When you find out you're expecting a baby, you start researching everything, don't you? I definitely did! I researched childbirth classes, breastfeeding, babywearing, cribs, carseats, strollers, and more.

I knew the reputations of the two hospitals in my city, and chose the one with the strong reputation for supporting natural childbirth, since that was my goal for my birth. But beyond hearsay and opinions I had heard over the years, I did not have any real information on which to choose my place of birth! Eight, almost nine (slow down time!) years later, and that's still all the information people really have when choosing a hospital for the birth of their baby; hearsay, and their peers' opinions.

As part of my Evidence Based Birth® Instructor training, I had to search for and compile maternity care statistics for my local area, Lincoln, NE, where my clients are giving birth, and for the state as a whole. This is my experience.

I was searching for the following statistics for individual facilities (Hospitals) and for the state as a whole:

Overall Cesarean Rates
Primary Cesarean Rates (What percentage of the Cesarean rate are women having their first Cesarean)
Low-Risk Cesarean Rate (What percentage of low-risk women, women carrying a single baby, delivering a head-down baby at term, with an uncomplicated pregnancy, had a Cesarean)
VBAC (Vaginal Birth After Cesarean) Rates
Episiotomy Rates
Induction of Labor Rates
Epidural Rates
Breastfeeding Rates

I searched the following sources for information:

http://www.leapfroggroup.org/
https://www.jointcommission.org/
https://www.cdc.gov/
https://www.hhs.gov/
http://dhhs.ne.gov/
http://lincoln.ne.gov/city/health/
http://www.cesareanrates.com/
http://www.consumerreports.org/health/hospitals/ratings
https://evidencebasedbirth.com
https://amino.com/

First of all, it was far easier finding information on different stroller options than it was to find any of this information! I had to request data from The Joint Commission, download a file, and then sift through the spreadsheet for the information I wanted. I had to browse and search the Nebraska Department of Health and Human Services (DHHS) website for almost an hour to even find information that I wanted. In order to find statistics regarding (VBAC), I had to go to CesareanRates.com, where Jill Arnold has compiled both overall Cesarean and VBAC rates for individual states, and overall Cesarean rates for individual hospitals, a monumental task, which likely explains why her latest dataset is from mid-2014. Just a couple of months ago, Rebecca Dekker at Evidence Based Birth® put out a blog listing individual state VBAC rates from the latest available dataset from the CDC, 2015.

I also hit several dead-ends. The Lancaster County Health Department, including Lincoln where I live and the majority of my clients give birth, had only demographic data on births, none of the information I wanted. The LeapFrog Group collects information from individual hospitals, including Cesarean and Episiotomy rates, but only three hospitals of 22 surveyed in Nebraska have responded to the survey.

There is a lot of information that I was unable to find about birth in Nebraska as well. There are no published episiotomy rates outside of The LeapFrog Group's survey. Only the Overall Cesarean rate is available, and the CDC has only preliminary 2015 data available on Cesarean rates. Consumer Reports has a hospital rating list, but most Nebraska hospitals did not report their information. It is possible to find individual doctor Cesarean rates on www.amino.com, but not individual physician episiotomy, induction of labor, or augmentation of labor rates, nor facility Cesarean rates.

Others in different states have had success asking their state or county DHHS for more recent statistics, but this is not practical for an expectant family just trying to make an informed decision on their maternity care! I will be reaching out to Nebraska DHHS in the coming months.

As you can see, there is some information available, but it is difficult to find, tedious to discern, and some of the latest available information is three years old. Making an informed decision on where to have your baby to get the best health outcomes is nearly impossible!

I was able to find information on:

Hospital and State Overall Cesarean Rates from 2014 and 2015, respectively
State VBAC (Vaginal Birth After Cesarean) Rates from mid-2014 and 2015
Episiotomy Rates for only 3 Nebraska hospitals from 2016
Hospital and State Induction of Labor Rates from 2014
Statewide Anesthesia Rates (This number presumably includes women who had general, spinal, and epidural anesthesia for childbirth, both vaginal and cesarean births) from 2014
Hospital Exclusive Breastfeeding Rates from mid-2016
Elective Early Delivery Rates for hospitals from mid-2016

Plus a great new resource to find your physician's Cesarean rate!

I have put it all together in an easy-to-read PDF, which you can receive free by signing up for my newsletter. In addition to this free PDF, those who sign up will be the first to know about my Evidence Based Birth® Workshops for Parents and Professionals, and other EBB® Services I will be offering! Once you download your PDF, be sure to scroll all the way to the last page for the Leapfrog Group's call to action!

Birthing in Nebraska

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