I just found this map that has made my jaw drop!
You can look at the whole state if you like, but I’m focusing in on one area. Alpena and Iosco (if you don’t know where that is, find the thumb of Michigan, then follow the hand up the index finger, see that white area? Yup keep going up, the two green areas just above but still next to lake Huron, those are the areas I’m talking about. Iosco is the first one you come to, and has a c-section rate of 35-40% if I can judge those colors correctly, which means that they are above the national average. Alpena is the darker green area with a rating of 40-50%, or if you look at the dark red bar connected to it you’ll see that more accurately it has a rate of 49.8%, which is way too close to 50% for my comfort.
What causes these areas to have such high c-section rates? Iosco we could give a break to, they are only slightly higher than the national average, but I’m not going to give them a break because they are indeed higher than the national average.
What causes the rate to be so high here? I’m going to take a guess and say that it is based on education for the mama. This is not to say that her c-section was her fault and could have been avoided if only she were educated, but to say that it is possible that this could be the case.
One possibility is maternal age, The average number of c-section births is higher for those of higher maternal age, according to the CDC. But they also say that the rate has grown for all age groups, and specifically for those who deliver their children under the age of 25, as they experienced an increase in c-sections by 57% between 2000 and 2007.
In Michigan the average age of a first time mother was reported by the CDC to be 25.0, an increase from 21.5 in 1970, so how does this affect Iosco and Alpena? Consideing the highest increase in c-sections was for women under 25 years of age, you could assume with reasonable safety that less women fit into that category than they did previously and that those who do, would contribute only slightly to the overall picture of the c-section rate rise.
Another thing to consider is race. The CDC (from the same article linked at the top) states that the national average for c-sections among non-Hispanic black women was slightly higher (34%) than it was for non-Hispanic white women (32%), and that American Indian and Alaskan Native women had a significantly lower number of c-sections at only (28%) Asians or Pacific Islanders (31%), and Hispanics (30%) rested in the middle.
How do Iosco and Alpena fit here?
Iosco stats show that “The racial makeup of the county is 96.92% White, 0.41% Black or African American, 0.66% Native American, 0.46% Asian, 0.05% Pacific Islander, 0.23% from other races, and 1.27% from two or more races. 0.98% of the population are Hispanic or Latino of any race.”
and Alpena stats show that “The racial makeup of the county is 98.21% White, 0.25% Black or African American, 0.39% Native American, 0.33% Asian, 0.00% Pacific Islander, 0.12% from other races, and 0.70% from two or more races. 0.58% of the population are Hispanic or Latino of any race.”
(both of these quotes were taken directly from the links under Alpena Stats, and Iosco Stats)
Both areas are pretty well white, with a sprinkling of other races, so the largest c-section rate would be from women who are white, and that rate as mentioned above sits at 32% in our national average, not the highest, but pretty close.
Gestational age also has something to do with c-section rates. Nationally the average has increased by 36% for infants born earlier than 34 weeks gestation (usually this is due to health concerns, and I wonder if the reasons are valid or not but that is a subject for another article). The rate of c-section increased by 50% for babies born after 34 weeks gestation. Let me be clear here, this does NOT mean that 50% of babies born after 34 weeks were born by c-section, it just means that the number of c-sections increased by 50% for that gestational age group.
Between the years 1996 and 2007 the state wide average for Michigan increased by 50%, going from 20.2 to 30.4, what happened in those 10 years? And even more what happened since then to make our rate increase even more? These questions can’t be answered simply, there are just too many variables. Here are a few more things to consider.
Resources available. Birth Centers are one way to assure you have your best chance at a vaginal delivery, but the closest one is well 3 hours from Oscoda and much further from Alpena, so that is pretty much out of the question for a mama in this area.
Another option is to have a midwife at a home birth, I’ve done the research here, and if you are delivering in Alpena you can actually contact a midwife that is located in Onaway and you might be interested in looking her up. Her website is: http://www.adamandevemidwifery.piczo.com, if you live in Iosco then your much more limited as Chantel doesn’t travel down as far as Oscoda. There are however two midwives who will travel out here, they just live 2 or more hours away from the area and whether you use them will depend on how comfortable you are with that distance. Laurie Zoyiopoulos has expressed to me that she is willing to come to the area and you can read about her at http://faithfulguardiansmidwifery.com/, There is also Cathy Dawd who I’ve spoken to and is willing to travel to the area, but again lives 2 hours away.
Studies show that having a doula present at the birth of your baby also reduces your risk of having a c-section, but there are so few of us out here as well. The nearest one to myself is over an hour away. Which means that if you live in the area but not in my city you are probably closer to one than I am. You can find a few of them by searching here.
There are also postpartum doulas, but I have found none in the immediate area, but you can use the above link to search for them as well.
Childbirth Education classes. The local hospitals in the area do have classes available, they are created with a woman birthing in the hospital in mind, not with those who may want to have a home birth, but for the most part that doesn’t even seem to be on the radar for the area, so this may not be a problem. There are no classes located near Oscoda, but may be a few in or near Alpena that are not directly related to hospital births.
I base my entire opinion on the fact that there are hardly any resources for alternative childbirth methods, and I know that is weak, but how can the c-section rate drop if we have only our doctors to believe about our safety, and the safety of our babies in childbirth. I have yet to meet a mama who has told me she researched her options before birth and found anything helpful in this area to back her up on a natural childbirth experience in this area.
My mission: To fix this! To show women they have options, and that they don’t have to attend their own births without any information to help them make decisions regarding their care and that of their baby. To help lower the rate of c-section in this area, and to assist in the happy births of babies in Iosco and Alpena
My hope is that YOU will have a Cherished Birth!