Real Mom Confessions for April 13th, 2016

Real Mom Confessions

I haven’t done #realmomconfessions for awhile. A few months ago, a Facebook friend complained about how petty the practice seemed, and I couldn’t have disagreed with her more. All of us are carrying our own challenges every. Single. Day. and it’s really crappy to go up to someone who is struggling on any level in any way, shape, or form and to downplay those struggles. What I love about this process is that it’s allowing us to take a small step out of the shadows and admit the things that we’re working through as women and as moms. I’m going to try to be more open again and post more regularly. So, I’ll confess away:

  • Sleep. I’ll confess that sleep at night has been elusive. Insomnia has been my companion for the last 5 weeks now. No matter what I do– take Benadryl, melatonin, turn on Night Shift on my iPhone, meditate before bed– invariably, 2-4 times a week I end up waking up around 2 AM and can’t get back to sleep. It’s been really frustrating. I can’t for the life of me figure out what’s been triggering it. Stress seems like the most likely answer, but I was stressed long before any of this started, and I do OK with self care. And then when I have nights I can’t sleep I get more frustrated and feel like it’s something I should be able to fix….ugh.
  • To take care of exhaustion related to the insomnia issue, I nap after I get the kids home from school.  So there.
  • My oldest is going to middle school next year and I’ll admit I’m getting really nervous. I’m not upset that she’s getting older, it’s that I REALLY suffered through middle school and I’m just so worried that my sweet little girl will have to figure out how to navigate this universally yucky part of life.
  • I’ve been thinking a lot the last couple of months about this concept of “kin keeping“– the stuff that we do as caregivers that’s impossible to quantify and monetize. There’s a lot of existential angst that comes BOTH from doing all of the things that are invisible to so many as well as the guilt that happens when those things get forgotten. I’m still thinking about it.

So that’s what I’ve got for today. If it seems like my issues are minor, I’m sorry…but this is where I am today. For the rest of you, hang in there. Let’s see how things are next week, ok?

Warmly,

Veronica

Can you have a natural birth and use Nitrous Oxide?

Nitrous Oxide Twin Cities

I’ve had this blog post tumbling through my head most of the week, and so it needs to be written so my brain can start processing other things…like different blog posts.

So, I don’t know if you know this, but we’re really lucky to have some of the things we do in the Twin Cities. Within the next week or so, almost all of the the hospitals in the area will have nitrous oxide as an option (Although it looks like the wait will be a number of months for St. John’s and Woodwinds), and I’m pretty certain that all of the birth centers have it available. Do you know how rare that is in the US? I know it’s popped up a couple of other places, but not in the widespread availability we have here. Ever since it first showed up as an option, I’ve been including it in our discussions of pain medication and interventions in classes, discussing the pros and cons. It is a medication, after all. But…..

Philosophically to ME anyway, using nitrous just doesn’t seem to be on the same plane as narcotics or epidurals. It doesn’t have any meaningful long term effects on mom or baby within a minute or two of not using the nitrous. It doesn’t involve restrictions on labor beyond the mom having to be the only one touching the mask and she must administer it herself. And the analgesic effects are only felt with active use, meaning a mom must actively breathe it in. The risks are low, the benefits are high, a mom can use it off and on throughout her labor as needed. It doesn’t work for everyone, though, and not everyone likes it.

You know what it reminds me of? Hydrotherapy, i.e. soaking in a tub or using a shower. The ease of use is about the same, the risks are low for both, you’ll still find providers actively against the practice. (ha!)

What worries me is that, as more people use nitrous for their labors and births, that this option– which was first embraced locally by birth center midwives– becomes another thing for “natural birth” proponents to place into the “bad” category. First of all, I’m not sure on any given day what people are labeling as “natural” (vaginal?), but the process of making decisions for birth isn’t a binary one. Things aren’t either good or bad. Pitocin isn’t inherently bad. Epidurals aren’t inherently bad. You can’t make decisions about birth that way. Birth and the process of making decisions IS a continuum. It’s always best to start from the place of the normal biological process of birth and then build in an understanding of where interventions, including pain management options, fall on that line. However, I’m concerned that parents aren’t choosing to take birth classes that help them understand the full scope and use, opting instead to take classes with little to no actual content, but endorsed by the hospital, or to take a class that does lean heavily on labeling certain interventions “bad”.

Using nitrous oxide is on one end of the pain management spectrum. Epidurals are on the other end. Both totally have their place in this world. As nitrous becomes an option everywhere and more families are informed about their pain management options, I’ll be interested to see how it ends up being labeled in the good/bad universe of birth options. For now, I’m going to very loudly and very firmly hold it as an option that may work for some people, that is fast acting, and has very few side effects when used properly…just like hydrotherapy.

That’s what I have for today. Thanks for listening.

Warmly,

Veronica

Guest Post: What is Postpartum Anxiety?

Today’s guest post comes from Sarah Letischuh, who sees patients in my building and is part of The BabyLove Alliance, Ltd. Anxiety is something I have struggled with all my life, with a bout after the birth of my son being one of the worst times I had anxiety. Sarah works with kids as well as adults and moms who are struggling with Perinatal Mood Disorders. One of the things I love about Sarah is how kind she is to everyone. She also has a lot of experience dealing with trauma, a must when we’re talking about pregnancy and birth. She’s truly wonderful. Check out her recent post on Postpartum Anxiety.
-Veronica

In my personal experience as a mom-to-be, I often heard about postpartum depression.    My doctors screened for it.  My friends experienced it.  It was talked about in the news.   On the other hand, I don’t remember hearing about postpartum anxiety until I began to learn more about perinatal mental health, in my role as a therapist.

6% of pregnant women develop anxiety.

10% of women develop anxiety during the postpartum period.

It is certainly normal to experience some anxiety during pregnancy and after the birth of a child.   Anxiety is a natural response to change and we know that being pregnant means lots of changes are occurring and will continue to occur.   The symptoms of perinatal  anxiety (anxiety during pregnancy or the postpartum period) are more intense and last longer than fleeting worries.

Symptoms of perinatal anxiety may include:

  • Constant worry
  • Racing thoughts
  • Difficulty sleeping
  • Change in appetite (eating too much or not enough)
  • Intense fear or expecting something bad to happen
  • Difficulty relaxing
  • Physical symptoms such as headaches, stomachaches or feeling shaky

If you believe you or a loved one are experiencing symptoms of perinatal anxiety please know you are not alone, even if no one else is talking about it.   These symptoms can be very overwhelming.  You may feel like no one understands what you are experiencing, but don’t let that stop you from reaching out for help.

A trained mental health provider can help you assess your symptoms and determine the best treatment option in order to help you obtain some relief from your anxiety.

I am available to meet with new parents in the South Metro to assess and treat symptoms of perinatal anxiety.   Please click here to read more about the counseling services I offer for new or expecting parents.   I can also be reached at 952-457-2322 or sarah@sarahleitschuhcounseling.com.

If you are from outside of Minnesota, I suggest visiting the Postpartum Support International  website to locate support in your area.
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Primary Cesarean Rate By Group: Thoughts

I promised some thoughts on my blog post with the medical group rates last week. I was really interested in how many people actually clicked through to read the long as heck report! That’s awesome! But in some discussions online, a few things came up that need clarification.

First of all, this report is put out by Minnesota Community Measurement, an non-profit. I just find it and try to boil down the information in a way that’s more manageable. A lot of people were also wondering why some groups, namely midwife groups and family med groups, weren’t on the list. Here’s the exact methodology, as found on page 175:

This measure assesses the percentage of nulliparous women with a term, singleton baby in a vertex position delivered by cesarean section between July 1, 2014 and June 30, 2015 patients who had a C-section delivery. Any clinic that is part of a medical group in which the medical group has providers who perform cesarean deliveries were eligible to report data for this measure.

The statewide rate for Maternity Care: Primary C-Section Rate was 22 percent (a lower rate is better for this measure). Table 26 displays the details of this statewide rate. Figure 12 shows the average rate for this measure over time.

In maternity care, patients often seek care from multiple providers across locations within a medical group. Additionally, there are some providers who provide maternity care but may not perform c-sections, and patients who require a c-section are referred to a physician who does. Previous clinic level reporting of the maternity care measure did not include the deliveries performed by providers at a site without providers who performed c-sections, and as a result, rates for the state and at the medical group level had the potential to be artificially elevated. The maternity care measure is most appropriately calculated and reported at the medical group level in order to account for these considerations.

A few other people bemoaned the fact that we don’t have info on VBAC rates versus repeat cesareans. I agree. Given that, out of their whole existence, this is only the third report that MN Community Measurement has put out that has any Cesarean information, we’re really lucky to have the info we have. And really,  maternity care transparency is just a problem in Minnesota– we don’t really have any. We have a teeny bit, and I share as much as I can find.

OK, but my thoughts on the numbers:

For their volume, Park Nicollet had a really impressive primary rate of 20.1%, though it was up slightly from last year’s 19.2%. Since being bought by HealthPartners, which had a rate of 21.7% in this report, I do worry about the Park Nicollet number creeping up. Oh, and if you remember back to the post on costs of birth, there’s a major difference in price between Methodist and Regions.

In groups that had drops, I’m really impressed by John A Haugen Associates at 16.2% ( down from 21.2%), Multicare Associates at 19.3% (previously at 29.5%!), Adefris and Toppin Women’s Specialists down to 21.9% ( from 27%), and the biggest group on the list was Allina Health Clinics who was at 21.6%, down from last year’s 25.8%.

Hennepin County Medical Center, which had high marks in the 2012 report from MNCM, had an even worse showing than last year, going from 24.7% in the 2015 report after having a primary cesarean rate of 19.1% in 2014’s report. I’m curious to see how this will be reflected in the 2015 cesarean rates.

Speaking of 2015 Cesarean rates, that info isn’t available, but I’m going to throw caution to the wind and make a few guesses. I think we’ll see an increase in rates at Woodwinds, a slight increase at Methodist and a larger increase at Maple Grove (largely as a result of the high primary rates from OBGYN West and Western OBGYN), increases at Ridges, Southdale, and Regions. I’m going to predict a drop in the overall censarean rate at Abbot Northwestern, St. Joe’s, and North Memorial. I don’t think there will be many changes at St. Francis, St. John’s, or United. As far as the Unity and Mercy…who knows. Now, we’ll have to see if I’m right.

What do you find interesting about all of this? I’d love to know your thoughts!

Warmly,

Veronica

2015 Twin Cities Medical Group Primary Cesarean Rates

I’m a big nerd when it comes to birth data. Maybe you’ve noticed. So when new information becomes available, it’s like Christmas to me. Yesterday, I figured out that MN Community Measurement had finally released their 2015 Health Care Quality Report. For the second year in a row, they reported Primary Cesarean rates by Medical Group.

So, some good news. The State’s rate of primary cesarean dropped from 22.2% to 21.9%. After a decade of rapid increases in cesarean rates, this is just another measure that shows we’re going in the right direction. Whee!

OK, time for the real stuff. From highest rates to lowest, here’s what the report has for Medical Groups. For comparison, I put the rate from 2014’s report in parentheses.

  1. Allina Health Specialties- 34.7% (27.9%)
  2. Comprehensive Healthcare for Women- 33.0% (30.5%)
  3. Western OBGYN- 29.2% (26.1%)
  4. OBGYN West-27.9% (24.1%)
  5. Women’s Health Consultants- 27.0% (24.9%)
  6. Metropolitan OBGYN- 26.0% (29.5%)
  7. Partners OBGYN- 25.2% (27%)
  8. Clinic Sofia- 25.1% (25.1%)
  9.  Obestetrics and Gynecology Associates- 24.8% (21.9%)
  10. Hennepin County Medical Center Clinics -24.7% (19.1%)
  11. Fairview Health Services- 23.5% (24.8%)
  12. Adefris and Toppin Women’s Specialists- 21.9% (27%)
  13. Healthpartners Clinics- 21.7% (n/a)
  14. Allina Health Clinics- 21.6% (25.8%)
  15. Southdale OBGyn Consultants- 21.5% (21.6%)
  16. Park Nicollet Health Services- 20.1% (19.2%)
  17. North Clinic- 19.6% (24.4%)
  18. Multicare Associates- 19.3% (29.5%)
  19. U of M Physicians-18.4% (17.3%)
  20. Oakdale OBGYN- 16.3% (18.7%)
  21. John A Haugen Associates- 16.2% (21.2%)
  22. Hudson Physicians- Minnesota Healthcare Network- 14.9% (11.8%)
  23. AALFA Family Clinic- 4.7% (13.0%)

You can read the full report for 2015 here.

Coming up in the next post, I’ll share my thoughts on some of these numbers. In the meantime, enjoy!

Warmly,

Veronica

Announcing The BabyLove Alliance’s Doula Program

As the Executive Director of The BabyLove Alliance, Ltd., I’m proud of many things. I’m proud of our 501(c)3 status. I’m proud of the little organization we’ve built. I don’t think building this or any non-profit is as hard as anyone likes to think it is, but it’s still an impressive little accomplishment. We’re working on creating a program that integrates prenatal education and birth doula support with mental health and medical risk counseling, and I’m working on raising money to open our very own Baby Cafe to provide breastfeeding help and support to families free of charge. Today, I want to tell you about our doula program.

First, a little background: I’ve been a doula for 9 years. I started my career in Southeast Minnesota. Things there 9 years ago were very different than they are in the Twin Cities now. First of all, there were (and still are) only a handful of doulas in the area; however, those doulas were some of the kindest, most caring doulas I’ve ever had the pleasure of working with and I miss seeing them on a regular basis. Second of all– do you know how much doulas cost? I charged $350 for the first two years I was a doula. That was a totally normal fee. By the time I started taking clients again after my son was born (7 years ago), I think I was charging $550. Third, many of the doulas that started as doulas the same time I did are no longer doulas. Why? Being a doula in a solo practice is brutal to maintain over any length of time. It’s hardly steady income, it’s almost impossible to balance with any other job, and if you have kids it requires many sets of extra hands to be willing and able at any given time to pitch in when a doula is called to a birth. It makes it exceptionally difficult for doulas who don’t have family at the ready. It also means almost any doula ends up having to be a stay at home mom.

As my doula fee for private clients crept up, I’ve become acutely aware that, in all likelihood, that fee was out of line with my own family could afford if we had to hire a doula today. Paying what amounts to a mortgage payment or a month’s rent on a doula? Whoa. Now, it would take a book to explain how doula costs got this high, but if you believe in market forces (and, yes, I actually do), then it’s easy to tell it was time for something to change.

So, if you’re keeping track, there are a couple of issues at play: It’s hard for anyone who needs to work a regular job to pay the bills to work as a doula in private practice (how 99%* of doulas in the US operate). It’s hard to be a doula in private practice unless you have a ton of flexible social and family support to help with childcare. It’s hard for families to pay for doulas out of pocket (and no–I’m not going to tell parents to go to extreme measures to pay for doula care). Over 40 studies have found that doula care improves birth outcomes for mothers, partners, and their babies. No study has ever found negatives to doula care. Having access to doula care is a critical part of providing evidence-based maternity care. That’s why The BabyLove Alliance, Ltd. is doing doula care differently than anywhere else. So, here’s what we’ve come up with:

TBLA Doulas (800x800)

The BabyLove Alliance, Ltd.’s doula care is different. The fee for doula care is determined by a family’s income level, and our doulas and providers work as a group to ensure complete collaborative care.

  • Fees range from $150-$800 based on a family’s income (more here).
  • Families are matched with 2-3 of The BabyLove Alliance, Ltd.’s doulas, whom they will work with during pregnancy, birth, and postpartum. We call this a “pod”. They work together as a team to help families throughout their pregnancies and attend births based on a rotating call schedule. This way, the doulas can balance jobs, kids, life, all while being paid a fair wage for their time spent with clients.
  • The program starts with a comprehensive intake to make sure we can do our best job of supporting our clients. If necessary, we may have them work with other professionals in our organization.
  • Our doulas are accountable to the organization and to each other. They are trustworthy, professional, and kind– a must for any birth professional you’d hire!

I really, really, really believe in this model. It’s sustainable. It’s the most fair to everyone. Yes, others are doing similar things in the US (maybe?), but I think it’s enough of a difference that doulas and families looking for doulas should take a look.

To find out more, shoot me an email at info@thebabylovealliance.org or call me at 651-200-3343.

Or, attend one of our upcoming Doula Information Nights to meet our doulas, have a chance to ask questions, and to start the process of working with our program. They are: 

  • February 26th, 7PM
  • March 25th, 7PM
  • April 22nd, 7PM

At BabyLove– 4590 Scott Trail, Suite #102, Eagan, MN 55122

Having a doula is more within your reach than you think. Being a doula is something you can actually do. Hooray!

Warmly,

Veronica

*I’m totally guessing there. 

Is there a problem with doula care?

Last week Choices in Childbirth released a report on doula care and insurance coverage. As someone who is deeply interested in the subject (and very opinionated on the specific barriers and possible solutions), I found it very interesting and even useful. Unsurprisingly, the report also became fodder for an anti-doula option piece. On Slate, Elissa Strauss wrote the very click-baity titled piece “More Doulas Can Lower the Cost of Childbirth. There’s Just One Problem.” My mom actually ended up sending my the link, asking me if I could believe what she wrote. I read it. I yawned a little. It was nothing I hadn’t heard before, but I think it’s still a good idea to address her article point by point.

Point #1:  Doulas aren’t regulated or licensed

Yep, this is totally true, and realistically, it is creating a major issue in many ways. In fact, Strauss writes,

Anyone can call themselves a doula without any training, certification, or practice. I could declare myself a doula right now. So could you.

Some doula trainers that I totally respect and admire have pointed out the number of certifying organizations has increased exponentially in the last couple of years. Every program is a little different, some requiring more documentation than others, some having in-person trainings while others are mostly done online. Not every organization promotes certification, either. Certification can protect families by knowing that, absent any other regulations, the doula can be sanctioned by her certifying organization. I am a birth doula who was trained to be a doula in November of 2006 and have been certified through DONA International since August 2007. Currently, no doula organization is accredited, either; however, Lamaze International IS an accredited childbirth education program.

I have more opinions about this specific subject than can fit in this post, but parents can still find doulas who are held responsible in some way, shape or form. Which brings me to her next point:

Point #2: Some doulas resent certain protocols

OK, so this is a really sweeping generalization, and I’m not sure if it makes for a good argument about why doulas are in of themselves bad. However, yes, my experience in the last 9 years is that there are doulas who can push the limits of what a non-licensed professional can and should do. However, in the absence of a standardized Scope of Practice (I follow the scope and standard of practice as set forth by each certifying organization depending on which hat I’m wearing), it’s up to the hiring party to figure out what that needs to look like.

Point #3: They are biased!

This is a tricky as heck little paragraph. Strauss states,

With standardization, women, as well as insurers, could feel confident that the doula they hired would be providing them with sound advice. This means providing information that is accurate as well as unbiased. Doulas currently have a reputation as being advocates for intervention-free childbirth; for many of them, having an epidural is a sign of personal weakness and/or capitulation to the medical industry and maybe just a big, fat failure. (Note how the report mentioned above doesn’t distinguish between C-sections and epidurals in terms of their potential value to mothers.) There are some good—if often overstated—reasons to avoid epidurals, but there are also manygoodreasons to get one. It would be unfair to women to populate our labor and delivery units with doulas who insist that childbirth will not hurt too much if the mother just remains calm and breathes.

First of all, as I’ve stated before here, too often the discussion of pros and cons is labeled as being biased. As far as I know, at no point was the CiC report meant to be a comprehensive report on the use or overuse of maternity care interventions. If Strauss needs to be enlightened on evidenced based maternity practice, I’d suggest she start by looking at the groundbreaking Obstetric Care Consensus “Safe Prevention of the Primary Cesarean Delivery” released by AGOC and SMFM. Maternity care in the US needs to be be improved in all metrics, including cost.

Second, all humans are biased. All professionals are biased. However, some are better at recognizing their biases and at removing those biases from their day to day professional interactions. As a doula, I would never, ever talk a mom out of an epidural. Now, that’s different than telling a mom who has a baby’s head halfway out that the epidural might take longer than the one push needed to finish giving birth. No care providers, be they doulas, nurses, midwives, or doctors, should ever, ever, EVER disrespect or manipulate patients. Period.

Point #4: I didn’t have one

Whenever I read or hear discussions about public health policy, it’s really silly to bring any one person’s experience into the larger discussion. Really, it’s not how anything scientific ever gets done. Since Strauss didn’t have one, it’s a great reason to ignore a really well-done report, I guess. Or it’s not. Let’s go with this being a bad reason to ignore the report, ok?

Overall, the piece points out nothing that those of us who are working on doula care access don’t already know, namely that we have a lot of work to do on standardization and definitions before we can even talk about reimbursement. And on it’s face value, it’s possible that Strauss could have written a more thoughtful piece on the other issues that exist in doula care being covered health services. Instead, it comes across as a piece to justify her own rejection of doula care under the guise of commenting on the Choices in Childbirth/ Childbirth Connection report.

Interestingly enough, the use of doulas to improve a medicalized life experience have popped up in conversation about health care on the other side of the life continuum: Death. PBS’s Next Avenue brought up the topic this week. My ideal solution to gain access to doula care as a covered service recognizes that there is a need for emotional and physical support for patients in many different health care scenarios. A proper doula serves as a conduit, a guide, a translator, and a constant companion who is wholly invested in the emotional support of the patient and his or her family. Doulas fill the gaps.

My post is by no means meant to be a comprehensive discussion on the state or future of doula care. I do have very practical, actionable ideas on insurance coverage of doula services that I’d be happy to talk about with people in person. But just because a writer on the XX Blog thinks doulas are terrible, it’s no reason you should too.

Speaking of doulas, the non-profit I run, The BabyLove Alliance, Ltd, offers doula services on a sliding scale. Our very first Doula Information night is coming up on January 29th at 7pm at BabyLove at 4590 Scott Trail, Suite 102, Eagan, MN. Come meet our doulas (who aren’t pushy, btw), find out what makes our doula services more complete than anywhere else, and ask any questions you have about having a doula at the birth of your baby. Email info@thebabylovealliance.org or call Veronica at 651-200-3343 for more information. Spread the word!

One thing about using nitrous oxide during labor

I’ve long thought that dental work has parallels to obstetrics in that finding a good doctor (or midwife? What would a tooth midwife be?) in either category can mean the difference between being OK with your regular appointments or being intensely fearful of going in to have anything checked out. My mouth is what I jokingly call a “million dollar mouth” insofar as it’ll eventually cost me a million dollars to fix all of the issues with my teeth. The last 2 months I’ve had ongoing tooth pain with my top molar– first, a chipped filling that resulted in a crown prep, a CAT scan that revealed the root canal that was done 2 years ago wasn’t done correctly, TWO root canals to try to clear up a massive infection that was raging in the neglected canal, and all of that culminated in having the damn tooth pulled last Friday. Seriously. All that work and the stupid thing was fractured and couldn’t be saved.

While spending hours and hours in the dentists’ chairs, I’ve written a version of this blog post over and over in my head–the problem being that I was under the influence of nitrous oxide, so when I came to me senses, the brilliant blog posts left my head. HOWEVER….I did have a MAJOR ah-ha moment on Friday that I needed to share.

See, as more and more hospitals and birth centers add nitrous oxide as a pain management option, there’s one thing that may be obvious about using it, but it may not be very obvious to everyone. Nitrous oxide requires active participation by the user in order for it to work; epidurals and analgesics work systemically without the user actively doing anything to feel an effect.

Bottom line? If you’re using nitrous for labor pain and anxiety management, you gotta breathe it in. The best results happen when you focus all of your attention on breathing in the “gas and air” mixture. If you don’t breathe it in, you’re not going to feel anything significant.

You see, when they were getting ready for the extraction, I really wasn’t feeling the effects of the NO2; it turns out, I wasn’t really breathing much because I was so nervous. After the nurse pointed out I needed to focus on my breath, it look less than 30 seconds of deep breathing to feel the wave of relaxation rush over me.

I needed to breathe.

So I do know that the mixture of nitrous to oxygen used during labor is different, and unlike the cannula (see the first picture) used by dentist offices, moms self-administer the nitrous oxide via a mask (see the second picture) or a mouthpiece (an example is shown in the third picture), but my point still holds: If you’re going to give nitrous oxide a whirl, you’ve gotta actually breathe it in, or it won’t work.

Breathe on, people!

Warmly,

Veronica

What do you think about this? Have you tried “gas and air” during your labor and birth?  Is it something you want to use? 

Twin Cities Hospital Baby Costs

Twin Cities Baby Costs

In case you missed it, last week I published a blog post that compiled the costs listed on the Minnesota Hospital Price Check website. Like I said then, there are some limitations on the information; those numbers don’t reflect variations in deductibles, co-pays, and co-insurance. Also, I used the “Average Cost”, which takes into account that various hospitals and various conditions have longer or shorter average lengths of stays. However, it’s a number that makes for some useful comparisons.

One thing I wanted to mention: If you’ve been following this blog over the last 4 years, you’ll know that I think this data is exceptionally important to help parents pull together the information that they need to make decisions about safe births. Giving birth is the one “medical” life event that usually allows people enough time to plan and ask questions in preparation for finding good care. Where you go and who your care provider is is THE biggest factor in determining outcome. Not mom’s health. Not baby’s health. And certainly, hospitals are businesses (although non-profits), so following the money is really important.

I love to have in-depth discussions about these things in my childbirth classes, and I love to help families who are unsure about their options or the choices they made ask the questions they need to ask to find the best care for their family. It’s a huge part of Lamaze education, and it’s something I think every parent can benefit from.

Back to today’s chart. Most births involve healthy newborns, but there are times when complications arise for baby. For this reason, I included 6 total diagnosis codes in the chart. Some hospitals, due to lack of appropriate facilities to care for sicker babies, won’t have data listed; they transfer those babies to hospitals with NICUs. Also, in the “Prematurity with Major Problems” and the “Extreme immaturity or respiratory distress syndrome, neonate” categories, you’ll notice some hospitals have very low costs listed compared to other hospitals. Those “cheaper” hospitals had very few babies in 2014 with those diagnosis codes, usually less than 10. Those are outliers that can mostly be ignored. And certainly, this doesn’t capture all the intricacies, so I urge anyone who really wants to know more to look at the data on his or her own, or leave comments below.

Baby Hospital Costs

If you think this is valuable, please check out everything I offer at BabyLove and come see me!

Warmly,

Veronica

Twin Cities Hospital Birth Costs

MN Hospital Birth Costs

(Update 11/13/15 12:39PM) Please note that these numbers do NOT include charges for baby.

A long time ago, during the Pawlenty Administration, the Minnesota Hospital Administration was required to provide information about hospital costs online to allow consumers to compare prices. Lucky for us, this includes obstetric charges. There are some limitations to this information– it doesn’t give us the information on what a specific individual’s costs will be when you take into account deductibles, plan allowances, and co-pays. I also decided to use the 2014 Average Total Cost rather than the Average Daily Cost or the Median Cost in this table. There’s a million ways to slice this information, but I’m a busy mom and this is what I did.

I sorted the information by health system rather than just alphabetical. There are some big surprises– since the Park Nicollet/ HealthPartners merger, Methodist Hospital and Regions are owned by the same company, but the differences in costs are HUGE. You can find more of the information on the Minnesota Hospital Price Check website, but they only allow you to compare 3 hospitals for one kind of charge at a a time. So yeah, the work to get this was tedious. It was also really tricky to get the data from the spreadsheet to this blog.

Minneapolis Hospital ChargesI hope you find this interesting and helpful. Have questions or observations? Post them below!

Warmly,

Veronica