True, 2018 ended 2 months ago. Still, better late than never to share with y’all about our year.

2018 was a big year for us! We doulas attended 47 births at five different hospitals, and one at home. We spent a total of 682 hours with our clients, that’s an average of 14 and a half hours per birth! The shortest was 2 ½ hours, the longest, 41 hours (oh my)!

The hospitals we visited (in order of frequency) were Princeton (just over half), Brookwood, St. Vincent’s, Grandview and Northport in Tuscaloosa.

The majority of our clients were patients of Simon Williamson OB/Gyn clinic.

We are super excited for the opportunity to attend more home births this year.

How about some birth stats? Only 15% of our clients had c-sections, which is in the range recommended by the World Health Organization. The WHO suggests 10-15% is the right number, any fewer would mean people who need them aren’t getting them.

Many of our clients have a goal of giving birth without an epidural. This year, 75% reached that goal. For those with an epidural, we know sometimes an epidural is just the thing needed right then. And we are all trained in providing special support for our clients who chose an epidural!

Besides labor support, we also hosted 24 group childbirth classes and 3 private classes, and 5 group breastfeeding classes. Our CLC (Dalia) did in home breastfeeding consults for 10 people.

We were so glad to meet lots of new expecting families at our eight, 2018, FREE Open Houses. At Open House we share about our classes and the importance of hiring a doula, followed by an hour of doula “speed dating”. Visit our Open House page for dates for 2019.

Birth is BIG BUSINESS! Many (possibly most) people have their first real interaction with a hospital when they are having a baby. If that is a positive experience, then a family returns to this same hospital for future births, and also for any future health needs. Because birth is the entry point for your health care consumer dollars, there is a great deal of competition between hospitals. When one hospital upgrades by renovating maternity suites, it isn’t long before others follow.

In the eyes of most consumers, “The HOSPITAL” is one unified system. However, it helps to understand several parts of the hospital structure as it relates to birth:

1. The Marketing Department is focused on getting people to choose their hospital. The in-house marketing team works with outside advertising agencies and web content designers to create engaging marketing campaigns. It is important to note that they work with market data, and information provided by the in-house marketing team, but possibly do not get direct input from care providers, staff or patients. (This is the marketing company that created the iDecideHow campaign )
   
2. OB/GYN Care Provider Groups contract independently with the hospital to provide obstetric services to hospital patients. As contractors, they control their own practices, set up their call schedules, and may have their own set of patient care protocols/policies. Additionally, within each care provider group, Individual practitioners have autonomy, which means that within a group, you find providers who treat pregnancy and birth in a variety of ways ranging from a normal physiological event to a medical emergency waiting to happen.
3. Hospital Administration establishes hospital protocols and policies, hires and manages staff, including nursing staff, and contracts with providers. Hospital administration and staff have direct patient contact.

As you can see, these various parts may not always function as a smoothly integrated whole. To illustrate that fact, let’s look more closely at two examples from our area: Brookwood and St. Vincent’s.

So you have a Birth Plan signed by your carefully chosen care provider: All set, right? Well… maybe not… because: Who’s on call?

Here are some thoughts about what Birth Plans DO and what they DON’T DO: