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Thursday, December 31, 2009

Maple Grove's Opening Act? A C-Section

The first hospital to be built in the metro area in 10 years opened it's doors to business today. It's first act? A scheduled cesarean.

WCCO reports:

Melissa Bistodeau, had a scheduled C-Section in the afternoon. She, along with her husband Joe Bistodeau, and son Cole, got the royal treatment.

Nurses and doctors gave them a standing ovation as they made their way to their room.

The hospital is opening in stages, due at least in part to the current recession. It's current focus in on labor and delivery, and it's marketing campaign to attract patients appears to be working. The hospital website heralds its facility as the "region's premier birth center" and boasts of labor and delivery suites that help you feel "at home."

According to the Star Tribune (emphasis added):

On Saturday, nearly 6,000 visitors showed up for an open house at the new facility. People milled around the lobby clutching gift bags and chatting with Cochrane as the Maple Grove High School jazz band played. Kids got their faces painted. Outside, families posed for photos in front of a North Memorial helicopter.

Todd and Christine Nelson of Ramsey were in a long line waiting to tour the birth center and surgical area. Christine is expecting her first baby in April. She says she changed obstetricians so she could deliver at Maple Grove.

Hmmmm. The birth center AND surgical area? Since when do these two things go together? I guess the state's 26% cesarean rate might tell us something about that.

While Maple Grove Hospital may be selling itself as the best maternity care around, evidence from scientific research suggests other standards. The Milbank Report on Evidence-Based Maternity Care: What it is and What it Can Achieve, based on a rigorous analysis of the best scientific studies of childbirth available, states (emphasis added):

Although most childbearing women and newborns in the United States are healthy and at low risk for complications, national surveys reveal that essentially all women who give birth in U.S. hospitals experience high rates of interventions with risks of adverse effects. Optimal care avoids when possible interventions with increased risk for harm. This can be accomplished by supporting physiologic childbirth and the innate, hormonally driven processes that developed through human evolution to facilitate the period from the onset of labor through birth of the baby, the establishment of breastfeeding, and the development of attachment. With appropriate support and protection from interference, for example, laboring women can experience high levels of the endogenous pain-relieving opiate beta-endorphin and of endogenous oxytocin, which facilitates labor progress, initiates a pushing reflex, inhibits postpartum hemorrhage, and confers loving feelings. Large national prospective studies report that women receiving this type of care are much less likely to rely on pain medications, labor augmentation, forceps/vacuum extraction, episiotomy, cesarean section, and other interventions than similar women receiving usual care. Such physiologic care is also much less costly and thus provides outstanding value for those who pay for it. Burgeoning research on the developmental origins of health and disease clarifies that some early environmental and medical exposures are associated with adverse effects in childhood and in adulthood. Recognition of known harms and the possibility that many harms have not yet been clarified further underscores the importance of fostering optimal physiologic effects and limiting use of interventions whenever possible.

Unless the care providers at Maple Grove Hospital (or any birth place, for that matter) support this kind of evidence-based care, expectant mothers and families in the Twin Cities might want to think twice before signing up for this "premier" birth center.


heather d said...

It is disheartening but not surpising that the first birth was a scheduled c-section. It sounds as though the hospital is planning for a rise in csections and no change in current obstetrical practices. It will be interesting to see if in a year they top Abbotts high rate. And if they have many, if any, VBACs!

Jill and Chrish said...

I've been trying to decide what to say about this story since yesterday. Mostly, the story made me sad. "Dad and big brother" were showing baby off sans mommy because she was probably still recovering from her major abdominal surgery. Then they mention that the hospital's focus is on labor and delivery...well, maybe not the labor so much. I found another story from earlier this year that seems a more accurate description of what is going on - the hospital was expensive so they are focusing on delivering babies to get their books into the black. And we all know that c-sections will get you into the black a lot faster than boring old natural labor and birth!

Sarah said...

Wow, Jill and Chrish! Thank you for sharing that link...sad but true. Babies = Big Bucks for Big Business and cesareans are the biggest cha-ching of all...

SheGotHipsLikeCinderella said...

Grrrrr.... My mama-bear brain is dumbstruck right now.... grrrrr is all I can come up with!!
Who cares about the long and short term health implications of this business plan of theirs.... First do no harm my ear.

z said...
This comment has been removed by the author.
z said...

yes, you are correct Sarah, Jill and Chrish they are focusing on exactly that, c-sections and induction, as many as they can get on the books. That is where they say "they are focused and going to make the money".
The director running labor and delivery and surgery isn't helping staff out to learn they're jobs or creating any proper work flows to ensure them to be successful at their work. She lacks managerial, accountability and credibility.
They are short staffed and didn't hire enough staff to open the hospital, they were not prepare or ready to start surgery's, they haven't had the proper supply's or instruments and have been scrabbling from day one, total chaos and not organized to start serving the clinics or the public.
They are hiring people from temp agency's to fill in L&D, and over working the one they hired.
Fact!! they were not prepared at all to open, but had to, due to grants and getting a tax deductions.
Not to mention, they are already firing people after just a short time of being open, and this is from their own negligence in poor and fast training to get opened. Staff is confused and being misguided as to their responsibilities. They are hiring people for less wages than competition and work them like a horse theory. Since people are at the mercy of the economy and being jobless. That is why they only hired 200 people out of 8500 applicants.
They also want to claim they are not part of North Memorial, but NM owns 75% of it and NM is assisting them in supply's, instruments, training,employees, billing ETC. If they are separate, why are they modeling NM hospital? and the ambulatory center right next to them. Something to think about.
Best wishes to those who decide to receive care from them and I hope nothing catastrophic happens.
" Its not what they do, but how they do it" Is one of the guiding principal and a very Misleading principals.