Each year, Birth Centers and Midwives all throughout Florida submit an annual report to the Agency for Healthcare Administration (AHCA) and to the Florida Department of Health Council of Licensed Midwifery with statistics about their practice. We tally our work for the year and report on the number of births that we did, transfers, outcomes, waterbirths and laceration rates.
While we are not required to publish our statistics, most reputable practices will publish and provide statistics to anyone asking. If you are looking for a midwife or a birth center in Florida, you can inquire about the statistics of that practice.
Statistics are not only important for state tracking and research studies, but they are also a very important tool for us to use in analysis. By analyzing our statistics each year, we can link cause and effect, and thereby enact changes and improvements in our practice to better our outcomes. For example, when we see an increase in preeclampsia in our practice, we can increase our efforts in nutritional counseling and preventative measures.
Over the last year, we’ve grown and made changes along the way in response to our statistics. We have begun a patient education handbook for all of our moms that includes all of the handouts that we provide during the pregnancy. So now everything is in one place and our patients have more control over their education and a higher continuity of care. We continually make adjustments to our childbirth education program. We’ve updated our handouts, including a list of reputable pediatricians, doulas and other resources throughout the Tampa Bay area. We’ve standardized practice protocols on certain issues like diagnosing breech at 32 weeks, diagnosis and treatment of water breaking versus false rupture of membranes or a high leak. We’ve focused increasingly more and more on nutrition and adequate protein intake in pregnancy. We focused more on mom’s posture during pregnancy and birth and good fetal positioning. For example, we find that when moms get in the tub in a semi-reclining position, their babies will often turn posterior. A posterior position of the baby can prolong labor and may cause the baby to get stuck, necessitating a cesarean. As a result, we advise our moms to avoid the semi-reclining position in the last month of pregnancy and during labor. Also, we often use our ultrasound machine during pregnancy and labor for fetal position checks and take corrective actions as needed.
By analyzing our statistics, we’ve seen year after year that the highest transfer rates in labor are in the winter months, January through early March. Why? Perhaps there is less attention to nutrition and exercise through the holidays. Maybe mom is lounging on the couch more watching TV because it is dark outside so early. Maybe in January, there is more stress and fatigue, more bills, failed New Years’ Resolutions, and increased depression/post holiday blues. The shorter days with less sunlight could be a factor in mood, energy, activity and hormonal function. All of these possible causes can be addressed and come October, we will be giving additional counseling to our moms to help ensure that those who are due during the winter stay healthy, maintain healthy habits, and are less likely to transfer in labor. We’ll let you know next year if this is successful.
So, as you can see, statistics are not just for bragging. Even though we are very proud of our hard work and great statistics, there is always room for improvement and this analysis keeps us on our toes. We can never slack off. We take our work and our patient education very seriously. Every time we give advise, it’s not because we like to hear ourselves talk. We want our moms to have the best outcomes and to have a wonderful birth experience. So, if you hear your midwife say “take iron” or “eat 6-8 servings of protein every day” or “get 30 minutes of walking or cardio every day” or “do your pelvic rock exercises” or “make sure you are taking a sip of water or juice after every contraction”… we are trying to help you achieve your goal of having an intervention-free, natural birth.
With all of this being said, sometimes, despite all of our efforts and after doing all that we can to promote a low interference, natural birth, situations arise that require that a mom or baby go to the hospital. We don’t see this as a failure. We want to psychologically reframe a birth plan change in a positive way. Hospitals and surgeons save lives. And when they are needed, they are a blessing for which we can be grateful.
Below are the statistics for the Sweet Child O’ Mine practice, including both birth center and home births.
Sweet Child O’ Mine Statistics for 2015-2016
Reporting Period: July 1, 2015 to June 30, 2016 (reporting period changed this year so there is overlap with 2015 Statistics)
104 Babies Delivered
10.3% Transfer Rate in Labor (12 out of 116: 7 for failure to progress, 2 for maternal exhaustion, 1 for pain management, 1 for PROM/waters released no contractions, 1 for fetal distress) 5 out of 12 transfers occurred in January, 2016.
3 Postpartum Transfers (retained placenta)
1 Newborn Transfer (transient apneic episodes)
6.8% cesarean rate (8 out of 116)
52% Waterbirths (54 of 104)
29.8% Laceration rate
24 Antepartum Transfers for medical reasons out of 163 patients accepted into care (Breech-6, Preeclampsia/HELLP-5, Preterm Labor-4, Hydrocephaly-1, Macrosomia/large baby-1, Gestational Hypertension-1, Gestational Diabetes-1, Down’s Syndrome-1, Anemia-1, Oligohydramnios/low fluid-1, Twins-1, Postdates >42 weeks-1)
Here are Sweet Child O’ Mine’s statistics from years past for your reference.
Sweet Child O’ Mine Statistics for 2015
105 Babies Delivered
5.4% Transfer Rate in Labor (6 out of 111: failure to progress due to nuchal cord-2, failure to progress due to posterior positioning of baby-2, PROM, water broke and labor did not kick in strong enough-1, meconium stained amniotic fluid-1.
4 Postpartum Transfers: retained placenta-3, transferred to be with baby/exhaustion-1.
2 Newborn Transfers: respiratory distress-1, transient apneic episode-1. Both babies were stable on arrival and remained for observation in the NICU for 5 days.
4.5% cesarean rate (5 out of 111)
52% Waterbirths (55 of 105)
20.9% Laceration Rate (22 of 105, half were waterbirth)
Sweet Child O’ Mine Statistics for 2014
85 Babies Delivered
2.3% Transfer Rate in Labor (2 out of 87: 1 for failure to progress in second stage, 1 for maternal exhaustion)
0 Postpartum Transfers
1 Newborn Transfer (respiratory distress)
2.3% cesarean rate (2 out of 87)
51% Waterbirths (43 of 85)
22.3% Laceration rate
Sweet Child O’ Mine Statistics for 2013
76 Babies Delivered
7.3% Transfer Rate in Labor (6 out of 82: 3 for premature rupture of membranes without sufficient contractions, 1 for maternal fever, 2 for failure to progress in second stage) All transfers were non-emergency car transfers.
0 Postpartum Transfers
0 Newborn Transfers
2.4% cesarean rate (2 out of 82)
50% Waterbirths (38 of 76)
30% Laceration rate