Comparison of Cincinnati Hospitals C-Section Rates and Reputations

I have been curious for a while about my cities c-section, and episiotomy rates for our individual hospitals. Up until the writing of this blog, I have just had the general statistic of Cincinnati hospitals having a 30% cesarean section rate and then each hospitals reputation. Their reputations would come to me through other birth workers and be passed around like a cute baby. I knew I had to share these reputations as a service to the pregnant population of Cincinnati. Anyone utilizing these hospitals should have all the information possible so they can make an informed choice. In this blog, I’ll share the general reputations and the statistics that I have been able to get my hands on.  As a warning, take my opinions with a breath. I understand that any woman can have an amazing birth anywhere and any negative comments from me, is only my understanding and is in no way meant to discount your experience. That being said, if you would like to share your experience, please comment below or contact me directly. You can help round me out, LOL.  

I know, as much as any birth worker, that the type of delivery a pregnant person has will depend largely on the provider, followed by the characteristics of the support team and finally by the practices of the hospital that is utilized (if she uses one of course). I can think of a provider I would recommend at most of my local hospitals who knows natural birth well and supports women making informed choices. As could be assumed, I highly recommend a laboring parent having a support team that will encourage her labor and delivery preferences. Ideally that will mean a supportive partner and a doula. But the statistics of our local hospitals, which give solid information about their tendencies, was new to me. Finding these statistics was challenging, and will be a work in progress. As I gain more information with my questioning, I will update this post.

Tri-Health Bethesda North Hospital: 10500 Montgomery Rd, Cincinnati, OH 45242

Cesarean Section of first-time mothers giving birth to a single baby, at term, in the head-down position: 17.3%

Episiotomy rate: 4.5% (1.)

Bethesda North, or B. North, like we like to call it, has a pretty good name for itself, especially because this is the hospital that Dr. Daniel Bowen http://thebowencenter.com/ works out of. Bowen is the OBGYN who has a HUGE following of natural birth mommas, and a while back he was so kind as to even work as homebirth clients backup physician. Though he has moved away from being backup, his name is the most commonly mentioned as the go-to-guy for a natural birth. Too bad his office staff makes patients cry, #bekind.

Good Samaritan Hospital of Cincinnati: 375 Dixmyth Ave, Cincinnati, OH 45220

Cesarean Section of first-time mothers giving birth to a single baby, at term, in the head-down position: 23.3%

Episiotomy rate: 4% (1)

Good Sam has a poor reputation for natural birthers but is the place to be if a baby needs intensive help. This hospital, along with only two others has a Level 3 NICU, with the highest level 4, being at Cincinnati Childrens, a few blocks away.

Christ Hospital: 2139 Auburn Ave, Cincinnati, OH 45219

Cesarean Section of first-time mothers giving birth to a single baby, at term, in the head-down position: 27.2%

Episiotomy rate: 9.8% (1) YUCK!!!

Christ Hospital has a poor reputation for natural births, but… then there’s the respected Michelle Zamudio, CNM, who works with two others, Jacqui Martin and Jessie Bertsch. Michelle provides patients with incredible care. Search her on Facebook, with the key words ‘Cincinnati Midwife’ and the praises don’t stop. They are also certified as Bag Free https://www.ohiohospitals.org/ohiobagfree

Mercy Health- Anderson Hospital: 7500 State Rd, Cincinnati, OH 45255

Cesarean Section of first-time mothers giving birth to a single baby, at term, in the head-down position: 24%

The rate of women who pursue a vaginal birth after cesarean section (VBAC): 19%

The rate of women who are successful in their VBAC: 88%

Episiotomy rate: 7%

Epidural rate: 75%

All this information is self-reported to me from the manager of labor and delivery. It has not been assessed for accuracy by a third party.

Mercy Anderson follows the 10 steps for Successful Breastfeeding https://www.unicef.org/newsline/tenstps.htm, is Bag free and has a great reputation for those wanting a natural birth. It is also the home to Dr. Patridge and Dr. Varnau, http://bcwh.org/staff.htm who many homebirthers choose when they need a hospital birth. They are incredibly comfortable with allowing birth to unfold, while simultaneously being up to date on all the latest studies. Dr. Patridge is sure to keep the room laughing in the immediate postpartum, with her slightly crude jokes.

University of Cincinnati Medical Center: 234 Goodman Street Cincinnati, OH 45219

*Refused to answer my questions and does not self report to the public

University of Cincinnati has horror stories attached to its name and I have heard multiple clients say they would NEVER birth there again. It is a teaching hospital, but why does that have to mean they cant provide respectful care. They do have a couple redeeming qualities. They have a Level 3 NICU, and are certified Bag Free. They are also beginning a Centering Pregnancy program https://uchealth.com/womens-health/centeringpregnancy/  , which I am totally stoked about. Watch this YouTube video and you’ll see how transformative it can be to women’s prenatal care. With the idea that the care will be empowered and community based, Im hopeful that their reputation will only improve from here. https://youtu.be/oixaRbS9Tww .

Resources:

  1. http://www.leapfroggroup.org/hospitals/search/list/location/Cincinnati%2C%20OH%2C%20USA/50

How to Prevent Tearing During Birth: A Midwives Method

Almost every client is worried about tearing during the birth of her baby. Tearing is a real and legitimate fear women have and I am glad that I have the experience to address it! When I read blog posts I want writers to GET TO THE POINT so, I’ll go ahead and bullet out a midwives approach to preventing tears during birth now.

1. Slow down drastically at the birth of your babies head.

2. Support your tissues externally as they stretch during birth.

3. Get body work at term to keep you and your baby in an ideal position for birth.

For those of you who want more information about those bullets above I will go into detail now.

1. Slow down drastically at the birth of your babies head:

The whole purpose of this is to allow the vaginal tissues to stretch instead of popping open. (I know some of you just did a involuntary kegel with that word pop! Lol.) When a client reaches term, we discuss that when she feels a burning or stinging sensation during pushing (otherwise known as ‘the ring of fire’), she should communicate that to me. This is the point where the head is crowning, or where the largest portion of the head is at the vaginal opening. Its interesting to me that slowing down at crowning isn’t something that women naturally do. Its much more common for women to feel the intensity of crowning, think to themselves that they can finish the birth real quick and just blast the baby out. This is the point when your support people come in. When I see and hear that a woman is crowning I say a couple things. First, I ask her to take a breath, then open her eyes and tell her it’s time to slow down. Then we lock eyes and take a couple big breaths together. If she can just breathe through a couple contractions, allowing her uterus to push but not putting force behind it, that is usually all the stretching that the tissues need to be tear free!

2. Support your tissues externally as they stretch during birth:

Otherwise known as perineal support. See image below.

When I’m at a birth as a midwife, I use a folded washcloth to support the anus and perinuem as much a possible during every contraction once there is active head movement with pushing. This extra exterior support not only reminds mom to slow down but also holds the skin together to keep tearing from happening. Perineal Support is even more beneficial if the mom is providing it for herself because she can feel exactly where the support is needed, but alas, it’s difficult for her to reach! Providing perineal support can be discussed with your care provider to see what their practice is.

3. Get body work at term to keep you and your baby in an ideal position for birth:

An ideal baby position at birth will keep the diameter of the head the smallest it can be to lessen the likelihood or tearing. This means your babies chin will be well tucked and the babies back is towards your belly, on the left hand side. Body work can align YOU, so the baby is free to move to the best position. I always recommend a deep tissue massage therapist who is comfortable working on pregnant moms for body work.

Notes to know:

There are degrees of tear depth, that go anywhere from just a scratch all the way to through the anus. See the image below:

Questions? Feel free to contact me or comment below.

This one goes out to Cincinnati’s pregnant women of color

As I move deeper into my journey to become a midwife, I’m struck by the disparities that are faced by women of color in the Cincinnati Area. It is not for socioeconomic reasons like education or their yearly income that makes their statistics so much worse than their white counterparts, it’s the sheer fact that racism is prevalent and far reaching. It causes such undue stress on these women that they are more likely to give birth prematurely, and experience other pregnancy complications that could ultimately result in maternal or infant mortality.

Check out the following for more information. https://www.marchofdimes.org/peristats/tools/reportcard.aspx?frmodrc=1®=39

https://www.npr.org/2011/07/08/137652226/-the-race-gap

https://www.theroot.com/why-giving-birth-is-deadly-for-black-women-and-why-1797763052

I am newly impassioned to do what I can to change these statistics. This will include offering the following to women:

-low cost birth doula services for those that are inhibited by the cost of my services

-being available via phone for questions or concerns

The above are my ideas and I understand that I may not be addressing the greater need. If you have ideas about alternatives please contact me. I am open to feedback.

The hardest part of birth

There is no doubt that you will work hard during a natural birth. We all know it! Any of us who have done it have heard comments like, “I could never do that” and “You are way stronger than I am”. The thing is that those comments aren’t true and I think it gives the wrong idea to New Moms who are considering a natural birth. What really is the hardest part? It’s not that contractions are so incredibly painful, it’s that you have to LET GO. Some of you reading this will know exactly what I mean immediately but I’ll explain for the rest of you.

Letting go is a process that ideally you will begin at the beginning of your pregnancy and continue working on until your birth. It means letting go of expectations of exactly how your birth will go, letting go of fear, and allowing your body, heart, and mind to do exactly what millions of women’s before you have done. Allowing a baby to pass through you and out into the world. That’s the hardest part! Letting go and allowing trust of the process in.

Is homebirth messy? 

That homebirth is messy is a common thought for individuals who haven’t seen birth or a brand new to it. There’s an idea that fluids shoot out of the mother’s body followed quickly by fluids from the newborn’s, and soon enough there is blood dripping from the ceiling! Or wait… Maybe that was my idea when I first started going to births. I think that partly had to do with my fear that went hand-in-hand with thoughts of birth. The fear that mother’s bleed too much, there’s a whole lot of screaming and that women couldn’t do it without their doctors, preferably male at that. Oh how I’ve changed!

My fear has been replaced with reverence. My work at Birth is done with compassion and in awe of the power that we as women hold to produce and sustain life straight out of our bodies! It is fantastical! Okay I might have just made that word up but it fits perfectly. Can you imagine that one body produces another. So have I seen a mother Hemorrhage and bleed too much… Yes of course. Have I seen her leave little puddles behind her as she walks across the floor, yes of course. Have I seen her water burst, spraying the area around her, yes of course! And guess what? It’s all quickly wiped up. At most we have to use hydrogen peroxide to Bubble it out of the carpets, but I’m telling you it’s like the baby came from a stork by the time we leave. It’s that clean! Except for the fact that Mom is sore and exhausted from some of the hardest work she will ever do.

Free Postpartum Depression plan 

I recently realized that I have something that others may not have when it comes to postpartum depression. I not only have personal experience and really understand it, I have tools that can help. I’m so passionate about this issue because I know how debilitating it can be not only for the mother but for her whole family. Psychologist agree that the mother and her child set the tone for their relationship within the first couple years of life and if that first year is wrought with postpartum depression it can be challenging to come back from. I’m offering my community a free document which I have titled, ‘Get out of my life: postpartum depression plan’. It’s a plan to create with your partner and I will be happy to pass it on to anyone who requests it! Placenta encapsulation can also really help, so feel free to ask me about that as well. Here’s to beautiful postpartum periods!

Beautiful Pregnancy 

I hope you take the time to celebrate your pregnancy,  it can be as simple as snapping some pictures of your belly on your phone,  or spending 15 minutes every night connecting with your baby and partner.  You won’t regret it and it will only make this time and birth more beautiful! XOXO

Doctors, nurses, partners, doula… Oh my! Theres a place for everyone?!

It does seem like a lot doesn’t it?! Plus laboring mom that’s five people right there! It feels like too many to be watching you push a head that feels SO big, right out of you. I know, and it might be if everyone stayed there staring at you the whole time. But while your working your baby down and out, theres all of labor to go through beforehand. Though everyone will be there at the very end, I promise, you won’t care!  

Let’s break it down. First of all, you should know that your doctor plans to only be in the room with you for the very last moments of your birth.  Like, once they  can see the head, they will be there with you and stay until the birth of the placenta. And then they are saying, “Congratulations!” and are out the door. Its not that they dont care about you,  its just that they don’t want to be a disruption. So they do their work and wait to be summoned by the nurses.  At the very end, it’s very exciting, you can feel how close you are and the doctor flies in like a burst of light! They catch your beautiful baby and then is gone to let you mask in the glow of the sweetest baby you have ever seen!

The nurses are in and out of the room.  There’s no way to tell who you will get, and shifts change whether you want them to or not.  They are smiling at you while they monitor you and the baby.  They do vitals, listening to the babies heartrate and charting everything.  If you need ice chips or more pillows, they will be happy to grab them for you.  They are so sweet but usually have other moms to help too.

Your partner is your rock.  They arent leaving your side and are supporting you though every contraction. They are encouraging you,  massaging you and sneaking you honey straws. Your partner is a dream until they don’t know what to do anymore.  Here’s where the doula cones in. 

The doula is the gap filler, the runner, the second support to the partner and laboring mom. It can get tribal during labors, it hurts! Mom can get interrupted, loose her flow and start getting anxious or scared,  feeling out of control. The doula is there to help know what to say, what positions to try next. To remind everyone that this is normal, that we can continue to say yes to the process, and that this is the feeling of your baby getting closer to meeting you! She will also do little things like making sure your cup is full, you are emptying your bladder and that your partner doesn’t need anything. 

Laboring mom, partner and doula are the three constants in the room. While nurses and doctors come in and out, the partner and doula are charged with maintaining a calm and supportive atmosphere, your doula especially is a sponge of things that could effect the couple.  Simple questions, comments, opened curtains are no match for her! 

Really, with a role for everyone, it works together really nicely. You can even add a photographer in there or best friend who’s only job is to hold your hand and it would be great.  

Role of a midwife at an uncomplicated homebirth

Hello! I’ve been asked recently what you can expect from a home birth midwife and I think that’s something that I can talk about… at least as it pertains to expectations of me and the midwives that I directly work with here in Cincinnati.

 It all starts with prenatal care! You can expect a normal scheduling of visits, each prenatal will last about an hour and they will be monthly until your 28 weeks, bi-weekly until you’re 36 weeks and then weekly until you have your baby. Prepare to go deeper in these prenatals then you would with your local obstetrician. This is an opportunity to delve into not only about what is physically and clinically happening with your body but also what is emotionally and psychologically happening in your pregnancies process. Personally this is one of my very favorite parts of midwifery care! 

Once it comes to the day of your birth you can expect that your Midwife will be present with you from active labor on. 

When your midwife arrives she will begin by washing her hands, quietly saying hello and then having a good long listen to your baby using the handheld fetal doppler.  She will then do frequent listens throughout your labor, at least once an hour, remind you to eat, drink, empty your bladder and try to encourage your individual process as much as possible. 

Once it’s time for you to begin pushing she will remain watchful and calmly and quietly await the arrival of your baby. Once she can see your babies head, she will encourage you to reach down and feel your baby, so you can be even more connected to the process. 

As long as everything is progressing really smoothly, the midwife can coach anyone to which the mother agrees to catch her baby. The baby will immediately be brought to the mothers chest and should remain there if at all possible throughout the immediate postpartum period. We leave the cord intact for a minimum of 30 minutes.

The midwife will be closely monitoring from the background. She will deliver the placenta and then again assist the mom to eat,  drink and empty her bladder. She will tuck mom into bed and allow her to enjoy these first impressions of her new baby.  

After the birth team has cleaned up the birth space, it will be time for the newborn exam, clamping and cutting the cord, examining the placenta with the family and processing the labor and birth.  

Finally the midwife will go over postpartum instructions, when to call and set up a time in the next 48 hours that she will return with instructions to contact her if anything were to arise before then. 

Homebirth is really a peaceful and intimate, life changing experience. 

Getting Partners involved in Birth

As a doula and midwifery apprentice I see a lot of dads and other partners at a birth who are standing around awkwardly, just lost, and not knowing what to do. And thats okay, I know how hard it is! I started out that way too, but now I’m deep in this process of supporting women during birth here in the Greater Cincinnati area and have learned some things. I want to prepare you, as partners to a pregnant woman, to be your very best self, one who is prepared, willing to work hard and will meet the mom right where she is.

So there are a couple things I want to talk about…

First: If you get nothing else from this post, I want you to remember that during a birth, you should be calm, grounded, peaceful and know without a shadow of a doubt that she can birth her baby. Everything else after your grounded energy comes second.

For those of you who are list people, here are the top things i think you should have under your belt.

Before the birth, its incredibly valuable if you, as the partner…

  • have met the care provider and established a relationship of trust and respect
  • are friendly, grounded and aware of others in the birth space
  • know the mothers birth plan and a little about each aspect
  • share the mothers expectations of you during the birth experience
  • have practiced different positions and ways to touch her during her labor
  • are familiar with the stages of labor
  • have 2-3 encouraging phrases that you know she will like to hear during her labor
  • know that its inappropriate to be on your phone in her line of vision during the labor
  • are able to establish boundaries around the mom if she needs a it
  • be open to having an experience too

Luckily for you… I have midwifery classes, which means I have to make client handouts, and then want to share them with all of you! So here is mine on supporting moms as partners during her labor and birth : ) PS: its a trifold in case you want to print it out. Partners at Birth.pdfbuiltforbirth-1

 

Dream Catcher in Doula Mode

Last week i was on call for a doula friend and i was called to the birth! I couldnt believe it! My friend was unavailable for a 18 hour window, and it was the babies due date, so i mean, come on, the odds were SO low. Lesson learned… I am the luckiest!!!! : )

Its been awhile since I have been to a birth as a doula, with all my apprentice/ student midwife work, and man have i gotten good! I kept surprising myself with knowing how to be, what to say to her and her husband, how to touch her and what suggestions to make next. I was with Julie and her husband for 17 hours at the hospital and never once did i get stressed or anxious, I have been struggling with those in my life and it was so good to let go. I have been reaffirmed that birth work is in my blood! Its in my heart and i LOVE it!

So Im moving forward, Im going to pursue more doula work! And ill keep being a student and do placenta encapsulation because i believe in this work, and i believe in women and i believe in the power of birth!

Please let me know if there is someone who could use a doula and i would love to talk to them!

PS: Tolabor is the organization i was trained through, and i would recommend them to anyone. They also have this free podcast, link provided here…. http://www.tolabor.com/toraise-podcast/. Its called To Raise Questions and they have so many great topics, and one of the ladies who is talking Terese, is the women who trained me. Man! She is great. I listen to this podcast sometimes to connect me with the broader picture and because these ladies and so sweet and they talk about their experience as doulas and its all about honoring women. tolaborbanner-4

Taking Back Breastfeeding

I watch new mothers and babies learn to breastfeed a lot these days. Its a whole trial and error learning curve, for both. Some get the perfect latch the first time they try, just after birth and some take weeks to work out, with tongue tie revisions or torn up nipples.  I feel so lucky to work with clients who are so devoted to breastfeeding that, despite challenges, they dont give up, even if it means donor milk… they keep pursuing a breastfeeding relationship with their child.

Im sharing this video, that a friend shared with me awhile back about laid back breastfeeding. Its just another position to try while your learning, or if you have an oversupply, with gasping baby to show for it ; ) I hope you find it to be another helpful resource. Laid Back Breastfeeding

laid back

For those of you who are learning to breastfeed, I applaud you. For those of you who will be learning soon, you wont regret it! And for those who have, I bet you miss it!

A Day in the Life

My life recently consists of two types of days, both pull at my heart and keep me excited to do the other. My life as a mother and life as a birth worker.

As a mother my life is paced by a sweet baby girl, Everly Ruth. At 9 months old her life is set by naps, and putting everything possible in her mouth. She enjoys playing games with her older brother like, who can crawl the fastest. It is so sweet when he lets her win too! Oliver, my brave and rambunctious 4 year old, keeps me learning and growing. Most recently we have been focused on ‘Birds of Prey’, ‘Big Cats’ and learning all the letters of the alphabet. It’s too exciting to contain!

Being a birth worker consists of going to prenatals, births, and postpartum visits, Meet the Doulas, writing blog posts, and studying in any gaps of time. I’m reading textbooks such as Varneys, Holistic Midwifery, Clinical Practice Guidelines, and Heart and Hands.When I’m not reading books I listen to all the talks I can get my hands on. I often find myself going down rabbit holes learning about nipple pain, fetal heart tones, and practice guidelines. I laugh it off when i get it wrong and keep trying to get it right.

At the end of my days I am both exhausted and anxiously excited. I have pushed myself and remain open to where my path will lead me. I have arrived and I keep telling myself, “what i put in, is what i will get out”.

 

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Another Reason NOT to fear Homebirth

I have attended a few homebirths lately, And i am continuously awed by the peacefulness, respect and trust that is flowing through the space. I just cant stop talking about it… even around those who i know may think its dangerous, etc.

I found this table recently and am thinking about making a wallet sized copy to flash at people as they scoff at my path of Student Midwife. Hahaha. Really, i know that the best defense will be to become educated, so i study away, every day. 

Check it out: 

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