Friday Five (#39)

FRIDAY! We are in full summer mode with littles. Kiddie pool time twice a day. Bug repellant and sun screen in equal amounts. And…my favorite, some homemade strawberry shortcake. Delish. The Five is full as usual!

Let’s jump to it.

1. This article examining lower cesarean section rates in hospitals that have midwifery programs. The authors used one of the largest databases for live birth in the United States and found that in those hospitals, the midwife deliveries increased 33% from 2007 to 2018, while the cesarean rate decreased 7.2% in that same time period. #makemoremidwives

2. The Evidenced Based Birth Podcast

Rebecca Dekkler’s Evidenced Based Birth has been educating mamas for a number of years now. The organization puts out great content that’s factual and evidenced-based for parents to use in pregnancy and beyond. If you’re looking for even more, check out their podcast!

3. This article on the out of pocket cost for pregnancy and birth. Wow. A pediatrician paid $5,000 after the birth of his child and then decided to do some research on out of pocket costs for childbirth for parents with private insurance.

The researchers reviewed 400,000 births between 2016 and 2019. They found that 1 in 6 families paid more than $5,000 out of pocket. If a baby was admitted to the NICU, 1 in 11 families paid more than $10,000.

The average cost out of pocket for birth was $2,281 for the mother’s hospital stay and $788 for the newborn’s hospitalization. The average out of pocket cost was $3,068 (deductibles = $1,292, coinsurance = $1,711, and copayments = $66).

The average cost of a cesarean birth cost $3,389 and the average cost of a NICU admission was $4,969.

These costs are not to be ignored. Families are already burdened with the costs of items to raise children. But also, these costs occur for each child a family desires to have.

4. The United States has hospital cesarean rates that range from 6% to 69%.

How does a hospital reduce its cesarean rate? Researchers found that successful hospitals implemented a number of best practices:

Providing midwifery services
Implementing programs to support early labor at home
Providing more doula services
Reducing the number of inductions of labor for non-medical indications

Of note, were some very important points about nursing care at successful hospitals:

Successful hospitals had nurses that agreed that direct labor support to laboring women was important
Successful hospitals had units in which nurses supported vaginal birth and were unlikely to state that their unit does too many cesarean sections

I also think the researchers offered some points about physicians. They found that successful hospitals were more likely to peer review elective cesareans before the birth (to ensure that the cesarean is medically recommended), internal sharing of cesarean rates, and a department peer review of all cesarean sections not indicated by ACOG/SMFM criteria. I think these are all really great things for any obstetric department to be doing!

The article is a great read for any nurse or provider on a labor and delivery unit.

5. Lastly, this article about a trial that offered an infant carrier (and education on proper use of the carrier) to women in third trimester to see if carrier use is associated with a longer duration of exclusive breastfeeding. Well, although the population was only 100 people, they found that at 6 months, 49% of the group that received a carrier was still exclusively breastfeeding compared to the 26% that didn’t receive a carrier.

Although it’s a small study, the implications of prolonged breastfeeding would save any insurance company millions of dollars. Maybe insurance coverage for an infant carrier is the new breast pump for maternity care?

Other goodies…

A nurse leader that is working to reduce new nurse turnover by scheduling 1 on 1 meetings. This leader is onto something.
This is more of a public service announcement….But….Have you checked your credit reports lately? Unfortunately, we live in a time where personal information is sold left and right – often times without you knowing what was sold or who it was sold to. We’ve been debt free and without credit cards for a number of years at our household, but we still check our credit reports frequently. Annual Credit Report is offering free credit checks every week during the pandemic. Check is out here: https://www.annualcreditreport.com/index.action. Don’t use credit anymore? Consider freezing your credit accounts on each of the credit bureau sites to protect yourself from someone opening up a new credit line in your name. Each of the bureaus allows you to create an account online and freeze your credit in about 10 minutes.
- TransUnion at www.transunion.com
- Experian at www.experian.com
- Equifax at https://www.equifax.com/personal/

Have a wonderful weekend wherever you may be. Take time for self care and for family. Do something in your community. Talk a walk outside 🙂

Hugs,

Jamie

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