#WhyPM 
+
#birth
What's Needed
Data collection
Data liberation
Collaborative, patient-centered innovation
Maternity Care 2.0
A Tipping Point?
3 key recent events
Why maternity care consumers matter to the PM movement
What we're up against
A tipping point?
e-Patient innovations 

"Activated and informed consumers foster maternity care quality improvement and system performance."
http://www.childbirthconnection.org/article.asp?ck=10625
4.2 million births/year
C-section most common operating room procedure
25% of hospital discharges are childbearing women or their newborns
Hospital charges ($86 billion) far exceed any other condition


“The data show many mothers and babies experienced inappropriate care that does not reflect the best evidence, as well as other undesirable circumstances and adverse outcomes. This sounds alarm bells,...Few healthy, low-risk mothers require technology-intensive care when given good support for physiologic labor. Yet, the survey shows that the typical childbirth experience has been transformed into a morass of wires, tubes, machines and medications that leave healthy women immobilized, vulnerable to high levels of surgery and burdened with physical and emotional health concerns while caring for their newborns.”

-Maureen Corry, Co-author of "Listening to Mothers 2 Survey." 
http://www.childbirthconnection.org/article.asp?ClickedLink=205&ck=10068&area=2




Ripe for Participation
Highly motivated for health behavior change
Naturally seek community and support through online and offline social networks
Long interval of time to learn about choices, consider risks/benefits, etc.
Will make future choices on behalf of children and others

What We're Up Against
http://www.latimes.com/news/science/la-sci-maternal-deaths-20100523,0,236953.story
#WhyPM?
Perinatal Core Measures set    
    * Elective delivery
    * Cesarean section
    * Antenatal steroids
    * Health care–associated bloodstream 
       infections in newborns
    * Exclusive breast milk feeding
http://www.theunnecesarean.com/blog/2009/10/1/page-hospital-in-arizona-threatens-woman-with-court-ordered.html
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5402a5.htm 
Conclusion
28% hospitals ban VBACs
21% allow VBACs but no provider will attend them
http://www.thebirthsurvey.com
NIH VBAC Statement Primer for Consumers
Statistics
Analysis
Action
“Not allowed to refuse, they have no forms for refusal of a procedure. Even if you are crowning they will section you because it’s against hospital policy.”   Johnson Regional Medical Center

“Can't refuse, its hospital policy. Will be sectioned unless there is absolutely no time to do it.”   Quachita County Medical Center

“Unless the baby is just about ‘hanging out’ they will send you home if you refuse the section. That's the only way"  Vaughn Regional Medical Center

“Too high risk. Too much liability. You won't find anywhere around her that does them.” El Centro Regional Medical Center

Women arriving at the hospital and refusing a c-section will be "sectioned anyway." Montrose Memorial Hospital
http://www.ican-online.org/vbac-ban-info
Public Health Impact
by Amy Romano, MSN, CNM
(@midwifeamy)
Lamaze International
Health 2.0 Goes to Washington
June 7, 2010

http://consensus.nih.gov/2010/vbac.htm
#HowPM : e-Patient Innovations
4.2 million births/yr
C-section most common operating room procedure
25% of hospital discharges are childbearing women or their newborns
Hospital charges ($86 billion) far exceed any other condition