Posts Tagged ‘ hospitals ’

Non-Hospital Births Reach 37-Year High

Thursday, March 6th, 2014

The number of babies being born outside of hospitals–either at birthing centers or at home–is on the rise, according to new numbers released by the Centers for Disease Control and Prevention.  More from Yahoo News:

In 2012, 1.36 percent of all U.S. births occurred outside of hospitals — either at home, or at a birthing center — up from 1.26 percent in 2011, according to the report.

Home and birthing center births have been on the rise since 2004, and the 2012 level is the highest since 1975, the report said.

Out-of-hospital births were more common among white women compared with other races: About 1 in 50 births to white women, or 2 percent, were outside of a hospital, compared to 0.54 percent of births to Asian or Pacific Islander women, 0.49 percent of births to black women and 0.46 percent of births to Hispanic women.

Northwestern states tended to have the highest percentage of home and birthing center births. More than 3 percent of births took place outside of a hospital in Oregon, Washington, Idaho, Montana and Alaska, and also in Pennsylvania.

Out-of-hospital births had lower rates of some complications, compared with births that took place in hospitals: The percentage of babies born preterm or at a low birth weight was lower among out-of-hospital births compared to hospital births, according to the report, from the CDC’s National Center for Health Statistics.

This finding suggests that women who have a low risk of pregnancy complications (such as preterm birth) are making up a relatively larger proportion of out-of-hospital births than hospital births, the researchers said. In other words, women at higher risk for these complications are appropriately giving birth in hospitals instead of in other settings.

The report comes at a time when home vs. hospital birthing is a highly controversial topic.  Recent data, also released by the CDC, found a growing number of infant deaths among babies who are birthed at home.

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Your Baby Is Almost Here: Week 35 of Pregnancy to Birth
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Your Baby Is Almost Here: Week 35 of Pregnancy to Birth

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Growing Number of Home Births Result in Deaths

Thursday, February 6th, 2014

Giving birth at a hospital–even under the care of a midwife–is less likely to result in infant death than giving birth at home, according to new research conducted using data from the Centers for Disease Control and Prevention.  The take-away from the study is not that women should avoid holistic care options like midwives and doulas, but that they should think twice about giving birth at home.  More from Time.com:

A new study from researchers at New York-Presbyterian/Weill Cornell Medical Center presented at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting, in New Orleans, found a growing rate of newborn deaths associated with home births.

That’s disturbing because the practice is becoming more popular in the U.S. In 2012, the CDC reported that after declining from 1990 to 2004, the rate of home births has increased by almost 30% from 2004 to 2009 (the latest years for which numbers are available).

Using CDC data collected from 14 million infant births and deaths, the research team learned that the rate of newborn deaths was greater for home births delivered by midwives (12.6/10,000 births) compared to births delivered by midwives in a hospital (3.2/10,000 births). The death rates were even greater for first-time mothers having a midwife delivery at home (21.9/10,000 births). Births in a hospital–even if delivered by a midwife, were still safer than home deliveries.

Taken together, there were about 18 to 19 additional newborn deaths from midwife home deliveries compared to midwife hospital deliveries. If home births by midwives continue to increase at the current rate, the researchers suspect that newborn mortality could almost double from 2009 to 2016.

Based on these findings, the scientists say that expectant parents should be aware of the risks of home births, and doctors should strongly encourage women who want to use midwives to deliver at a hospital. Many families choose home births because they believe that having their baby at home is more comfortable for both mom and baby; to accommodate them, hospitals could make their birthing experiences more welcoming and relaxing for mothers.

Image: Woman laboring at a hospital, via Shutterstock

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Saline Shortage Affects Hospitals Nationwide

Thursday, January 30th, 2014

A shortage of intravenous (IV) saline solution, which is routinely used to help patients, including children, hydrate, is affecting hospitals across the U.S., the Food & Drug Administration is warning.  More from Time.com:

Millions of bags of the solution, which are essential for hydrating patients, and are also critical for cleansing the blood of dialysis patients, are used nationwide each week. The Washington Post reports that manufacturers told the FDA last year that they were expecting delays in filling hospitals’ orders after some plant shutdowns for routine inspection and upgrades. The IV solution cannot be replaced with other forms of saline because it is specifically designed to be administered by injection; in a letter to health care providers, the American Society of Health-System Pharmacists warned that saline solutions used for irrigation are “not approved for injection because it may have higher levels of particulates.”

The FDA says the shortage was triggered by several factors, including delays in delivery and increased demand by hospitals to treat flu patients.

Some healthcare providers are asking staff to find ways to conserve the IV solutions by using smaller bags, while others are using alternatives such as oral hydration fluids. Valerie Jensen, an associate director of the drug shortages program at the FDA told The Washington Post that no hospitals have actually run out of saline, they are “still reporting that they may only have a few days supply.”

Image: Hospital IV bag, via Shutterstock

 

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Kids Get Uneven Care After Tonsillectomy, Study Finds

Tuesday, January 21st, 2014

Hospitals vary greatly in how they treat children who are undergoing surgery to have their tonsils out, according to a new study published in the journal Pediatrics.  More from NBC News:

Getting your tonsils out: It’s a rite of passage for hundreds of thousands of U.S. kids every year.

Yet a study released Monday shows hospitals vary greatly in just how they handle this common procedure. And kids fare differently depending on which hospital they go to. At the best hospitals, just three percent of kids came back for complications like bleeding. But at others, close to 13 percent did.

It is the latest in a series of studies showing that Americans get vastly different care depending on where they live.

It’s not clear why, but the researchers who did the study say it will be worth looking into so that all hospitals can make sure children recover well from the operations. New guidelines issued in 2011 may help get all hospitals and pediatric surgeons on the same page, other experts said.

….Dr. Sanjay Mahant of the University of Toronto and the Hospital for Sick Children in Toronto, and colleagues across the United States, looked at the records of nearly 140,000 children who got simple, uncomplicated tonsillectomies at 36 children’s hospitals between 2004 and 2010. All got same-day operations and were sent home on the day of their procedure.

Over that time, about 8 percent had to go back to the hospital within a month, usually for bleeding.

The researchers also looked at the use of two common drug types — dexamethasone, which can reduce complications such as nausea, and antibiotics.

New guidelines issued in 2011 advise giving dexamethasone to children before the operation, and they recommend against giving any antibiotics.

In the study before the guidelines came out, 76 percent of the children got dexamethasone, and at some hospitals almost none did. And 16 percent of children got antibiotics, although at some hospitals 90 percent of patients did.

“More than 500,000 tonsillectomies are performed each year in children in the United States, most commonly for sleep-disordered breathing and recurrent throat infections,” the researchers wrote. There shouldn’t be such variation from one hospital to another, they said.

Image: Child recovering in bed, via Shutterstock

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Cost of Childbirth Varies Widely, Without Apparent Explanation

Friday, January 17th, 2014

The cost of having a baby ranges from $3,000 to $37,000 in the state of California, a new study published in the journal BMJ Open has found, with no apparent logical explanation for the wild range or the high costs.  The study highlights some of the issues with soaring health care costs in the U.S.  More from NBC News:

“Even after adjusting for patient characteristics like their length of stay and their age and even adjusting for hospital characteristics and things like the cost of living, we found significant variations in price,” said Dr. Renee Hsia of the University of California, San Francisco, who led the study.

For a simple, uncomplicated vaginal delivery, prices ranged from $3,296 to $37,227, Hsia’s team found. For a C-section, women were billed between $8,312 and nearly $71,000.

“This is, unfortunately, the appalling state of affairs of health care in the United States,” Hsia said.

Even getting the prices wasn’t easy. Hsia’s team had to tease it out from state data on each patient admission. They figured out which ones were for childbirth, and then eliminated any complicated cases.

“Of course we would expect that if woman is in the hospital for six days as opposed to for two days, she would have larger charges,” Hsia said. “And if you deliver a baby in San Francisco, it will be more expensive than if you deliver in a cheaper suburban area.”

But the prices her team found — they are not naming individual hospitals — varied way more than these differences should account for.

The main problem is that patients do not know how much their insurers are paying on their behalf, and they certainly don’t know the price up front, Hsia says.

“This study shows that the market doesn’t take care of health care the way that we would like,” Hsia said in a telephone interview.

“If I go to buy a dozen eggs at the grocery store, I know if they are cage-free,” she added. “As a consumer, I know what I am buying and why there might be price differences. But as a patient, I don’t even know what things cost.”

Health experts say this is one of the main reason U.S. health care is so much more expensive than in other countries — $8,915 per person in 2012, for a total of $2.8 trillion. Of that, $882 billion is spent on hospitals services, like giving birth.

In May, the federal government said it would start publishing data on hospital charges. Their first numbers confirmed what health reform advocates complained about for years: The charges vary enormously, and for seemingly unclear reasons.

The Obama administration hopes that publishing prices will help force health care providers to be more consistent in their billing.

Image: Woman giving birth, via Shutterstock

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