Hospital Bethlehem

346

69

16.6%

St Mary Medical Center

255

17

6.3%

Temple University Hospital

471

76

13.9%

Thomas Jefferson University Hospital

232

63

21.4%

Titusville Area Hospital

16

3

15.8%

Uniontown Hospital

125

6

4.6%

UPMC Bedford

46

1

2.1%

UPMC Mercy

167

29

14.8%

UPMC Northwest Seneca

76

5

6.2%

Warren General Hospital

49

8

14.0%

Washington Hospital

74

11

12.9%

Wayne Memorial Hospital

25

4

13.8%

Waynesboro Hospital

32

13

28.9%

Western PA Hospital Forbes Regional Campus

76

12

13.6%

Western Pennsylvania Hospital

491

76

13.4%

Williamsport Hospital & Medical Center

160

13

7.5%

Windber Hospital

28

0

0.0%

York Hospital

421

52

11.0%

Freestanding Birthing Center

23

N/A

Other

102

N/A

0 Comments

Danny's birth

5/21/2013

1 Comment

 
Our son joyously arrived at 10:08pm on Monday, April 29th.  He came on his due date, which happily is the first of my expectations he decided not to fulfill.  I had told people for months that we would have a May baby, but he had other ideas.  My husband and I were lounging on the couch in the afternoon of the 28th when I felt a sudden desire to rush to the bathroom.  I knew immediately that my water had broken and remembered to note the color, smell, etc. like Lori had told us.  Water continued to seep from me for the next eight hours or so, in varying amounts.  The amount of water surprised me!  Good thing I had a bag of sanitary napkins on hand.  

Dan (the husband, not the baby!) and I frantically packed our bags and called The Birth Center in Wilmington, which is where we were planning on giving birth.  Because I am Group B Strep positive, the midwife (Durenda) requested we come in and start an antibiotic.  I felt high and expectant on the ride to Delaware.  I had not had any contractions yet.   When we arrived  Durenda confirmed that I had experienced premature rupture of membranes (PROM).  I was about 2cm dilated and 60% or so effaced. She suggested that we take a walk and get something to eat at a local restaurant, which we did feeling anxious and gleeful.  After dinner, we considered getting a hotel, which would have meant that we would have to come back to TBC every four hours during the night so the antibiotic could be readministered.  Durenda suggested we sleep there, saving us the hassle.  Very nice!  

During dinner and the walk, I had several slight contractions that felt more like the Braxton-Hicks  variety with little pain.  Things were going slowly so we were reminded that if active labor had not begun within 24 hours of PROM we would be transferred to Christiana Hospital. After we returned to TBC, Durenda suggested taking some homeopathic tablets to help speed the process of labor.  She also presented castor oil as an alternative.  After consulting with Lori, I decided to try to castor oil immediately and try the homeopathy in the morning if it was needed. In hindsight, I should have done everything suggested immediately, but at the time I wanted to sleep a little and thought contractions would begin very soon.  I slept on my left side that night with my belly hanging over the edge of the bed to try to help Baby Danny position himself in the ideal position, with the knowledge that he had been on my right side for the majority of my pregnancy.  The castor oil did not kick in until early the next morning, and I had mild contractions through the night and was able to sleep pretty well.  

The next morning, midwife Sarah gave me the homeopathic herbs and Lori arrived with breakfast foods from Wawa. I was still only about 3 cm dilated and a little more effaced, but satisfactory progress wasn't being made.  I started to feel slightly desperate with the thought that we would be transferred, so after some more castor oil I tried nipple stimulation in the shower, which brought some better contractions.  After about thirty minutes in the shower, we tried taking a walk and doing some pelvis-opening stretches, but another exam revealed that I still wasn't 4cm dilated, which had been our indication that active labor had begun.  Sarah told me that we would need to be transferred, which was heartbreaking to me because I saw a C-section at the end of the ordeal.  I had a good cry, then we packed up and went to the hospital.   

As soon as we arrived, my contractions became more painful.  I was incredibly frustrated with the paperwork in triage, including seemingly irrelevant questions like the name of the county in which I was born.  Apparently, my husband, who took over after I showed clear frustration with the questioning, was also asked three times, "Are you sure she has no Spanish heritage?"  Not sure why this was of interest to them.  Finally, Sarah spoke up and asked if I could go to our room and we were told we could. We arrived in the room about 2:00pm.  As soon as we arrived an IV was started and I was given Pitocin to induce more contractions. The nurses were kind to all of us; I didn't feel any animosity about our wanting to do things as naturally as possible.  The nurses even seemed to respect Sarah and Lori's perspective and knowledge. I think they would agree.   

I found not being able to walk, squat, or move in general very difficult.  I turned to my left and waited between contractions. I experienced very little sensation in the front of my body, but the pain in my back was sharp.  Luckily, Dan never left my side and massaged both sides of my spine during each contraction.  Lori or Sarah stayed in front of my face, while the other stroked my leg or applied pressure on pressure points to help the contractions speed along.  

A habit I developed that Lori later said was unique: during contractions I sang or repeated phrases.  In the beginning, I said things like: "OPEN" in a firm, calm voice; "somos juntos" ("we are together"), a phrase that resonates with me after a trip to Mexico a couple of years ago; "ganbare!" ("go for it!" in Japanese); "there is no bliss like this" (a favorite affirmation from yoga practice); and simply "YES!"  I also told myself to be calm and that what I was feeling was a pain that creates, not that destroys.  As the contractions increased in duration and frequency, I sang long high notes or scales and didn't repeat phrases.   Lori told me I also sang "Somewhere Over the Rainbow." I could not have made it through without this comfort measure, which made me feel powerful and as though I was still in control of something.  At one point, the nurses explained that they were concerned about the baby's heart beat, so they wanted to use an internal monitor.  This device sticks into the baby's head using a piece of wire that looks like a screw.  Lori and Sarah said it was a good idea, and with the idea that a healthy baby was the goal I agreed.  

Around 9:00pm someone asked if I was feeling pressure in my bowel, which I said was true. The pressure increased with each contraction, and Lori was coaching me not to push but to use puff breaths during each contraction to avoid the urge.  During the puff breaths, I began to push uncontrollably.  The pushing felt like a sort of muscle reaction that I could not control, similar to what I imagine a seizure might feel like.  Someone (a doctor?  I never saw her again) said that I was fully effaced and dilated, so everyone agreed with smiles that I could start pushing.  A bar was used across the bed for me to put my feet on and the OBGYN on call arrived.  He said the pushing was going very quickly.  I commented to Lori and Sarah that this part was very satisfying and almost pleasurable because it was empowering to feel I was getting things accomplished.  Several other nurses joined us and everyone was shouting "Go, Sara! Push!" which really helped me stay motivated.  The hospital nurses commented that it was unusual for me to be smiling and seemingly enjoying myself. I think around this time I said to Lori, "I am a warrior" and she heartily agreed with an encouraging smile.  

I expected to be shocked by my baby, so had done a lot of visualizing during pregnancy of the moment when he emerged.  There was no shock involved, he felt like mine and someone I already knew. I don't think the visualizations had anything to do with this feeling; I just think it was the first hormonal reaction of motherhood to know that this creature is mine and no one else's, not even my husband's in the same way as he is mine.  

The placenta came away quickly, though I think the doctor had something to do with that as his arm was somewhere inside me just before it emerged.  The stitching process was not pleasant; I had a third degree tear because our baby was on the larger side (9lbs, 14 ounces) and came out with his arm wrapped around his head. I am disappointed with doctor's performance; he was by far the least caring member of the team and did nothing to keep me informed of what he was doing.  He almost seemed annoyed by my questions.  Our baby spent the next 3 and a half days in the NICU, which is another long story!  If anyone is interested I'd be happy to share.  The end result of all of this is currently asleep on my lap.    :)

Last thing for all you first timers who might come across this: a short list of recommendations.
1.  Hire a doula.  I VERY HIGHLY recommend Lori.  If possible, also have another support person plus your partner for a total of three.  I know that these people's presence there meant that the interventions were kept to an absolute minimum.
2.  Pack a bag in advance and pack as though you'll be gone for several days.  Better to have to much than too little.
3.  Get in shape NOW.  Even if you're already pregnant, find something to do that will keep you fit.
4. I hate to say this, but expect to be disappointed in the doctors you meet.  Find others to trust.   

THE END! Ah, but also a huge beginning for our family!  
1 Comment

Birth StoriesĀ 

6/22/2012

1 Comment

 
Picture

A collection of birth stories are posted below. Variety is included - medicated and unmedicated births, unplanned cesareans, VBAC's, homebirths, hospital births, birth center births, waterbirths, large babies, midwives, OB's, with and without doulas and more!  From a first birth to a fourth, these are real stories of women's birth experiences, told by the women themselves. Thanks to all who have shared already!  Others learn so much from hearing all the variations of labor and birth.  It is encouraging to read and hear other women's stories of birth - it builds a sense of community that we are sometimes missing in our 'real' lives since most of what we hear and see of birth from other women nowadays is on t.v. or negative, scary, dramatic events people like to share sometimes.  If you'd like to share your birth story on my site, please email me and I'll add it.

***For a collection of stories specifically about changing care providers, read here.***

   
Birth Stories

1) Rory's unmedicated hospital birth (3rd baby)

2) Isaiah's unmedicated hospital birth (1st baby - BIG baby)

3) Jonah's homebirth (4th baby, 2nd homebirth, born in the caul!)

4) Lakshman's birth (first baby, birth center) - Momma Rupal's blog "From Doctor to Mother

5) Nonah's homebirth (first baby, 10 lb baby!)

6) Luke's birth (first baby, hospital, cesarean)

7) Julia's hospital VBAC (Luke's sister!)

8) Gabe's birth (third baby, RCS)

9) Leo's birth (unmedicated hospital birth, 3rd baby, after a traumatic 1st birth and 2nd baby loss)

10) Lilliana's birth (postdates hospital induction after birth center transfer)

1 Comment

Taking the fear out of a fearful atmosphere.

1/24/2011

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We either trust birth, or we fear it. For those of us who trust birth, we feel more like bystanders or sometimes guardians of the birth process. I am a calm and encouraging energy for my clients. For those who fear it, they manage it. Step by step. If it is under their control, then they think they can better predict, better anticipate the next step of management and the next and the next, all the way up until a baby is born, one way or another and even after. Sometimes never wondering what would have happened if they had 'done' nothing and just let it be. Initiating some sort of control at some point, usually followed by further necessary control and intervention, and ending in a completely 'managed' process is so typical in our hospitals today. Mothers may not know any different because this has become birth as we know it in America - we hear the stories from our friends and coworkers.  Managed birth is so fear based.  And quite honestly, the midwives, doctors, or nurses working there in the hospitals may not know different either. But, truth is...birth usually works. By usually, I don't mean 60-70%...I mean USUALLY - like almost always!  Management is almost always unnecessary, yet I see the opposite happening. It is the norm instead. Which creates this atmosphere of fear. I can smell it in the air, I can see it on their faces and in their actions and I can hear it in their words. They are so accustomed to managing each step, they don't even think to do 'nothing'.  Sometimes my job is to replace that fear in the atmosphere with trust and calm.  You know who is often times the calmest?  Mom. She is wondering what all the fuss is about.  Yes, it is the most crazy intense feeling in the world to be pushing a baby out of her vagina, but at the births I attend - mom is listening to her body just as we've talked about prenatally and during labor.  As I glance around the room, I see fear and impatience underneath those trying to seem cool and collected and in control. I can sense discomfort from everyone who is supposed to be the most experienced with childbirth, and then watch this instinctively calm mom who is birthing her baby intuitively. Yet, she is still vulnerable because birth is simply intense...physically and emotionally.  How bizarre that she is usually the one trusting her body more than anyone, right?  Well, maybe not.  I mean, these people living in those moments of fear, impatience, and discomfort are sort of accustomed to these over managed births that do tend to lead to more problems with birth and baby. Yes,  interventions and management do CAUSE things to go wrong which often lead to more interventions and management.  See how this becomes the norm for them?  It is COMMON, but NOT NORMAL.  That is a difference to be understood. Being overcautious is NOT always good, especially when talking about birth.  Our bodies are amazing.  They know what to do.  Yes, birth is hard. Yes, babies go through a lot in the process.  And, yes, that is normal - could we please try to let moms know that???  Are interventions needed sometimes?  Yes, I am no dummy.  All interventions can be useful sometimes.  If we keep being overcautious and overtreating/managing things that come up in pregnancy and birth that can 'possibly' 'maybe' affect a small percentage of women, we are heading towards a culture or a world that eventually will not birth babies vaginally anymore at all.  In fact, let's just imagine that for a second. Ok, now that is something to fear for the future of humankind.

Instead, I'd like to trust. I do trust birth.  The more births I attend, the more I trust.  Most of the births I attend are natural, unmedicated births so yes, I do trust!  When do I sometimes fear?  When interventions and management completely take over the process and the environment changes from one of trust to fear.  I want to take that out of the atmosphere for women. I want to prevent that air of fear in their birthing space. My recipe is this: Prenatal education, nutritional counseling, labor and birth preparation, support for mothers throughout the entire process (ah-hem...doulas!), and caring/trusting care providers in a setting where mom is most comfortable. Wah-lah.  Trust needs to start appearing more in hospitals...it cannot just be the gift that homebirth and some birth center's provide.  This needs to be available for all women.

I have another thought that I often ponder.  What if hospital staff attend some non hospital births sometime?  I think it should be a part of their training - no matter who they are. How much difference that would make if all nurses, doctors, and midwives saw the normalcy of it all enough times to cause them to reflect on their own practices in the hospitals?  It seems to be getting worse rather than better.  How else can we create trust again? 
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