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Deaths During Home Births vs. Hospital Births News Coverage: WTF?


This afternoon, I was talking to someone about home birth and midwifery, and they brought up a very interesting point.  They CONSTANTLY hear about home birth deaths, but they’ve never seen a news story about a mother or baby dying in the hospital.  There wasn’t a whole lot I could say about it, because truthfully, I haven’t seen any coverage of maternal or infant mortality in hospitals in the mainstream media, ever.  All I see related to the subject are broad statistics.

Why is it that when I search hospital birth death cases, the first few results are about HOME BIRTH DEATHS?!  Then the rest of the results are just lawyers who want to represent you in cases against hospitals, and one result about a hospital who got sued after mortality resulted from a birth there.  It’s kind of appalling.  It’s not like women and their babies don’t die in the hospital during and after birth.  It’s not like the interventions taken during a hospital birth never result in death of mother or child.  THEY DO!  I don’t want to scare anyone.  Please remember that birth anywhere carries great risk, but with well-educated, trained medical professionals present those risks are much less likely to result in Mom or Baby dying.  And midwives who are trained properly fall under that ‘medical professionals’ category.

I think it is supremely unjust that such high weight is put on home birth deaths.  The top result from that search for hospital deaths earlier?  Check it out here.  She died of cardiac arrest the day after giving birth.  Something that would have happened anyways if she had given birth in a hospital or even a birth center.  And 24 hours after birth, if she had done it naturally in the hospital, there’s a good chance she would have been at home already anyways.  This complication is exceedingly rare in childbirth, and isn’t something that would have been easily caught even if she were in a hospital setting.  And yet the article is titled “Death After Home Birth Raises Questions.”  I feel like it’s pure propaganda.  It makes me sick.  It also makes me fear for my future profession.  With such propaganda flowing freely around otherwise reputable news sources, how in the world am I supposed to find patients who will trust me to do the job I will be extremely well qualified for?!

Here’s the truth: We are all only human.  Both hospitals and midwives do sometimes make mistakes.  Bearing children carries risks.  Midwives and doctors alike do everything in their power not to miss anything.  We are all trained to recognize symptoms and treat them as quickly as possible.  While a hospital IS a better place to be if you show signs of those risks (which usually can be seen far before labor begins), unforeseen circumstances such as a postpartum heart attack or hemorrhaging can happen long after you would be discharged from the hospital anyways.  Every woman has a different comfort zone when it comes to where they give birth.  And that is perfectly fine.  But I urge EVERY woman to do as much research about alternatives to hospital birth as possible, and try to see past the vast array of propaganda.  Birthing at home (WITH A QUALIFIED MEDICAL PROFESSIONAL ON HAND) isn’t any more dangerous than birthing in a hospital.  Be careful when you look at statistics, and remember that the home birth stats almost always include unattended home births where the mother has not sought any type of medical care, which is reckless and extremely dangerous.  Example of one such study here.

Yeah.  I just went on a full-fledged rant.  Sorry about that!  But it is true.  There is a ton of propaganda out there against home birth that is just not true.  And it makes my heart hurt for women out there who end up going through traumatic births at the hospital because they weren’t properly educated on what home birth and natural birth really mean and what risks they truly carry.  I also feel bad that no one tells them that a hospital birth is just as filled with risk and just as likely to produce infant or maternal mortality.  It’s sad, but ladies please remember: it’s your job to educate yourselves about your options in childbirth.  And it’s a long process.  Don’t be ignorant just because the media is biased.  Use your noggins.  Do the research.  Do what is best for you, whether it’s hospital, home birth, or birth center.  Only you know which environment is best for yourself.

Anyone have personal stories related to this post they’d like to share?  Midwives who weren’t properly trained, doctors who didn’t explain all the risks, etc?  Share below!

 
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Posted by on April 6, 2012 in Rants

 

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Too Posh To Push? Then Don’t Get Pregnant.


Cesarean sections are a hot-button topic for me, and when someone has one electively and plans it months in advance it makes me so angry at them.  I have nothing against C-sections when they are used for the purpose they were designed for – to save a baby who is in distress during labor – but otherwise the practice completely repulses me.  These days, you hear supporters of women’s rights, feminists, celebrities, and plenty of other women going on about how we are strong, and we can do anything.  But I call BS on it.

There are very few women who consider themselves to be strong enough to take the childbearing plunge without the help of drugs or scalpels.  And for some reason, everyone sees it as normal, and safe.  News flash, ladies: a cesarean section is a highly invasive surgery with many possible complications and a long recovery time.  We, as women, are willing to put up with that (and with a cranky newborn in the house no less!), but why?  Every woman has her reasons.  Some are completely justified: if you have an STD that could potentially be passed to your baby, a c-section may be a good option.  Others are not: if you are scared of your hoo-ha being stretched and not returning to it’s previous tightness, a c-section is just selfish.  But women tell themselves it’s for the baby’s health, that they won’t get their heads misshapen by going through the birth canal, that the baby is breech and couldn’t possibly travel through the birth canal safely that way, that it takes less time to have a c-section.

For a list of things women tell themselves (and apparently women’s WEBSITES tell women), check out this horrifying slideshow from iVillage.  Please read the whole thing, then read what I have to say about it.  I had a lot of issues with this article, so I want to address each of the excuses presented in it.  They made a lot of false claims and claims that aren’t supported by good evidence.  So here’s the real story:

1. You’ll Know Exactly When Your Baby Will Arrive.  So having a baby makes your life a little unpredictable for a few months at the end there.  The reason there’s not an EXACT amount of time every baby spends in the womb is that every baby needs a slightly different amount of time to get ready to join the rest of us out here.  Just like they develop at different rates after being born, babies may fluctuate in the amount of time necessary before being born.  Scheduling your c-section may deprive your baby of the extra week he or she needed to develop fully. That can cause all sorts of complications, such as minor social and learning disabilities and difficulty breathing when first born, among many other things.  Is it really worth knowing the exact day and time you’ll meet your child if the consequences last a lifetime?

2. Your Baby Will Be Camera Ready. This is a dumb excuse.  Babies were meant to travel the birth canal.  That’s why their heads are soft, so they can fit.  It’s not bad for them, so the only reason this excuse is valid is cosmetic.  And are you really that shallow?  Also, even if the baby’s head comes out a little squished, it returns to normal adorable roundness after a few days.

3. Operating Rooms Have Gotten Cozier. There is nothing cozy about an operating room.  People die in operating rooms, and yes, that is a risk of cesarean section.  And yeah, your partner can stay with you now!  They can stay during vaginal birth, too.  Many doctors skim over the risks of a cesarean section, which is totally unfair to the woman going through the procedure.  Here’s a link to check out the risks yourself.  It’s not a pretty picture.

4. You Get A Little More Privacy.  Yeah, you don’t have 6 people staring at your hoo-ha. You do have someone’s hands buried inside your internal organs, though!  It’s silly to be self-concious about people seeing your intimate parts during labor – they’re all professionals, unless you’re at a teaching hospital where they let students watch, and even then you can tell those students to get out.  That’s your right as a patient.  If privacy is what you seek, though, think about looking into a birth center or even a home birth – us midwives try to be very discreet during birth, and are more open to having less people in the room if it makes you uncomfortable.

5. Extra Hospital Time Has It’s Perks. Really, who likes being in a hospital?  The food is horrible, your partner can’t stay the night with you (unless he’s willing to take on a very uncomfortable couch and/or chair), and you are in recovery from major surgery, meaning you will probably be on pain meds and have a more difficult time bonding with your baby and breastfeeding.  The reason you’re required to stay longer for a c-section is because you literally would not be able to care for yourself or your newborn in the first couple days without a support staff.  Vaginal births get to go home faster because they are already feeling like they can get up and do things, not to mention take care of their own baby.  And if you have a vaginal birth and don’t feel 100% after you go home, that’s what your PERSONAL support team is there for.  You just had a baby!!  You are the queen.  Ask your husband to take on a few extra things like cooking and cleaning while you’re recovering.  Ask some good friends and family if they want to come see the baby, and when they ask if there’s anything they can do to make your life easier when they come to check out the little ball of joy, don’t lie!  Let them know you’re too tired to stand at the sink and do dishes.  Tell them you’re craving a home-cooked meal but baby starts crying as soon as you set him down.  I guarantee that they will be all too happy to help – if they can hold the baby for a few minutes! 😉

6. You Get Treated Like A Queen. This should be a given whether you get sliced open or not.  After a c-section, you will almost definitely be unable to perform simple daily tasks.  After vaginal delivery, you can do what you’re comfortable with, and see my response to number 5 for the things you don’t want to do.

7. Everyone Will Take Your Pain Seriously.  You really do need painkillers after surgery.  If you have a c-section, take them.  However, you aren’t prescribed prescription painkillers after natural birth because you don’t need them, and they can interfere with the care of your newborn.  Are you really going to pick up your baby while you’re on Vicodin?  Some people would call that irresponsible.  Yes, you can have pain after natural birth.  It’s a given.  But those remedies that doctors recommend, such as warm compresses and sitz baths, are usually plenty to ease the discomfort.  And when they’re not, you can always call your doctor and ask what else you can do, or consult a naturopath who may have natural remedies that will eliminate your pain.

8. You’ll Get Extra Help With Breastfeeding. Whether or not you have a c-section, there are always options for getting help with breastfeeding.  Most cities have lots of support groups, if the problems you’re experiencing aren’t serious, and lactation consultants you can hire by the hour for more difficult cases.  They’re probably less expensive than the thousands you’re going to spend if you stay extra time in the hospital.  Also, the claim about the drugs here is wrong.  If you are given Percocet, Morphine, Oxycodone, or Vicodin, these can certainly be transmitted to your breast milk and do harm to your baby.  Most doctors will tell you it’s ok to take them, but there haven’t been many studies on the actual long term effects of these drugs on newborn children. There are theories that they can effect their ability to learn later in life, that they can make babies more susceptible to drug and/or alcohol addiction later in life, and even that it could cause minor social and learning disabilities.  None of these have been proven, yet, but correlations have been noted.

9. Everything Will Be The Same Down There. If you do your research, you’ll find that there are many ways to return your vagina to awesomeness after natural birth.  First of all, DON’T let the doctors slice open your perineum during birth.  Episiostomies aren’t necessary if you employ perineal massage before and during labor.  That muscle will never heal to the way it was if it’s sliced.  If it tears, it will heal properly but will take time.  I’ve seen two births so far, both pretty large baby boys, delivered naturally.  With massage, there was zero tearing for both women.  I’m not saying you will magically regain your previous vagina.  It takes work.  You have to be willing to do kegels and squats (squats strengthen your pelvic floor), and you have to accept that it will be a little wonky for about six months.  But your vagina is meant to have a baby pass through it, and it does eventually return to normal.  Many mothers actually report better sex after their vagina has fully healed.  This book may be of some help to you if you want that old sex life back after baby!  It’s also good if you’ve been having trouble with “leaking”.

10. You May Actually Like Your Scar.  Really?  Yes, it’s a visual representations of the life you created.  So is the actual baby.  Most women who have c-section scars are self-concious about them.  It can be difficult to come to terms with having a line across your stomach forever.  If you have to have a c-section for health reasons, then yes, the scar is something you can be proud of, because you went to great lengths for the health of your baby.  If you have a c-section because you’re scared of natural birth, it’s just a reminder of your cowardice.  If you have a c-section because a slippery slope of interventions put you there at doctors orders, it can actually be a reminder of a very traumatic, scary experience.  It’s generally hard for women to feel good about their scar, though.

11. You’ll Embrace Your Inner Tough Chick. I can name something harder than caring for a newborn.  Birthing said newborn naturally.  You want to be a tough chick?  Go through 3 – 48 hours of excruciating contractions and pop a bowling ball out of yourself- without painkillers.  Caring for a newborn while recovering from surgery is NOT a good situation.  And it lasts a lot longer than natural birth.  it takes 4-6 weeks to fully recover from c-section if there are no complications, much longer if you get an infection or another complication arises.  4 – 6 weeks of terrible pain while attempting to care for a bawling, screaming, breastfeeding baby sounds like a much more sadistic kind of hell than natural birth, in my opinion.

12. You Can Probably Try For Vaginal Childbirth Next Time. THIS is true.  And should be very much taken to heart!  If you have your heart set on natural childbirth for your next baby after a c-section, but can’t find an obstetrician willing to attend, seek out your city’s birth centers and midwives.  VBAC is possible!!!  Never lose hope in it.

13. You’ll Be Putting Your Baby’s Safety First.  This is total propaganda against vaginal birth.  C-section poses a much higher risk of complications.  The American Journal of Obstetrics & Gynecology published a study which concludes: “A planned cesarean delivery doubled both the rate of transfer to the neonatal inten- sive care unit and the risk for pulmonary disorders, compared with a planned vaginal delivery.”  How is this safer for the baby?  And the higher c-section rate hasn’t created a drop in infant mortality rates, either.

All in all, this article really struck a nerve for me.  Women should be provided the whole story in articles such as these.  Yes, vaginal birth is difficult!  There’s no argument from me here.  But Cesarean delivery has its own difficulties, and I personally think the risks outweigh the benefits unless there is a good reason behind the choice.  I’ll do a post sometime in the near future about the acceptable medical reasons for cesarean section, but it’s going to require a lot of research so it gets its own post.  For now, remember that you are a woman, and you are strong, and your vagina was built for having babies.  Don’t forget it.  And before you go to the hospital, for vaginal or cesarean birth, do your research on c-section.  Educate yourself about the risks, and good reasons a doctor can give you for a c-section.  Sadly, some doctors will recommend a c-section to a laboring mother simply because they’re going to be late to dinner.  They’ll give you an explanation which sounds reasonable, but if you’ve educated yourself you’ll be able to tell if there really is a problem or not.  I hope this is helpful to women who are on the fence.  It’s a very tough decision, and has a lot of implications.  I hope that I can prevent at least a couple women from making a decision they may regret.

 
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Posted by on January 26, 2012 in Rants

 

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A Very Interesting Article


Journal Article Review – Bipedalism and Parturition: An Evolutionary Imperative for Cesarean Delivery?.

Today, courtesy of The Navelgazing Midwife on Facebook, I found this piece on bipedalism and birth as something that makes birth dangerous to “both the mother and her young”.  As someone who has studied human evolution on a college level, I found this article fascinating.  There were so many things I saw that were untrue, or didn’t account for the pelvis size changing as the birthing mother changes positions.  I think the results of the study reviewed here are complete BS.  As midwives have noticed for many generations, mothers who give birth calmly and peacefully and let their baby go at his or her own pace, so long as he is not in distress, are usually quite successful.  They experience much less pain than a woman who is terrified in a hospital surrounded by OBs who want to slice her open and who make her feel like a bad mother when she doesn’t want interventions.  Hopefully in the coming years more research will be done which is unbiased.  I believe, in an unbiased study, natural, unhurried birth would be found to be the safest, least traumatic way to have a baby.  It’s true that sometimes things do go wrong, and we are lucky that in those cases women can turn to OBs and find the help they need.   Most species of mammals have the same issues we do with birth- stillborns, miscarriages, mutations.  We’re lucky we’re the only species who is able to help in those situations.  Stillbirth can be avoided in certain circumstances via cesarean.  Miscarriages after 20 weeks can be cared for in ICU and can survive.  Mutations can be rectified through plastic surgery, prosthetics, etc.  We are lucky to have these innovations at our fingertips.  But obstetricians need to stop seeing birth as an unnatural process.  Just because sometimes problems are encountered during birth doesn’t mean women who don’t encounter problems should be treated like they will at any moment.  We are powerful, ladies!!  Don’t let anyone convince you otherwise.

 
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Posted by on January 5, 2012 in Perspectives, Rants

 

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Why You Should Wait At Least Two Minutes to Clamp & Cut Your Newborn’s Cord


The common practice in hospitals today is to cut newborn baby’s cords immediately after birth.  The cord is usually still pulsating, which is NOT a good thing.  You see, the baby is still sharing it’s blood with the placenta at this point.  Until that cord stops pulsating, at least 1/3 of baby’s blood is still stuck in the placenta.  This won’t kill baby, but research has shown that it can increase iron deficiency and anemia.

Give the cord some time to get all the blood back to baby!

A study was done by Ola Andersson, consultant in neonatology at the Hospital of Halland in Sweden, and a team of researchers on 400 full-term babies who were from low-risk pregnancies.  Some of those babies had their cord clamped just ten seconds after birth, while others were given a full three minutes.

Results showed that the babies who were given more time were, at the age of four months, experiencing better iron levels and had fewer cases of neonatal anemia.  According to the study, only about 1 in 20 babies who received delayed cord clamping would suffer from iron deficiency.  Furthermore, there were no other health risks found to be associated with delayed clamping.

Based on this study, I can’t believe that this isn’t common practice in the United States.  But even some midwives don’t wait for the cord to stop pulsating.  I think this is an issue that is so easily solved, and poses no health risks, so I don’t see why anyone is waiting to fix it.  Take your baby’s health into your own hands.  Demand that the doctors wait to cut the cord.  Iron deficiency and neonatal anemia are serious problems!  If your child becomes anemic, they could suffer permanent mental and physical problems.

Give your baby his or her best chance.  Tell your doctor to back off for a couple of minutes, and stick to your guns.  You’ll get valuable bonding time with your bundle of joy before they’re whisked off to be examined, and your baby will have an easier time out here in this big world.

 
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Posted by on December 6, 2011 in Perspectives, Rants

 

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Home Birth: It’s Not Just A ‘Hippie’ Thing!


The first time I heard about home birth, it was in an article I read about a woman who had an unassisted home birth, high off her ass on LSD.  This was maybe 2 years ago?  I distinctly remember thinking “Damn, those crazy hippies.  Why would anyone give birth outside of a hospital?!  It’s so dangerous!”  Looking back on that, I feel like an idiot.  Obviously, there are going to be some women who choose to do crazy things like that, but the majority of home-birthers are just like you and me, only they want an empowered birth experience where they call the shots – something you can kiss goodbye in the hospital!  And as for dangerous, multiple studies have shown that it’s no more dangerous than giving birth in a hospital.  Take THAT, Obstetricians!

For some reason, most people today think that home birth is dangerous and insane.  It’s something that they expect a woman in flowy skirts and hemp sandals with dreadlocks in her hair to be doing.  That stereotype is a crock.  All types of women go for home birth!  Hell, Gisele Bundchen had a home birth!

Back in the day, home birth was the only way to give birth.  Medicine didn’t have a solution for women who really needed help.  That all changed when the field of obstetrics came to be.  The advanced new methods they offered were intriguing and piqued the curiosity of pregnant women everywhere- giving birth in the hospital became the fashionable, safe thing to do. In 1938, home birth accounted for half of births.  In 1955, fewer than 1% chose home birth.

In the 1920s, a doctor described birth at home:

You find a bed that has been slept on by the husband, wife and one or two children; it has frequently been soaked with urine, the sheets are dirty, and the patient’s garments are soiled, she has not had a bath. Instead of sterile dressings you have a few old rags or the discharges are allowed to soak into a nightdress which is not changed for days.

This experience is contrasted with a 1920s hospital birth by Adolf Weber:

The mother lies in a well-aired disinfected room, light and sunlight stream unhindered through a high window and you can make it light as day electrically too. She is well bathed and freshly clothed on linen sheets of blinding whitenes… You have a staff of assistants who respond to every signal… Only those who have to repair a perineum in a cottars’s house in a cottar’s bed with the poor light and help at hand can realize the joy.

Obviously, these days beds aren’t soiled that way, and I sincerely doubt most home births in the twenties were that unsanitary, either.  And women were completely abused by hospitals while giving birth – completely sedated, strapped down, and subjected to forceps or worse.  Advocates of hospital birth are excellent at making women feel embarrassed if they choose any other option.  These kinds of stereotypes were one of the many ways they achieved that.

Today, out-of-hospital births account for around 1% of all births.  27% of those are in a birth center, 65% in a home.  It’s crazy, because the treatment received by obstetricians in hospitals can be horrifying.  Personal acquaintances of mine have been bullied into interventions, given interventions without being asked, and walked out on by their doctor for saying no.  I’m certainly not saying every doctor does this – I’m absolutely sure most don’t – but even just a handful treating women in this vulnerable state in such a way is unacceptable.  Home birth is one of the ways to take back that loving, joyful birth experience.

I think it would be so much healthier for everyone if only high risk births (such as preemies, birth by a mother with an STD, etc) were attended in the hospital.  Low risk, normal pregnancies aren’t an emergency.  They don’t require all sorts of help to happen.  They just flow.  So, all you mommas out there: consider your options carefully.  It’s possible to do things your way at the hospital, and if you feel more comfortable there, great.  Go to the hospital.  But if you’re not comfortable with the idea, then explore other options.  Interview a midwife.  Tour a birth center nearby.  Research as much as possible.  You’ll know what’s best for yourself, girlfriend.

All that being said…Home birth rocks!!  I can not wait to have a child by laboring in my own bed and seeing all my loved ones anytime I want, eating as much food as I want (NOM!), and screaming my head off at anyone who doesn’t do things the way I want!  I can’t wait until I get to be that woman.  Until then…the plan is to help all the currently pregnant ladies who desire my help and give them everything they want!  It’s going to be a rush.

 
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Posted by on December 4, 2011 in Perspectives, Rants

 

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