Twin Cities bucks trend

Local hospital’s numbers not in line with national increase in mother mortality rates

TEMPLETON — Despite the result of a national report stating that the U.S. mortality rates are increasing, conditions for North County mothers are some of the safest in the world.

An NPR and Pro-Publica joint investigation released in May reported that women are “three times more likely to die in childbirth than women in Canada, and six times more likely than Scandinavian women.” During the course of their inquiry, they looked into the reason for the surge of maternal deaths in United States “at a time when developed countries from England to South Korea saw their numbers plunge.”

They uncovered a hodgepodge of hospital protocols for dealing with potentially fatal complications, which in some cases allowed treatable complications to proceed to a lethal level. At the same time, some doctors entering the growing specialty of “Maternal-Fetal medicine” were able to complete that training without ever spending time in a labor-delivery unit.

Given the grave nature of this report, one might wonder how North County birthing facilities compare. During interviews with health practitioners and patients, as well as a deeper examination of recent data, it seems that California — and Twin Cities Community Hospital specifically — are in contradiction to these troubling national trends.

Dr. Shan Thomas, who works with a private practice and with Community Health Centers, disagreed with NPR’s assessment based on his experience as an OBGYN on the Central Coast. During his 21 years of practice in the area, he has delivered more than 5,000 babies. During that time, he said that he personally knew of one maternal death at Twin Cities Hospital. Further, the claim that maternal care is lacking did not ring true.

“The best way to take care of baby is to take care of mom,” Thomas said. “You always have to have maternal safety at the top because if mom’s not safe, then the baby’s at risk. During the last 21 years of my practice, I haven’t seen the NPR-reported trends. I think there are certain areas, such as Texas, that are skewing the maternal mortality rates.”

Thomas’s assessment is confirmed by the results of a 2016 longitudinal study, published in the medical journal Obstetrics and Gynecology, that explored maternal mortality rates in the U.S. In this study, Dr. Marian MacDorman and colleagues had to separate California and Texas out from the other states because their trends were significantly different: California’s maternal mortality rate significantly decreased, while Texas’s more than doubled.

Additional data from the California Maternal Quality Care Collaborative reports that California’s maternal mortality rate has gone down in recent years, decreasing from 21.5 deaths per 100,000 births in 2003 to 15.1 maternal deaths per 100,000 births in 2014.

By contrast, the same study reported that in 48 states and Washington, D.C. (California and Texas were excluded), maternal deaths have increased from 18.8/100,000 births in 2000 to 23.8/100,000 births in 2014.

On the whole, childbirth-related maternal deaths in the U.S. are increasing, although not in California. The state remains on par with international goals for decreasing maternal mortality deaths, and Twin Cities Community Hospital has exceeded state goals for reducing C-section rates: they have the lowest Cesarean-section rate of any hospital on the Central Coast and one of the lowest rates in the state, according to Smart Care California’s 2015 maternal performance data.

Twin Cities’s focus on maternal health has also led to a zero-episiotomy rate, earning them a “superior” rating.

Women who have given birth at Twin confirm this data: Rebecca Romero, who called her first birth experience “a disaster emergency C-section,” chose to return to Twin because of the quality of maternal care she received.

“Honestly, as far as after-care, the OB nurses are amazing,” she said.

She further acknowledged that the changes made in the last decade to make Twin Cities a “baby-friendly birthing center” have made a difference: “the recovery time to get your baby in your arms is much shorter,” she said. In addition, Romero has personally seen the quality of emergency care: her cousin had a severe placental abruption and was saved from bleeding out by the doctors at Twin.

Expectant mother of two Becky Herzig had many of her fears assuaged by Twin’s mother-centered approach.

“I was scared that they wouldn’t respect my wishes because I hadn’t had a baby before,” she said, “but I gave them my birth plan and they never questioned a thing. They just let my body do what it needed.” 

In addition, Herzig explained that the free natural childbirth classes at Twin helped her to be prepared during each of her pregnancies.

“They talked a lot about the different parts of childbirth and taught me how to write a birth plan,” she said.

For Herzig, these classes were invaluable.

According to Thomas, Herzig’s experience is indicative of the mother-centered approach that Twin’s maternal unit strives for: “Nature usually knows what it’s doing just fine, and usually I like to be hands-off” he said. “As long as nature’s doing what it needs to do safely, it’s about the patient and whatever she wants to do and how she wants her labor to go as far as intervention. My job is to recognize when things aren’t going safely and intervene appropriately.”

Thomas concluded, “The quality of care, here, I imagine, couldn’t be better.”

In this case, the numbers agree.

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