You’re pregnant, you live in Morgan County, Alabama, you’re 22 and African American, what are the odds you’ll have a c-section?
You’re pregnant, you live in Salt Lake City, you’re 19 and white…
You’re pregnant, you live in Miami, you’re 28 and Hispanic…
Using a new online tool called the “Childbirth Risk Calculator” I calculated the odds for each of these women. Here’s what I learned:
Pretty big disparities here. Our Hispanic friend in Miami is about three times more likely to have a c-section than her Asian peer in Seattle. The teenager in Utah has a much lower odds of needing a c-section than her young African American friend in Alabama. Pretty interesting, right? (If you’re interested, calculate your odds of a c-section or preterm birth or low birth weight baby, based on your age, location and ethnicity.)
I had fun playing with the calculator yesterday. But the numbers only hint at the much more complicated back-story– one that has to do with class inequalities, racism, poverty, the bi-products of a for-profit healthcare system, rising obesity rates, lousy nutrition, complicated malpractice laws, a crisis in maternity care, excessive use of fetal monitoring, over-reliance on technology, lack of education about choices in childbirth …
Tools like this can help shed a light on disparities between care based on some factors. But they can also make pregnant women feel very anxious and/or fated to a particular outcome. When I shared this new “childbirth risk calculator” with my pregnant colleagues at Babble.com , the response was clear: This is stress-inducing. I’m not clicking on this link. Now I’m obsessing the high rate of c-sections where I live. I get it. Discussion of pregnancy and birth these days is too often framed almost entirely in terms of risk. You get pregnant and the word risk shows up constantly in every email, book, chart, headline, doctor’s visit. I remember googling the odds of getting hit by a bus at some point during my last pregnancy just to get some perspective. I joyfully alerted my husband to my findingst: I have a bigger chance of dying in a freak accident than getting listeriosis from this non-steaming hotdog. WOOT! You know things have gotten a little out of hand when this is how you calm yourself down.
So here are a few things to know when looking at data:
Your care-provider’s statistics are more relevant to the way your birth will be handled than the county’s. So while regional data is helpful– if you live in New Jersey where the c-section rate is very, very high you may want to work hard to find a care-provider who is resisting this state-wide trend, for example– it only tells part of the story.
I link my childbirth education students to a website that shows the statistics for their hospitals because it can give them a sense of how things are handled. At Cornell in NYC the epidural rate is 98%, for example, which is considerably higher than the anesthesia rate on the other side of Central Park at St. Luke’s Roosevelt where there’s an adjoining birthing center with birthing tubs for women who don’t want pain medication. This can be a good thing to know whether you want an epidural or not.
Ask your care-provider for his or her statistics and visit the hospital where you plan to give birth. Remember that you’re a consumer and there are choices you can make to influence the odds of this or that happening.
What do you think about this tool?
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