Where to go to prevent tearing

vaginal tears

Awhile back, I did a quick post on a few of the rates of tears at different hospitals in the Twin Cities area. The info has been slightly updated, and I decided to pull the information for all of the area hospitals.

A few notes: The website that lists this information doesn’t specify what degree of perineal tears they are talking about. Tears are rated first degree, second degree, third degree, and fourth degree. First and second degree tears can be pretty common. Most epidemiological discussions about tears focus only on 3rd degree tears and second degree tears. I’m hoping to get some clarification on what the heck they are talking about when they say “tears”, and I’ll update this post as I can.

Perineum Tears: Rates for Vaginal Deliveries without Instruments; for some reason, St. Joseph’s is missing.

Lowest rates to highest:

  1. Shakopee- 1%
  2. Ridgeview- 1%
  3. St. John’s- 1%
  4. HCMC- 2%
  5. Lakeview-2%
  6. Unity- 2%
  7. Regions- 2%
  8. North Memorial- 2%
  9. Mercy Hospital- 2%
  10. University of Minnesota- 3%
  11. United- 3%
  12. Regina- 3%
  13. Ridges- 3%
  14. Methodist- 3%
  15. Northfield- 4%
  16. Woodwinds- 4%
  17. Southdale- 4%
  18. Maple Grove- 4%
  19. The MotherBaby Center/ Abbott Northwestern- 5%

Perineum Tears: Rates for Vaginal Deliveries with Instruments

Lowest rates to highest:

  1. Regina- 0%
  2. University of Minnesota- 5%
  3. Hennepin County Medical Center- 10%
  4. St. John’s- 10%
  5. Woodwinds- 10%
  6. Regions- 12%
  7. Unity- 12%
  8. St. Joseph’s- 13%
  9. Southdale- 13%
  10. Northfield- 13%
  11. United- 14%
  12. Shakopee-15%
  13. Ridges- 16%
  14. North Memorial Medical Center- 16%
  15. Mercy- 19%
  16. Methodist- 24%
  17. Ridgeview- 27%
  18. Maple Grove- 20%
  19. The MotherBaby Center/ Abbott Northwestern- 24%

Beyond choosing your care provider and place where you give birth with a lot of thought and care, make sure you know the different ways you can make pushing and birth as safe as possible. Check out our Confident Birth and Beyond (Lamaze) classes, too, to learn how to have a safe and healthy birth.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

6 Easy Questions to Ask Your Midwife or Doctor

Questions to ask your OB

I’m a big fan of talking to your care provider about things that have a huge impact on the outcome of birth for both mom and baby, but I know some of those big questions can seem awkward. After talking with some of my Confident Birth and Beyond (Lamaze) classes lately, I’ve come up with some questions that should be pretty easy to just slide into your prenatal appointments.

1) When’s the last time you did an episiotomy?- Episiotomies are only really necessary in very rare, very specific circumstances (victims of female circumcision can need episiotomies, for example). If you trace the history of episiotomies, it’s pretty clear that it’s rarely needed. A good answer to this question goes something along the lines of, “Well, I haven’t done one in 8 years” or “I’ve done maybe 4 in my whole career at the very most.”

2) Are you OK with me using upright pushing positions?

and

3) Are you going to make me lie down for the actual birth? Question #2 and question #3 kind of go hand in hand, but you’d be surprised how often a doctor or midwife tells a mom she can PUSH in any position, but will then, at the last minute, tell a mom that she HAS TO lie down for the “delivery”. Lamaze Healthy Birth Practice #5– Avoid Giving Birth on Your Back is best for moms and best for babies, period.

4) So, what do you think about the ACOG/ SMFM Consensus Statement on the Safe Prevention of the Primary Cesarean Delivery? When it came out in March of 2014, the Consensus Statement was a really big deal. How big? It redefined the onset of active labor from 4 cms cervical dilation to 6cms of dilation. That’s just one of the numerous guidelines published to help improve our rising maternal mortality rate in the US. Your care provider should be up to date and following these practice guidelines, because there is a need for improvement from the normal way of doing things.

5) Do you do a lot of VBACs? The issue of VBACs versus Elective Repeat Cesareans is so much bigger than just the oft-cited “rupture”. The rising cesarean rate in the US is largely a result of reduced access to VBACs, and our rising maternal mortality rate has been tied to repeat cesareans. Most women who gave birth by cesarean are candidates for VBACs; it’s a matter of finding a care provider who will “allow” them. And if your doctor “allows” them (see how I put that in quotation marks? heh), does he or she actually DO any?

6) How quickly after birth do you clamp the umbilical cord? The case of delayed versus immediate cord clamping is pretty much decided– it needs to be delayed. A recent study on cord milking following cesareans (since you can’t really wait for the cord to stop pulsing on it’s own during a surgery) had some pretty important results, including a reduction in cerebral palsy. Yeah, you know that thing fetal monitoring was supposed to prevent but doesn’t? At this stage, it’s pretty hard to defend immediate cord clamping, even when babies are born prematurely or need resuscitation. Clamping and cutting needs to wait.

  • What questions did I miss?
  • Did you ask your provider about any of these things?
  • What kind of answer did you get?

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Cesarean rates in US

The CDC has crunched the numbers, and the preliminary data for Cesarean rates in 2014 were published last week. There was a good amount of good news; as ACOG put forth their recommendations for the safe prevention of primary cesarean in March 2014, cesarean rates did, in fact, go down. Many thanks as always to Jill from cesareanrates.com for this info. (And if, like me, you’re forever grateful to all the work she’s done in the arena of maternity care advocacy, you can thank her with a monetary contribution. Ahem.)

In 2013, Cesarean rates for the US were 32.7% for total cesareans, and 26.8% for low-risk pregnancies; in 2014, the US preliminary total cesarean rate was 32.2% and 26% for low-risk births. Minnesota does better than the US average. in 2013, Minnesota’s total cesarean rate was 26.9% and 21.3% for the low-risk cesarean rate. Those numbers were 26.5% and 21.1% in 2014. So, yes, progress! YAY!

I’d like to think that increased transparency is helping move these numbers in the right direction. In fact, a study done at the University of Minnesota that was published this month showed that public reporting improves outcomes. And while I love, love, love the push from organizations and nonprofits to pull together information on outcomes and costs, it’s critical for providers to get asked about outcomes by the parents who are coming to them for care, and then parents need to be able to make a thoughtful, deliberate decision based off of that information that’s in the best interest of both mom and baby.

If you’re curious about who has the highest and lowest cesarean rates….well, check it out:

Highest 2014 total cesarean rates

1) Louisiana – 38.4%

2) Mississippi- 37.7%

3) New Jersey- 37.4%

4) Florida- 37.2%

5) Alabama- 35.4%

Lowest 2014 total cesarean rates

1) Utah- 22.3%

2 ) Alaska- 23.7%

3) New Mexico- 23.8%

4) Idaho- 24.2%

5) Hawaii- 24.6%

I’d love to add some information to this about costs, etc. I’ll see how the week goes; maybe I can pull some more into this information.

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Meet our new doulas!

As you may remember, I announced the launch of Metro Doula Agency, LLC just over a year ago. Since then, my doula partner Liz and I have been taking clients as a team, and it’s been wonderful. We know our team model improves the quality of support that families receive and it makes life easier on us and our families.

The word “agency” implies there will be other doulas…and I’m excited to announce that we’ve brought on two wonderful women. They will be working as a team as well. I’ve had a chance to spend time with them and I could not be more thrilled with their gentle hearts and bright spirits. Below you’ll find pictures and introductions from Liz R. and Katelyn. They are both trained and have experience, but are working on their certifications.

We know that the agency model is something new to the area, but I’m confident families and providers will come to know that our doulas are the most professional doulas around, that they are highly knowledgeable, and that families will never be without support for their birth, no matter what. Metro Doula Agency stands behind our promise to support families, even through long labors, epidurals, or cesarean births.

With the addition of these two fine ladies, we are able to offer doula services on a sliding fee. So if you’ve been wanting to hire a doula, but have been trying to scrape together pennies to pay for one, we may be a wonderful solution to give you continuous labor and birth support. Contact us at info@metrodoulaagency.com metrodoulaagency@gmail.com and we’ll get you the excellent doula care you deserve.

Warmly,

Veronica

Minneapolis birth doula

Hi!
My name is Liz Ripka. I am 30 years old and have been a birth doula for the past year. I have always been fascinated with pregnancy, birth and the postpartum period.  After many of my friends, and family told me how wonderful I would be as a birth doula I thought I would look into it. A few weeks later I found a workshop and began my training. I have never felt so passionate about my job! I love being able to help and support women and their partners.  I focus on offering a nurturing presence, educating, supporting a woman’s choice, and making the birth of their child as special as possible to each family. I believe that laughter and love are important in the birth process. In addition to working with BabyLove as a birth doula, I am a nanny for two adorable little boys. I love serving each and every family and I feel so honored to be welcomed into their life story. I look forward to this journey!

St. Paul Birth Doula

Hello!

My name is Katelyn Hinrichs. I was born and raised in Minnesota and currently reside in the suburbs of Minneapolis with my family of four. My interest for birth came about when I gave life to my firstborn. I found myself reading anything I could get my hands on, and it was then that I realized this was my calling and there was no looking back! When I’m not spending time with my family, I love to grab some coffee and go shopping, snowboarding, and getting cozy with a book! I love to collect glass containers in hopes to give them another use down the road. My favorite subject in school was my fine arts acting classes. Being a doula means supporting my fellow sisters through this transformative time; giving them the support and means to feel empowered throughout their pregnancy, birthing experience, and beyond.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Breastfeeding Help…And Why You Can’t Get Any

Minnesota Breastfeeding Help

I’ve been thinking about this for a long time, and I need to get this off of my chest. I’ve written a little bit previously about some of the issues moms face in getting competent breastfeeding help, but after having this conversation with many providers recently, I think it’s time to have a little bit of a discussion about the state of lactation support in Minnesota.

So, first of all, the advice that ONLY IBCLCs are qualified to help moms with lactation issues is ludicrous. When we’re talking about something that about 90% of moms start doing right after giving birth, there’s no need for stupid turf wars. There are a number of breastfeeding trainings and certifications, some with more rigorous standards than others, but just as Minnesota doesn’t mandate one specific type of training or certification for midwives who want to attend homebirths, a rational breastfeeding supporter would acknowledge that there are a few different ways that professionals can gain the information that they need to help moms figure out how to make breastfeeding work. Even the CDC, when they issue their annual breastfeeding report card, reports not only how many IBCLCs there are in a state, but also how many CLCs there are.

Second, it’s time to acknowledge that hospitals don’t have enough inpatient resources to help every mom get breastfeeding well established before being discharged. Although I don’t have any hard evidence to prove this, but anecdotally I’ve heard from families who gave birth in Baby-Friendly hospitals got absolutely no one-on-one support, perhaps because the dedicated lactation staff was either reduced or eliminated completely. Sometimes administrators think that by paying for 20 hours of trainings for all of the nursing staff, they need to recoup that money by getting rid of the experts. Or something. Whatever it is, the access to help is not improving.

Third, once moms get discharged, finding outpatient help can be nearly impossible. One health system makes everyone in their system go to one clinic in St. Paul, which may or may not have more than one IBCLC on staff. Visits from a public health nurse can help, but visits are not universally done, and not all nurses have the time to properly assist moms with breastfeeding. Many outpatient clinics report waiting lists of up to a week. And while there are LCs in private practice, most of them require moms to pay out of pocket upwards of $200 per visit, despite the fact that the Affordable Care Act mandates that insurers cover breastfeeding help at 100%. Now, there are some barriers to becoming an in-network provider, but those hurdles can be overcome. The larger issue is getting providers to understand reality versus the whispered lies and half-truths about insurance reimbursement they’ve heard in the past.

My point? Fixing our broken breastfeeding system in Minnesota is going to require that the IBCLC turf war goes away. It’s going to require that hospitals hire more lactation staff. Private practice lactation specialists need to to think outside the box (rather than only trying to build one box) to make sure families don’t have to pay out of pocket for services they shouldn’t be asked to pay for. After all, for every mother that gives up on breastfeeding sooner than desired, I’ll show you a mom who had little or no competent support. That’s just not fair to moms or babies. They deserve better.

Two things we’re doing at BabyLove to address these issues: First, Mama Cafe, free breastfeeding support on Tuesday mornings, has been around since day 1. Second, you can get one-on-one breastfeeding help in our office or in your home, with some insurances accepted, and more being added. It’s my way of not just talking the talk, but walking the walk.

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Am I biased? You bet.

BiasedBiased

Recently, although I’ve heard it before, the charge was leveled at me that I am biased in my classes. I was called, “Pro-breastfeeding, anti-drugs.” I spoke with a few other Lamaze Certified Childbirth Educators, and it seems that this charge is something that we’ve all heard. So, I think it’s time that I out myself for all of my biases.

First of all, I teach what’s best practice, what’s evidence-based, and what’s biologically normal. Now, keep in mind that it takes, on average, 17 years from the time something is deemed best practice (ie. safest) in maternity care before it used on a regular basis. 17 years. When new practice bulletins come out from ACOG, when the American College of Nurse Midwives issue statements, when the AAP put out new guidelines, guess what? That’s what I’m teaching. If I only taught what was being done by doctors and midwives– well, I have major ethical concerns with that. In an environment of “shared responsibility,” there’s a moral imperative to give families the information that they need to know if they are getting safe and competent care.

As for the “pro-breastfeeding” charge; I’m always interested to know why someone’s motivated to make that charge. Yes, I am a Certified Lactation Counselor. So? In classes, I teach the American Academy of Pediatric’s guidelines on infant feeding and mention what the World Health Organization’s stance is on the issue. Maybe the issue is that my classes meet the standards as set forth in the Baby Friendly Hospital Initiative. Again…so? We have 6 hospitals in the Twin Cities that are certified as meeting the Baby-Friendly requirements, all of the Healtheast system, one HealthPartners hospital, HCMC, and the U of M hospital, I hardly think I hold a renegade position. If those hospitals want to maintain Baby-Friendly status, they need to make sure their childbirth education classes have the same content as mine do. With almost 90% of moms initiating breastfeeding, I’ll stand with and support them. This is not about condemning one feeding choice, it’s about helping moms reach the goals they have for themselves.

What else?

I believe that it’s important to teach an understanding of the processes that are the biological norm.

I believe in maternity care transparency.

I believe that moms need to be responsible for finding competent care. They need to learn what that looks like and how to find it.

I believe that infant car seats are usually a waste of money and, since they are more often recalled and used incorrectly, can quickly become not as safe as convertible car seats. I also hate that parents aren’t taking their babies out and more than half of kids now have flat heads by age 1.

I believe in teaching about healthy choices and safe choices.

I believe in judging a hospital and birth center by their outcomes, not their wallpaper.

Are these things really that bad? Is it wrong to make sure parents aren’t being lied to? Is it wrong to be critical of those “educators” who are giving parents unsafe information because it’s the cultural norm? Is it wrong to help parents seek out safe care? Is it bad that I advocate for the right of a mother to be listened to? I hope not.

Every day, I hear birth stories and breastfeeding stories from moms who didn’t get the education or support that they needed and either they ended up with poor outcomes or their babies did. And you know what? I’m going to stay the course, because moms, babies, and families deserve it.

-Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

“I had no idea!”: Unrealistic Expectations for Pregnancy, Birth, and Baby

unrealistic expectations

There’s a common theme that I hear over and over and over: parents experience a huge disconnect between what they expect versus reality, and they find that very upsetting, irritating, and frustrating. Some of these unrealistic expectations are deeply ingrained into our popular narrative about what it means to become parents. This narrative is reinforced by fictional portrayals of pregnancy, birth, and parenting, and large commercial forces exist to profit off of these. It’s time to change that. And while there may be the rare case where these assumptions and intentions are met, those situations are not the norm. So, listed below, are seven of the most common scenarios I run across:

1) Your prenatal visits will have lots of time to answer all of your questions and are enough to teach you everything you need to know about giving birth. Prenatal visits can last anywhere from 5 to 30 minutes or more, and are entirely clinic and provider specific. In high-volume clinics, short appointments are not uncommon. Additionally, a recent study found that many moms did not fully understand what their doctors or midwives were telling them.

2) The care provider you saw during pregnancy will be there during birth. Depending on the provider’s specialty and practice structure (Individual, small group, large group), you’re most likely to be at the mercy of their call rotation schedule. With the exception of the practices that work on a rotating call basis with care providers at the hospital or birth center during an entire shift, or if they happen to have a chance to pop in earlier, you won’t see a doctor or midwife until you’re pushing–and then, who shows up may be a surprise.

3) A nurse will be there to help guide an support you through the entire birth. First of all, a nurse’s primary job is to keep tabs on the health and well-being of baby and mom throughout the labor. They are also required to document heartbeats, blood pressures, temperatures, cervical checks, etc. And while in many cases,  best practice is to have staffing ratios that allows for one nurse to be taking care of one mom in active labor, some hospitals are more likely to have much lower staffing ratios; some Twin Cities hospitals have one nurse for every 2 or 3 mom in labor.

4) An epidural is guaranteed to work (and everyone can have one). Not all women are able to have epidurals– and your doctor or midwife may not catch that ahead of time. Also, epidurals only work perfectly about 80% of the time. No matter what your goals for pain medication are, it’s good to know about other options–just in case.

5) Having a birth plan is enough communication of your preferences. Birth time is NOT battle time. While you are in labor, you don’t need to be using that time to negotiate over the things that are important to you. While nobody knows what your birth will be like, you need to go over your preferences with your doctor or midwife. They should be willing to listen to your concerns and what’s important to you. If they are dismissive or tell you what you want won’t matter, it’s time to think about finding a provider who will be flexible (as you should be, too) to wait until labor unfolds.

6) You won’t need any postpartum help. A new baby is way more overwhelming than most people expect. The baby takes a lot of care and attention, and mom will need 2-4 weeks to really recover from birth, so everything else can quickly get out of hand. Groceries need bought, food needs made, dishes need to get done, laundry needs washed, etc., etc., etc. Ask for help! If you can’t coordinate help via friends, family, coworkers, or church community, then consider hiring a postpartum doula.

7) Your baby’s doctor will help you achieve your breastfeeding goals. The reality is, very few pediatricians covered breastfeeding for more than a few hours in med school. They don’t often seek out breastfeeding education after they start practicing, either. When you take the lack of knowledge base, a common desire to be able to measure every single thing, including how much a baby is eating, and an inherent distrust in the ability of women’s bodies, it’s no wonder so many women give up breastfeeding at the direction of the pediatrician. Some providers so have a passion for breastfeeding, so choose that doctor or nurse practitioner very, very carefully.

Those were the ones I came up with. What else did I miss?

Warmly,

Veronica

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

The cost of birth in the Twin Cities

cost of birth mn

If you read Monday’s post, then I hope you took the time to check out MN HealthScores. If not, that’s ok–you still should, but I poked around for a little bit and pulled more information. On the cost side of things, I was able to pull what they had for local medical groups as far as how much they charge for vaginal births and cesarean births. Not all medical groups had information, but quite a few did.

There are a lot of things this doesn’t take into account. This fee does not include any facility fees or any charges for the baby. It only reflects the charges for the care of mom before, during, and after giving birth. It’s still an intriguing metric.

Vaginal Birth, Highest Cost to Lowest (MN Average $3202)

  1. Park Nicollet- $4287
  2. Allina- $3792
  3. Healthpartners- $3323
  4. Metro OBGYN- $3175
  5. Healtheast- $3059
  6. North Memorial- $3049
  7. Diamond Women’s Clinic- $2996
  8. Clinic Sofia- $2900
  9. OBGYN Specialists- $2749
  10. John Haugen- $2734
  11. Women’s Health Consultants- $2762
  12. Entira Clinics- $2720
  13. Comprehensive Healthcare for Women- $2585
  14. AALFA- $2543

Cesarean Birth, Highest Cost to Lowest (MN Average $3555)

  1. Park Nicollet- $4907
  2. Allina- $4623
  3. Healthpartners- $3970
  4. Metro OBGYN- $3555
  5. North Memorial- $3440
  6. Clinic Sofia- $3297
  7. OBGYN Specialists- $3262
  8. Diamond Women’s Clinic- $3233
  9. John Haugen- $3191
  10. Women’s Health Consultants- $2972
  11. Comprehensive Healthcare for Women- $2972

It’s entirely possible I missed some data, so feel free to head on over to Managing Costs at MN HealthScores and poke around for yourself. And remember: The best care isn’t always the most expensive care.

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Medical Group HealthScores- Cesarean Deliveries and Perineum Tears

minneapolis cesarean rates

If you may recall, back in 2013, Minnesota Community Measurement released a report that included clinic-level primary cesarean rates. That information was left out of the 2014 report, but I was told by the organization that they were working on revamping the collection process to better comply with national standards. The 2015 report isn’t out yet, but there is some info on the Primary Cesarean rates available on a medical group level and perineum tear rates on a hospital level over at Minnesota HealthScores.

You can check out the full information via the links above, but I wanted to highlight, in each category, which clinics and hospitals had the worst outcomes in each measurement. Now, not all medical groups and hospitals submitted information. It’s highly possible that some medical groups who had really awful outcomes aren’t listed. Perhaps in a future post I’ll try to tease out which groups did not participate, but for now, here are the lowest performers in the Twin Cities metro area.

Medical Group Measure: Highest Primary Cesarean Rates

  1. Comprehensive Healthcare for Women- 31%
  2. FamilyHealth Medical Clinics- 31%
  3. Metropolitan Obstetrics and Gynecology- 29%
  4. Allina Health Clinics- 26%
  5. Fairview Health Clinics- 25%

Hospital Measure: Highest Perineum Tear Rates for Vaginal Delivery with Instrument

  1. Abbott Northwestern (The MotherBaby Center)- 29%
  2. Maple Grove Hospital- 22%
  3. Buffalo Hospital- 29%

Hospital Measure: Highest Perineum Tear Rates for Vaginal Delivery Without Instrument

  1. Abbott Northwestern (The MotherBaby Center)- 6%
  2. Maple Grove Hospital- 3%
  3. Park Nicollet Methodist Hospital- 3%

Over the next few days I’m going to try to find time to tease out more data to share. In the meantime, I hope you find this information helpful!

Warmly,

Veronica

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

5 things that $800 stroller can’t do

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photo credit: stobor via photopin cc

OK, so I have a confession: I’m sure he’s  REALLY nice guy, but….I’m not a fan of The Baby Guy. The baby gear industry racks up 50 BILLION dollars worth of sales every single year. Fifty BILLION dollars. As the NYT times review on this book about the baby gear industry points out, this is an industry that preys on parents fears and anxieties, with ever-skyrocketing prices that all sell the illusion that the right products are NECESSARY to make it through pregnancy and postpartum.

I’m not trying to shame anyone. Hey, any industry that makes billions of dollars is really hard for anyone to compete with. And like I said, Jamie Grayson is, I’m sure, a perfectly nice guy, but you have to stop for a moment and wonder what exactly you’re hoping to get from his advice. What specific things do you hope to gain from only having the priciest gear piling up in the nursery? Beyond the gorgeous articles and glowing reviews telling you that you MUST HAVE THIS STROLLER AND THESE VIEWS, there are a few things I want to point out:

1) The $800 stroller can’t help you learn how to have a safe and healthy birth and help you find a care provider and birth place you are happy with

2) The $800 stroller can’t support you at home during early labor

3) The $800 stroller can’t help you with breastfeeding

4) The $800 stroller can’t help you recognize the signs of postpartum depression or anxiety and then refer you to qualified help

5) The $800 stroller can’t come over to your house, make meals for you, clean your house, and answer your questions about how to take care of your baby

So, I invite you think about where you put your dollars. How much will you actually gain from those items you scan in the baby store onto your registry? I’ve been there too–with baby #1, I made sure we had all the STUFF (though 9 years ago there wasn’t as much stuff as there is now); by baby #2, I went and got a couple of not-pink sheets, maybe a new changing table cover, a few lap pads–and that was it. Everything else was unnecessary.

What DOES help with the fear, the anxiety, and the uncertainty?

1) Take evidence-based childbirth classes

2) Hire a birth doula (remember, a doula isn’t a substitute for childbirth education)

3) Take breastfeeding classes and find a breastfeeding support group

4) Make sure to be open with a loved one or friend if you feel like you’re experiencing anxiety and depression, and know help is out there

5) Consider hiring a postpartum doula

You know, believe it or not, you can put THOSE things on your baby registry. Ask for money to pay for doulas and classes. I’m sure Pinterest has some ideas for cute things people can do to gift you these services.  And while the expensive stroller looks impressive, navigating pregnancy, birth, and beyond takes more than things– it takes actual support.

If you want to see a sensible list of what you should put on your baby registry, head on over here and find my FREE checklist.  It’ll get the piles of presents under control.

Thoughts? Comments? Leave them below!

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.