I just read a great piece on Ravishly, Natural Childbirth Is Great But Let’s Stop Pretending It’s A Matter Of Choice.
I agree with a lot that the author has to say:
Labor is excruciating.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Natural childbirth is an affectation just like a designer handbag.[/pullquote]
…There was no warning, no gentle increase of pressure, just sudden stabbing pain, followed by incredible pain, followed by a pain that obliterated all of my other senses until I was just a small, pulsing ball of pure, radiating pain. And then the contraction ended, and I could think and see and speak again. And then, without warning, the pain would return. My mom stood over me, rubbing my back, encouraging me to “relax, breathe, relax,” but I couldn’t. My body was a muscle fully contracted. I couldn’t anticipate the pain so I couldn’t ease into it. It consumed me.
Epidurals are miraculous.
Take the worst pain you’ve ever felt. Double, triple, quadruple it. Reset your entire pain scale so that instead of 1-10 it now goes 1-1,000. And then stop it completely. Replace it with a gentle tickling sensation. The epidural took the pain away and, as my body continued to labor, I took a nap.
Choice is a luxury.
Natural childbirth is all about choosing to suffer in agony. If that’s what you want, you should go for it. But don’t pretend it’s some sort of achievement to refuse effective pain relief. It’s a privilege that most women who have ever existed never had and would have given a great deal to have.
But I take issue with the author’s fundamental premise expressed in the title. There’s nothing great about natural childbirth. It’s not healthier, safer or better in any way than childbirth with pain relief
It’s not an achievement, either, unless you think that root canal without pain relief or refusing pain relief after breaking your leg is an achievement.
It’s no more of an achievement than having good vision without glasses, breathing without asthma or eating without being gluten intolerant.
It’s what nature intended? Nature intended that an astronomical number of babies and women will die in childbirth. That doesn’t making dying in childbirth an achievement, does it?
Natural childbirth is a choice just like a designer handbag is a choice. There’s nothing intrinsically better about a handbag that has a designer label than one that doesn’t. A designer handbag doesn’t carry more items or carry them better. I like designer handbags and occasionally buy one, but I recognize that they are an affectation. The entire point of a designer handbag is that others recognize that you have a designer handbag.
They are also a big money maker for designers. They are often no more expensive to fabricate than non-designer handbags. They command a premium in the marketplace because of snobbery, not because of value.
Natural childbirth is also an affectation. There’s nothing intrinsically better about unmedicated childbirth than childbirth with an epidural. It isn’t more likely to result in a vaginal birth, and it doesn’t decrease the C-section rate. Natural childbirth is an affectation primarily among Western, white, relatively well off women. The entire point of natural childbirth as a philosophy is bragging to yourself and others that you “did it.”
Pro-tip: if it’s not an achievement when a 15 year old Afghan child has an unmedicated vaginal birth because she had no choice, it’s hardly an achievement when a well off 35 year old white woman does it because she has the luxury of every possible choice.
Natural childbirth is a big money maker for the natural childbirth industry — midwives, doulas, childbirth educators — and they market natural childbirth as aggressively as designers market their handbags and in the same way. The focus of marketing efforts in both cases is to convince women that purchasing the products (books, courses and services in the case of the natural childbirth industry) marks them as superior to other women.
If you want to spend hundreds of dollars on a designer handbag, I won’t stop you. But don’t tell me that it marks you as better than other women. If you want to buy the goods, services and philosophy of the natural childbirth industry, go for it. But don’t pretend that it marks you as better than other women.
Natural childbirth, like a designer handbag, is a choice — not a good choice, not bad choice, and certainly not a great choice — nothing more.
Vaginal tears and fistulas are tres chic.
http://www.bbc.com/news/health-39565846
The medical director at the Shrewsbury and Telford Trust, Dr Edwin
Borman, told BBC News the trust was no worse than anywhere else.
“When I look at the perinatal mortality rate at our trust compared to the
rest of the NHS, we are at an equivalent level to the rest of the
country,” he said.
What the whatting what? So we aren’t worse than the average rate, so all is peachy despite having 7 – SEVEN – preventable deaths in about 2 years? Where is your fucking mind, doc? All is great, we should look at the average, do not speak of the fact that those babies should all have lived. Average rate. All is great.
What a dusgusting moron. I can well believe that he keeps Cathy Warwick in high regard as his esteemed colleague.
I just love the way he seems totally oblivious to the implications of what he said. If they have an average rate and they have had 7 preventable deaths in the one trust doesn’t this imply that these preventable deaths are happening all over the country at about that rate? If he’s right that translates to hundreds of preventable deaths (there are 137 trusts in the UK according to google) every year and somehow that’s all ticketty-boo according to this cretin?
I know. It’s all good, as long as it doesn’t make us look bad, amirite?
His comment does much to enlighten the high stillbirth rate in the UK, I think. Take 137 of him, and here we are. It doesn’t matter who lives and who dies, as long as it’s within the average right.
This is the system Neal Shah and the other homebirth advocating loons want everyone to adopt? The ideal? Barf.
Question: infertility is also natural. So, what is the natural birth movement’s position regarding fertility treatments? Are some babies not meant to be conceived? If I conceived with fertility treatments because my body could not do so without help, maybe some people can’t give birth without interventions? Or breastfeed exclusively? I know my body couldn’t do any of these 3 things! I only got pregnant the first time because of clomid, I needed a csection because labor would not start (at 41 weeks and 12 hours of pitocin), and I needed to supplement with formula or my daughter would have starved to death.
Was my fertility treatment the first of a “cascade of interventions”?
If by some miracle I had conceived, birthed and breastfed my daughter without any problems, then the birth of my son (second baby) would surely have killed us both. He was a “surprise baby” (and after infertily I was over the moon to have an accidental pregnancy). He was a true transverse, with his head jammed under my bottom ribs (ouch!) and his feet kicking under the other side. I had a maternal-request csection at 39 weeks (I was done being pregnant, and he was a big baby). He was born butt first, big, pink and healthy. Had I waited for a vbac he could have pushed his arm out first! I can’t even imagine how horrible that would have been!
Sorry for the long OT comment…
“So, what is the natural birth movement’s position regarding fertility treatments?”
They often attribute it to some failure on the woman’s part: her impure diet, her emotional outlook, her spiritual or moral failure, her lack of health and wellness, her ‘stress.’
They prey on these women and sell them oodles of snake oil – natural therapies, massage, acupuncture, extreme diet therapies, etc. If it doesn’t work, the woman didn’t commit enough to the alternative therapy.
I’m reminded of Ina May Gaskin, with her “labour stalls because the mother has unprocessed feelings within her! Let’s have her and hubby repeat their wedding vows!” line.
You’re a CNM, or studying to be one, right, Rudy? I seem to remember you work in hospital in some capacity. Aren’t you proud to claim her as your respected colleague?
I’m not sure what Ina May Gaskin has to do with CNMs.
She’s the mother of midwifery in the USA, or so they claim! And a CPM is just the same as a CNM or better!
Well, I disagree, and disagree. But I think you’re being sarcastic. 🙂
She shouldn’t have a damn thing to do with them, but my CNM friend with the year old certificate regularly posts Ina things on FB.
It’s the same in the UK – she may not be qualified but she’s regularly quoted as an expert by NHS midwives – several of whom recommended her books during my pregnancy. This may well help explain the flurries of preventable perinatal deaths in various nhs trusts that we keep hearing about.
I’m trying to come up with words for what this is. Outrageous? Disgusting? Ugh. It truly is a cult/religion for these people.
Cult is accurate.
“Was my fertility treatment the first of a “cascade of interventions”?”
I could envision the natural childbirth and natural-all-other-things people making this argument. Not a stretch at all for some of these people.
I want to start a movement to claim that REAL women can become pregnant without the ‘intervention’ of sperm.
too funny!!!
So, Christianity? 😉
Does Divine Intervention count? 😀
http://www.bmj.com/content/347/bmj.f7102
Like a virgin (mother): analysis of data from a longitudinal, US population representative sample survey
Objective: To estimate the incidence of self report of pregnancy without sexual intercourse (virgin pregnancy) and factors related to such reporting, in a population representative group of US adolescents and young adults.
Conclusions:
Around 0.5% of women consistently affirmed their status as virgins and did not use assisted reproductive technology, yet reported virgin births. Even with numerous enhancements and safeguards to optimize reporting accuracy, researchers may still face challenges in the collection and analysis of self reported data on potentially sensitive topics.
You can also *technically* be a virgin after a very heavy petting/makeout session and get pregnant.
Anyone remember that Scrubs episode?
I don’t need to imagine it – I’ve been told precisely this by various people convinced that if I’d only relaxed/dealt with my fear of having a baby (a fear I didn’t feel but clearly had according to folk or I would have conceived) or got on to the right regime of herbs/ candles etc to get myself in the right zone I would have conceived naturally without a problem. Ivf apparently was “taking the easy way out”.
Clearly people who’ve never actually had IVF. Taking pills and injecting yourself to induce faux-menopause is *so* much easier than sex by candlelight. *eyeroll*
Yep – one person who’d conceived naturally first month in, so was clearly an expert at all things fertility (in her mind anyway) and one who is cheerfully child-free. Isn’t it wonderfull how people can become experts at things from positions of near total ignorance?
For the sake of argument, let’s grant that it is “the easy way out.”
So the fuck what? What’s wrong with doing it the easy way? Why must we have to do things the hard way?
So dumb on so many levels.
Spoken like someone who’s never had IVF. (Which I haven’t either, but I know that it’s the complete opposite of “the easy way.”)
How can someone think IVF is ‘taking the easy way out’? when the alternative is ‘having sex’? Some people are just stupid.
I think the idea is that it was easier than facing up to whatever psychological hang ups were obviously responsible for my failure to conceive. (Note the I think – I must admit I stopped listening at that point lest I lay myself open to the possibility of attempting to conceive in prison whilst doing a stretch for GBH.
Funny how your ‘psychological issues’ weren’t able to stop IVF from working.
pro tip-if doctors did what was actually scientifically proven to help mother and baby, I wouldn’t be rushing towards homebirth. But the standard procedures in hospitals are not beneficial for moms and babies. There is a great deal of pressure in a hospital to do little things that aren’t in my best interest.
I don’t think epidurals are bad or induction is bad or c-sections are bad. I don’t think any less of anyone who is in that situation. I’ve been induced and had epidurals. I just recover FAR better when I don’t. The baby is FAR safer (there are statistics…it’s a thing).
The United States needs to put women and babies first in their child birth practices.
In texas in the last few years 600 women have died in childbirth. It’s now as safe to deliver in Texas as it is to deliver in Oman!. That’s no designer handbag people want. That’s LIFE!!
There are many diverse reasons for that, but our over 30% c-section rate isn’t doing women any favors. Women are more likely to die if they have a c-section . That’s not a designer hand bag…that’s LIFE.
And yet women choosing homebirth are rushing towards even less safe choices. I support their right to do so, but be in no doubt about that. Have you read the posts about MANA’s stats?
(also, do you think women in Texas are increasingly likely to die during pregnancy and childbirth because of lots of sections, or could it have to do with the tightening up on abortion…?)
why? why are woman rushing towards homebirth? (which statistically is safer in texas than birth in a hospital–if you disregard WHY the stats are what they are. )
Why are they? texas reaceted to Obama care by reducing medicare and limiting options! so not related to their rising c-section rate…that’s Texas big medicine issues.
Again…not against epidurals or c-sections or induction.
I’m against pressure (EITHER WAY). I don’t think it’s healthy to pressure people to go natural or have a c-section. I just would LOVE for doctors to be reliable in offering what is actually in the best interest of mom and baby.
continuous EFM has been shown to increase c-sections unnecessarily. It doesn’t improve outcomes for baby or mom.
We neednt be divisive. we can work to make brith safer for mom and baby. It’s not about who’s better…AT ALL. It’s about what can we do to make it a better, safer experience for mom and baby.
Why? Because they are uninformed.
You wouldn’t actually LOVE for doctors to be reliable. You would love if they treat your google reading like legitimate medicine. Because you’ve already decided whom you believe: homebirth midwife clowns.
Continuous monitoring has been shown to decrease neonatal mortality and morbidity. That’s a plus in my book. For your book of someone who thinks women get induced just for fun and not because there is a legitimate reason that might make birth harder – not so much.
Why are women rushing to homebirth? Because they don’t know the info. Just like you. Your post about continuous monitoring was extremely revealing.
just as an FYi…I’m very healthy. I’m not tje average” american woman. I’m not against hospital birth remotely.
I’m completely in favor of what is best for a mother and baby.
That may be a c-section. That may be natural (which doesn’t have to be home birth…I’m not sure why everyone has to jump there).
I just don’t like the divisive nature of skeptical OB.
I’ve read a lot of studies about continuous monitoring. They only help in high risk cases. and then they are fabulous! Just like many interventions they are wonderful and life saving when they are needed.
I just don’t like pressure either way. I don’t like the concept of pressuring a woman towards natural birth…OR a c-section…or a highly medical birth.
i’m for health of mom and baby.
You’re under no obligation to read or comment here. Nice tone trolling, though. Doesn’t change the fact that you are wrong.
good to know, I thought I had to according to lactohomebirthy laws.
remove sarcastic font now.
You made the choice to parachute in here and start spouting garbage. Don’t bitch about tone when you get called on it.
“That may be a c-section,” then why do you lie about the stats showing the real safety measures of interventions? And we “jump to homebirth” because you lie and say homebirth is safer than hospital birth when it NEVER IS. What’s your definition of “best,” seriously???
when did I say homebirth is safer?
less intervention is healthier. and safer.
best? healthy and happy mom and baby…how we get there would be different with different woman.
“In Texas” homebirth is safer? Which is nonsense. Control for risk, for god’s sake – and take out unplanned homebirth – before making those claims.
And less intervention is not safer – the reason why interventions look bad is because they’re being used *in response to bad situations* which are causing problems. This is like saying “people taking chemo are more likely to die of cancer than people not taking chemo,” and it’s inane.
And putting mom’s happiness on equal footing with the survival and health of both parties gives the lie to your “it’s LIFE” smokescreens too.
“pro tip-if doctors did what was actually scientifically proven to help mother and baby, I wouldn’t be rushing towards homebirth. But the standard procedures in hospitals are not beneficial for moms and babies. There is a great deal of pressure in a hospital to do little things that aren’t in my best interest.:”
What things, specifically, aren’t in your best interest that are standard? If labor is progressing normally and you haven’t had an epidural, you are almost certainly going to have intermittent EFM, and a lot of hospitals even have telemetry units so you can still be up and moving. You complained specifically about inductions, epidurals, and c-sections. What exactly is “standard” regarding these procedures?
Please tell me you’re not bitching about things like a heplock. Because I would have given my right arm for I.V. access during the manual examination of my uterus, done without any anesthesia because I didn’t have that pesky heplock.
“pro-tip” seems to be a warning that someone is about to be (more of) an ass.
When things are going well, you don’t need interventions. Why is this so fucking difficult to grasp?
I’ve had several friends who had intervention-free hospital births, because the births were going well and they didn’t frikkin’ need interventions. Hell, I was an intervention-free hospital birth in the ’70s! When things go well, you’re not getting interventions in the hospital or at home. When things aren’t going well – you’re not getting interventions at home…
If fewer interventions are safer, explain the Oregon planned homebirth safety data.
Less interventions aren’t going to stop the conditions that require them. Women who have no access to a hospital stall out in labor all the time, there is just no pitocin or OR to help them. Pre eclampsia and cord accidents will happen without access to induction or c-section.
No Britt Kelly. Less intervention is NOT healthier. The moms who die in Texas die due to lack of access to “interventions” — in the form of prenatal care and good hospital care. They do not die due to fetal monitoring! They die because they don’t have the money or time or knowledge to get good prenatal care; because they are already sick (due to bad health care); and due to the effects of race/economics in access to health care.
Exactly. There is a whole lot of nothin’ in Texas. If you live in an urban area, you can generally get access to some sort of health care, with the quality of service varying wildly from city to city. If you live three hours into the boonies with no free/reduced cost clinics nearby? That’s a lot different.
For me, less intervention would be one dead baby and a mom who either went through the hell of having a dead transverse baby torn limb from limb and pulled out of my cervix or a dead mom. Me? While I would have LOVED a natural birth, I prefer the C-section that resulted in a live baby and mom.
So no, less intervention is not always healthier or safer.
Another point: as I said above, I live in Texas. I love it here, but there are a lot of considerations to be made that are specific to Texas. We have worse overall health results because of less access to healthcare (limited public funds, a lot of very rural areas, historic poverty, etc) than much of the country. I live in the Houston area. Take Texas Women’s hospital as one example. Do they have a 30+% CS rate? Yup. Is it also a great place to go for a natural birth? Yup. Why both? Because you have a LOT of very, very sick moms and babies getting transferred to Texas Women’s. Just because Sally Smith is undergoing a crash C-section to try to save her 27-weeker who has spinal bifida and IUGR and half-dozen other medical problems doesn’t mean that Betty Jones, who walks in in spontaneous labor with a head-down baby at 39 weeks is going to have one, too. However, while she labors in her Jacuzzi and slow-dances her way through contractions, Betty can also feel safe in the knowledge that if baby’s cord, which no one knew was wrapped around baby’s neck three times, prolapses when her water breaks and baby’s heart rate crashes, she’ll be having a much-needed C-section in about two minutes, and she’ll be going home a bit sorer but with her arms full.
Britt Kelly clearly has never been responsible for providing safe maternity care – or any other form of health care.
Interventions are done to reduce risk. If there is no need for emergency action because the risk has been averted, the intervention has worked.
35 years ago: less intervention – a dead or brain-damaged Amazed. Born to a young and healthy mom who weighed 120 pounds upon leaving the hospital. Not your average old, fat, sick and whatever excuses NCB invents for drawing the short stick American.
30 years ago: less intervention (actually, the first intervention in this birth at all) – the same healthy slender mom who was not so young anymore but still not a crone at 29 dead for sure in under 10 minutes. No time for a midwife to diagnose and TREAT the problem if she had gone rah-rah homebirth, rah-rah.
Healthier? Safer? Come again?
“Britt Kelly Sarah • 3 hours ago
why? why are woman rushing towards homebirth? (which statistically is safer in texas than birth in a hospital”
Here you go. I cut and pasted that for you.
You said homebirth was safer in Texas. Also, how is less intervention healthier and safer? That’s a rather large claim.
‘Less intervention is healthier and safer’
Absolutely not.
Tell me, when are you starting to count the ‘interventions’? Because first of all, if you want homebirth to be reasonably safe, then you need to be able to assess your risk level. And doing so requires MANY intervention.
All through the pregnancy, a woman will have prenatal care, which consists of many Doctor appointments, multiple blood tests, urine tests, blood pressure, weightings, uterus measurements, foetal heart rate measurement, vaginal exams, step B culture, STD testing, various numbers of US, possibly rhogam injection etc.
ALL of those are interventions. So, is less interventions still healthier and safer?
Or are you going to say that prenatal interventions are ok, but interventions during birth are bad? Because after spending 9 months making sure you are healthy, doctors just wants to screw you over for fits and giggles?
I <3 my "interventions". I've had all of the above (except rhogam) and am being seen weekly or more at this point, all to make sure this VERY wanted baby is still doing ok in there. You better believe I'm going to welcome fetal monitoring and anything else they think is necessary once I'm in labor.
I’ve had everything, and I either didn’t care or loved everything except the forceps.
Geez, I even LOVED the urinary catheter the NCB advocate hate so much. After months of having a baby constantly press down on my bladder It was like heaven to not constantly feel the need to pee and not having to get up every 5 minutes to go to the bathroom XD
Ah, forceps are something I would like to avoid. My OB is already aware that I want a cesarean if there is even the slightest doubt of a good vaginal fit.
Honestly, if he had asked me, I would have told him to skip the forceps and go straight for a c-section.
But you know, apparently as long as baby comes out of the vagina there is little need for informed consent. They didn’t ask me and didn’t told me about the risks or anything. Yet, the OB took all the time in the world to tell me the risks about the c-section and make me sign a consent form.
I’m sorry to hear that.
Haha, did you know sometimes you need forceps during a CS when the kid is hard to grasp, either because there’s not enough space for hands around them or because they’re “swimming” away? I only found out mid-CS: My massive headed LO was of the wedged in pelvis variety and had to be pried out.
Just sayin’.
Still loved my CS, no labour and all.
Oh, I know I can’t guarantee anything regarding this upcoming birth. If we were in a situation though where my OB asked me “forceps or cesarean?” I would pick the surgery.
I couldn’t agree more. I loved everything about my CS, though admittedly the best bit was the mini-hovercraft-like inflatable mat they used to transfer me from OR table to bed afterwards. Oh, and the baby. 😉
I’m always a bit disappointed when they take mine out. I mean, I don’t miss the tube as such–I hate being hooked up to stuff–but not having to pee every thirty seconds? AWESOME.
Somehow, I managed to get a kink in mine.
homebirth is arguably safer if someone is dropping bombs on the hospital. that’s about it though.
My friend was healthy too. Didn’t make a lick of difference.
The post was not about Britt Kelly, right? You were asking why are women rushing towards homebirth and then pretended to know the answer.
It isn’t about you and you weren’t talking about you when you were listing the NCB talking points.
You are wrong. That about sums it. You are wrong about what you think you know.
Reminds me of the person who parachuted onto Gavin Michael’s page and made it about her wanting a home birth. It was quite the eye opener.
Come on, Bomb, we both know you weren’t surprised at all. That’s what they do – and I know you know it.
It was remarkably tactless, though.
Yeah, I can’t believe I was shocked by it, it’s not the first time it’s happened and it won’t be the last. The funny part was her insisting she wasn’t privileged at all. Yes, there are women who have no access to prenatal care or skilled medical professionals to attend their births but they aren’t the same women who are whining about high c-section rates and worried that if they don’t have dim lights/candles/aromatherapy/snacks during labor that it’s the end of the world.
The problem is that most CPMs completely close their eyes to potential problems. Don’t want gestational diabetes? Just don’t test for it! Don’t want preeclampsia? Just don’t test for it! Don’t want placenta previa? Just don’t test for it. Don’t want a post-dates baby? Don’t do an early ultrasound (after all, ultrasounds just cause autism anyway), and then you don’t know that a baby is post-dates and at a higher risk for stillbirth, because, after all, babies know when they are supposed to be born.
Pretending problems don’t exist doesn’t mean they aren’t there.
I don’t like a lot of things about hospitals. I would prefer to give birth at home. However, most of all, I want a live mom and baby. If I’d followed the advice of friends and had my last baby VBAC at home, then baby would be dead, and I probably would have been. If I’d gone into labor, I would have ruptured. There weren’t any indicators for that, or anything I could have done that I didn’t to prevent it. I ate well, exercised plenty, waited 18 months between babies to get pregnant, the lot. That didn’t do squat for thickening my uterus around my scar, though. So I’ll put up with the sometimes irritating nurses and hospital rules in order to get a live baby at the end, because no amount of water births or essential oils or being in my own space could make up for not having my wonderful, fat, happy little son.
Edit: Sorry, KotB, I meant to reply to Britt Kelly.
I was young, extremely fit, healthy, also did everything right, and was damned lucky to be in one of the best hospitals in the US who could do a smash and grab section in under ten minutes “decision to incision”, and then transfer the one pound baby to a top notch NICU, and now both of us are alive this morning, nearly 15 years later.
My friend was not so lucky. She also did everything right, had the baby in a top notch hospital with a top notch NICU. Her baby is dead. But thanks to that hospital he had a chance, and she’s alive so her older child isn’t an orphan.
You may think you know all the things, but the reality is that you don’t. You believe what NCB has told you. NCB is wrong. You haughtily said “statistics, it’s a thing”, but you clearly don’t know enough about statistics to know that you’re believing numbers manipulated to tell a story that just isn’t true. That’s the thing about stats; they can be easily manipulated. My students always complain “when are we ever going to use this”, and you are now my new example of why we require stats 101. You are unable to recognize that you are being lied to.
Many delivery issues happen with little warning: My pregnancy was pretty much textbook, my labor was fast and productive..until they noticed something on the trace from the fetal monitor, then they did an exam and notice meconium stained waters. Trace got worse so they went for vacuum assisted delivery. My daughter had to be suctioned and watched for a few days but was fine BECAUSE they didn’t just wait to see what happened. You are VERY healthy, good for you, so was I, that’s not going to save your baby if something mechanical goes wrong, physics doesn’t care how healthy you are. A lot of times you are low risk right up to the minute you aren’t and then everything goes to hell really fast. Drs and nurses don’t make it obvious how seriously bad things could potentially go.
My nephew’s baby got stuck (shoulder dystocia) he survived but a C-section prelabor due to size would have been safer for him and his mother. My sisters third baby’s cord prolapsed. Which would probably have been missed without fetal monitoring. My 19 year old sister in law developed pre-e and then HELLP syndrome over a matter of days. If her OB had not taken the persistent headache and hand swelling seriously she might have died from it ( a C-section was necessary )
History time – My great grandfathers 16 year old sister died of pre-e/HELLP syndrome. My great-grandmother died at 18 giving birth to her 2nd child (hemorrhage). My mother almost bled to death on the way to the hospital (placenta previa/transverse lie). My grandmothers 3rd baby was stillborn. All these women actually had doctors delivering their babies. But they mostly delivered at home and they did not have all the equipment and “interventions” we have today (blood transfusions, Rhogam, penicillin, ultrasounds, drugs to help preemies lungs, vacuum)
My mother and brother lived because the hospital was literally down the street and even then it was almost too late.
Delivering at home and not having something go wrong doesn’t mean you did everything right, it means you got lucky.
A family I know IRL had their third baby at home almost two years ago. Dystocia, baby born seizing. Child spent a week in a level IIIb NICU being cooled, another week inpatient, and was on anti-seizure meds for nearly a year. He seems okay, but only time will truly tell.
My nephew spent almost a week in the NICU, he seems mostly OK but has some weakness in his arm. He seems on track developmentally bu they won’t really know for another few years. I think they(hospital) did not do a C-section because of all the pressure now to not do “too many” Un-necessary C-sections. His mom was scheduled for an induction(because the baby was already large) but when into labor the day before it was scheduled to happen.
“I’m very healthy”
*slow clap*
There is no pressure. There is only a call for informed consent and real info.
You want a homebirth? As long as you know that your risk of death and the risk of death of your baby is higher than in a hospital. Go for it, it’s your right.
Giving people real information about the risk isn’t pressuring them. It’s making sure they know what they are getting into.
If you want a homebirth because it’s ‘safer’ then sorry honey, but you are wrong and people SHOULD be telling you that you are wrong.
You totally can want a homebirth. But it’s not safer, and wanting a homebirth means that you understand and chose to risks that come with it.
Why? Because they are enamoured with the NCB/homebirth propaganda. “Stay in your own home! Use your own bathroom! Snack when you want to! Move around as you wish! You are more comfortable in your own environment! Plus, there is no pesky EFM, dilation checks, vaginal exams, IV’s, nurses, doctors, harsh, bright lights or a timetable for delivering! It’s all about making you, the Mama, comfortable and happy so that you can safely deliver your perfect baby in the bed where they were conceived! It’s so beautiful, YOU’RE beautiful and everything will work our perfectly because you are MADE for this!”
Homebirth is not safer in Texas. Or Oregon or Washington or California. Or any other state or country, for that matter.
my babies were conceived in hospital, so…
My favorite response to “You have deliver in the same place they were conceived” is, you mean in the back seat of the car?
If you really want to harken back to the conception, you might also want to be drunk.
Just angelic!
Hey, cheap anesthetic!
Eh, “Born in the car” tends to be a good story, anyway!
Didn’t Dr T have some data a while back showing that it was safer to be born in the back seat of the car than with a CPM at home?
That’s a Grunebaum study, with taxis.
Although it was not clear in that work what the baseline reference was being used, or that they were the same for both cohorts.
That was it, thanks! Yeah, there’s probably some confounding going on with a baby that’s going to be able to pop out in a taxi without help. But at least a taxi will get you to the hospital, and not prevent you from getting there…
Or a couch in a friend’s living room, after having consumed one too many Sam Adams Lagers.
Damn, and to think i wasn’t even in the same town for my children’s conception!
You know, it’d be kind of fun to tell them that Airport Security objected to us giving birth in the check-in line
Mine was conceived the week I got my house…..but I’m not sure if it’s before or after we actually moved.
It’s actually a good bet that I was conceived in St Louis. In that context, Evanston Hospital wasn’t much different from the house my parents lived in at my birth.
My mom and dad were students in different cities when I was conceived. Bet you their respective landlords would have had a fight over who should have the honour to house the blessed event.
(In this vein: about a year ago, during a conversation about marriage, the Intruder said, “Well, out of everyone I know, except for…” He falls silent and starts thinking. Counting, I mean. And then he starts agaon. “Out of everyone I know, I am the only one who got married well before the baby was on her way. Yes, Dad, this includes you.”
“”You have deliver in the same place they were conceived””
That’s something that someone has actually said??? Says who???
I’m pretty sure mine was conceived the day the space shuttle broke apart over Texas upon re-entry.
I still chose the hospital. Elective CS, scheduled. I went into labor about 2 am the day of the CS. Doctor offered me a chance for a TOL, since labor had started. I said absolutely not, let’s get this show on the road. The CS was lovely.
Mine were conceived in a petri dish 30 miles from my home. I don’t think they make petri dishes big enough for giving birth into.
Mine, too, but dishes were in a hospital. 🙂
Yup, the fertility clinic where I had my IUI would have been over the moon if I’d turned up on their doorstep in labour demanding my bed back.
Mine was conceived in a fertility clinic which is in the same hospital building as the delivery suite where I had my caesarian – in fact the surgical areas for ivf egg collection and c-section are shared as the two departments are so close (I think). Ironically therefore my synthetic baby with his un-natural c-section birth probably was born and conceived in pretty close to the same place!
I love the smell of antiseptic in the morning. 😛
Making birth safer means women having access to good prenatal care, hospitals that can care for high risk women and NICUs. That is what is in the best interest of women. It’s in the best interest of anyone who makes a cool three or four thousand from home birth to encourage women to “do their research” and google “risks of epidural/continuous fetal monitoring/pitocin”. Because when you google that stuff, you are directed to the pages of the very people who benefit from scaring you about those things.
EFM does, however, decrease the stillbirth rate. After doing rigorous research, doctors have also found that induction is better than expectant management at preventing c-sections, regardless of parity or Bishop Score. That’s how science works, and if you are going to start making claims, you had best have actual evidence to back it up.
Epidurals are demonstrably safe for the baby, have relatively few risks for mom, and do not increase your chance of having a c-section. Why do so many women have to claim that they “caved in to the pressure” rather than just admit that labor is excruciatingly painful?
Heck, new studies have shown that the less pain women have in childbirth, the less postpartum depression you get (or it’s milder).
They’ve also found that the stress a mother feels from pain during birth can affect the baby, if the baby is struggling or is borderline struggling, the stress hormones can make it worse and make it more likely to need a c-section too. So you can have a baby that is more likely to be doing poorly as well as needing a c-section simply from uncontrolled pain.
I don’t have the links for these two studies right now but I’ve posted them before on the site.
Being in so much pain that you can’t function is debilitating if you’re not giving birth. It’s extremely hard to give birth when your pain is not letting you mentally or physically function. Some women have less pain in childbirth, some women have higher pain thresholds or they have a shorter labor and have expended far less energy when they get to the point of actively pushing. But not every woman can get to that point and not every woman even wants to risk being exhausted and unable to function physically or mentally before pushing out a baby and that’s what epidural choice is all about.
How is it safer to be far away from an OR if you do need a C-section?
I don’t want to be divisive. I want to be inclusive. Truly.
I used to believe many of the things you do. I trained to become a CPM, I had my own children at home.
I no longer believe the things I believed because I started to look at the evidence and statistics critically and not emotionally.
Emotionally, I wanted all the midwifery and home birth beliefs to be true – and it became very hard to hold on to those beliefs in the face of factual information.
I see things much, much differently now. And that is what I would like to share with you.
Well, sure. Let’s see those stats, comparing healthy women with good prenatal care who birth at home (planned) vs healthy women with good prenatal care who birth at the hospital (planned) with EFM and epidurals. Let’s see the stats of live births with no complications.
I don’t know many doctors who *don’t* act in the best interest of mom and baby. That’s usually why they went into OB in the first place. The fact that they have to practice preventative medicine (and have malpractice insurance to cover their rears) compared to your usual homebirth midwife who doesn’t, and who won’t lose her shirt if your baby dies or has life-long issues, makes a huge difference too.
Better? Safer? Deliver in a hospital. It’s better and safer.
(Signed, CNM for years, no longer practicing for many reasons.)
Didn’t MANA publish stats using those populations and show that home birth is more dangerous even if you are healthier?
Could you explain how homebirth is statistically safer than hospital in Texas if you disregard why the stats are what they are? I really don’t know what that sentence means.
Also, of course the reduction in the availability of abortions in Texas is going to increase the section rate. Some women who are themselves ill or who are carrying a foetus that is, are now having to carry to term where they wouldn’t otherwise have chosen to, and for some of those conditions ELCS is indicated. You end up with more sections when you reduce the ability of women to terminate for health reasons, which is what has happened in Texas because it’s harder to get a provider.
Statistics is indeed a thing. A woman is more likely to be induced if she or her child have a problem. And are all those Texans enjoying full prenatal coverage?
Funny how the raise in maternal mortality dovetails with cuts to Planned Parenthood too…
Pregnant women in Texas (I don’t know how this works in the rest of the country) are automatically eligible for Medicaid. The problem is that most doctors won’t take Medicaid patients because a) reimbursement is a joke, b) moms on Medicaid are statistically more likely to have health problems, and ditto their babies (I know, shocking!), and c) Texas is a huge medical malpractice state. Basically, a doctor who takes on a Medicaid patient increases the likelihood that she’ll get sued for adverse outcomes that may well not be her fault at all while not really making any more money. At the same time, though, moms who are on Medicaid are far more likely to NEED really excellent medical care than their well-off counterparts. I’m not entirely sure what the appropriate solution to this clusterfuck is.
During my first pregnancy, I got referred to a MFM specialist whose client base was almost entirely public assistance patients. They drug-tested me without my consent, something I did not know until I got sent the obscene bill for the testing, as they had sent it to a lab not covered by my insurance. When I called to ask what the hell was going on and why did they test me for heroin et all (needless to say, I wasn’t on any drugs) without my permission or without checking on which lab to send it to, the office manager actually said, “You don’t understand. Most of our patients here are Medicaid patients, so they’re probably on drugs and that’s why we test everyone.” Charming, no?
lovely.
Very.
Ugh! I hope they didn’t make you pay for that.
The issue was it wasn’t really the lab’s fault–separate lab, all they did was process the sample that had been sent to them–so I was in a bit of a tight spot with that. However, when I called the lab, they were very understanding indeed about the situation. With my insurance, it’s nearly 100% coverage if it’s in-network, but no coverage out of network–and they were out of network. They’d had the same issue with this particular office not checking insurance before sending samples before, so they offered to take $100 of the $1300 bill and call it a day. I thought that was more than reasonable and agreed.
Ugh, owch.
Pro tip: they do.
Statistics are indeed a thing … and what they show, over and over and over again, is that homebirth kills women and babies who would have lived in a hospital. It also maims them- the percentage of babies who are born with severe brain injuries from homebirth is just staggering, while in a hospital that distress would have been seen sooner and a C-section performed.
An *unnecessary* c section, Feminerd. Remember, unless someone’s *life* is emergently in danger, a c section is unnecessary. Brain function doesn’t count.
You;re far too lenient. Just because someone’s life is in danger doesn’t make the section not unnecessary.
Yea, even after a baby has died in childbirth, you can’t even say that a c-section was necessary. After all, some babies just aren’t meant to live.
Maybe my c-section wasn’t “necessary” since only one twin was in distress. One baby is good enough, right? I mean, as long as it comes out vaginally.
Only if you exclusively breastfeed that one. Otherwise the whole thing was a wash.
Even in Europe, where homebirth with real, medically licensed midwives is a thing to be encouraged, homebirth is still more dangerous than hospital birth. It just isn’t as safe, because when things go awry, there is precious little time to deal with issues before serious injury/death occurs. Cord prolapse, placental abruption, uterine rupture, shoulder dystocia, PPH, 3rd and 4th degree tears, OP presentation, amniotic embolism, meconium aspiration, breech presentations, cervical tears, GBS positive mother, short umbilical cords, nuchal cords and knotted cords to name some complications that need varying degrees of medical intervention so that everyone comes through with the best possible outcome. No one thinks those things will happen to them and they don’t happen until they do. Then, time is critical. Would you like to ride to the hospital with the midwife’s hand up your vagina holding your baby off the prolapsed cord during labor? How long is that ride going to be? How about a massive PPH? You can’t get a blood transfusion at home and trying to get an IV into a dehydrated/low blood volume person is challenging at best. Plus, they have to type and cross-match your blood when you do get to the hospital. GBS positive and no antibiotics during labor? Um, no. Don’t want to roll those dice.
The CS rate is not too high. There is no way to know, prior to the CS, that one is “absolutely necessary”. Things start going to hell, the doctor is going to recommend a CS as the quickest, safest way to get the baby out if there is a complication. Believe it or not, doctors want the best possible outcome for both Mom and baby and sometimes that involves a CS. A crash/emergency CS is a lot more stressful than a planned one and if a mother is exhausted from 36 hours of labor and little to no sleep, then the CS is going to be harder to recover from.
And there is no guarantee that vaginal birth will leave you and your vagina, rectum, peritoneum, pelvis, ligaments and muscles intact. You can fracture your coccyx, have 3rd and 4th degree tears, stretch/damage nerves, rip muscles, and have other pelvic floor damage during a vaginal birth. Rectoceles, urinary and fecal incontinence, sexual problems are all risks of vaginal birth. If you have true informed consent about the dangers/risks of home vaginal birth and you opt for it, that’s on you. But to say that homebirth and vaginal birth is inherently safer and better all around is foolish.
I don’t have a lot of patience right now. A friend from childhood is in the ICU right now, and has been for a week. She developed acute fatty liver disease of pregnancy, and despite a stat c-section, her son was stillborn at 36 weeks. She has been transfused three times, and while improving, remains critically ill. Natural childbirth and typical CPM practices would surely have killed her. This condition comes on extremely fast, is very rare, and mimics other conditions. Only a true expert can diagnose it, and even with rapid diagnosis and ICU care, 18% of women will die. The mortality rate for their infants is even worse.
I don’t know how old you are or what kind of shape you are in, but if you are in line with the overall demographics of the birthing population of the United States, you are more likely to be overweight, older, and to have a preexisting condition that used to preclude pregnancy. Even if you aren’t, that’s no fucking guarantee that you won’t have problems. I’m also wondering why you feel as though you have no agency when you deliver in a hospital. Are you incapable of saying no, or does the fact that doctors will tell you that your baby could die if you refuse an intervention actually have an impact on you? Do you know how ungodly selfish you sound? Nobody can force you to have an epidural in the hospital, so if you got one, it’s no one’s fault but your own. You have zero evidence or statistics to back up your claim that the baby is “far SAFER” without epidurals or induction; in fact, the evidence demonstrates the opposite. C-section is actually safer for the infant.
I had a “natural” birth the first time. I would never willingly do it again, but it can be done; women with no options do it every single day. It sounds like you’re making excuses for your own inability to tough it out. Childbirth is excruciating, and I for one think it’s idiotic to expect empowerment through a process that you have no control over, but if you think you should be able to do it, take some responsibility and quit blaming the hospital.
Well, clearly labors are more painful and harder to recover from with use of epidurals and c/s. It has nothing to do with *more painful labors* needing more epidurals and more problematic labors requiring more c/s, it’s all the intervention’s fault. Also, “I’m not saying it’s bad, it’s just far less safe for your baby” is the most passive-aggressive horseshit I’ve ever heard.
Her head would probably explode to learn that my unmedicated birth was a horrific recovery and that I would have preferred a c-section. I’m sure she’s never had the joy of a cervical laceration, pph, and manual examination of the uterus without pain meds though. So much for “natural being better!”
Well, see lower on the thread, she’s “very healthy” and probably more responsible than the typical woman, certainly the typical American woman. You probably caused your problems by not being as healthy, or something.
Well, I am an asthmatic. But I didn’t know that asthma affects your cervix, lol! Otherwise, I was very healthy though. No GD, healthy pre-pregnancy weight, gained about 30 lbs. total, no GBS, etc.
Of course it does! The constricting of your bronchioles affects the other “constriction zones” of your body. You just needed to relax and intone long “OOOOHHHHHHMMMMMM” sounds to help open all the sphincters in your body. “Cause, you know, Ina Mae says that the cervix is a sphincter and all. /sarcasm
yeah, and if you trusted your lungs more you probably wouldn’t even be asthmatic. I bet the lungs are sphincters too.
Oh stop both of you! You know that asthma is because she had a controlling parent and she has control issues and if she would just be more calm and zen, her lungs could work. Stop using interventions like inhalers! You need to heal your anger at life, not rely on Big Pharma as a crutch! Louise Hay says so! (Snark)
Oh god, I went briefly to prenatal yoga because I’m the world’s most inflexible person and the instructor literally told us that about saying ohm in labor.
Yeah the throat/cervix connection. Supposedly if your throat is tight, you can’t speak up for yourself and your cervix won’t dilate. So only you can be to blame if you submit to an intervention and end up with stalled labor.
Well, everyone knows that throats operate on the same biochemical changes as the cervix. I have to wait for metalloproteases to break down the hard matrix of my throat before I can talk. No wonder I like email!
Completely OT but I have been singing the Red Dwarf theme all morning….wonder that THAT says about me
https://www.youtube.com/watch?v=PHSRbD_69yk
https://www.youtube.com/watch?v=E4TLto-nKfU
And yet people are allowed to clear their throats into a tissue on the bus in public, but whenever I try and do the same with my cervix I’m asked to leave. Shocking double standards there.
It’s because they’re both sphincters! (Ha ha – I’m remembering an old post/discussion about whether the cervix is a sphincter – might as well claim the throat is, too).
I remember that post too.
My yoga instructor was sweet but not so bright. Half the class was Indian women, likely here either to work for Intel or because their husbands do, so engineering types. I always wondered what they really thought of the more woo-ey aspects of the class.
Wait what! what if you are deaf and mostly use ASL (or equivalent) what if can’t speak? you don’t have a voice box/are mute? Do they think you then can’t go into labor, that your cervix won’t dilate all by itself? I’m getting a headache think about this.
Oh, you know that people who are differently abled don’t count to them. Unless it’s a paraplegic who wants a home birth, but she still has to be pretty and be upper middle class. If you can’t “vocalize”, if you aren’t able to do visualization because you have never had sight, these people who claim to be “advocates” will pretend you don’t exist. They specialize in first world birth problems
Whaaaat?
F that. I howled like a wolf, literally, in my labor. Because i wanted too and the faces people made, made me feel better.
This genuinely made me laugh out loud! Too bad I didn’t think of that; it’d have been kind of funny
I even had a wolf figurine as my ‘focal point’, and a section in my birth plan all about how much i was going to swear.
As much as i could, i had fun.
Plus, she sexually assaults women while they are giving birth. She’s awesome!
This shouldn’t even need a disclaimer as being sarcasm.
Even my “smash and grab” c-section that was performed to save my life after pre-e was rapidly progressing to full blown eclampsia was an easier recovery than my vaginal delivery. Of course, I had a epidural, which had worn off by the time the doctor had to shove his arm up my hoo-ha to unstick a stuck baby who wasn’t budging even with forceps and a vacuum, but hey, it must have been the epidural earlier in labor that made it so difficult.
The first few days after my C-section were hard. But then again, I went into the c-section after pushing for 1h30 and a failed forceps attempt (and at this point, my epidural had wore off) and I hadn’t slept in 36 hours.
I had never been so exhausted and in so much pain as I was before that c-section. (they didn’t even gave me the post-op demerol because I was just SO out of it with exhaustion) So it’s unclear what part of my recovery was the c-section itself and what was the failed VB.
And despite all this, my recovery was better than my SIL who ended up with a 3rd degree tear from her VB.
And I’m 100% getting a planned c-section for future pregnancy. No way in hell I’m trying to VBAC, Screw the ‘ideal’ c-section rate :p
Her comments on other blogs include facts about being a missionary in South Africa and having 11 children. She probably thinks that everyone is (or should be) just like her.
For someone claiming to be so educated, it’s interesting that she doesn’t know that being a grand multip is a risk factor for PPH.
She claims to have a degree, but she may have gone to a religious (not in a good way) university. You know, the kind that teaches creationism and won’t mention evolution.
11 kids? Seems a fair bet (if true).
It’s probably true, she is LDS.
Now this is all I can think of. “I have a degree… in science!”
https://en.wikipedia.org/wiki/Ask_Dr._Science
I think my Ask Dr Science pin is at work.
I have a Masters Degree…in Science from Dr Science. I have a diploma and everything.
That is AMAZING. You’re my new hero.
At one point, I had Dr Science’s autograph
In addition to your Pablo Midwife certification? You are full of wonders
https://uploads.disquscdn.com/images/e29e5e3167e03cec2db40bd41cec1c4403643cff7438b65240ef18debe485e31.jpg
I find the level of misinformation about c-section recovery rather bizarre. A friend of mine recently panicked that I shouldn’t be helping to carry my daughter’s buggy upstairs because of my c-section wound. To put that in context, my daughter was born considerably more than a year ago!
Meanwhile, the same friend was indoctrinated into believing that vaginal tearing during her first child’s birth was her “fault” for pushing wrong, and not just an occupational hazard of pushing out a 10lb plus baby.
Don’t get me wrong: all things being equal, I can see why most women would rather avoid surgery if they can. But how are women in the UK supposed to make informed decisions about childbirth if they’re being taught that (i) c-section carries the risk of your scar randomly bursting open after mild exertion 15 months later, and (ii) vaginal birth has no risks at all (unless you’re a silly woman who screws it up)?
Love to you and your friend. I had a dear friend lose a baby recently, too. And, I second nearly everything you wrote above.
That’s fine, Britt. You go ahead and increase the chance that your babies will be stillborn or brain damaged. More room in the top universities for my kids.
Your extreme privilege is showing.
It could be the fucking dictionary definition of privilege. “There is a great deal of pressure in a hospital to do little things that aren’t in my best interest.” No mention of the baby’s best interest. That’s telling.
WOW, invoking the Texas statistics which are *commonly known* to be due to failing prenatal care, lack of access to healthcare, and shuttering of places like PP, to say that LESS active care should be applied to obstetric cases. That’s despicable.
oh, the irony. Because if you give birth at home in Texas (or anywhere else in the US), you might as well BE giving birth in Oman.
Are you a doctor? A health administrator? I’m asking because “pro tip” generally means it’s coming from a professional.
Nah, these days pro tip is just shorthand for “hey, this works great because I’ve done it a lot!” like the newest one that was posted on reddit and passed around, about storing fresh greens in a ziploc bag with a paper towel to absorb excess liquid and keep the greens from rotting as quickly. Not for the bagged lettuce mixes you buy but the heads of lettuce you buy and make into salad yourself.
Little pro tip here: I’ve been doing that for 20 years. But hey, it’s brand new information to the world!
I also live in Texas. The CPMs here are mostly amoral, untrained lunatics. I looked into a homebirth, and was horrified when I started Googling potential midwives’ names or looking up their records.
You might remember that picture of the midwife riding an inflatable swan to a delivery in the Houston area, Cathy Rude? She’s a particularly prime example. In 2010, she nearly let a mom bleed to death because she had her labor at home in a hot tub for THREE HOURS after determining that she had had a placental abruption. Only after mom bled out for three hours, this midwife decided to transfer her to a hospital via private car. Baby Sam suffered a severe brain injury from which he died a couple of years later. Had mom been transferred to the hospital when she first saw blood, Sam would be alive today.
What happened to Cathy Rude? Was she charged with manslaughter or negligence or anything else? Did she have to pay for Sam’s extensive and expensive medical care that he needed as a result of her insistence on a home birth? Nope. She got six months’ probated suspension from the board, which was comprised entirely of her friends and coworkers. That’s *it.*
I also interviewed one midwife who told me she carried Pitocin and such with her at all times in case of an emergency. How did she get it? By, and I am not making this up, driving down to Mexico and bringing back boxes of the stuff from questionable pharmacies there. Nice.
One last question for your consideration. If your baby’s oxygen supply is compromised due to uterine rupture or placental abruption, you have 4-6 minutes until permanent brain damage occurs. Can you get from your home to an OR table in 4-6 minutes?
If you don’t want an induction or an epidural, that’s your right, and you can tell your doctor so. But if all hell breaks loose and something happens to you or baby, no home is close enough to a hospital to save your baby.
The “discipline” for one Texas midwife was writing an apology letter to the family whose baby she killed. That’s it. But hey, Britt says it’s safer so she must be totally ok just getting an apology if something goes wrong.
I would hazard a guess that that was one hell of a passive-aggressive letter. “I’m sorry your baby just wasn’t meant to live,” much?
I wrote a blog deconstructing one of these “apology letters” in the wake of the death (murder, IMO) of Gavin Michael. It’s at http://kumquatwriter.wordpress.com (I can’t pull the whole link because I’m at work right now).
Heck, you can even refuse a c-section if you want to in a hospital. You can refuse blood if you’re bleeding out from postpartum hemorrhaging, and you can let yourself die. So all this crap about not being allowed your own choices in the hospital is fear mongering bullshit.
Totally in favour of hospitals here; I just have a question:
If you show up at hospital, especially in an emergent situation, if you are unconscious and nobody can reach your power of attorney; let’s say you don’t have any ID on you because you were in a severe car accident and they couldn’t find your wallet.
I have been under the impression that they do everything to save your life because until someone shows up with a legal document forbidding doctors to do so, the assumption is that the patient WANTS everything possible done to keep them alive.
Is this accurate?
This is pretty accurate for the US.
Well, unless you are at a Catholic hospital. Then they may choose to not do a life saving procedure if you are pregnant. https://www.aclu.org/blog/speak-freely/one-nations-largest-catholic-hospital-systems-says-it-can-deny-women-emergency
“The hospital sent her home — not once, but twice — while she was in excruciating pain and developing an infection. Only once she began to deliver during her third visit did the hospital start providing care.”
I’ve said it before and I’ll say it again, it terrifies me that Catholic hospitals are a thing that exists. If you’re Catholic, fine, refuse any care that violates your beliefs. Don’t refuse it for me.
Giving birth at home will not reduce your risk of death in childbirth.
Is 30% the primary section rate or does it include repeat C-sections. Is that the rate for a university hospital that handles all the difficult cases (twins and high order multiples, placenta previa, mothers who started their pregnancy with a heart condition, older or diabetic or with high blood pressure, or obese.
Is the reason poorer women in Texas are more likely to die in childbirth because they don’t have access to good prenatal care and prevention and treatment for their other health problems? This would seem to call for more medical care not less. Women who have C-sections are often suffering from additional pre-pregnancy helath issues , what were their risks going into the C-section?
Is 30% the primary section rate or does it include repeat C-sections.
It includes repeats. The rate is counted per all births, not per all first births.
Statistics exist and they also show homebirth is far UNSAFER for babies than hospital birth, you should look it up. There are many papers on american homebirth and also you could look up the NICE guideline that specifies maternal outcome is similar but perinatal death is higher (even in a national health system with all kinds of safety and referral protocols).
I appreciate the 600 number on Texas childbirth maternal deathrate but an absolute number is no help. To put into perspective you need a nº of childbirths total, since it isn’t the same if there were 1000 births or 100,000 (again, statistics, as you are such a fan). Also it would be interesting to know the causes of those deaths, because given the high rates of chronic illness in the USA (high blood pressure, diabetes, cardiac disease, obesity, etc) and specially in Texas, that might actually have more to do with it than with the care given at a hospital. A helpful example of how you should frame that data: my hospital (in Spain) has had 1 maternal death in the past 5 years, we have 3000 births aprox. per year. So that means we have a 0.00006% maternal death rate. THAT is how you do a statistic you can compare to another center or country. Now it’s your turn to do the math correctly, if you have all the data necessary (obviously).
It’s even more complicated than that. The other difficulty is which deaths are “counted” as maternal deaths. I believe that deaths within a year of childbirth are counted in the US, and things like overdoses and homicide are included.
That’s for infant mortality… but I believe they recently changed the way maternal deaths are counted, in a way that appeared to create an increase in maternal mortality?
Did I screw that up? Sorry. But yes, I know they changed the way maternal deaths are reported in a manner that appeared to “cause” a sudden increase in deaths; there was an article in the Green Journal by Joseph et al discussing this.
So this is what DOESN’T fit into this picture. First of all, midwives should be caring for low risk women only.
44 babies died out of 17,000 “low risk” term births.
About 4,000 women transferred care prior to the onset of labor, their outcomes were not recorded.
A few midwives admitted to dumping patients at the ER and running. They did not find out afterward whether the baby survived.
15% of mothers were diagnosed with postpartum hemorrhage, several times higher than the hospital rate. (Active management of the third stage of labor is a good thing.) ((this math was calculated by a college professor and gives a better picture of what the numbers presented in the picture really mean)) #homebirth #notburiedtwice #midwife #whynothome #stillthinkhomebirthissafer
https://uploads.disquscdn.com/images/7a5cb9219c1c219153d08b3d63dc7f7510a706b5aa602f0d67970d69f274469b.jpg
Homebirth is way less safe than hospital birth.
You can 100% give birth in a hospital without an epidural. You can also refuse induction if you want to (but science actually says that induction is often much safer than waiting)
For example, my water broke before my labour started. My OB was totally fine with waiting a while to see if it would start. It didn’t. And induction turned out to be safer.
600 women have died out of how many? You can’t just point out to absolute numbers without any context and think it’s proof of anything. And yea, childbirth is dangerous, which is why you’d better do it in a hospital if you want to have the highest chances of making our alive and have a living baby. Homebirth statistics are very clear that they have MUCH more dangerous than hospital birth.
Indeed, I seem to recall giving birth in hospital with no epidural myself. Against my fucking wishes, I might add, but I can assure all readers that it’s possible.
My mom had to go through 3 inductions without epidurals. Apparently back then, inductions didn’t get them because of the bullshit belief it slowed labour and made the induction less effective.
When she came in for induction for her 4th one, she outright refused to let them put the IV in until they gave her a freaking epidural. Took a few hours, but eventually she got it.
So yea, you can also refuse induction while in hospital.
I also had to sign a consent form for my c-section. I 100% also could have refused to get one.
Yep, and good for her. I had to sign one too, despite it being a Cat 1.
I seriously doubt your number of 600. In 2011, there were nationwide only 702. “In the United States
Of the 1,751 deaths within a year of pregnancy termination that occurred in 2011 and were reported to CDC, 702 were found to be pregnancy-related. The pregnancy-related mortality ratio was 17.8 deaths per 100,000 live births in 2011.
Considerable racial disparities in pregnancy-related mortality exist. In 2011, the pregnancy-related mortality ratios were
• 12.5 deaths per 100,000 live births for white women.
• 42.8 deaths per 100,000 live births for black women.
• 17.3 deaths per 100,000 live births for women of other races.
The graph below shows percentages of pregnancy-related deaths in the United States in 2011 caused by
• Cardiovascular diseases, 15.1%.
• Non-cardiovascular diseases, 14.1%.
• Infection or sepsis, 14.0%.
• Hemorrhage, 11.3%.
• Cardiomyopathy, 10.1%.
• Thrombotic pulmonary embolism, 9.8%.
• Hypertensive disorders of pregnancy, 8.4%.
• Amniotic fluid embolism, 5.6%.
• Cerebrovascular accidents, 5.4%.
• Anesthesia complications, 0.3%.
The cause of death is unknown for 5.9% of all 2011 pregnancy-related deaths.”
I can’t find the source of Britt’s 600 number but apparently the higher rate of maternal mortality in Texas has a lot to do with poverty, racism and lack of access to good health care (surprise, surprise, not…)
https://www.thenation.com/article/the-story-behind-the-maternal-mortality-rate-in-texas-is-even-sadder-than-we-realize/
OK found it , except it’s very poorly sourced:
https://www.theguardian.com/us-news/2016/aug/20/texas-maternal-mortality-rate-health-clinics-funding
“From 2000 to the end of 2010, Texas’s estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.”
Note that 600 number is from 2010 to 2014 NOT over a single year.
“Indeed, the report said it was “puzzling” that Texas’s maternal mortality rate rose only modestly from 2000 to 2010 before doubling between 2011 and 2012. The researchers, hailing from the University of Maryland, Boston University’s school of public health and Stanford University’s medical school, called for further study. But they noted that starting in 2011, Texas drastically reduced the number of women’s health clinics within its borders.”
“In Texas in the last few years 600 women have died in childbirth.”
While Texas has issues with its medical coverage (or lack thereof), this number seems awfully high given the stats that Karen mentioned. Could you give a citation, please?
The baby is not “FAR safer” in vaginal birth over c-section or without an epidural. Try again.
I used to attend ICAN meetings in order to prepare myself for the healing VBAC I was entitled to. I was also taught to fear the risk of death to mother following a c/section. However that risk of death is complicated by pre- existing health issues suffered by the mother that are not c/ section related ( obesity, asthma. high blood pressure,maternal age etc…) Sickly mothers are offered c/sections in order to enhance the chance of their living through child birth. But we can not always out maneuver death.
I don’t think epidurals are bad or induction is bad or c-sections are
bad. I don’t think any less of anyone who is in that situation. I’ve
been induced and had epidurals. I just recover FAR better when I don’t.
The baby is FAR safer (there are statistics…it’s a thing).
Just for the record I don’t think any less of anyone for going with or without pain relief, or wanting or not wanting a c-section for themselves. But I do have to point out that the statistics on c-sections show that they are safer for babies than vaginal birth. The risk in a c-section is on the mom, while in a vaginal birth it’s mostly on the baby (“mostly” because mom does run one risk that is exclusive to vaginal birth, namely the possibility of severe tearing).
OT: I await congratulations. I’m just coming from a recent exchange with an anti-vaxxer on the Intruder’s Facebook page (here goes my determination that I only use facebook for work). And I managed not to tell him, “Well, just go and get measles already if you want to, it isn’t as if I care!” He rushed in the comments (we’ve just had a measles death here) to start recommending lack of fear for mommies because it’s a small thing that hydration and rest will fix. And he’s fixated on not being blamed if his unvaccinated kid gives measles to a friend’s newborn and the baby dies. He’s all about “my choice, I am not guilty!”, conflating choice with not being told that what he’s doing is dangerous.
I demanded stats in every post. I didn’t get them. Naturally! I managed to be as polite as reasonably possible. Not a single, “Just go and get measles if it’s so innocent.” So proud of myself.
The measles shot is a sore spot for me. Amazing Niece still can’t get it thanks to allergy. We’re counting the days until this goes away. The potato allergy seems on its way off. Eggs next!
Okay, fanfare please. I’m a fairly recent reader so a while ago I decided to take the time to catch up on older posts here and I’m finally finished. I started in 2014 and worked forward because I figured information prior to then would be repeated if it was still relevant. So now, I wish to present to you (in no particular order), what I found to be the top three most outrageous post topics.
1. The homebirthing mother who was so proud of her accomplishment that the death of her baby was mentioned as sort of an afterthought.
2. The lactivists who suggested that even a woman with NO BREASTS might be able to lactate, perhaps through her armpits.
3. Kate Tietje begging parents not to share stories about kids with vaccine preventable diseases because it’s “scary”.
I had no idea I shared a planet with people like these. On a positive note, I want to thank Dr Tuteur for writing such excellent articles and for all the awesome regular posters here who are willing to share their expertise in their varied subjects. I’ve learned a lot reading the comment threads as well!
Congrats :p
I went back and read almost all the posts when I found this blog as well.
My all time favourite outrageous post is the 40 years old insulin dependent diabetic, pre-eclamptic woman with HELLP syndrome that laboured for days and complain that bad doctors were pressuring her in a c-section she didn’t need.
Don’t forget how she was swinging between, “I’m a doctor and I know they were talking shit!” and “I’m a poor sweet compliant mom who faithfully followed her respected (by her) doctors’ wishes!” And how she called doctor friends in the middle of said emergency to have it confirmed that she could have her baby vaginally. And how she preened for proving her doctors wrong by pushing out her blue baby out of her mojo-jojo.
We’re happy to have you!
My personal unfavs are the posts about Christy Collins and Jan Tritten fiasco. The crowd-sourcing of an emergency, with homebirth midwives claiming all was great as the baby was DYING. Followed by the midwife blaming the mother.
God that was awful.
My favorite was the Australian midwife who crowed all over social media (and the real media, if I remember right) that her c section birth in which her baby survived was MORE traumatic than her five day long homebirth in which she lost her baby.
Charming.
Who was the mother who gave herself the Sophie’s Choice voluntarily and decided she’d rather lose the C-section baby than the VB one?
that was Kate Tietje.
Yes, that was it. Man, I feel terrible for her kids.
how about the one where a mother died in homebirth and the midwife said that she hoped the grieving husband would appreciate that she had a “really lovely spontaneous homebirth.”
Simply an opinion piece with based on nothing…Typical doctor who thinks that she knows best.
I agree with you to a point. If quality was consistent between designer labels and lower end labels I’d agree, but I’ve not found that quality remained consistent. In my personal experience, I got sick of replacing my bag every three to six months because they fell apart and splurged on a designer bag. That was Christmas of 2000. I just replaced that bag last January. I carry one bag all the time and rarely swap out (I do have a smaller bag for times when I don’t want my huge bag, but I use that bag maybe a half dozen times a year).
Unmedicated childbirth doesn’t have any sort of redeeming factor. There’s no long term medical benefit, no consistent advantage, nothing that can be pointed to that would make it somehow better “quality”.
Clarifying what I was trying to say here:
I don’t like the comparison because designer handbags, or at least some of them, do have redeeming factors like better quality, where NCB doesn’t, so I don’t like the implication that maybe it could.
I’ve been trying to think of a better comparison, and I just can’t. Euro cars that aren’t any better in carrying stuff and fuel economy than an economy car? Nope, the additional money gets you build quality and driving fun. Moto gear? Nope, Dainese holds up over time while Bilt falls apart. Even my hiking friend’s REI titanium spork – it’s lighter than a steel spork and sturdier than a plastic spork, so I can see why a serious hiker would find it worthwhile.
I think the shoes, below, are honestly the best comparison. Designer fashion shoes are generally ugly and overpriced, and often horribly uncomfortable; they only serve as a status symbol.
I think the handbag comparison works ok, because I see three levels of most basic retail goods, not just two. There’s the stuff that’s meant to be disposable, such as H&M or Forever 21. Then there are the decent brands, such as J Crew or Banana Republic. I have a Banana handbag I’ve carried off and on for seven years and it’s still in great shape and I continue to get compliments on it. From there you go to the designer brands and from what I know (my partner and I have both worked either directly or indirectly in fashion in the past) the designer brands and the mid range brands are the same bags, rebranded.
I totally agree that with many specialized retail goods, such as for a sport or hobby, you get what you pay for. My area of expertise is horses and when I need new gear, I go straight for the top of the line because I’m not happy with the quality of the lesser brands. My clients thought I was nuts paying $400 for a bridle when a $100 bridle looks just the same but after a year of daily use, the difference becomes obvious.
I’d maybe go for sports cars versus regular cars. I forget if it’s Ferrari or Lambourgini that’s famous for being pretty useless in an accident.
There are benefits and drawbacks to medicated and unmedicated birth. If a particular type of birth is what the individual chooses, and it works for that individual, that’s great. Another person might make another choice. I think my birth choices worked for me, but I don’t think they would be the right choices for everyone or that they’re better than others, just that they worked for my personal preferences.
Exactly – any benefits are personal, not absolute. Someone might find that a designer handbag gives them a degree of confidence in social situations that’s worth the price tag, and be in an SES bracket where the tag isn’t a huge deal – just like some women find the pain of childbirth bearable, and other concerns make unmedicated a better choice for them. In neither case can we say that the more expensive/more painful option has absolute benefits.
But (some) designer handbags have objectively better quality measures like higher quality materials and better workmanship than their Walmart counterparts. That’s the part of the analogy I don’t like. There’s nothing wrong with a Walmart bag. I place value on being able to carry the same bag for a decade or more, so it’s worth the upfront cost to me. Other women don’t want to spend that much at once, or can’t, or like to carry a whole bunch of different bags so that sort of thing is unimportant, and a Walmart bag is just fine for them. But that doesn’t take away the fact that under the same usage conditions, a Walmart bag is going to fall apart a whole lot faster than a Coach bag, and to me, that’s where the analogy falls apart. There are certainly personal preference reasons why an individual would prefer medicated vs. unmedicated birth, but there are no objective quality measures to indicate one is better than the other across the board.
That’s why I think it’s not meant to be Coach vs Walmart, it’s Fendi vs Coach.
Ahhh, that makes some sense. So not “standard vs designer” but “designer vs haute couture”. And on that comparison, I will totally agree.
I’m not much with names of designers, but I would think Gap vs Banana Republic… pretty similar price point and quality, but people might have reasons they prefer one or the other.
I actually find Banana Republic to be much better quality than Gap. Gap jeans fall apart after a year, but Banana Republic pants give you a few years. I just wish they made shirts for women with breasts.
Shirts for women who have breasts? That’s crazy talk!
Gap and Banana Republic are owned by the same company (also owns Old Navy).
What really bothers me is the premise that you are somehow more bonded with the baby and a more committed parent if you deliver naturally and the delivery “experience” will have life-long repercussions. I just want a healthy baby. My experience is that moms who have an epidural are able to be more present and initially bonded than the moms who are “shell-shocked” from the difficulty of a delivery without any help for the pain. The day my kids were born is a tie for most important day of my life, but that is one day out of the next 20,000 I will be their daddy. We are not geese that need to imprint on their mother immediately. I just want a healthy baby-and mommy.
I have to agree. I actually *didn’t* bond with either baby right after birth. I was exhausted, sick, and felt like crap. An hour with the baby in the nursery, and me dozing meant I was happy and alert when they brought out my baby (actually, I had to demand child 2 be brought to me, because the nursery nurse – someone I had worked with and disliked – told me they were keeping her in the nursery because she was breathing a little fast. I sat up, IV, Magnesium Sulfate and all, and said ” BRING ME MY BABY or I will come GET her”. They brought her… 🙂 )
I carry my school backpack. I can fit 2 gallons of milk and a bag of apples in it with room to spare (so long as my back holds out, lol)
Except I’ve never heard a woman scream in animalistic agony as a direct result of buying a designer handbag…
You will once she sees the price tag.
Except that with the exception of the super high end bags, the price winds up being a better value over time. The $300 I spent on a Coach bag wound up costing $18.75 per year over the 16 years I carried it. So it’s still not terrible in the long run.
Vimes economics.
Commander vimes ‘Boots’ theory. I miss Terry P, he died too soon with too many stories left untold. It’s so sad knowing that there will never be a new Discworld novel to read.
Yeah, I can relate. I paid (IIRC) $75 for a pair of Uggs thongs many years ago. Through rain, mud, snow, sand and many seasons, I’m still wearing them. Worth every penny. (They still look decent, though definitely worn).
Shoes, too. i went to Nordstrom the other day, saw a pair of Jimmy Choo’s going for nearly $1000 (The least expensive pair I saw went for $350). Quality wise, they were nothing special, as far as I could tell. And to top it off, they were fugly. Who the hell shells out a grand on fugly shoes?
“Who the hell shells out a grand on fugly shoes?”
I think there’s a parallel there with NCB. The shoes are distinctively fugly, and they cost a lot. Therefore, everyone will know that you spent a grand on shoes and be amazed (goes the theory). If you spend thousands on a doula, hypnobirthing, all the other accoutrements of upper-middle-class NCB, that’s just another form of status symbol. The fact that it varies from unpleasant to agonizing to have it is just like the shoes being fugly.
People who want to say “I’ve got a pair of Jimmy Choo’s! They’re uncomfortable, but I wear them so people can see I’m wearing Jimmy Choo”.
I always thought super expensive designer shoes must be so expensive because they were magically comfortable, and Carrie on Sex in the City made it look so easy to tromp around the city all day in 4+inch heels. It is not the case. I’ve stumbled upon a couple of pair of designer shoes for much lower than retail (I wear the same size that’s usually the display shoe!) and discovered that’s total BS.
A friend gave me a pair of Manolo Blahniks that she found uncomfortable, which in turn had been given to her by a client who found them uncomfortable. I wore them for less than 20 minutes before deciding I was going to break an ankle. On the other hand, I have Calvin Klein and Vince Camuto heels I find quite wearable (when I’m not pregnant…)
nothing was comfortable when i had to walk more than a mile or two when pregnant.
I’m 35+6 today and running errands in slippers.
I want to try Fluevogs. https://www.fluevog.com/ They have a contest going on right now, to win like 10k worth of shoes or something like that.
This may be one of my favorite posts yet.