Maternity Care: How Does Your Hospital Measure Up?


Even if you are not pregnant or planning to be, this topic should be of concern to you.  After all, Medicaid pays for almost half of all the births in the USA with your tax dollars. 4 million women will give birth this year and 13% will leave the hospital with at lease one serious medical complication (hemorrhage, infection, trauma) and a brand new baby. Plus, a surgical birth is not a “medical complication”….and the surgical birth rate is 32.7%. Put another way, one of every three women who goes to a hospital to have a baby ends up with (expensive) major surgery.

Your chances of having a problem and complication during birth are directly related to WHERE you have your baby!


Here are some simple things to look at, and if you cannot get the data from your hospital go somewhere else!

What is the surgical birth rate? How does it compare with other hospitals in the area?

Are women encouraged to have a vaginal birth after having a surgical birth (VBAC)?

What is the episiotomy rate? This procedure, once routine in hospitals, has been proven to cause many problems.  Practitioners who are aware of the latest evidence based practices stopped doing this 20 years ago!

What procedures are routine? Electronic fetal monitoring? IVs? Epidurals? The overuse of these procedures could lead to more interventions and more surgical births.

Mother and baby friendly policies lead to fewer surgical births, fewer complications and healthier moms and babies who are able to establish breastfeeding successfully before discharge.

Is your hospital baby friendly?  Do they follow these 10 Steps?

  • Have a written breastfeeding policy that is routinely communicated to all health care staff.
  • Train all health care staff in the skills necessary to implement this policy.
  • Inform all pregnant women about the benefits and management of breastfeeding.
  • Help mothers initiate breastfeeding within one hour of birth.
  • Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
  • Give infants no food or drink other than breast-milk, unless medically indicated.
  • Practice rooming in – allow mothers and infants to remain together 24 hours a day.
  • Encourage breastfeeding on demand.
  • Give no pacifiers or artificial nipples to breastfeeding infants.
  • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

Is your hospital mother friendly?

Your birth will affect your ability to breastfeed! WHO and UNICEF recommend that, to have the best and most successful breastfeeding experience, women in labor, regardless of birth setting, should have access to the following practices:

  • Provide care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s culture, ethnicity and religion;
  • Allow birth companions of your choice who provide emotional and physical support throughout labor and delivery;
  • Grant the freedom to walk, move about, and assume the positions of her choice during labor,
  • Provide care by staff trained in non-drug methods of pain relief and who do not promote the use of analgesic or anesthetic drugs unless required by a medical condition,
  • Require care that minimizes routine practices and procedures that are not supported by scientific evidence including withholding nourishment, early rupture of membranes, use of IVs, routine electronic fetal monitoring, episiotomy and forceps and vacuume extractor delivery;
  • Encourage care that minimizes invasive procedures such as unnecessary acceleration or induction of labor (pitocin) and medically unnecessary cesarean sections.

By asking the right questions you can be empowered to receive the care you deserve at your birth!

Rosanne Gephart, MSN, NP, CNM

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