Early in my career as an obstetrician, I was rigid in my thinking about the “right” way to deliver a baby.
Over the years, my view has evolved. While I still believe the hospital is the best and safest place to deliver a baby, I understand the appeal of birthing centers and home birth. In fact, I’m trying to learn from them.
Hospitals have done such a good job of preparing for every complication, every contingency, that we have lost sight of the magic inherent in bringing a new life into this world. Pregnancy is not a disease, and childbirth is not a clinical event. Increasingly what women want is a birthing process that embraces this truth and approaches delivery as a part of nature.
At Hoag, we are making great strides to de-medicalize delivery.
This year, Hoag posted a video from the March of Dimes called “Waiting for Baby,” which describes the benefits of waiting for labor to begin rather than scheduling a Cesarean delivery or inducing labor. It emphasizes the point that the uterus is second only to the heart as the strongest organ in the body and encourages women to trust their body’s ability to have a healthy and safe delivery.
By presenting natural childbirth as the ideal option, we are trying to change a culture in which C-sections for low-risk deliveries has gotten out of control. As a result, our C-section rate has gone down more than 6% in the last nine months. The percentage of women who deliver vaginally after delivering a previous baby via C-section (a delivery option known as VBAC, or vaginal birth after Cesarean) has shot up from 5% in 2012 to 13% today.
We are also working with patients to normalize the labor experience so that people feel comfortable beginning the labor process at home. Studies show that women who are admitted to the hospital at 4- to 5-centimeters dilated are four times more likely to experience a successful natural delivery than those who show up at the first sign of contractions.
Birthing centers and midwives excel at this more accepting, natural approach to delivery. And it’s what hospitals need to incorporate more. But should something go wrong, only hospitals are equipped to deal with it. Period.
At Hoag, our OB Triage and four-room OB Emergency Department sit adjacent to our 18 private Labor and Delivery suites. In case complications arise for the mother or her baby the triage and OB ED have a team of skilled nurses and board certified OB/GYNs immediately available for evaluation and reassurance. This level of care is not available outside of a hospital and is why I will continue to encourage women to choose a hospital as the safest place for both mother and baby.
While I understand the appeal of experiencing childbirth in a familiar place, I would like to work toward creating a more comfortable, nurturing environment within the hospital. That way, we can celebrate the beauty of childbirth in the safest way.
