BlogHer - MATERNAL HEALTH LEGISLATION - Comments

The vaginal birth is the one

maryadavis — Wed, 09 Jul 2008 19:11:59 -0500

The vaginal birth is the one that seems more violent for the child. Imagine his trauma trying to squeeze out. A C-section is less painful for both the mother and the baby. There aren't any big risks to this procedure. If given birth normally, the kid might present complications with the cord around his neck.
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security systems

Power, economics and the medicalization of birth

drumbeat — Mon, 30 Jun 2008 13:58:19 -0500

The more aggressive a culture gets the more that culture interfers with birth. Several themes have come up in the writings so far. What constitutes safety, and who has the right to determine safety and the type of birth.

As a midwife of many years, I learned that safety had little to do with a midwife's ability to practice in a medicalized system. Midwives had more than documented safety in providing safe and satisfing care. Midwifery care(being with woman) is ancient and modern. Medicine, specifically doctors, became involved in birth stating that they provided safer care because of a specific body of information that was held tightly within a male dominated educational system that prevented women from attending. Then birthing insturnments were highly protected and the public was lead to believe that technology provided them safer birth. Statistics did not agree with that and still do not agree, but we all know that statistices can be quoted for every point of view. By moving into technology our culture perceived that technology could control nature and this control belief got into the birthing scene. Our medicalized system does not allow for normal vs abnormal. When medicine, then liability, got involved in decision making, birth became pathology. As long as we continue to see birth as pathology there will be a domination of medicine in the normal process of pregnancy and birth. Yes, there are women who have medical issues that risk their life and their babies life. For these women we have an excellent medical care system. But the majority of women are healthy. Pregnancy without all the interference that technology brings would do well to stay away from medical perception that there is pathology in every pregnancy and birth. Women need to consider who they view as an authority over their body- is it medicine? or is there room for each women to be an expert of their own body. Pregnancy is more than the physical event that medicine has reduced birth to and every woman is aware of this. Yet pregnant women have been convinced that the MD knows more than they do about an universal female event- giving birth. It seems to me that women need to reclaim their own authoritative power in order to work in a system that sees them as pathology and dollars.

dolly

public nursing

MiriamAnton — Wed, 25 Jun 2008 18:05:49 -0500

I wonder if they have these discussions so much in other parts of the world (forgive me for lumping Canada in with the US here) but this issue seems so goofy to me. It's perfectly legal to lie topless on the beaches (and streets!) of New York, yet people get squeamish over the barely exposed nipple of a nursing mother??

I loved nursing so much that it's practically incentive for me to have another child. I nursed whenever and wherever I wanted. How people confuse this with exhibitionism or obscenity is beyond me. A hold over from our Puritan past perhaps? Moms who nurse in public are usually quite discreet. They typically cover up as much as possible without smothering the poor baby and tend not to overtly flash their nipples at the world. I don't remember any nasty looks or comments from my public nursing. But if rude on-lookers take issue I would just tell them not to look. Or how about "Sorry - I only have enough for one!"

In most states as far as I know, the law is on your side. My advice to those more timid with public nursing - find a quieter place when possible but do what makes you feel comfortable.

When baby is hungry and breast is full, nothing else matters.

TCMom — Wed, 25 Jun 2008 16:58:34 -0500

It never ever even DAWNED on me when breastfeeding my children that I could be offending someone. Consider that very self-involved of me but I guess it just didn't make sense. My baby was hungry and needed to be fed. We were all babies, we all got fed (breast or bottle, whatever) so doesn't logic follow that it wouldn't be a big deal if another being - one like YOU used to be - is being fed? Luckily, I was never hassled. Maybe b/c I had that look on my face like "What? Is my zipper down?" never thinking the issue was my boob being out. Or more often it was probably the look of "I am running on 2 hours total sleep, I am hugely engorged, this baby is starving and stressed and not quite latched on - DON'T CROSS ME." And they didn't, for their own safety. I really could care less about offending anyone, I was trying to nourish a life, you know?

A great point about actually having to state permission seems like it was something that wasn't ever there in the first place. Go Toronto with the best intentions but I can't believe we need a sign. I sure as hell didn't.

Caroline

http://morningsidemom.wordpress.com/

Breasts have many roles

Suzanne Reisman — Wed, 25 Jun 2008 16:36:25 -0500

I'm not disagreeing with you at all that breasts are meant to feed babies, but sometimes I think we should honor all the great things breasts do. They are there for sexual pleasure, when a woman decides that she wants them touched. They also are aesthetically pleasing. And, of course, when a woman has a baby, they are there for feeding. I just like to honor the whole thing, especially because calling out one of their functions as more valuable than the rest sort of indicates that those of us who aren't breastfeeding (for whatever reason, including that we don't have babies) don't have boobs that count. And I think boobs are too useful for that. :)

But definitely, feed away when the baby is hungry! That is one of the great things that boobs are there for.

Suzanne Reisman, Contributing Editor - Feminism & Gender
Campaign for Unshaved Snatch (CUSS) & Other Rants

They started out FUNCTIONAL!

AnissaMayhew — Wed, 25 Jun 2008 14:33:44 -0500

I nervously nursed my first child, casually nursed my second and by my third I was like a drunken girls gone wild video. But I do remember being terribly self conscious, feeling like everyone was looking at the lady with her boob hanging out in the food court of the mall. But, in all seriousness, when my baby cried, when he was hungry, everyone else could just BITE ME!

When did we forget, in the grand scheme of media, that breasts are not merely ornamental objects, they are not funbags of joy, as my husband calls them. They are meant to nurse our young, to provide the God given milk that is best for them and their bodies.

If I am nice enough to use a blanket to keep my nipples from poking your eye out, be kind enough to not bother me with your judgement that I am doing something "dirty" in public.

Anissa Mayhew

www.hope4peyton.org

How did it happen?

Vered — Wed, 25 Jun 2008 14:05:41 -0500

"Citizens have a right to not be exposed to breastfeeding in public."

It makes me sad that so many people consider breastfeeding as gross or obscene. Not sure how exactly our society got to this place, but it needs to be pulled out of it.

So I agree: a public education campaign is much needed at this point.

It’s been several years since I finished nursing my children, but the memories of nursing in public, of making a HUGE effort to cover myself, and still getting the occasional dirty look, are with me and are highly unpleasant memories.

Vered DeLeeuw

http://momgrind.com/

A place for both

Momshots — Wed, 25 Jun 2008 01:48:52 -0500

I am the mother of three; two birthed in seperate hospitals and my third birthed at home. All were good births. All had their own merits.

After my home birth experience, I don't believe I will ever birth in a hospital again. My home birth experience was 100% more satisfying than either of my previous births.

It saddens me to think that this choice could be legislated away. I believe that there is a place for hospital births. But I also think that the vast majority of hospitals treat pregnancy, labor and delivery as an illness instead of a healthy bodily process.

I firmly believe that midwives, birth centers and home births should remain a choice so that we can be treated with the respect that this process deserves. We're not getting it from the hospitals, that's for sure and now the AMA is certainly continueing with that trend.

Jessica

www.momshots.com

Education

lilmommythatcould — Mon, 23 Jun 2008 06:45:20 -0500

Very valid points here, coming in a little late. Maybe the key is to not dismiss Home Birth but for the goverment to look at ways to have safer home births, allow women to have the choice by making it a safer choice. I think were alot of anger comes is that the AMA is dismissing Home Birth altogether.

My first child I had in a hospital. I did not know what to expect. When it came to my second I knew my body and I thought of having a Home Birth. My Dr. was so supportive, he even stated he wished he could do home births. After hearing him state that I decide to stay with him through my 2nd pregnancy and delivered in the hospital, because I knew I could trust him.

http://lilmomthatcould.com/

I'm a homebirth believer

houndrat — Sun, 22 Jun 2008 15:35:27 -0500

Let's face it--our country's medical practices regarding labor and delivery are a little whacked. I mean,how many moms do you know that still labor and attempt to deliver in the supine position (flat on their backs), which doesn't allow for good pushing, doesn't utilize gravity, and doesn't do the pelvis any favors? Hospitals love to hook you up to those monitors, too, making it challenging to move around, and push drugs on you like crazy.

And our C-section rate is simply disgusting. Do you really, honestly think that one-third of women NEED a C-section? What the heck is wrong with us? Honestly, some doctors just want to fit everything tidily into their schedules, and by setting up a C-section, they can do that. Even WHO is on our case to get the rate down.

And don't even get me started on the induction rate. I think some doctors simply disregard that the fact that drugs can have side-effects. Uterus-bursting side effects. So if you're a day late, they start harrassing you to get acquained with Pitocin. Maybe if we could at least change the parameters of the "normal" gestation time for a first pregnancy, it would be helpful.

Am a biased? You bet. had my first child at a hospital and my second child at home. I had similar issues with both births (cord wrapped around the neck), but much different results. Due to a lot of misinformation and confusion, baby one ended up drugged out in the NICU at birth, while baby two did wonderfully at home.

I"m not saying that some births don't belong in a hospital---high risk pregnancies and the like---but I am saying that homebirths should remain a viable option.

And I think the medical field needs to approach birth as a natural occurence performed by healthy women, not a disease.

Debra Driza MSPT

My blog: http://www.houndrat.com

We must protect our rights for the sake of our posterity

mamabaig — Sun, 22 Jun 2008 00:30:23 -0500

It is vital that the public understands how the medical system is positioning themselves against midwives and homebirth.

I am the mother of 7 children. I have birthed in the hospital with CNM's twice, once at home with a lay midwife and 4 times unassisted. My home births were like apples vs. oranges in comparison. So different. I love birthing at home in my own surroundings, with my family present (but not in my face) and with no strangers. At home I am able to tune into what my body needs so that I can birth without overwhelming pain. At home my baby is better cared for as he/she is not exposed to ultrasound, electronic fetal monitor, germs, etc.. and I am not pressured to give medicines that are not needed.

Because of my age, I foresee in the future that I may want to call on midwives again, either at home or in the hospital, depending on the situation. I want that choice to be available to me, my daughters and future granddaughters.

The day this story broke I had been watching a hospital birth on the tv show A Birth Story before turning on the computer and being smacked in the face with the AMA's resolution.

You can read my thoughts about the show and the "resolutions" on my blog:
http://spiritledbirth.blogspot.com/2008/06/ama-blasts-homebirth.html

Just a few comments

Graceful Parenting — Sat, 21 Jun 2008 19:12:52 -0500

In my humble opinion, I think just about everyone is manipulating the numbers to their own advantage. My favorite is when home-birth advocates compare success of home births with hospital births when almost all high-risk, complicated pregnancies deliver in a hospital. Birthing centers won't accept women with risk factors, so they can't compare their success with hospitals who take on these cases.

My own personal truth and experience with the doctors and nurses who helped me with my difficult, high-risk pregnancy and births is that they genuinely did the best they knew how to help me and my babies. The weren't out to get me or do unnecessary procedures or make extra money.

I think the medical industry isn't perfect and it is a business and women need to educate themselves about their options, but what really bothers me is the sweeping generalities about the medical industry being evil. In at least my case (I won't use statistics, I'm just talking about me), my nurses and doctors were not evil, they helped save one of my twin baby girls and they were angels.

Carol Marie Ramsey
Finding balance and peace in parenting at Graceful Parenting

Tired of the horror stories

Sandradginzburg — Sat, 21 Jun 2008 14:05:47 -0500

I have to weigh in on this one just to say that I agree with the poster above who took to task the other poster who stated "I'd have probably stroked out if I wasn't in [a hospital] for my son's birth.". This is just such a ridiculous statement. The other poster is quite correct - you didn't give birth at home so you can't say what would have happened if your had.

It seems to me as if women love and need to justify all the horrifying things that doctors do them during and after they give birth so that they can come to terms with such a through violation.

But to make this point, I will chime in with a horror story of my own: I did give birth with a midwife in a freestanding birth center and I DID have a postpatum hemmorhage. The midwives calmly took all of the necessary steps of dealing with the situation including a call to the back up ob to discuss what was happening, IV fluids and careful monitoring. The situation resolved itself and I went home 12 hours later with my baby in my arms. I did not "stoke out'. I did not require a blood transfusion and I did not need a hysterectomy.

The scare tactics are what they are.

Point:

JennaHatfield — Fri, 20 Jun 2008 13:53:02 -0500

If mothers can "elect" to have c-sections, which are known to be LESS safe for mother and child (mother because it's major surgery and child because their lungs are not squeezed of excess fluid on the way out), then mothers should be able to choose to labor at home. It's really that simple. Their use of safety as an argument falls flat on its face when compared to unnecessary c-section rates in this country.

FireMom from Stop, Drop and Blog

Many false claims

Amy TuteurMD — Thu, 19 Jun 2008 23:58:24 -0500

One of the biggest problems with homebirth advocacy is that it is based in large part on mistruths, half truths and outright deceptions. Homebirth advocates repeat these false claims over and over to each other and no one ever bothers to check if they are true.

There are multiple examples of such false claims in the comments about my post showing that homebirth with a DEM has double to triple the neonatal mortality rate of hospital birth with an MD or a midwife.

For example:

"If homebirth is less safe, why is the country in the #1 spot one that 1/3 of their births take place at home. That is a SIGNIFICANT amount and their rates are considerably better than ours and clearly influenced by the homebirth statistics in their country."

The Netherlands does NOT have the lowest perinatal mortality rate. In fact the Netherlands has a HIGHER perinatal mortality rate than the US. I know that's not what homebirth advocates tell each other, but that's what the World Health Organization 2006 report on perinatal mortality shows. The country with the lowest perinatal mortality rate is Japan and they have virtually no home births.

"% of births take place at home in the USA...it's not the homebirths in our country that are making the rates higher than other countries, it's hospital births."

Actually, less than one quarter of one percent of births in the US are homebirths with a DEM. However, if the homebirth rate were to rise to 10%, homebirth would become one of leading causese of neonatal death, vaulting over most of the other major causes of neonatal mortality.

"All homebirths are not reported to the CDC"

That's false. The CDC data comes from birth certificates. If you apply for a birth certificate, the birth is reported to the CDC.

"In countries where homebirth is not seen as unsafe and were a large percentage of women have them, you see that they have much better results than the USA"

First of all, all other industrialized countries have midwives trained to a far higher standard than American DEMs. American DEMs could not meet the licensing requirements for any other country in the industrialized world.

Second, according to the WHO report I mentioned above, the US has a BETTER perinatal mortalty rate than Denmark, the UK and the Netherlands.

"I went to the site that Dr. Tuteur linked. And here's what I found"

That's because you didn't exclude premature babies as I did. You didn't exclude babies under 2500gm like I did. You did not look at neonatal mortality (death from birth to 28 days), you looked at infant mortality which includes deaths from 28 days to 1 year. Infant mortality is the wrong statistic for evaluation of obstetric care.

The bottom line remains the same:

Homebirth increases the risk of neonatal death, and American DEMs are grossly undereducated an undertrained compared to midwives anywhere else in the industrialized world.

Amy TuteurMD