Overall C-Section Rate: This rate reflects the number of women who had a cesarean birth with this provider in the most recent reporting year, expressed as a percentage of the total number of births with this provider in that year.  [# of cesarean births / total #of births]. For most providers, the reported Overall C-Section Rate is risk-adjusted as explained here. This rate will be higher if primary c-section rates are high and/or if VBAC rates are low, and will be lower if primary c-section rates are low and/or if VBAC rates are high (see definitions below).

Low First-Time (or “Primary”) C-Section Rate: This rate reflects the number of women who had a Cesarean birth with this provider in the most recent reporting year, expressed as a percentage of the total number of women who gave birth with the provider in that year who had not previously had a C-section. If you have not had a Cesarean birth before this pregnancy, this is the rate that will best predict your likelihood of having a Cesarean if you choose this facility.

VBAC Rate (or “Vaginal Birth after Cesarean”): This rate reflects the number of women who had a Cesarean birth before this pregnancy and who delivered vaginally with the provider in the most recent reporting year, expressed as a percentage of all women giving birth with the provider who had a Cesarean birth for a previous pregnancy. If you have had a Cesarean birth before this pregnancy, this is the rate that will best predict your likelihood of avoiding another Cesarean if you choose this facility.

VBAC Success Rate: Some providers self-report their VBAC success rate. This rate reflects the number of women who had a Cesarean birth before this pregnancy and who delivered with the provider in the most recent reporting year, expressed as a percentage of all women who attempt a trial of labor after Cesarean with this provider. The VBAC success rate will always be higher than the overall VBAC rate, because it includes only the population of women who qualify for and choose a trial of vaginal birth after Cesarean.

Exclusive Breastfeeding Rate: This rate reflects the percentage of all babies born with the provider who are exclusively breastfed in the first one or two days after birth, as reported on the baby’s birth certificate. The rate is based on self-reporting by the mother and the provider.

Episiotomy Rate: An episiotomy is a surgical cut made in the perineum (the birth canal) during childbirth.  This rate reflects the number of mothers who have an episiotomy as a percentage of all mothers who give birth with the provider in the reporting year.

Overall Induction Rate: Induction is the process of artificially stimulating labor to begin before you have gone into labor on your own. Labor can be induced using medication or by breaking your amniotic sac (“amniotomy”). This rate reflects the number of mothers whose labor was induced as a percentage of all mothers who gave birth with the provider in the reporting year.

Epidural Rate: An epidural is a procedure where pain-killing medication is injected in an area in your back near the lower part of your spine. The epidural numbs your lower body but you remain awake. This rate reflects the number of mothers who had an epidural as a percentage of all mothers who gave birth with the provider in the reporting year.

Early Elective Delivery Rate: This rate reflects the percentage of mothers who were scheduled for a C-section or whose labor was artificially begun before 39 weeks, except those who had a medical issue that required immediate delivery (health problem of mother or baby). This rate is expressed as a percentage of all mothers who gave birth in the hospital in the reporting year.

Water birth: This search term finds providers that give you the option both to labor AND to deliver your baby in a birthing tub. If you have certain risk factors or develop any complications in labor, you may not qualify for a water birth.

Breech trial of labor: This search term finds providers who offer breech trial of labor, which means that you will not automatically be scheduled for a cesarean birth if your baby is bottom first (instead of head down) as you approach your due date.

VBAC trial of labor: This search term finds providers that allow you to begin labor and try to deliver vaginally even if you have had a C-section in the past. Some providers that offer the option of a trial of VBAC (“vaginal birth after Cesarean”) only offer that option to women who have had only one prior C-section.

VBA2+C trial of labor: This search term finds providers that may offer you the option to try for a vaginal birth with this pregnancy even if you have had two (or possibly more) Cesarean births in the past.

Vacuum or forceps delivery (on site): Vacuum and forceps are two methods a doctor may use to help pull your baby out. These methods are available in every hospital, but are not available at home or in a freestanding birthing center without a transport to a hospital.

C-Section (or “Cesarean delivery”, “Cesarean birth” or just “Cesarean”): C-Section is a surgical procedure where a doctor delivers your baby surgically by making an incision in your abdomen and uterus. C-section is available in every hospital. If you choose to have your baby at home or in a birthing center and a C-section becomes necessary, you will have to transport to a hospital.

24/7 C-section (team on-site): A provider that offers 24/7 C-Section has a surgical team on-site at all times.

Family-centered/gentle c-section: A family-centered or gentle c-section will involve some combination of the following:

• the mother’s partner is allowed to be with her during the procedure
• a see-through drape allows the mother and her partner to watch the birth if they choose
• the baby is delivered through the surgical incision gradually and gently, similar to the process of being born vaginally
• the mother is allowed to reach down and bring the baby to her chest
• the mother’s IV and other monitors are placed so that she can hold her baby
• skin-to-skin contact is initiated immediately after the baby is born

Because there is no accepted definition, BirthGuide asks each provider that offers a family-centered or gentle -section to describe their version in the comments section under Delivery Options.

Moving throughout labor (e.g. telemetry): This search term finds providers that allow you to walk and move around throughout your labor. In some hospitals and birth centers, this is accomplished using telemetry, which is form of electronic monitoring of your baby’s heart rate that works wirelessly so that you don’t need to be hooked up to a monitor.

Intermittent auscultation: With intermittent auscultation, your provider uses a stethoscope or handheld ultrasound transducer (“Doppler”) to listen to your baby’s heart rate and tones at set time intervals throughout your labor. Intermittent auscultation is an alternative to continuous Electronic Fetal Monitoring. This search term finds providers that offer this option.

Eating throughout labor: This search term finds providers that allow you to eat as you choose throughout your labor.

Drinking throughout labor: This search term finds providers that allow you to drink as you choose throughout your labor.

Showering during labor : This search term finds providers that allow you to take a shower while you are in labor.

Laboring in a tub: This search term finds providers that allow you to labor in water.

Aromatherapy: Aromatherapy uses essential oils from plants (usually mixed with another “carrier” oil) to increase comfort, either by massaging them into the skin or diffusing them into the air. This search term will find providers that offer aromatherapy during labor.

Epidural (on site): An epidural is a procedure where pain-killing medication is injected in an area in your back near the lower part of your spine. The epidural numbs your lower body but you remain awake. This search terms finds providers that offer an epidural on site (without transporting).

Patient-controlled epidural: With a patient-controlled epidural, pain medication is administered by a pump that you can control so that you can self-administer pain medication during labor as you feel the need.

24/7 epidural (anesthesiologist on site): This search term finds providers that have an anesthesiologist on site who can administer an epidural 24/7.

Narcotics (on site):  Narcotics are medications like demerol, morphine, stadol, fentanyl and nubain that can be used in labor to reduce the perception of pain. This search terms finds providers that can administer narcotics on site.

Nitrous-oxide: Nitrous-oxide (“laughing gas”) is a medication that is inhaled and that can reduce pain and anxiety during labor. This search term finds providers that offer this option.

One room for labor, birth, recovery & postpartum (LDRP): This search term finds providers that allow you to stay in a the same room throughout your labor and for the day or two after your baby is born, so you do not have to move from one room to another.

One room for labor, birth & recovery (LDR): This search term finds providers that allow you to stay in the same room throughout your labor and during the hour or two after you give birth. You will then move to a post-partum or mother-baby room.

Private post-partum rooms: This search term finds providers that offer you a private room after your baby is born.

Doulas on staff: A doula is a non-medical birth attendant who is trained to support you emotionally and physically during labor. Doulas are usually hired by the family (an “independent doula”) but this search term finds hospitals and birth centers who have doulas on staff.

Doulas welcome: This search term fins providers who support your choice to bring an independent doula with you during labor.

Allows 3 or more support people: This search term finds providers that allow you to have at least three support people with you during labor. Some hospitals will allow a third support person only if she is a doula. That requirement is noted in the SUPPORT OPTIONS comments.

Siblings allowed during labor: This search term finds providers that allow you to bring your younger children with you during labor. Most will require that you have a separate support person for each child and that requirement is noted in the SUPPORT OPTIONS comments.

Partner rooming-in: This search term finds providers that offer a pull-out couch, chair or other accommodation to allow your partner to spend the night with you during labor and after birth.

One-on-one nursing care: This search term finds providers that assign one nurse to each laboring mother during active labor and/or after delivery.

Suctioning only if needed: The mouth and nose of a newborn is often suctioned immediately after birth to clear the airway. Some providers suction routinely. This search term finds providers who do not suction unless the newborn is having difficulty breathing after birth.

Delayed cord clamping: Some providers routinely clamp the newborn’s umbilical cord immediately after birth. This search term finds providers whose practice is to routinely delay cord clamping or who will delay cord clamping on request. “Delay” is defined as anywhere from at least 30 seconds to 5 minutes after birth.

Skin-to-skin contact until first feed:  “Skin-to-skin contact” is the practice of laying the newborn directly on the mother’s bare chest immediately after birth and covering them both with a blanket. This search term finds providers whose practice is to support skin-to-skin contact between mother and baby until the baby has breastfed for the first time or for at least an hour (or two) after birth.

Baby rooming-in: This search term finds providers whose practice is to allow your newborn to stay with you 24/7.

All baby exams in mother’s room: This search term finds providers whose practice is to keep your newborn in your room for all routine partpartum tests and exams.

Early discharge: This search term finds providers that offer mothers and babies the option of going home less than 24 hours after birth. Home birth practitioners necessarily offer “early discharge”.

Home postpartum visit: This search term will find practitioners who will come to your home to examine you and your baby in the days after you give birth.

Baby-friendly designation:  “Baby-friendly” means that a hospital has met requirements set by UNICEF and the World Health Organization to ensure that its practices support breastfeeding.

Lactation consultants on-site: A lactation consultant is a healthcare professional who is trained to help you breastfeed and who is certified by the International Board of Lactation Consultant Examiners^® (IBLCE^®), which is the highest level of certification for lactation support professionals. Lactation consultants are qualified to help with complex breastfeeding challenges. This search term finds providers that have a lactation consultant on staff who is available to visit you in the day or two after giving birth.

24/7 lactation support on-site:  Certified Lactation Counselors (CLCs) and Certified Lactation Specialists (CLSs) can help with routine breastfeeding issues. This search term will finds providers whose staff includes CLCs and/or CLSs who are available to help you with routine breastfeeding issues 24/7 in the day or two after you give birth.

Maternal Fetal Medicine specialists:  A maternal-fetal medicine specialist is an obstetrician who has completed an additional two to three years of education and training to become expert in caring for women with high-risk pregnancies. This search finds providers that have MFM specialists on staff.

24/7 Neonatologists: A neonatologist specializes in caring for critically infants from the time they are born until they are discharged from the hospital. This search term finds providers that have a neonatologist on site 24/7.

Perinatal Level IIE: [Also called “Level II with Extended Neonatal Capabilities”.] This is the designation given by the Illinois Department of Public Health to hospitals that are equipped to care for infants born after at least 30 weeks gestation and weighing at least 1250 grams (2.75 pounds), including infants who require assistance to breathe.

Perinatal Level III: This is the designation given by the Illinois Department of Public Health to hospitals that are equipped to care for infants with complex health care issues.  Level III is the highest level designation in Illinois.