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VAGINAL BIRTH RATE: THE NUMBERS DON’T LIE

I started with Kamm McKenzie OBGYN 8/16/2010.  As a necessary part of preparing for the OBGYN oral board examination (FYI: Drs. PrivetteRushWheeler, and I all passed!!), I had to keep track of all my obstetrical procedures.  I thought it would be interesting to share the numbers with you and then provide some insight into them.Here are my OB numbers from 8/16/10 through 11/12/11.

  • Vaginal Births:  181
    • Spontaneous: 163
    • Vacuum Assisted: 6
    • Forceps Assisted: 2
    • Twins: 2
    • VBAC (vaginal birth after cesarean): 8
  • Cesarean Sections: 50
    • Scheduled Repeat: 16
    • Breech: 12
    • Twins requiring or desiring c-section: 4
    • Placenta previa: 1
    • Prior myomectomy: 2
    • Primary c-section for arrest of labor or fetal heart rate abnormalities: 15

The way I look at it is as follows:  My overall c-section rate was 21.6%, which in the scheme of things is actually pretty low.  However, more importantly, I look at the c-sections that were done for women who attempted to have a vaginal birth.  I did 15 c-sections for women who either stopped dilating, had arrest of labor in the pushing phase, or whose babies had decelerations of the heart rate that prevented a safe continuation of labor.  To me, the 15 is the important number to look at.  That results in a rate of 6.5% of women who attempted vaginal birth and ended up with a cesarean. 

I have not had a chance to review all my partners numbers, but we all practice similar medicine, and I have to believe the numbers are similar.  Certainly, the overall c-section rate for some of the more senior partners will be higher because many more women will schedule repeat c-sections with them because they enjoyed their experience with them the previous time(s).  But I would predict, with confidence, that their primary c-section rate after attempted labor is similar to mine.

So why is that number so low?  I have to give credit to where credit is due, and that is with the WakeMed L and D nursing staff.  Most of the nurses on L and D have many many years of experience.  They are excellent patient-minded advocates and are comfortable with the ins and outs of the labor process.  When its use is necessary, they are not afraid of pitocin and will use appropriate dosing to allow our patients to achieve active labor, giving them the best chance of vaginal birth.  I have worked at other hospitals where this is not always the case.  And lastly, I think as a group of physicians, we share the attribute of patience.  This is especially necessary when first time moms are going through labor (or an induction of labor).  It is a long process and our doctors understand this.

The take home point… you should feel pretty confident that if you are going to try to have a vaginal birth with Kamm McKenzie OBGYN, then your chances are pretty solid that you will.  The numbers don’t lie.

Until next time, 

Dr. B.

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