I’ve been conflicted about showing my statistics regarding my doula services and childbirth education. On one hand, as a Birthing From Within mentor, I feel strongly that birth education and doula services shouldn’t be outcome-focused. I don’t want people reading these statistics and get angry with themselves if they become in the minority and decide to go for an epidural or require a cesarean. We can’t control birth, and in most cases there is no one to blame. Yet, many people looking for a doula or a childbirth educator are doing so in the hopes of avoiding pain medication or cesarean birth. And as a patient in the American medical system I wish that providers shared more statistics with their patients so that patients can choose the right provider for them. It is a sticky wicket.
I’ve decided to put them down here, for now. I don’t know how long I’ll keep them here. I may continue to update them, or I may delete them tomorrow. But first, please read a few disclaimers:
1) I absolutely realize that a healthy baby and healthy mother are goals number one for any birth. I don’t publish health outcome statistics, because as a doula or a childbirth educator, I don’t practice medicine. Doulas measure their success on the emotional happiness of the families who have their babies, which makes a ton of difference with regard to breastfeeding success, postpartum depression avoidance, and general family stability. Of course there is no easy way to measure happiness.
2) I don’t think all interventions are evil, and certainly don’t teach that in my classes. In fact, we do a lot of softening around the ideas of interventions if they become necessary, while at the same time empowering mothers and partners to ask questions that come up so they with their provider can make the right answer FOR THEM. It is no surprise that I think that as a whole, the American medical system uses interventions too often and this causes more health problems than it prevents, statistically speaking. I also believe interventions save lives every day. And while I GENERALLY agree that birth can happen more often than not without routine interventions, I INDIVIDUALLY will stand strong for what a woman’s particular case is, medically AND emotionally. Most, but not all, families who hire me are looking to avoid pain meds and/or cesarean birth, so that is what I’ll measure here.
With that said, here are the statistics so far for epidurals and cesareans from doula clients and folks who have taken my class:
***PEOPLE WHO HAVE ATTENDED MY CLASS WHO HAVE SO FAR GIVEN BIRTH***
EPIDURALS
Epidural – 16%* (Compare to average area hospital rates of 90%)
No Epidural – 58%** (note the unknowns lowers the stat – if unknowns are taken out, the number jumps to 79%)
Unknown – 16%
Other – 10%**
* Epidurals in most cases were because of inductions that were unplanned so their choice for pain medication changed. However in the “no epidural” camp are plenty of women who had inductions without epidurals (it can be done!).
** A couple of these include women who chose a narcotic to “take the edge off”.
** Cesarean births without labor.
CESAREANS
Yes – 16%* (Compare to area hospital/national rates of 33%)
Unknown – 11%
No Cesarean – 73%** (note the unknowns lowers the stat – if unknowns are taken out, the number jumps to 82%)
* cesareans include planned breech cesarean birth, induction that ended in cesarean, and a previa.
***BIRTHS I’VE ATTENDED AS A DOULA***
Out of 13 births – two homebirth, 11 hospital
EPIDURALS
Planned – 15%
Unplanned – 23%*
None – 54%** (Compare to area hospitals at 10%)
Other – 8% ***
* Unplanned epidurals were mainly because of induction, however as soon as they found out they would be induced they became open to epidural. An occasional induction was used as a last-ditch attempt to avoid a cesarean.
** Two were homebirths with a licensed midwife in attendance, most were hospital births with no pain meds at all, and occasionally there is a hospital birth with a shot of narcotic to “take the edge off”.
*** This was a planned cesarean birth I attended.
CESAREAN BIRTHS
Planned – 8%
Unplanned – 15%*
Total Cesareans – 23%**
* Unplanned cesareans were half for medical anatomical issues and half for failed induction.
** Since I’ve been teaching Birthing From Within this number has gone down considerably – so far not one of my doula births have been by cesarean.