In reviewing the outcomes for births in NSW, it is worthwhile looking at the rates for induction, as this is a well known starting point for the cascade of intervention that often leads to either an instrumental or caesarean birth.

The rate of spontaneous onset of labour with no further intervention varies between 18.4% at Kareena Private Hospital to 66.6% at Broken Hill Base Hospital (where they have caseload midwifery). Amongst the big city teaching hospitals, the rates are 51.5% at King George V (now the Royal Prince Alfred Women and Babies Unit), 44.7% at Royal North Shore, 45.1% at The Royal Hospital for Women and 50.5% at Westmead.

Once labour starts, many women are then augmented with either ARM or oxytocics, but again there are wide variations: 13.5% augmented at King George V, 17.1% at Royal North Shore, 21% at Royal Hospital for Women and 18.7% at Westmead. Kareena Private augments 17.1% and Broken Hill Base 11.6%.

Inductions tell another story: 21% at King George V; 27.3% at Royal North Shore, 20.9% at The Royal Hospital for Women and 19.3% at Westmead. Kareena Private induces a whopping 37.8% and Broken Hill induces 14.9%.

Wyong Hospital (another with midwifery programs in place) also has interesting figures: 62.6% of women begin labour spontaneously, however 34.6% go on to be augmented. Their rate of induction is only 2.5%! It seems you won’t be prodded into labour artificially in Wyong, but once you start you’ll be expected to get on with it!

Perhaps the moderate approach found at Bankstown Hospital in Sydney is the way to go: 62.4% spontaneous labour rate, 8.9% augmentation and 19.3% inductions.

In case you are adding up these figures and are wondering why they don’t add up to 100% for each hospital - there are a percentage of women who have no labour (i.e. they have an elective caesarean) and this ranges from 13.9% at King George V, 15% at Royal North Shore, 12.9% at The Royal Hospital for Women, and 11.5% at Westmead. Kareena Private Hospital’s obstetricians are busy with 26.4% elective caesareans, and Broken Hill’s midwives have 7% of women with elective caesareans. Wyong Hospital has 0.5% elective caesarean rate!

Why I am I giving you all this detail? First, NSW is the only state that makes these statistics freely available to anyone who wants them, a proper state of affairs for taxpayers and customers (patients) alike. Second, to illustrate the fact that it is worth shopping around for maternity care as it varies considerably. Knowledge is power and we need to use these figures to argue the case for a more rational approach to maternity services, and by that I mean midwifery care not obstetric over servicing.

Next, let’s look at use of pain medication...... Posted by andrea at February 10, 2003 08:03 AM