If you are planning to have surgery, you can go online and find out about hospital surgery complication rates. You can also find out about complication rates related to stroke, heart attack, infections, or sepsis. But what about childbirth complication rates?
If you are interested in finding out childbirth complication rates at U.S. hospitals, you might have a hard time locating reliable information. Why? Because these complication rates are a well-guarded secret. Most hospitals, insurance companies, health agencies, and researchers know what childbirth complication rates are, but this information is not made readily available to the public.
At Birth Injury Guide, our goal is to help patients advocate for themselves and the best interests of their families. Read on to learn more about childbirth complication rates and the data that hospitals don’t want you to know.
Why are Childbirth Complication Rates Kept Secret?
There are a few reasons why childbirth complication rates are kept hidden from the public. Hospitals, state health agencies, researchers, and insurance companies report that complication rates are too complicated for the public to understand. Some hospitals cater to labor and delivery patients, and others are better equipped to handle complications, so they are regularly referred patients. While these factors could impact complication rate data, is it enough of a reason to withhold valuable information?
According to one of the nation’s top childbirth safety experts, the answer is no. Dr. Elliott Main is the medical director at the California Maternal Quality Care Collaborative. According to Dr. Main, releasing childbirth complication rates provides hospitals and healthcare providers with opportunities to assess the care they provide and improve.
We all think we’re giving great care and we are treating everybody equally. The data doesn’t support that. – Dr. Elliott Main
New Data about Childbirth Complication Rates
In an effort to unmask the secret data withheld by hospitals, USA TODAY has conducted an in-depth investigation. Their findings have been released in a report titled “Deadly Deliveries: Childbirth Complication Rates at Maternity Hospitals”. USA TODAY journalists obtained records from hundreds of hospitals across 13 states. Many states refused to cooperate, or put restrictions on the information journalists could access.
What journalists did obtain was records from around seven million childbirths across those 13 states. What they found was that women experienced life-threatening childbirth complications at rates of at least double the median reported across U.S. hospitals. To reach this conclusion, journalists used a method for calculating childbirth complication rates that was created by the U.S. Centers for Disease Control and Prevention (CDC).
The CDC calculation method works like a composite score of possible hospital complications before, during, and after delivery. It looks at factors including:
- Heart Attack
- Blood Transfusion
- Maternal Emergencies
- Fetal Emergencies
The CDC developed the calculation method as a means of studying trends at the state and federal levels. However, it is most often used to privately evaluate childbirth complication rates, with the public being kept in the dark.
Variables Create Tension
Hospitals argue that variables make it difficult to accurately analyze and compare hospitals. These variables include:
- Some hospitals are specialty facilities where high-risk patients are sent.
- Some hospitals serve women who are poor, or have had less access to prenatal care.
- Some hospitals serve larger populations of African-American women, who have a higher risk of experiencing certain complications of pregnancy such as hypertension, blood disorders, and gestational diabetes.
Despite hospital arguments, the USA TODAY report revealed that many hospitals studied faced similar variables, but reported lower complication rates than others. That suggests that the variables do not impact complication rates as much as some hospitals would like to argue.
Ultimately, the USA TODAY rates can serve as a starting point for scrutinizing a hospital’s maternity care.
“It’s important we treat providers fairly, but it’s also important we hold them accountable,” said Carol Sakala, who leads maternity care programs for the National Partnership for Women & Families.
Unfortunately, federal organizations have the power to collect data about childbirth complication rates, but they do not. Valuable information that could improve patient outcomes, or even save lives is not being adequately collected, analyzed, and then released to patients. Neither the Joint Commission or the Centers for Medicare and Medicaid Services have established data collection or reporting methods for childbirth complication rates.
What Hospital Complication Rates Mean for Patients
The reason why patients need access to hospital complication rates is so that they can assess their best options for receiving healthcare based on their individual needs. Women who have certain pre-existing conditions, or are high-risk, may need to choose a hospital that is better equipped than the facilities located in the immediate vicinity.
Further, patients may review childbirth complication rates and decide to use alternative methods for labor and delivery. They may also choose to discuss their concerns with their healthcare provider so a plan of action can be created before labor and delivery begins.
When hospitals do not provide information about complication rates, patients can only guess as to how safe or well-equipped the facility is. When emergencies do occur, patients must then place their trust in a facility and healthcare providers without knowing whether they are in good hands.
New Orleans Hospitals Serve as Tragic Example of Poor Care
New Orleans, Louisiana has served as an example of how the USA TODAY analysis looked at, and compared, hospitals. In New Orleans, there are seven hospitals that deliver all babies born in the area. One facility in particular stands out compared to the others as having unusually high childbirth complication rates.
Touro Infirmary is one of the seven hospitals studied in New Orleans. The complication rate at Touro is 2.8 percent, which accounts for around 360 of the 13,000 women who gave birth at the facility between 2014 and 2017. Women who gave birth at Touro had consistently worse outcomes than women delivering at other hospitals in the area.
Touro also stood out in the research because complication rates did not vary depending on race, socioeconomic status, or health insurance status. By and large, patients at Touro experienced worse outcomes.
Examples of these outcomes include:
- In 2011, a patient suffered a stillbirth and a subsequent pelvic infection. The infection was unrecognized and undiagnosed for so long that the patient developed sepsis and gangrene. In order to save her life, doctors had to amputate her legs below the knee, her right hand, and most of her left fingers.
- In 2012, a pregnant woman went to Touro after falling and hitting her stomach on the bathtub. Her pregnancy had been healthy. Shortly after arriving at Touro, the woman had a seizure and then went into respiratory arrest. Doctors ordered an emergency c-section, and the baby was delivered successfully. Unfortunately, the mother suffered additional complications and was diagnosed with kidney problems and a rare blood disorder. The diagnosis was wrong. When the patient’s blood pressure spiked to emergent levels, it took nurses more than three hours to get a doctor to respond to their calls for help. In a matter of hours, the patient had died.
- In 2014, a mother gave birth at Touro, then entered into a coma. She remained in the coma for 19 months before she died. The hospital team – mostly trainees – was accused to administering too much pain medication and failing to address the patient’s difficulty breathing.
- In 2014, a patient was sent home after delivery without medication to prevent blood clots. She had been on such medication during her pregnancy, and should have continued them based on a family history of blood clots. She died shortly after being sent home from a blood clot in her lungs.
- In 2015, a woman was admitted and underwent an emergency c-section. She began hemorrhaging from a ruptured uterus on the operating room table, but the three doctors in the room – all trainees and none board certified – panicked and failed to call for help. None of the doctors called for help until 20 minutes later.
What is even more concerning about Touro in particular is the fact that the hospital was on probation from 2005 to 2007, and was placed on “warning” status in 2018. Yet, the hospital continues to operate and deliver babies, potentially putting more lives at risk.
The complications experienced by these patients could likely have been prevented had hospital staff followed national treatment guidelines. These are just a few examples of the impact of climbing childbirth complication rates among mothers.
Injuries, deaths, infants left without mothers, and families torn apart. These should not be the norm at hospitals in the U.S. – one of the most advanced nations in the world.
Have Questions about Childbirth Complications?
If you have questions about childbirth complications or childbirth complication rates, contact Birth Injury Guide. Our team of birth injury lawyers can help you understand your legal rights and determine if you are eligible to take legal action against a healthcare facility or provider.