Henderson – Doula Group of Evansville

Statistics tell us part of the story of how a hospital cares for their patients and about the culture of a place. They do not tell us the entire story in any way shape or form, but they are a way to measure change and track goals. Leapfrog is a group that tracks statistics about hospitals around the country using a survey that 75% of hospitals participate in each year. Today was the day that they published this data for 2020.

You can find the 2018 Statistics in this post we wrote. I did not write a post for 2019’s statistics, but I think we all remember April 2020 right? You can look these statistics up for yourself here, because you really don’t have to just take my word for it.

Definitions & notes for you:

This Cesarean Section data is for NSTV (research speak for 1^st time parents, 38+ weeks pregnant, with a single head-down baby) cesarean rates and does not include repeat cesarean deliveries or 1st time cesarean deliveries in people who have had previous vaginal deliveries. This is an important distinction. Leapfrog Group uses the Healthy People 2020 goal of 23.9% for primary cesarean deliveries in this category. I want to note here that the WHO stated target NSTV cesarean rate is 10-15%, so that is something to also think about when looking at this data.
Early Elective Deliveries are defined as elective induction or cesarean sections before 39 weeks. This does not include medically indicated early deliveries, therefore the goal is for these to be less than 5%.
Episiotomies are a cut made to the perineum during the birth process. While sometimes necessary, routine episiotomies are not evidence-based practice, and Leapfrog sets their goal as less than 5%.
The numbers in (parentheses) are the previous numbers reported in 2018. I did not include numbers for Good Samaritan Hospital previously, so apologies to our friends in Vincennes for the lack of change comparison possible in this table.
New numbers that reach or exceed the Leapfrog goals are in blue.

Hospital	NSTV Cesarean Sections	Early Elective Deliveries	Episiotomies
The Women’s Hospital Newburgh, IN	26.2% (22.9%)	6.8% (1.7%)	11.5% (14.8%)
Ascension St. Vincent Evansville*	25.3% (27.2%)	0.0% (.8%)	5.9% (6.8%)
Owensboro Health	29.5% (29.7%)	.7% (1.4%)	5.7% (12.7% )
Deaconess Henderson Hospital**	25.5% (26.1%)	0.0% (2.4%)	2.8% (2.4%)
Memorial Hospital & Healthcare Center Jasper, IN	11.1% (12.8%)	5.9% (0.0%)	7.9% (9.8%)
Daviess Community Hospital Washington, IN	17.9% (15.2%)	0.0% 1.9%)	8.2% (13.1%)
Good Samaritan Hospital Vincennes, IN	20.7%	4.0%	14.2%

*Previously St. Vincent’s Medical Center of Evansville
**Previously Methodist Hospital of Henderson

What the Numbers Don’t Say

What these numbers don’t say is what an incredible strain 2o20 was on all hospitals, including in maternity care. While there were clearly jumps in early elective deliveries at Memorial in Jasper and The Women’s Hospital in Newburgh, we don’t know when those happened. Were those elective deliveries in March and April last year when everything was locking down due to the growing pandemic and people were truly scared for their lives? Conversely, maybe the pandemic was an easy excuse to push for early elective induction too. We can’t know that from the numbers. These statistics represent thousands of birth stories that we can’t know just by reading them.

These statistics are also not the only ones worth looking at when making decisions regarding your care. Other important factors such as VBAC success rates, availability of lactation help, availability of anesthesia, proximity to your home, provider access, insurance coverage etc. Sometimes that last one ends up being the deciding factor no matter what your preferences are on location.

How to Use These Numbers

First use them to think about where you want to deliver. You do have options and choices on where to go, and we would be happy to talk to you about our experiences at these places as well. Know that these are overall statistics that paint a generalized picture, and start there. Even if you don’t have a choice on where to go to birth, because we know that happens, these statistics can help you look at the norm where you will be delivering. They can help you know what to expect and watch for during your delivery.

Next use the numbers to start a conversation with your provider. Where do they deliver? What are their personal statistics compared to the facility? How do they feel about episiotomies?

We ALWAYS encourage everyone to have open, honest, and frank conversations with their providers. Don’t be intimidated by the white coats, they are people too. Keep it positive and be inquisitive, and go with your gut when it comes to making decisions regarding your provider and location for delivery.

We look forward to comparing 2020 with 2021 when those numbers come out!

What is the first question that comes to mind looking at this table?
Do any of these numbers surprise you?
Which of these statistics most line up with what you previously thought about these facilities?

As a doula, I often get asked about home birth here in Evansville, IN. There are plenty of myths and misconceptions about home birth, midwives, and doulas, and plenty has been written on these. My purpose with this post is to give you Evansville area specific resources and a little bit of advice too. As always, I am happy to chat with anyone who has questions about home birth here, and about my experiences as a doula at home births as well.

Choosing Home Birth

There are plenty of reasons that people choose to birth at home. Currently, I am fielding concerned messages about the safety of the hospital and visitor policies. We haven’t seen a restriction of zero visitors here yet, but it could come in the future. One important fact: only low risk parents are able to choose home birth. That means if you have any risk factors such as insulin controlled diabetes or placenta previa, then you are not a candidate for home birth. The good news is that 85% of pregnant people are considered low risk!

Finding a Provider

There are currently 2 home birth midwives that serve the Evansville area: Michelle Sanders, CPM & Jennifer Williams, CPM. They are both Certified Professional Midwives who carry emergency supplies such as oxygen & medicine to stop bleeding. Both are newborn CPR trained, very experienced, and have local assistants in Evansville. They both hold prenatal meetings at their office spaces around 2 hours away. I believe they are both doing virtual visits currently because of the concerns about COVID-19.

Both midwives also require you to have a parallel care provider. That means if you hire a home birth midwife, you will still need to have another provider with hospital privileges such as an OB or family doctor. There are not many providers locally who are able to openly support home birth. That may be changing, but I am also happy to talk to you about which providers we have found to be supportive. It is important that you have an open and honest conversation with all of your healthcare providers about your wishes and plans for your birth.

Cost

Home birth is not cheap. It is also not covered by most insurance companies. You can ask your insurance about a “gap exception” for covering the cost of your midwife. The midwives are not able to bill your insurance, and you should expect to pay your midwife out of pocket and then to perhaps be reimbursed from your insurance company. Some people may be able to use their HSA or FSA for these costs, but again you should consult your individual company.

In addition to the cost of the midwife, you also need to factor in the cost of either renting or purchasing a birth tub and supplies for it if you want one. You will also need to purchase other supplies; your midwife will give you a list. I always recommend getting more towels than you think you would ever need and that you don’t mind throwing away if necessary.

Other Considerations

If you are thinking about a home birth, call early! Both of the midwives who travel here get busy very quickly, so don’t wait to contact them.
Study up on childbirth and coping techniques! You will want to know what to expect even more at a home birth. I will have a blog post up soon about online childbirth education options.
Unassisted Birth or Free Birth is not an option you should choose lightly. If this is something you are thinking about, please reach out to us so we can talk to you about some of the things you might want to consider. Home birth with a midwife and free/unassisted birth are NOT the same thing.

Home Birth Doula

I love being a doula at home births. I have worked with both of the above mentioned midwives. My job as a doula is very different than their job as a midwife. I have balanced on the end of a bed while holding my client in a supported squat position as she pushed her baby out. One client gave birth sitting on my lap. I’ve poured warm water over one clients back as a she labored in a birth pool for hours. As a doula at a home birth, my job remains to help my client ask good questions, move around, be more comfortable, & be emotionally supported. We doulas always try to fill in where we are needed, no matter the location. I often arrive before the midwife and their assistant. I am there to help you.

Reach Out

If you are thinking about home birth in the Evansville area and want to talk about your options, please reach out to us! I love talking about my home birth experiences. Birthing at home might not be the right choice for everyone, but it is an option here. I have spent the last 6 years gathering resources, making professional connections, and learning all I can to help support families in all kinds of birthing situations. I would be happy to talk to you about all of your options.

Tag: Henderson

Measuring Change: Local 2020 Hospital Statistics