GA Cesarean Section Rates According to the CDC, the national rate for total C-sections in 2012 was 32.8%. There are no current hospital-level cesarean rates for Georgia available online to the public. The most recent rates published are from 2010 (Source: We checked with the GA Hospital Association, but only got numbers for the last quarter of 2013, so CBS46 surveyed local hospitals, and obtained updated rates for all of 2013.

Hospital Total Cesarean Rate (Jan. 2010-Dec. 2010) Updated Rate

Atlanta Medical Center 30.30% 25.5% (2013)

DeKalb Medical – N. Decatur 35.32% 36.0% (2013)

Emory Johns Creek 28.24% 30.9% (2013)

Emory Midtown Unknown 29% (2013)

Gwinnett Medical Center 32.46% 32% (2013)

North Fulton Regional 20.05% 19.5% (2013)

Northside Hospital 38.20% 40% (2013)

Northside – Cherokee 33.93% 33.5% (2013)

Northside – Forsyth 38.51% 35.5% (2013)

Piedmont Hospital 34.60% Did not provide

Piedmont Henry Hospital 30.64% 22.8% (2013)

Rockdale Medical Center 33.00% Refused our request

South Fulton Medical Center 24.76% (merged with AMC)

Southern Regional Med. Center 29.92% 28.2% (2013)

Wellstar Cobb Hospital 35.69% 35.86% (2013)

Wellstar Douglas Hospital 34.69% 33.84% (2013)

WellstarKennestone Hospital 35.01% 35.39% (2013)

We have had several moms believe their water has broken when indeed upon being checked, their amniotic sac was intact. So, I thought I would share a few things to help you determine if indeed your water is broken.

80% of women will have their amniotic sac break in the late stages of labor. Unike in the movies where almost always the water breaks at the onset of labor, this is rare- only 8 to 10% of women have this actually occur.

The amount of fluid most moms have is around 2 liters of fluid- so it usually is a gush of fluid that continues. But for a lack of a better way of describing it- women get a lot more “juicy” in the later weeks of pregnancy. It is nature’s way of keeping a woman clean as it forces any germs that may be entering the vagina out. So this extra amount of secretions causes some moms to feel their water is broken. A few tests to determine if it is your amniotic sac are to:

  • Cough or laugh- does it gush a bit when you do so?
  • Lay down or get up, does it gush with a change of position?
  • Sit on the toilet and lift up on your belly- this helps to dislodge the “cork” of the baby’s head and often times the fluid will leak out.
  • Remember it is continual- it is not a onetime leak- it continues to leak.
  • Put on a thick menstrual pad and is it soaking with fluid within an hour or two?
  • Try to feel the stream of fluid away from your body while sitting on the toilet, is it slick? Vernix is in the fluid and it causes the fluid to be slick- very visceral unlike urine. But  it doesn’t count if you are getting the mucus instead of the fluid- you must “catch” this fluid away from your body when you cough.
  • Is it clear or pinkish- that is fine. If it is brown or greenish, call your midwife or doctor right away. This may be a sign of meconium which could indicate the baby has experienced some stress.
  • Is there an odor? Amniotic fluid should have a sweet scent if any odor at all.
  • Many care providers will not intervene for several hours- unless you are Group B Strep positive. They will allow your body to begin to contract on its own if you are negative.
  • Every vaginal exam after your water is broken increases the chance of infection. Limit them or decline them all together.
  • Being in the bath after your water is broken is not contraindicated- your vagina is not a straw. Remember just like a tampon is effective when swimming without the tampon filling up with fluid, your vagina does not pull water into your body.
  • I know it is embarrassing to think you may have peed on yourself, but it is fairly common in the late weeks of pregnancy. Your baby could be blocking a section of your bladder from emptying and then when the baby shifts, that part of your bladder is kicked and it empties without any action on your part.

So if in doubt, go in to your care provider and have a litmus paper test or a slide test done. The Ph of amniotic fluid will turn the nitrazine paper purple. Or the fluid on a slide will show up looking like a fern under the microscope. But remember it is not that common. And it will continue to leak- and often times labor will begin within eight to twelve hours of your water breaking.

Recently I had a mom contact me who wanted the midwifery model of care but her partner was disturbed that she would not be using a doctor. She said she was not sure she could live with herself if something happened if she did not use a doctor. I thought that was odd since the midwifery model of care has been shown to be superior for well women throughout the world. The United States is the best country to have a baby- right? Wrong! There are many countries that have better infant outcomes than the US! In fact we are not even in the top 30! What is the difference? Midwifery is the model of care in these countries that have better outcomes! What does that mean? You can draw your conclusions.

There are many differences in the type of care most obstetricians offer and most midwives offer. Here is a fabulous article about the differences between the two models of care.

It has often been said,” OBs see birth as an emergency about to happen vs a midwife sees birth as a natural empowering process.”

And my favorite evidence based place for information- the Cochran Database concluded: “. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects.” Read the full conclusion here

Infant mortality (deaths/1,000 live births):


Rank Country or territory 1975 /
1980 /
1985 /
1990 /
1995 /
2000 /
2005 /
last three average
1  Singapore 12.85 8.70 7.79 4.49 3.33 2.55 1.92 2.60
2  Iceland 9.39 6.29 5.63 4.70 4.00 2.61 2.07 2.89
3  Japan 8.75 6.63 4.96 4.44 3.76 3.04 2.62 3.14
4  Sweden 7.85 6.70 6.09 5.27 3.64 3.33 2.56 3.18
5  Finland 8.69 6.44 5.93 5.07 3.86 3.28 2.81 3.31
6  Norway 9.07 7.44 8.42 5.81 4.01 3.52 3.00 3.51
7  Luxembourg 13.07 11.92 8.88 7.26 4.86 4.95 2.32 4.05
8  Czech Republic 17.72 14.61 11.45 8.46 5.21 3.90 3.19 4.10
9  France 11.51 9.27 7.90 6.54 4.68 4.09 3.54 4.10
10  Slovenia 17.10 13.48 10.75 7.64 4.97 4.07 3.51 4.18
11  Switzerland 9.70 7.80 7.03 6.07 4.71 4.10 3.75 4.19
12  Germany 14.93 10.76 8.07 5.98 4.75 4.15 3.71 4.21
13  Spain 16.13 11.02 8.48 6.88 5.08 4.15 3.76 4.33
14  Austria 16.90 12.55 9.47 7.12 4.81 4.52 3.97 4.43
15  Belgium 13.26 10.38 9.05 7.87 5.13 4.37 3.81 4.44
16  Italy 17.94 12.92 9.65 7.59 5.64 4.22 3.51 4.46
17  Denmark 9.20 7.85 8.08 6.46 4.90 4.66 4.03 4.53
18  Netherlands 9.25 8.29 7.35 6.17 5.29 4.86 4.42 4.85
19  Australia 12.56 9.93 8.83 6.88 5.43 4.96 4.66 5.01
20  Israel 17.11 13.74 10.79 8.36 6.44 4.98 3.85 5.09
21  Ireland 15.19 10.22 8.39 6.79 6.11 5.51 4.04 5.22
22  South Korea 33.23 24.61 14.85 9.74 6.61 5.32 3.76 5.23
23  Portugal 31.47 20.33 14.49 9.54 6.49 4.75 4.45 5.23
24  Canada 12.58 9.31 7.52 6.26 5.46 5.23 5.22 5.30
25  United Kingdom 14.12 10.83 9.13 6.88 5.90 5.33 4.91 5.38
26  New Caledonia 23.75 17.32 12.61 9.18 6.68 4.86 4.78 5.44
27  Greece 25.10 15.30 11.22 8.28 6.92 4.80 4.65 5.45
28  Brunei 21.93 16.39 12.24 9.13 6.81 5.08 4.78 5.55
29  New Zealand 13.80 12.01 10.72 7.56 6.24 5.46 5.07 5.59
30  Macau 20.22 15.73 12.22 9.49 7.37 5.71 4.43 5.84
31  Cyprus 19.73 15.50 12.17 9.55 7.49 5.88 4.60 5.99
32  Croatia 21.20 18.30 13.60 10.52 7.11 6.84 6.05 6.66
33  Cuba 22.34 17.38 15.86 15.30 9.58 6.14 5.12 6.95
34  United States 14.34 11.60 10.37 8.81 7.49 6.92 6.81 7.07


When we speak we are afraid our words will not be heard or welcomed.
But when we are silent, we are still afraid.
So it is better to speak.

~ Audre Lorde

No one can take our voice away…except perhaps ourselves. We can choose to not speak if we are afraid.  We choose to not speak because we are afraid… afraid of being misunderstood, afraid that we will sound awful if we share what we truly feel, afraid we will be treated differently once we share, afraid we can not explain what we feel in a way that will really be what we feel, we are afraid of repercussions…. BUT… if we fail to speak- fail to share what we feel, they our silence does not benefit us at all- we are still afraid- still unheard- still misunderstood- so SPEAK.

Those who matter- those who care will ask more questions if they misunderstand. They desire to know more, understand more.  Those who do not wish to understand or want to retaliate due to your words are those you can live without.

I posted a question on our very busy Facebook page and got 45 responses to this question: What one thing do you wish you had done differently regarding your pregnancy/labor/birth?  I offered some optional answers but allowed the responders to put their own in as well. The number one thing was one they added.

And these were the responses:

  • Had more pictures taken during pregnancy and the birth  34 votes
  • Rest more during the pregnancy and in early labor 14 votes
  • Hire a doula 9 votes
  • Hire a home birth midwife 3 votes
  • Explored water birth more 2 votes
  • Had a video of the birth 3 votes
  • Resolve fears that I pushed away 3 votes
  • There’s nothing I would have done differently the last two times 2 votes
  • I honestly would not have done anything different either times 2 votes
  • Took a shower when they told me I couldn’t 2 votes
  • Not gotten induced despite being “two weeks late” … it started a cascade 🙁  1 vote
  • While in labor I remember wishing I had a potty seat to sit on inside the tub  1 vote
  • Relied more on supporters and caregivers by communicating more   1 vote
  • Time right after birth alone with babe, family, then invite team in   1 vote
  • Stay home in early – mid labor  1 vote
  • Changed providers when my instincts told me to  1 vote

Often times curiosity leads to trouble. When a woman is curious, sometimes it causes her to take off her panties in the OB office to determine how far dilated she is, but it can mean trouble. If she is not dilated at all, she feels like her body is broken. If she is dilated, it can cause her to become anxious and think she may go into labor soon. But the truth is a vaginal exam really means nothing. You can be dilated for weeks and not go into labor. You can be closed up tight and be holding your baby in a few hours. It really means nothing.

But, it is not without risks. If you get checked and things are starting to ripen, it may cause you to agree to intervention – even being induced although your body still wants some more time. If you get checked it could stir things up enough to irritate your uterus- causing you to contract but not be progressing- just enough to keep you awake and uneasy, but not in labor.  It could also introduce infection and possibly cause your water to break then or within a few days due to the exam. And sometimes the exam itself can cause your waters to release. Then you are on a time clock and at a higher risk of infection. So, ask yourself, is it worth doing if it means nothing?

So, try to remember what your mama told you- “Keep your panties on!” It could keep you out of trouble!

Charlotte and I were chatting today. I love making up phrases using the letters in the words. Today we were preparing for our FEAR to FREEDOM class and we were discussing keeping DRAMA out of the labor room. We chatted and came up with this:

D-Don’t stay in your head in labor- Don’t think too much but allow yourself to become immersed in the process naturally.

R-Remember to listen to your body- and allow your true essence, your intuitive voice to guide you.

A-Address your fears before labor begins so that they don’t rear their ugly heads in surprise as your labor tried to unfold.

M– Monitor and Moderate the attendees to your labor- too many folks makes you more of a hostess than a woman who can let go and surrender to the process.

A– Assign tasks or special jobs to those in attendance so that expectations can be reasonably met.

We both felt like if you did the things above, the likelihood of unwanted drama in the labor room would be limited for sure!