Hi OP, I had a conversation w my OB about this last week since I am nearing my due date and was curious about hospitals in the area and how they lean. The impression my OB gave me is that Georgetown will push vaginal birth as the primary mode with C-Sections really only for medical reasons or mothers choice - but they will assess why you want an elective C and will try to “educate you” on why a vaginal birth is better. That’s how they lean. Sibley has a ton of ama moms and they’re quick with a C section but that’s just a function of who goes there (I think another post digs in on that better than I am rn). OB didn’t provide rates or anything though but knowing philosophies is helpful to me.

I am high risk and would prefer a C bc it “feels” safest to me with my complicating factors, but I’m at Georgetown and they have already indicated (even during this convo w my OB) that they would work to educate me and sway me towards vaginal to the extent it makes sense for my situation. They are open to an elective C, but stated often that maternal and fetal outcomes are better with a vaginal birth.

Anonymous wrote:I hate how every thread where someone asks for information to support a birth choice they’re making freely (not being coerced uninformed into) gets derailed by one extremely anti-vaginal birth poster. The OP is entitled to the information she asks for even if you think vaginal birth is the devil and we should all have mandatory c-sections.

OP here, thank you. My choice as a woman is to have a vaginal birth. I’m asking specifically about hospitals rates.

Anonymous wrote:People who choose home birth are making the a selfish choice, they are putting their own desire and fantasies above the health of their babies. There is zero reason in America in 2022 for you to risk your life and your child's life by delivering at home.

https://people.com/parents/kara-keough-bosworth-son-died-final-moments-daughter-gma-interview/

Lady, go to bed. Seriously. You show up on every one of these threads looking like an idiot. I feel so bad for your family.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a question for the group that feels c-sections are being unfairly maligned. I’m willing to accept it is possible, but who benefits? Like, ACOG recommends bringing the number down, not just the WHO. What is their agenda if not better maternal outcomes? I can see the agenda for more c-sections (insurance pays twice as much) but who is “big vaginal birth” that has an incentive here?

I don't think there's a giant conspiracy ("Big Vaginal Birth"), I think it's a vague "the more natural the better" philosophy that at its worst is very misogynistic and moralizing and judgmental, and at its best is pro-woman and maybe kind of idealistic. But sure, there's money in this philosophy too. Birthing centers and midwifery groups drive patients to specific hospitals, uncomplicated vaginal deliveries may not bill as much to insurance but they're significantly cheaper for the hospital too, doulas are 100% just money that would have been in mom's pocket (no shade; I had one), and all the pre-childbirth classes and books and mom's groups and online womanhood togetherness circles (I don't know if this was a thing pre-Covid, but a friend joined one to prepare for childbirth last year) all cost money. The interesting thing about this side of the scale is that the people who get paid get paid whether mom has a vaginal birth or not. "Big C-Section" isn't keeping deposits on C's if mom gives birth in the car on the way to the hospital, but Ina May didn't refund me my book money when I ended up with a c-section after a four day induction, ya know?

Just to add on: I'm not Team C-Section or anything. I think the pendulum is usually swinging between two camps (We've found a safer way through technology / This is what our bodies are supposed to do, just get out of the way and let them do it) and in DC the pendulum is wedged to one side. This is why on this board people don't just tell you they want a vaginal birth, they tell you why a c-section is bad or dangerous or will result in an inferior child. In other parts of the country and world the pendulum might be in other places on its swing (like Brazil, mentioned earlier, and my high school friends in Texas experienced genuine "your baby will die if you don't get a c 8 hours after your water breaks" bullying that would send Ricki Lake into a killing rage).

That’s an interesting and well considered perspective, thank you!

+1. This is a good post and I agree with everything you said.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a question for the group that feels c-sections are being unfairly maligned. I’m willing to accept it is possible, but who benefits? Like, ACOG recommends bringing the number down, not just the WHO. What is their agenda if not better maternal outcomes? I can see the agenda for more c-sections (insurance pays twice as much) but who is “big vaginal birth” that has an incentive here?

I don't think there's a giant conspiracy ("Big Vaginal Birth"), I think it's a vague "the more natural the better" philosophy that at its worst is very misogynistic and moralizing and judgmental, and at its best is pro-woman and maybe kind of idealistic. But sure, there's money in this philosophy too. Birthing centers and midwifery groups drive patients to specific hospitals, uncomplicated vaginal deliveries may not bill as much to insurance but they're significantly cheaper for the hospital too, doulas are 100% just money that would have been in mom's pocket (no shade; I had one), and all the pre-childbirth classes and books and mom's groups and online womanhood togetherness circles (I don't know if this was a thing pre-Covid, but a friend joined one to prepare for childbirth last year) all cost money. The interesting thing about this side of the scale is that the people who get paid get paid whether mom has a vaginal birth or not. "Big C-Section" isn't keeping deposits on C's if mom gives birth in the car on the way to the hospital, but Ina May didn't refund me my book money when I ended up with a c-section after a four day induction, ya know?

Just to add on: I'm not Team C-Section or anything. I think the pendulum is usually swinging between two camps (We've found a safer way through technology / This is what our bodies are supposed to do, just get out of the way and let them do it) and in DC the pendulum is wedged to one side. This is why on this board people don't just tell you they want a vaginal birth, they tell you why a c-section is bad or dangerous or will result in an inferior child. In other parts of the country and world the pendulum might be in other places on its swing (like Brazil, mentioned earlier, and my high school friends in Texas experienced genuine "your baby will die if you don't get a c 8 hours after your water breaks" bullying that would send Ricki Lake into a killing rage).

That’s an interesting and well considered perspective, thank you!

Anonymous wrote:

Anonymous wrote:I have a question for the group that feels c-sections are being unfairly maligned. I’m willing to accept it is possible, but who benefits? Like, ACOG recommends bringing the number down, not just the WHO. What is their agenda if not better maternal outcomes? I can see the agenda for more c-sections (insurance pays twice as much) but who is “big vaginal birth” that has an incentive here?

I don't think there's a giant conspiracy ("Big Vaginal Birth"), I think it's a vague "the more natural the better" philosophy that at its worst is very misogynistic and moralizing and judgmental, and at its best is pro-woman and maybe kind of idealistic. But sure, there's money in this philosophy too. Birthing centers and midwifery groups drive patients to specific hospitals, uncomplicated vaginal deliveries may not bill as much to insurance but they're significantly cheaper for the hospital too, doulas are 100% just money that would have been in mom's pocket (no shade; I had one), and all the pre-childbirth classes and books and mom's groups and online womanhood togetherness circles (I don't know if this was a thing pre-Covid, but a friend joined one to prepare for childbirth last year) all cost money. The interesting thing about this side of the scale is that the people who get paid get paid whether mom has a vaginal birth or not. "Big C-Section" isn't keeping deposits on C's if mom gives birth in the car on the way to the hospital, but Ina May didn't refund me my book money when I ended up with a c-section after a four day induction, ya know?

Just to add on: I'm not Team C-Section or anything. I think the pendulum is usually swinging between two camps (We've found a safer way through technology / This is what our bodies are supposed to do, just get out of the way and let them do it) and in DC the pendulum is wedged to one side. This is why on this board people don't just tell you they want a vaginal birth, they tell you why a c-section is bad or dangerous or will result in an inferior child. In other parts of the country and world the pendulum might be in other places on its swing (like Brazil, mentioned earlier, and my high school friends in Texas experienced genuine "your baby will die if you don't get a c 8 hours after your water breaks" bullying that would send Ricki Lake into a killing rage).

Anonymous wrote:I have a question for the group that feels c-sections are being unfairly maligned. I’m willing to accept it is possible, but who benefits? Like, ACOG recommends bringing the number down, not just the WHO. What is their agenda if not better maternal outcomes? I can see the agenda for more c-sections (insurance pays twice as much) but who is “big vaginal birth” that has an incentive here?

I don't think there's a giant conspiracy ("Big Vaginal Birth"), I think it's a vague "the more natural the better" philosophy that at its worst is very misogynistic and moralizing and judgmental, and at its best is pro-woman and maybe kind of idealistic. But sure, there's money in this philosophy too. Birthing centers and midwifery groups drive patients to specific hospitals, uncomplicated vaginal deliveries may not bill as much to insurance but they're significantly cheaper for the hospital too, doulas are 100% just money that would have been in mom's pocket (no shade; I had one), and all the pre-childbirth classes and books and mom's groups and online womanhood togetherness circles (I don't know if this was a thing pre-Covid, but a friend joined one to prepare for childbirth last year) all cost money. The interesting thing about this side of the scale is that the people who get paid get paid whether mom has a vaginal birth or not. "Big C-Section" isn't keeping deposits on C's if mom gives birth in the car on the way to the hospital, but Ina May didn't refund me my book money when I ended up with a c-section after a four day induction, ya know?

I have a question for the group that feels c-sections are being unfairly maligned. I’m willing to accept it is possible, but who benefits? Like, ACOG recommends bringing the number down, not just the WHO. What is their agenda if not better maternal outcomes? I can see the agenda for more c-sections (insurance pays twice as much) but who is “big vaginal birth” that has an incentive here?

An NPR story on BBC efforts to reduce their primary C-section rate. They talked about this in the L&D info session as well. https://www.virginiahospitalcenter.com/news-publications/news/2018/hospital-leading-the-way-in-reducing-c-sections-a-npr-report/

I had an easy, uneventful VBAC at VHC and found the staff to be very supportive.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The WHO target rate of 15 percent is made up. It is not evidence based. And it has been debunked thoroughly. Countries who have this rate have high levels of maternal and infant mortality. Please stop furthering this tired, incorrect, and outdated statistic like gospel. It’s damaging and irresponsible.

What is your evidence for this assertion?

https://www.skepticalob.com/2018/05/the-whos-

Marsden Wagner made the number up in 1985. Gawande and the insufferable Neel Shah who is a midwife wannabe and total vaginal birth nut determined an optimal rate is 19 percent or higher. Doh.

Interesting, but it has a fatal design error: what about taking into account complications to future pregnancies? It is safer for that particular baby to be born via c section, not safer for baby #2 and certainly not safer for mom to be collecting multiple c sections.

Yeah but having two planned C sections is pretty reasonable and low risk. If women want more kids than sure, risks go up but for one or two deliveries to
be C section risks are pretty low.

But many women want more than two, or don’t know for sure how many they will want. Which is why the recommendation to avoid primary cesarean.

Yeah except in the DMV among UMC most people are having 1-2 kids at 35 plus.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The WHO target rate of 15 percent is made up. It is not evidence based. And it has been debunked thoroughly. Countries who have this rate have high levels of maternal and infant mortality. Please stop furthering this tired, incorrect, and outdated statistic like gospel. It’s damaging and irresponsible.

What is your evidence for this assertion?

https://www.skepticalob.com/2018/05/the-whos-

Marsden Wagner made the number up in 1985. Gawande and the insufferable Neel Shah who is a midwife wannabe and total vaginal birth nut determined an optimal rate is 19 percent or higher. Doh.

Interesting, but it has a fatal design error: what about taking into account complications to future pregnancies? It is safer for that particular baby to be born via c section, not safer for baby #2 and certainly not safer for mom to be collecting multiple c sections.

Yeah but having two planned C sections is pretty reasonable and low risk. If women want more kids than sure, risks go up but for one or two deliveries to
be C section risks are pretty low.

But many women want more than two, or don’t know for sure how many they will want. Which is why the recommendation to avoid primary cesarean.

Anonymous wrote:

Anonymous wrote:I hate how every thread where someone asks for information to support a birth choice they’re making freely (not being coerced uninformed into) gets derailed by one extremely anti-vaginal birth poster. The OP is entitled to the information she asks for even if you think vaginal birth is the devil and we should all have mandatory c-sections.

Wanting people to be informed of the risks of vaginal birth instead of just hearing about the risks of C sections is not anti vaginal birth. It’s pro consumer, pro woman, and pro choice. Hiding the realities of vaginal delivery and promoting it to women as the best way to birth (a practice that has origins in the belief that women need to experience the pains of birth due to original sin) is masochistic, and Antiwoman. It’s also what, ironically, underpins a lot of the ideology of midwifery, which is a profession that badly needs to embrace evidence and science instead of having large contingents of its practitioners be largely unqualified (CPMs, CMs) with little more than HS education and a bit of training.

I’m not the PP who is supposedly anti vaginal birth, but I agree with the bolded part of this post. My only post in this thread so far is about being switched from a midwife practice to OBs at 34 weeks. I join in on threads like these sometimes because when I was pregnant, I spent a lot of time and energy researching things like the practices and hospitals with the lowest c section rates, and I was really scared of having a c section “forced” on me. I spent a lot of time on a birth plan, practicing techniques, and had a doula. In the end, I had to have an induction in the hospital for a medical reason and it was really hard for me to get over the idea that I’d failed in some way. Also, when my induction started, I was still so committed to avoiding a c section at all costs that I went through an incredibly long (multiple days) and painful process that had little hope of working. My OBs were respectful and listened to my preferences so long as baby and I weren’t in danger, but in hindsight, I wish someone had just suggested a c section earlier before it turned into an emergency situation. It wasn’t the end of the world to have a c section, and it was far preferable to the experience I went through - I chose a scheduled c for my second and it was night and day better. After the birth of my first I really struggled with both the trauma of how things went down and the fact that I felt like I’d failed in some way by not avoiding a c section. If If someone gets the message to be kinder on themselves and not be focused on avoiding a c section at all costs, I’ll be happy.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The WHO target rate of 15 percent is made up. It is not evidence based. And it has been debunked thoroughly. Countries who have this rate have high levels of maternal and infant mortality. Please stop furthering this tired, incorrect, and outdated statistic like gospel. It’s damaging and irresponsible.

What is your evidence for this assertion?

https://www.skepticalob.com/2018/05/the-whos-

Marsden Wagner made the number up in 1985. Gawande and the insufferable Neel Shah who is a midwife wannabe and total vaginal birth nut determined an optimal rate is 19 percent or higher. Doh.

Interesting, but it has a fatal design error: what about taking into account complications to future pregnancies? It is safer for that particular baby to be born via c section, not safer for baby #2 and certainly not safer for mom to be collecting multiple c sections.

Yeah but having two planned C sections is pretty reasonable and low risk. If women want more kids than sure, risks go up but for one or two deliveries to
be C section risks are pretty low.

I am one of the positive-home-birth posters above. It was in response to a negative c-section experience at Sibley, letting the OP know of the experience there. So it is indeed related to the original question.

Anonymous wrote:

Anonymous wrote:I hate how every thread where someone asks for information to support a birth choice they’re making freely (not being coerced uninformed into) gets derailed by one extremely anti-vaginal birth poster. The OP is entitled to the information she asks for even if you think vaginal birth is the devil and we should all have mandatory c-sections.

Wanting people to be informed of the risks of vaginal birth instead of just hearing about the risks of C sections is not anti vaginal birth. It’s pro consumer, pro woman, and pro choice. Hiding the realities of vaginal delivery and promoting it to women as the best way to birth (a practice that has origins in the belief that women need to experience the pains of birth due to original sin) is masochistic, and Antiwoman. It’s also what, ironically, underpins a lot of the ideology of midwifery, which is a profession that badly needs to embrace evidence and science instead of having large contingents of its practitioners be largely unqualified (CPMs, CMs) with little more than HS education and a bit of training.

Sure (although most folks who use a midwife in this area go to a CNM and an evidence based practice) but no one said vaginal birth was risk free or even was debating the value of different approaches to birth until you started yelling at everybody. The first two responses provided OP with valuable education on the dangers of vaginal birth/why c section rate is not always a useful metric, should she need that information. Now you’re just derailing the thread.

OP, I don’t actually know the answer to your question but I think a PP a few pages back. Congratulations on your pregnancy and best wishes for your birth.