Birth Choices: Hospital Safety is it a Fact or Blind Trust?

Home births are often the subject of scrutiny when it comes to safety.  Doctors and proponents against home births try to incite the “common sense” of medical expertise, equipment and knowledge to validify the safety of hospital births over the home. These points at first glace appear true, but in all consideration, it’s the second glance that gives these points less weight.

By example, we know that 99% of women give birth in hospitals, yet our infant, mortality and cesarean ranking is abysmal for a country of our stature. Doctors who champion against birth choices bank, quite literally, on the lack of connection between these stats to hospital safety. And now a new report further gives women a good reason to reconsider the “common sense” that seemingly adheres to improvement of safety when birthing in a hospital.

The Department of Health and Human Services, Officer of the Inspector General released the latest report of hospital incidence reporting. Here are some some of the findings…

“The administrators acknowledged that incident reporting systems provide incomplete information about how often events occur, but they continue to rely on the systems primarily because they value staff accounts of events.”

“In the absence of clear event reporting requirements, administrators classified 86 percent of unreported events as either events that staff did not perceive as reportable (62 percent of all events) or that staff commonly reported but did not report in this case (25 percent). “

“Nurses most often identified events through patient observation and routine hospital safety
assessments.  Information regarding one-quarter of events was not accessible to the staff responsible for monitoring patient safety within the hospitals and for making policy changes”

This is not new information. Hospital safety has been, and is a battled cause. Medical errors are said to occur in one third of hospital admissions. In other words, a simple visit to the hospital just may lead to an unrelated injury. This finding is not unfamiliar to mothers in labor. An early visit to the hospital increases the chance of a cesarean section. Some health care practitioners admit the obvious. To err is human.

"We as a society have an expectation of perfection, but it's unrealistic to think surgeries will be perfect," said Feldman. "Humans are not perfect beings, and there are always going to be mistakes." (Feldman)
Dr. Thor Sundt, professor of surgery at Mayo Clinic, agreed.

"These errors are unfortunately inevitable because of the complexity of the business we're in," said Sundt, another strong advocate of surgery guidelines. "The trick is error management. Everyone on the team must be mindfully engaged and empowered, so they can capture those errors and correct them."

If it is unrealistic to expect perfection, then why the “do or die” sentiment when it comes to hospital safety? Why are there not more birth options available if we are faced with evidence of risk? The truth is this, when it comes to maternal and prenatal care, practitioners stand on a “shake-y” leg. Their bottom dollar depends completely on your trust.

I completely agree. “Everyone on the team must be mindfully engaged and empowered”. That team should consist of you, your body and your faith. The question is, who should have your trust when you're in the throes of labor?

Sources:
http://abcnews.go.com/Health/Wellness/hospital-staff-report-hospital-errors/story?id=15308019&page=2#.Twfe-TUV041
http://abcnews.go.com/Health/hospital-errors-common-underreported-study/story?id=13310733#.TwffDzUV041
http://healthaffairs.org/blog/2011/04/07/new-health-affairs-hospital-errors-ten-times-more-common-than-thought/
http://abcnews.go.com/Health/story?id=2099000#.TwfoLDUV040

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