• In Santa Cruz County, 29% of women gave birth by cesarean.* This remained the same as 2009.

*World Health Organization (WHO) recommends 10-15% 

 

• Fewer than 7% of the women with a prior cesarean who gave birth here in 2010 actually had a VBAC.* This is down from just under 8% in 2008, but remains the same from 2009.*WHO recommends 85%
  

• In 2010, Watsonville had 11 VBACs, Dominican had 4, Sutter had 18, 0 out of hospital, and 3 to out-of-county.There were only 36 VBACs in the entire county last year.
  
  

• There were 342 preterm babies born in 2010 (born before 37 weeks gestation).  That's 9.5% of all births, with 1.5% born before 32 weeks and 8% born between 32-36 weeks gestation. This is a significant increase from 8% in 2009 .

National recommendations from Healthy People 2010 federal program is 7.6%.  

• More than half of the births in Santa Cruz County are paid for by Medi-Cal. This went from 51 to 55%.

*Despite this fact, Medi-Cal does not cover the most cost-effective way for low-risk women to give birth: at home. There is a national campaign to encourage legislators to include Certified Professional Midwives on the Medicaid list of covered providers. For letters you can email or fax to your legislators, click HERE.

• Scheduled inductions
• Not allowing women to go past 41 weeks' gestation
• Inductions using Cytotec (misoprostol)*
• Cesareans for more than a quarter of all births
• Very few Vaginal Births After Cesarean, <7%**
• Continuous electronic fetal monitoring
• I.V./hep lock on admission
• Artificially rupturing the membranes (breaking the bag of water)
• Epidurals and pharmaceutical forms of pain management

Not true. Santa Cruz has two hospitals, and Watsonville has one.  While hospitals have begun to use the term "birth center" as a way to attract women to their Labor and Delivery units, a true birth center is free-standing (unaffiliated with a hospital), supports natural birth, and does not supply pain medication or perform cesarean sections.  In addition, most birth centers offer water birth and employ Licensed and Certified Professional Midwives, not just Nurse Midwives.

 

To read more about what defines a freestanding birth center and how an institution can become one, check out the American Association of Birth Centers position statement:

 

AABC Birth Center Position Statement

 

The Coalition for Improving Maternity Services (CIMS) has recommendations for all sites of birth on how to promote the wellness model of maternity care that will improve outcomes and substantially reduce costs:

 

10 Steps to Mother Friendly Care 

**Bring these recommendations on the tour of your intended place of birth and ask if they incorporate these guidelines for healthy moms, babies and birth outcome!**

 

 

 

'The Gals' are wondering too!  This is a complex issue we hope to see change for our county, but in the meantime, YOU can help freestanding birth centers nationwide in the push to get Medicaid reimbursement, paving the road for more options locally.

Click here and find out what you can do:

http://www.birthcenters.org/news/breaking-news/?id=88

 

 

Not true. Your first birth is actually extremely important to consider for homebirth. Rates of cesarean for planned homebirth are very low compared to planned hospital birth. If you have an avoidable cesarean due to your hospital birth, your options for future births become narrowed considerably. (For instance, the 2010 rate of VBAC among women in this county with a previous cesarean was less than 7%.)¹

 

While hospital transfer rates for planned homebirth are a little higher for first-time moms than second-time moms, the most common reason is failure to progress...a non-emergent situation. In this instance, it is likely that the interventions you receive in the hospital are actually necessary...because you've tried non-medical methods (acupuncture, etc).

 

Not true. Studies are clear: for low-risk women, a planned homebirth with a qualified attendant (midwife) is as safe as a hospital birth. Mortality rates are the same. Morbidity rates (rates of injury to mother and/or baby) are better for the women choosing homebirth.  

 

Additionally, homebirth midwives carry medical oxygen, medications to control hemorrhage, resuscitation equipment, suturing equipment, and other supplies to births.  Midwives are prepared for the common complications that could arise during birth as well as plans for coordination of care and emergency back-up for when birth requires the next level of care.  

 

Not true. Many PPO plans pay for homebirth with a Licensed Midwife or Certified Nurse-Midwife. There is a national campaign effort to get Midwives covered under Medicaid. This is important, as more than half of births in our county are Medi-Cal (California Medicaid) births.¹

 

The price of a simple vaginal hospital birth at Sutter is around $12,000. This does not include physician fees for the birth, prenatal care, postpartum care, anesthesiologist fees, etc. These add up!

 

The cost of a homebirth--including prenatal and postpartum care as well as the birth itself--is a small fraction of that, ranging from about $4,000 to $4,500. Your insurance may well cover it!

 

When you factor in your deductibles, copays, and other non-reimbursed fees, the cost of a homebirth paid for out of pocket is often less expensive than a hospital birth covered by insurance. Additionally health care spending accounts (HSA) typically reimburse for midwifery care.

Not true. There is no denying that you can potentially have a great birth in the hospital, particularly if you have an experienced doula by your side. However, many elements of the quality of homebirth care are simply not translatable to the hospital.

 

• Do you want to know everyone at your birth?
• Do you want to avoid induction, episiotomy and cesarean section? Do you want freedom of movement and ability to eat and drink whatever you want?  (These elements are the most essential parts of normal labor that are usually not permitted in the hospital.)  
• Do you want freedom to try alternate methods, such as acupuncture, to get labor moving?
• Do you want the option of Water Birth?  
• Do you want to avoid routine interventions (such as IV, continuous electronic fetal monitoring, bloodwork, etc.).  
• Do you desire the comfort and privacy of your own home?