Category: Statistics

Black Breastfeeding Week 2014!

8/27/2014

Raising Awareness with Black Breastfeeding Week! Yes, they deserve a special week in world breastfeeding month! :) Please read on if you have a different opinion or don't understand why. Black breastfeeding moms absolutely face more challenges than other mothers in the US AND they need the benefits of breastfeeding even more because they and their babies are even more at risk. If you don't know, read on. Studies, surveys, CDC reports and more support this. "The barriers are financial, cultural, systemic and logistical. When dominant culture women aren’t aware of the challenges that women of color face, that lack of awareness becomes a barrier of its own." And please remember that race matters not just in breastfeeding, but in life... everyday. Whether you think it does or doesn't or should or shouldn't - race impacts everything.

http://blackbreastfeedingweek.org/why-we-need-black-breastfeeding-week/

http://lactationmatters.org/2014/08/25/seven-ways-to-support-black-breastfeeding-week/

And...Why Ferguson has everything to do with Black Breastfeeding Week

SO CATCHY! "All the...all the babies love it!" :)

_________________________________________________________________________
...And just because it's relevant to race and the times (not breastfeeding fyi), I have to include this as well as another example of all that is holding us back from moving more towards equality... If you're interested, go for the link below...

http://www.huffingtonpost.com/2014/08/27/jon-stewart-ferguson_n_5720622.html?ncid=fcbklnkushpmg00000063

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2011 Pennsylvania Cesarean Rates, by hospital

4/21/2014

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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

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CDC Breastfeeding Report Card, 2013

8/1/2013

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http://www.cdc.gov/breastfeeding/pdf/2013BreastfeedingReportCard.pdf

"The percent of US infants who begin breastfeeding is high at 77%. While there is concern that infants are not breastfed for as long as recommended, the National Immunization Survey data show continued progress has been made over the last ten years. Of infants born in 2010, 49% were breastfeeding at 6 months, up from 35% in 2000. The breastfeeding rate at 12 months increased from 16% to 27% during that same time period."

Why, you wonder? Well, it is attributed to an increase of Skin-to-Skin contact between mother and baby immediately following birth AND the practice of Rooming- In (23 of 24 hrs spent with mom instead of baby away from her in nursery). These practices are being implemented more and more at area hospitals here in and around Philadelphia, PA and we are seeing great results for moms and babies success with breastfeeding. While we hope to lower the rate of cesarean sections happening, we can also hope to increase these numbers even more. The report demonstrates that as the percentages of hospitals and birthing centers where >90% mothers and babies get skin to skin and rooming in INCREASES, so does the immediate and long term success of breastfeeding. This supports the Healthy People objectives for 2020 while making mothers and babies happier! Let's keep it up, America! Let's keep it up PA! Let's keep it up Philly! Support support support! Hospital procedures effect breastfeeding success so greatly, more than mothers realize, so we need procedures to support moms and babies getting the best start to breastfeeding. Come on nurses, docs, midwives, doulas, lactation consultants, and let's not forget our peer counselors - This week is also World Breastfeeding Week and the theme is focusing on the importance of support from moms in the community, ie peer counselors! ;) And last but definitely not least, let's keep it up, mommies! You can do it!

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Informed Consent?

2/8/2013

1 Comment

How's this for informed consent? First time mom says to her favorite doctor at 38 wk check up,

"I'm getting pretty uncomfortable but I really don't want to be induced because I heard it makes things harder" OB response, "1)The nice thing about inductions is you can not only plan your baby's birth into your schedule without the risk of surprise or something going wrong before you make it to the hospital in labor but you also get to assure I'll be the doctor delivering you. (He also reminds her that she won't have to push out as big of a baby either) and 2) We are only giving you the hormone your body makes itself, so it's not going to be any 'harder'. Labor is hard. We have epidurals for that." Mom is surprised how much the answer eases her mind despite everything she's been reading - and feeling much more in control now, says, "As long as it doesn't increase my risk for having a csection, because I definitely don't want that... when is the soonest we can do it?" Doc responds, "The ones coming in with Birth Plans increase their chance of cesarean. (chuckles) You'll be fine. Let's do next Wednesday, you'll be 39 wks and a few days - policy changes - I have to wait until at least 38 wks now no matter how uncomfortable you are."

SO. MANY. PROBLEMS. WITH. THIS. Where to even begin? Now, I feel pretty comfortable in my knowledge base of the evidence as well as ACOG guidelines, etc., so there are a few things glaring at me that I want to JUMP on... big time. But I fear if I start to address each untruth and danger within this OB's responses, I will write a book tonight, not a blog post! And frankly, I don't have the time! Ok, Breathe. In....all things good and right in the world, Out....all things &U#&$$*ed up....ok, again....nice and deep and slow. Repeat.

Ok. If this was your sister, friend, or anyone you cared about - what would you say to keep it short and simple!?!? For you doulas and childbirth educator's out there - what information would you be sure to relay to this client/student?

I tend to think that if I was involved with this woman either professionally or personally I might start with this:

The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 107 addresses counseling for induction of labor and specifically addresses elective induction in nulliparous women with unfavorable cervices as to the 2-fold increase in risk of cesarean delivery, length of labor, and the need for a readily available physician capable of performing a cesarean delivery. ACOG also offers a Patient Safety Checklist for induction of labor that includes documentation that risks and benefits were discussed with the patient.

I realize we can't save every woman and baby from similar doctors who are, believe me, absolutely still out there practicing in a hospital near you - but, if you heard a similar conversation being relayed to you, WHAT DO YOU SAY? And why do you speak up or not? I'm curious of the different perspectives on this topic.

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Client 'stats'

3/30/2011

2 Comments

So, today during a consult I was asked about my stats. It is common for me to be asked how many births I've been to, how many at hospitals vs. birth centers vs. home, or how many at a particular hospital, etc. But, this expecting father today was specifically curious as to how many of my clients had unmedicated births. I am surprised actually that more people do not ask that now that I think about it. I remember wanting to know the same of my childbirth educator/doula when pregnant with my first, too. And I'm now also curious if other doulas know those kinds of statistics off the top of their head. I, personally, had to make a guesstimate. I guessed 70% roughly have birthed their babies without medication. I think this is something I should maybe know at least for consult purposes, but not be focused on in any way, though. To be honest, I am a statistics/research gal. I like to see numbers. I like to analyze them especially. I see numbers and want to know WHY. I do not like to assume anything...but I do like to question them and use information I may be privy to in order to see behind the numbers. I think I'm pretty fair in my assessments, too. I've read so much birth related evidence-based research and explanations from Henci Goer at this point that I know what kinds of questions to ask of the studies to see what facts we're really dealing with.

However, in discussing my client's birth stats, I would never want them to enter my mind as being important or telling. Here's why.
Number one reason: What is MOST important to me AND them is whether or not they had a positive birthing experiece. Ya know? This is not about if drugs in labor are good or bad, generally speaking, this is about each specific woman being happy vs. traumatized on the day of her child's birth. I want them to feel as good as possible about their labor and birth. I want them to feel supported, empowered, and loved... and that they were able to make informed decisions.
Reason #2: My clients give birth in every different setting possible. I've said it before a hundred times and I'll say it again. Where you CHOOSE to birth your baby matters. It DOES affect your labor and birth. Period.
Reason #3: My clients are all different people. My clients have been first time mothers to fifth time mothers, VBACers, low risk, some with medical conditions, some with supportive care providers, some not, some with supportive partners and some completely alone, some that for whatever the reason could not freely move based on restrictions in the hospital, some who didn't have access to drugs, some with malpositioned babies, some with long exhausting labors, some with labors that struggled to progress, some with fast labors, I could go on and on - but you get the point.

My clients all have stories. I know those stories, I know their labors, I know their circumstances, and I know that whether or not they got medication during labor only tells one piece of the story. Whether or not it was necessary is not something I EVER know. And whether or not it was a reason for their labor experience being either positive OR negative, I will NEVER truly know. It is just one piece. One decision. Yes, maybe it is a huge one, but behind each of my clients' decisions is a story. I do not view any as 'better' than another based on this decision on pain medication, or as any of my client's as failing to labor naturally because they chose medication. It is SO individual. Labor is unpredictable. Do I believe MOST women are ABLE to do it without medication if they really want to? Yes. Does it sometimes take the combination of a comfortable laboring and birthing environment matched with the right support and the labor not being complicated by factors or interventions that may cause dystocia or more intervention? Absolutely. And do sometimes women set themselves up with the perfect recipe for a great unmedicated normal birth and it still go another way? Absolutely. Do some women doubt their abilities to manage without medication and leave all options open without a 'birth plan', etc and then birth their babies easily without much assistance from anyone or anything? Absolutely. I know one thing, though - Having a doula matters. We DO make a difference. Yes, overall we lessen the need for epidural pain relief. Not a guarantee, though, as nothing is. Ya know what difference we almost always make? Whether or not the mom feels good about her birth-day. And that IS important.

That being said, is it still all that interesting to know what percentage of my client's labored without the famous epidural? Hmmm....

I serve such a diverse population with varying situations and perspectives on medicine, interventions, and birth beliefs as well as varying hospital practices influencing my client's labor experiences. I think it would be interesting just to see what my small numbers say and if my guesstimate was close or not.

Check back later after I do some calculations. :) :) :)

Originally I posted the calculations and some more stats in the comment section and then changed my mind about posting them publicly. I fear that people will focus on it as being important. And it's really not. Every client and every situation is individual. I'd prefer to not calculate again, actually, and probably never will. I learned that I'm a good enough guesser if any potential client ever really wants an answer from me again. :)

I'd love to hear feedback from other doulas on this topic, too.

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Black Breastfeeding Week 2014!

2011 Pennsylvania Cesarean Rates, by hospital

CDC Breastfeeding Report Card, 2013

Informed Consent?

Client 'stats'

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