"From Worst to First" - Getting hospitals to change their ways

There's an inspirational campaign going on in New Jersey called "From Worst to First". With New Jersey at a 39.4% cesarean rate, they are publicly naming and shaming hospitals with high cesarean (and episiotomy) rates. Once there are women out front of a hospital with brightly colored signs saying "Bad Maternity Care Harms Women", most hospital administrations seem eager to at least meet with them.

The Worst to First website is here - if you scroll down to "Status of New Jersey Hospitals Addressed by NJMCWTF2010" you can click on individual hospitals and see photos of each protest and a short report of what happened.

I learned about this campaign through e-mails via a doula listserv. The e-mail reports were longer and more detailed than the reports on the website, and I thought I'd share an excerpt of one here:

We met with the Administrative staff of Saint Clare's Hospital in Denville
on June 8th, 2009 for a meeting to discuss the first steps towards our "Worst to First" Campaign.

In attendance was the Administrative Director of Nursing, the Maternal Child
Education Coordinator, the Communications Manager, the Executive Vice President of the Hospital, the Patient Care Manager, the Maternal Child Heath Coordinator, the Vice President of Public Affairs, the Labor and Delivery Staff Nurse and Doula, Quality Manager of Maternity, and the Director of Clinical Quality. Stacey Gregg Action VP for NOW-NJ, Anne Mitchell Stacey Gregg's Summer College Intern/Activist, & Morris County NOW Secretary Doreen Manno.

For the first hour and a half of the meeting, Stacey and the administration went back and forth about the condition and quality of patient care and how it was reflected negatively in the statistics that we're trying to break with our campaign.

Unfortunately before this point, the hospital staff present was unwilling to admit their statistics. They were trying to question the validity of the state's statistics of the ten hospitals that already really have episiotomy rates below 5%.

It wasn't until Stacey made the analogy between the unnecessary cutting of woman during birth and how if a woman was a rape victim, you would not be discussing the reasons why a rapist does what they do. You would only be concerned with coming up with solutions and ways to protect her. She gave the examples of a rapist claiming any justifications "didn't have enough time, it takes to long the other way"," that's the way I was trained to do it", "the women want it or they ask for it", and "they don't mind it this way", the way a doctor might defend his high rate of episiotomies. She stated that she did not want to discuss how they got here it just had to stop, and she took one of the signs that we had bought with us into the room that stated "STOP Violence Against Women" and stated that Women are being harmed. ...

"There are ten hospitals with low episiotomy rates that are doing things differently; obviously they're not doing the same things that are going on around here." Stacey said. ... Discussion was held about how to get the doctors to best respond and change the way they practice. From there, we began to formulate an action plan to reduce episiotomy rates at Saint Clare's.

Wow.

On the doula listserv I get these e-mails through, doulas are saying "We need to do this in OUR state!" Is it too much to hope this goes nationwide? I'll head up my state's chapter!