While the rates of Caesarian surgeries (C-sections) soar around the country, a Navajo-run hospital in Tuba City, Arizona, is bucking the trend with a C-section that is half the national rate.
This statistic is even more impressive since maternity patients at the Tuba City Regional Health Care Corporation present more of the risks associated with C-sections than US women on average, including diabetes and high blood pressure.
Most obstetricians and maternity patients agree that recovery is quicker with vaginal deliveries simply because they do not require anesthesia or surgical intervention. Women who deliver their babies vaginally see far fewer complications and enjoy shorter hospital stays, saving money for patients, hospitals, and insurers.
The hospital’s success comes largely from a program that uses midwives to attend to patients in labor. The midwives’ presence has helped increase a key maternity statistic, vaginal birth after Caesarian (VBAC).
For years, obstetricians assumed that any woman who had a C-section could not have vaginal deliveries later on. Tuba City is among a handful of hospitals that have disproved this through maternal care program that emphasizes midwifery and de-emphasizes C-sections.
Midwives are trained to support women during pregnancy and especially during childbirth. They work with patients to identify their unique physical, social and emotional needs, including the need for specialized prenatal care. They stay with patients during the entire labor process, offering comfort, support, and encouragement–all of which help eliminate the need for C-sections.
At Tuba City, it is not unusual for an entire family to attend a birth. Midwives welcome family support and the traditions of their patients, who include Navajo, Hopi, and Paiute Indians.
Some observers say midwives also remove the profit motive for C-sections. Tuba City is among a number of smaller rural hospitals that can’t afford to have a team of surgeons and anesthesiologists around the clock. This alone puts midwives and patients more in control for decision-making during labor.
However, doctors, nurses, and midwives at Tuba City are salaried and do not earn more by providing more surgical interventions. They are also federally-insured against malpractice and are possibly less inclined to practice defensive medicine. They are also close to the community, with some staff living on hospital grounds or in the immediate community.