Did You Know?
In 2015, there were 3,317 babies born in Santa Cruz County (484 were residents of other counties).
The report on Birth in Santa Cruz County for 2015 is hot off the presses. Note that most of the stats are for Santa Cruz County residents, which does not make up the total of those giving birth here. Some of the most interesting information in the report includes:
- In Santa Cruz County, 30% of women gave birth by cesarean.* This is up from 29% from 2014.
*World Health Organization recommends 10-15%.
- 12.7% of women with a prior cesarean had a VBAC. This is an improvement from 2014!
- In 2015, Watsonville reported 11 VBACs, Dominican 18, Sutter 35, 0 out of hospital, and 7 to out-of-county women.
There were 71 VBACs reported to Vital Statistics in the entire county last year, and 437 repeat cesareans. This is 18 more VBACs in the county than 2014!
Please note that there may be reporting error occurring if hospitals are reporting VBACs as vaginal births only (not VBACs). We believe that there is recently improved reporting for VBAC from hospitals.
- There were 328 preterm babies born in 2015 (born before 37 weeks gestation). That is 9.9% of all births.
This stat increased for 2015. National recommendations from Healthy People 2010 federal program is 7.6%.
- Half of the births in Santa Cruz County are paid for by Medi-Cal. This is a drop of a few percentage points compared to the past several years.
Common Local Birth Trends
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, ~10%**
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
*Click here for why this is not a safe option for labor induction. **Click here for evidence-based VBAC information.
In 2015, Sutter Maternity's cesarean rate was 21%, (primary 13%, repeat 8%)¹, with Dominican's rate of 29%, (primary 18%, repeat 12%) and Watsonville's rate of 36%, (primary 17%, repeat 19%)¹. This is some improvement in north county hospitals but a significant increase in cesareans in Watsonville (up 4% from 2013).
It is important to note that Sutter does not do deliveries for babies younger than 36 weeks of gestation, and most high-risk deliveries occur at Dominican because they house the county's Level III Newborn Intensive Care Unit (NICU).
Common Myths and Misperceptions
Santa Cruz has a free-standing birth center.
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:
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:
**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!**
I should have my first birth in the hospital and, if that goes well, I'll have a homebirth for my second baby.
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.
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).
Homebirth isn't as safe as hospital birth.
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.
Insurance Doesn't Pay for Homebirth.
Not true. Many PPO plans pay for homebirth with a Licensed Midwife or Certified Nurse-Midwife.
The price of a simple vaginal hospital birth at Sutter is around $26,000. This does not include physician fees for the birth (~$6,600), 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 $4,500 to $5,500. Your insurance may well reimburse for it!
Additionally, 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. Healthcare spending accounts (HSA) typically reimburse for midwifery care.
I can have a homebirth in the hospital.
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?
Ask someone who has birthed in the hospital and at home what they think of the difference!
Birth Santa Cruz is an unincorporated not-for-profit association.
Photos By: Celeste Duran Photography
Site Rev. 4/2014