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-centimeteres
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.