7 ms·

>With all of the above, you are far less likely to be subjected to time pressures that will lead to drugs and ultimately to major surgery. See here's the probl

by giarc 9y ago

>With all of the above, you are far less likely to be subjected to time pressures that will lead to drugs and ultimately to major surgery. See here's the problem with the American system. You feel like the 'better choice' is a private birthing centre rather than a hospital because of the issues you outlined. The better option is single payer health. In Canada, where I live, there's no pressures to get it over with. If you have a 3 day labour, you have a 3 day labour. If you need an extra day stay, you stay an extra day. Not once does someone bring up cost... not the doctors, not the patient, not the family, nobody. We have birthing centres for those who want them. You can deliver at home with a midwife if you want. When I had my two kids, my cost was $14.95 for parking and ~$20 for my lunch/dinner.

Consultant32452 9y ago
Birthing centers, statistically, offer better outcomes for both mother and child than hospitals. This is even after you adjust for everything like if you have a high risk situation you would always wind up at the hospital.
- the_mitsuhiko 9y ago
  Depends on where i suppose. State hospitals have a sigificantly better outcome rate than private hospitals in Austria and they generally need to send mothers and the newborns to a state hospital in emergency reasons. Why? Because they are too small relatively speaking and don’t have enoughs births.
  - Consultant32452 9y ago
    The general rule of thumb is that birthing centers are less likely to interfere with the natural birthing process. For example, babies are more likely to be born on weekends at birthing center than hospitals. This is because births at the hospital are less "convenient" for staffing reasons. Hospitals are less likely to force labor to go faster with drugs, and obviously birthing centers don't perform any c-sections, so mothers giving birth there will be less likely to get unnecessary c-sections which increase risk to mother and baby.
- giarc 9y ago
  I'd love to see some papers on that. I remember being in our pre-natal class and the instructor talking about hospitals etc. People in the class were talking about how they wanted to deliver at X hospital because they heard that Y hospital had double the amount of C-sections etc. I had the benefit of being an epidemiologist that worked in Y hospital and knew a few things that others didn't. One, we don't publicly report c-section rates at a hospital level and two, hospital Y is a tertiary care centre with a level 3 NICU where all risk mothers are sent. So of course we are going to have a higher c-section and complication rate. We just don't send high risk mothers to other hospitals. So even though you said outcome is better even after adjusting for risk, I'd still like to see the data. I assume there aren't a ton of matched cohort studies that looked at birthing centres vs hospital deliveries.
  - Consultant32452 9y ago
    Here was the first result from a google search for a paper showing birthing centers provide better results. https://www.sciencedaily.com/releases/2013/05/130508213107.htm https://www.sciencedaily.com/releases/2013/05/130508213107.h...
    - giarc 9y ago
      You read it right? >However, Virginia R. Lupo, M.D., chair of the department of obstetrics and gynecology at Hennepin County Medical Center in Minneapolis, said the problem with these types of studies is that they "compare apples and oranges." "Women who have no risk factors do better, no matter where they are," Lupo explained. This is a retrospective study where the authors had no control of who went where. What's needed is an RCT.
      - Consultant32452 9y ago
        Yes, I did. >For women without medical complications who can be served in either setting, the study concluded that midwife-directed prenatal and labor care results in equal or better outcomes for the mother and newborn. Women with medical complications don't start at the birthing center to begin with. That's of course part of what I stated in the beginning that the data is corrected for at-risk patients. You compare the healthy people who choose birthing centers against the healthy people who go to hospitals. Unhealthy people only go to the hospitals, but they aren't counted against.

by giarc 9y ago

Consultant32452 9y ago

Birthing centers, statistically, offer better outcomes for both mother and child than hospitals. This is even after you adjust for everything like if you have a high risk situation you would always wind up at the hospital.

the_mitsuhiko 9y ago
Depends on where i suppose. State hospitals have a sigificantly better outcome rate than private hospitals in Austria and they generally need to send mothers and the newborns to a state hospital in emergency reasons. Why? Because they are too small relatively speaking and don’t have enoughs births.
- Consultant32452 9y ago
  The general rule of thumb is that birthing centers are less likely to interfere with the natural birthing process. For example, babies are more likely to be born on weekends at birthing center than hospitals. This is because births at the hospital are less "convenient" for staffing reasons. Hospitals are less likely to force labor to go faster with drugs, and obviously birthing centers don't perform any c-sections, so mothers giving birth there will be less likely to get unnecessary c-sections which increase risk to mother and baby.
giarc 9y ago
I'd love to see some papers on that. I remember being in our pre-natal class and the instructor talking about hospitals etc. People in the class were talking about how they wanted to deliver at X hospital because they heard that Y hospital had double the amount of C-sections etc. I had the benefit of being an epidemiologist that worked in Y hospital and knew a few things that others didn't. One, we don't publicly report c-section rates at a hospital level and two, hospital Y is a tertiary care centre with a level 3 NICU where all risk mothers are sent. So of course we are going to have a higher c-section and complication rate. We just don't send high risk mothers to other hospitals. So even though you said outcome is better even after adjusting for risk, I'd still like to see the data. I assume there aren't a ton of matched cohort studies that looked at birthing centres vs hospital deliveries.
- Consultant32452 9y ago
  Here was the first result from a google search for a paper showing birthing centers provide better results. https://www.sciencedaily.com/releases/2013/05/130508213107.htm https://www.sciencedaily.com/releases/2013/05/130508213107.h...
  - giarc 9y ago
    You read it right? >However, Virginia R. Lupo, M.D., chair of the department of obstetrics and gynecology at Hennepin County Medical Center in Minneapolis, said the problem with these types of studies is that they "compare apples and oranges." "Women who have no risk factors do better, no matter where they are," Lupo explained. This is a retrospective study where the authors had no control of who went where. What's needed is an RCT.
    - Consultant32452 9y ago
      Yes, I did. >For women without medical complications who can be served in either setting, the study concluded that midwife-directed prenatal and labor care results in equal or better outcomes for the mother and newborn. Women with medical complications don't start at the birthing center to begin with. That's of course part of what I stated in the beginning that the data is corrected for at-risk patients. You compare the healthy people who choose birthing centers against the healthy people who go to hospitals. Unhealthy people only go to the hospitals, but they aren't counted against.