The New York Times reports that the overall Caesarean rate in Tuba city last year was 13.5%, less than half the national average of 31.8%. This article begins with the description of one woman’s experience with childbirth in a Tuba City Regional Health Care Corporation hospital—and goes on to highlight several lessons this small hospital could teach the rest of the U.S.A. about obstetric care.
“…This week, the National Institutes of Health will hold a conference in Bethesda, Md., about the country’s dismal rates of vaginal birth after Caesarean, or VBAC (pronounced VEE-back), which have plummeted since 1996. ‘I think it’s the purpose of this conference to see if we can turn the clock back,’ said Dr. Kimberly D. Gregory, vice chairwoman of women’s health care quality and performance improvement at Cedars-Sinai Medical Center in Los Angeles.
Tuba City will not be on the agenda, but its hospital, with about 500 births a year, could probably teach the rest of the country a few things about obstetrical care. But matching its success would require sweeping, fundamental changes in medical practice, like allowing midwives to handle more deliveries and removing the profit motive for performing surgery.
Changes in malpractice insurance would also help, so that obstetricians would feel less pressure to perform Caesareans…
…The hospital serves mostly Native Americans — Navajos, Hopis and San Juan Southern Paiutes. Four other hospitals in New Mexico and Arizona, run by the Indian Health Service, also offer vaginal birth after Caesarean to some women (it is not safe for all) and have relatively low Caesarean rates without harming mothers or children, whose health in the first month after birth matches nationwide statistics…”
Read the full story and listen/watch the audio slide show here.