Best Place in Boston to Deliver a Baby
Having A Baby? Big Differences In Hospital Quality Across Massachusetts 04:06 Copy the lawmaking below to embed the WBUR audio player on your site
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If y'all're one of the roughly lxx,000 women who volition give birth in Massachusetts this year, you may exist planning to deliver at a hospital close to home or where your OB practices. But what you might not realize is that when it comes to childbirth, there are big differences in hospital quality across the state.
For example:
- Your chance of having a Cesarean section is almost three times higher at some hospitals
- While some hospitals allow you to schedule an early on delivery even when it's not medically necessary, other hospitals take stopped this practice because a baby'south brain, lungs and liver need the total 39 weeks to develop
- Your chance of having an episiotomy — a surgical cut to enlarge the vaginal opening — ranges from 0 to 31 pct
- Trying for a natural commitment later having had a C-section is encouraged at some hospitals but not offered at others
- Iii times as many women breastfeed their babies at some hospitals every bit compared to others
"The door you lot walk in will take a large bear on" on what happens during and subsequently childbirth, says Carol Sakala, director of programs at the nonprofit maternity quality group Childbirth Connection.
The hospital where women choose to evangelize "admittedly matters," says Dr. Neel Shah, an banana professor of obstetrics at Harvard Medical School. Have C-section rates, Shah says. "In many ways, which hospital you go to is a bigger predictor of whether or non you're going to get a C-department than your own risk or your own preferences."
You can compare the C-section rates and 4 other childbirth quality measures using our childbirth quality tool here. (Instance below is a screenshot. Click here to launch the tool.)
Nosotros packaged this information for the kickoff time concluding year. Now, as we update the tool, you tin can come across how hospitals compare to each other, as well as the country average where that figure is available. You can besides dig into the information we collected here to run across how hospitals are doing from one year to the next.
Hither'southward a snapshot:
C-sections – Cambridge Hospital continues to have the lowest C-department rate in the Boston surface area. Tufts Medical Eye, which handles a lot of high-run a risk, transfer births, has the highest. Five other hospitals in Massachusetts have rates that are 25 percent or higher: Holy Family, Practiced Samaritan, Southward Shore, Winchester and Falmouth.
Vaginal Nativity Later C-section (VBAC) – Seven hospitals, generally small community facilities, did non perform this process concluding year. Some of the larger hospitals (Newton Wellesley and Brigham and Women's) exercise few for their size. Four hospitals perform a significant number of VBACs, with rates 25 percent or higher: Baystate Franklin, Holyoke Medical Center, Mount Auburn and Cambridge Hospital.
Early Constituent Deliveries (deliveries scheduled earlier 39 weeks with no medical reason) – One-half of the hospitals in Massachusetts that reported this measure out did not perform whatever early elective deliveries in the first six months of 2014, but four hospitals were to a higher place a state childbirth quality grouping target of less than five per centum: Beverly at 14 percent, Heywood at 9 percent, Newton Wellesley at 7 percent and Holy Family unit at six percent. (Beverly says it has made a number of changes so that the hospital's charge per unit this yr will be zero.)
Episiotomy (a surgical cut to overstate the vaginal opening) – Well-nigh one-half (47 percent) of hospitals in Massachusetts are higher up 5 percentage, which is the current recommended cap ready by the grouping that collects this data. Holy Family in Methuen is on the high stop at 30 percent.
Breastfeeding – The range of babies fed exclusively breast milk was from 33 percent to 92 per centum final year, only this is not even so a reliable measure for all hospitals. One third either don't collect this information or don't report it. For those that do, the reporting requirements accept changed, which has dislocated some nurses and others collecting the data at hospitals. We will proceed to assemble and post what data nosotros can get because many mothers tell us they want to breastfeed their babies and because research shows breast milk is best for most babies.
Overall, Sakala, with the nonprofit maternity quality group Childbirth Connection, says Massachusetts is doing a expert job of reducing rates of early elective delivery. But she and other experts run into lots of room for improvement on the other iv measures.
As you review the data, Dr. Shah, the Harvard Medical School professor, has a caveat. He says managing quality is harder for many pocket-sized hospitals than for larger ones, considering pocket-sized hospitals exercise non always have the staff to comb through and analyze patient records.
"Use the published data as a starting point to ask questions about the nature of care that's provided at different hospitals and by unlike providers," suggests Factor Declercq, a childbirth quality professor at the Boston University School of Public Health, who oversees the website birthbythenumbers.org. "If a hospital is a major outlier, and so it is fair to ask them why that'southward the case and what that would mean for your intendance."
Declercq also urges women to enquire how information and instructions are shared between doctors, nurse, midwives and their infirmary.
"It is notwithstanding besides easy for women to fall through the cracks in a system where care isn't coordinated." Declercq said. He highlights the example of mothers who develop gestational diabetes many of whom do non go "the follow upwards intendance that is essential to foreclose problems down the road."
If you lot desire to more childbirth quality data from your doctor or hospital, here'due south a listing questions and considerations offered by Bonnie Glass, a nurse who chairs the Massachusetts Perinatal Quality Collaborative.
Nosotros'd like to give you more ways to compare the quality of childbirth at hospitals. Some moms have asked if hospitals could get together information virtually care in the weeks and months after nativity, including screening rates for postpartum depression, breastfeeding once leaving the hospital, and complication rates for babies. If there is something that you recall makes a deviation in the hospital-based nascency feel, let us know in the comments and we'll try to add together it to the tool in the coming yr.
Source: https://www.wbur.org/news/2015/07/02/differences-hospital-quality-childbirth
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