I commend VHC for their work in bringing down their c-section rate to 20.9%. Here is an article about how they did it:
"Leapfrog: How did leadership react when learning about the high C-section rate, and was it difficult to get the necessary support to prioritize the issue?
Dr. DiLisi: You always want to be proactive, if possible, but in our situation, we found out our C-section rate was high after compiling data for the Leapfrog Hospital Survey in 2014. At that point, our C-section rate was 33 percent, well above Leapfrog’s target rate of 23.9 percent. Once we saw that, we said, “That’s not who we are. We’re about putting the patient first and this is a big issue.”
I love this transparency:
The Medical Director for Labor and Delivery "started posting C-section rates by provider in the OB physician lounge. At that point, the rate began dropping very quickly. Once you start displaying performance publicly like that, good things generally happen."
Keep up the good work, VHC!
*There are a few reserved spots in front of the Women and Infant Health wing. Park there until you are able to move the car to the Green Parking Area.
Some pain-relief options are not available later in labor. In fact, the closer you get to delivery, the more likely you'll only be able to use an Epidural. If you are hoping to use something else, be sure you mention it early on.
|Local Anesthetic Injection||✓|
|Sterile Water Injections||No|
Labor and Delivery Amenities
Visitation During Labor and Delivery
|Persons allowed in triage||Partner and Doula|
|Persons allowed in LDR||Up to 5|
|Persons allowed during epidural insertion||Partner Only|
|Siblings allowed during labor||✓|
|Persons allowed during c-section||Partner Only|
Nurses can accommodate most safe birthing practices. Some alternative birthing practices may need to be approved by your midwife or doctor.
|Drinking||Clear liquids only|
|Time Limit after PROM||Labor must start within 18 hours|
|Stalled Labor||Pitocin after 1-2 hours|
|Pushing time limit||3 hours|
|Blood pressure cuff||Intermittent*|
|Electronic Fetal Monitoring||Intermittent*|
|Typical monitoring||40 off - 20 on|
* You'll need to be continuously monitored once your water breaks, you start Pitocin, or if your baby is in distress. If you don't have an epidural, you can still move around, as long as they can get a good strip.
Your doctor has the most influence on which position you can deliver in. Thought options are more limited with an epidural, you can still ask for an upright position.
|Laying down with stirrups||Most Common|
|Hands and knees||✓|
|Squat on bed||✓|
|Backward on bed||✓|
|Squat on floor||No|
Though the staff may encourage you to comply with routine newborn procedures, you can opt-out of any procedures and screenings - except the newborn exam. You'll need to sign a waiver.
If you have a strong desire to delay cord clamping or the newborn exam, be sure you mention it when you arrive - and remind them again just before delivery.
Newborn procedures (except weighing) can be done on mom's chest; just ask for a nurse that is comfortable doing it there.
|Cord Clamping||Can delay|
|Encourage immediate skin-to-skin||✓|
|Encourage first feeding in LDR room||✓|
|Delay procedures while mom and baby bond||✓|
|Vitamin K shot||✓|
|Vitamin K oral drops||You must provide|
|Erythromycin eye ointment||✓|
|Metabolic screening test||✓|
|Hep B Vaccine||✓|
|Public cord blood collection||✓|
|Private cord blood collection||✓|
|Placenta Services||Can be taken home within four hours|
|Length of stay: Vaginal||2 nights|
|Length of stay: C-section||3 nights|
|Private postpartum recovery rooms||All rooms|
|Sleep-chair for partner||✓|
|Family Visitation||11:00 AM - 7:00 PM|
|Other vistors over 12 years old||11:00 AM - 7:00 PM|
Nurses can help you get started with breastfeeding. A lactation consultant is available during the day to offer guidance and support. The day after your baby is born, you are invited to attend a lactation consultation on the L&D floor.
|Certified Lactation Consultants||✓|
|Breastfeeding supply store||✓|
|Breastfeeding support group||Meets Weds 12:00 PM & Thurs 10:30 AM|
|Mom, baby, and partner have matching security bands||✓|
|Family waiting room||No|