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The Business of Being Born... are they for real?


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Wow...the most popular hospital here used to have a MANDATORY 2-4 hour separation after c-section...the required all c-section babies to stay in the "transitional" nursery.

 

Now they don't have that as an official policy, but mom isnt' given the baby until she is out of recovery AND they have a nursery worker available to move the baby...still is often hours.

 

It's amazing how different it is in different places. FWIW, I had a c-section (for breech) at a very large hospital in IL and nursed in the recovery room. (I also VBAC-ed premie twins there.)

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It's amazing how different it is in different places. FWIW, I had a c-section (for breech) at a very large hospital in IL and nursed in the recovery room. (I also VBAC-ed premie twins there.)

 

I'm in central florida. The nearest doctor that will attend a VBAC for twins is in Atlanta.

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I think that answer differs for each woman, depending on her personal history, her health, her available options for care, her family status, and so forth. There is no black or white, one-size-fits-all, answer to that, much to the dismay of birth fanatics (both pro-med, and pro-NCB).

 

:hurray:

 

Loved this whole post, but edited it down to just this part. :)

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wow, in our hospitals you have to push to GET your baby back in an hour.

 

You see the baby for a brief moment then to the nursery it goes. If you're lucky you'll have it back within a couple of hours, but usually not before it has been given a bottle of sugar water and a pacifier. Our breastfeeding support is as bad or worse than our 40% c-section rates. It's quite pathetic.

 

Is it possible that it's regional?

 

The hospital at which I've delivered all 5 of my children had the mandatory skin to skin time (The nurses even leave the room during that time to give privacy-I've gone as long as 2 hours before they come back in to clean everyone up and wash and weigh the baby), pushed breastfeeding, had complete rooming in (no baby in nursery for any reason other than medical), they'll even bring in all the equipment they need for hearing tests etc so the baby never leaves your side. My doctors were by my side during the entire delivery, even in the middle of the night, even when it took several hours.

I'm starting to believe I've found some sort of hospital/doctor utopia or something... :D

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That makes two of us.

 

 

 

I'm not surprised by this. I had my one and only child without medication. I would say that even though it was a "smooth" labor, uncomplicated, fairly short (about 5 hours of really active labor), and otherwise unhindered by Birth Drama (as I call the TLC phenomena where some crisis always pops up and scary music and lighting ensue to make sure all of us are duly afraid)--it still sucked in many ways.

 

Mostly cuz of contractions and the fact another human being made my pelvis his passageway. That s**t hurts.

 

Although I'm a proponent of evidence-based midwifery care as the standard (for public health, because of lower morality and costs), I fiercely defend the right of every woman to access the kind of birth model she wants. My best friend says if she ever has a baby, she wants a planned, elective c-section. I think she should get it, and nobody better criticize her for it in my hearing.

 

I am not a NCBer who believes birth is some magical unicorn ride to self-actualization or whatever is the current mode of B.S. It's a natural event in the human life span, certainly, and like many things in nature, it's got its share of danger.

 

I hear a lot of them saying, "trust birth," but how is that really any different from "trust your doctor?" Both give over to potential forces beyond our control.

 

And anyway, in an unbalanced society as ours, where we worship technology, I don't think many of us have a lot of experience "trusting" our instincts and knowing how to interpret them.

 

What's worse, we're a society full of depleted critical thinking skills. So, you combine a female population doped up on artificial foods, medicines, environment, whatever, and then you add to that mix a distinct lack of good judgment, and really...sometimes I think no matter if you steer them towards OBs or midwives, are they really gonna make an "informed choice?"

 

Most women just watch some documentary like BOBB, or go with a sister's recommendation of an OB, or seem some pretty brochure about a hospital's L&D, and they consider themselves informed.

 

Then, they go hop on boards like this one, and have endless debates about who made the "safest" choice, or who made the most "empowering" choice. The newly pregnant eagerly click on the most pertinent links or sources shared, maybe research it for a few weeks, become experts, and make their "informed" choices. Then the cycle repeats itself.

 

I'm convinced that's why we are still having the same dumb arguments with people like Her Shrillness, Dr. Amy, whose sole purpose in life I guess, is to finish the job ACOG's forebears started in the early 1900s, and completely drive midwifery, as an industry, out of business.

 

 

So, my point is, don't let others make you feel like your decisions are less informed or whatever, because you did not apparently give birth in a tree house, delivered the placenta on a beach, and commune with dolphins as Nature Intended. Both sides have their loons, and both sides are indeed looking for "converts." I believe you when you say you investigated and did your homework, and I think if you hadn't pursued the choices you did in your later births, you would have had more traumatizing experiences.

 

I hate to put it in these terms, but really, for me, it came down to "Which of my options would be least damaging to me, physically, emotionally, and psychologically?"

 

I think that answer differs for each woman, depending on her personal history, her health, her available options for care, her family status, and so forth. There is no black or white, one-size-fits-all, answer to that, much to the dismay of birth fanatics (both pro-med, and pro-NCB).

:iagree: Thank you, Aelwydd. I appreciated your post very much, and agree with every word.

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CPMs aren't licensed in our state, yet they still practice semi-legally (the State decided to license them and then never funded the pilot program, or something to that effect, so technically it's all still not legal). I get the impression that many of them like their under-the-radar position. Yes, the OBs are against it, but the midwives don't seem to want legitimacy, either. And ultimately it's the mothers who lose out because they don't get the safest possible midwifery care.

 

I think a lot of midwives in places like that are scared that becoming integrated will just be a way for the medical model of care to subvert the midwifery model. It has happened in places before that when midwives become really regulated they are given standards to follow that basically force them to do managed care - they work under the authority of doctors and OBs, in essence.

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Is it possible that it's regional?

 

The hospital at which I've delivered all 5 of my children had the mandatory skin to skin time (The nurses even leave the room during that time to give privacy-I've gone as long as 2 hours before they come back in to clean everyone up and wash and weigh the baby), pushed breastfeeding, had complete rooming in (no baby in nursery for any reason other than medical), they'll even bring in all the equipment they need for hearing tests etc so the baby never leaves your side. My doctors were by my side during the entire delivery, even in the middle of the night, even when it took several hours.

I'm starting to believe I've found some sort of hospital/doctor utopia or something... :D

 

It can vary by hospital within the same region. The hospital in which my oldest was born thinks they own the babies. She was on me for 30 seconds before being handed off to a nurse. This was/is standard procedure. I got her back after they had poked, prodded, and wrapped her up. Thankfully I did get to nurse her for 10-15 minutes before they took her to the nursery for four hours. Her temp had dropped after her bath, so they said they HAD to keep her under the warmer instead of bringing her back to me. This same hospital has mandatory nursery observation for all c-section babies, even if they are perfectly fine at birth. The mother gets a brief look at her baby and doesn't get to see him/her again for three hours.

 

The hospital was so bad that I had home births with my next four babies.

 

My last baby involved a complicated pregnancy. I planned a hospital birth, but I deliberately researched every option to find the most hands off hospital available. My water broke and I didn't have contractions. I was given complete control over when/if to start pitocin. My midwife talked to me at length about what was important to me personally with regard to birth practices. I chose pitocin and had an intense, but pain-med-free birth. I walked around, got in the tub, and did whatever I wanted. After he was born he stayed on my belly with the cord unclamped until I said it was ok to cut the cord and weigh him, etc. He stayed with me in my room, which was encouraged. It was a totally different experience than I had with my first baby and it was totally different from what I would have experienced if I had chosen to again birth at the horrible, but much closer hospital.

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Is it possible that it's regional?

 

The hospital at which I've delivered all 5 of my children had the mandatory skin to skin time (The nurses even leave the room during that time to give privacy-I've gone as long as 2 hours before they come back in to clean everyone up and wash and weigh the baby), pushed breastfeeding, had complete rooming in (no baby in nursery for any reason other than medical), they'll even bring in all the equipment they need for hearing tests etc so the baby never leaves your side. My doctors were by my side during the entire delivery, even in the middle of the night, even when it took several hours.

I'm starting to believe I've found some sort of hospital/doctor utopia or something... :D

 

I told my doctors that my baby wouldn't leave the room unless it was medically necessary. Sadly, because she was 6 weeks premature, they did remove her after an hour because they were worried that her breathing was not strong enough and they took her to NICU. It turned out that her lungs were fine, but her digestive system wasn't. She ate nothing for almost a week. It scared us so much.

 

I think you have to be very, very firm with doctors about some things, like removing the baby. And have a husband/mother/friend who is also firm. My husband was great for this on nearly everything (except random people in the room with me at the 11th hour).

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Mine did the episiotomy. When I said I didn't want one (early in labor - this was my OB's backup who I first met at the hospital), she said she wouldn't unless I was tearing towards the urethra. Well, guess what she said happened :glare:.

 

(And I found out later that urethral tears are generally not a big deal, anyways)

 

Second birth - tiny 1st degree tear at the same spot. Third birth - no tear.

 

I said no to the episiotomy because everything I read beforehand said that a natural tear would heal better than a surgical cut.

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Well, yeah! I guess that is why I didn't understand any need for pitocin after delivery.

Let me guess...they discourage or prohibit nursing right after birth in the hospital? On TV, they seem to whisk the baby away and do stuff right away.

 

At home, the midwife just plops the baby on your chest and tells you to start nursing immediately.

Um, no. Not for anyone I know. I didn't nurse, but both the boys were immediately given to DH after birth - with Link, that meant they wrapped him up, gave him a bracelet, and took him out to DH (who couldn't come in because I was under general anesthesia); with Astro, they wrapped him up and he sat there with him next to me. Pink wasn't because she was having difficulties.

Everyone I know was given the baby immediately after birth, unless there was a problem CVS. Nursing after birth is standard. Even c-section babies go right back to mom.

:iagree:

Full disclosure: I haven't read the thread yet and I just had a homebirth of my fifth baby a month ago. So you know where I'm coming from. ;)

 

My questions, just from reading the initial post are, is your position on this matter consistent?

 

Do you also acknowledge that hospital births are risky? That women and babies die every day from procedures and practices that are only done in hospitals or from infections caught in the hospital?

All births have the potential to be risky. I choose hospital births because I feel like they are better equipped to handle the 'just in case'.

 

So, if a woman who chooses to have a medically unnecessary repeat c-section and her baby dies from the procedure or as a result of the procedure, would you advocate that she be charged with murder as well? I would certainly hope not!

Well, in my defense, the case I am referring to was a woman who would not have a c-section because she didn't want a scar. It was a case of pure vanity and honestly - that's dumb. I don't think the two things are the same at all.

I know you describe your pregnancies as picture perfect, but just from your description of your first pregnancy, (interjecting here, my pregnancies WERE easy as pie. I didn't have any medical interventions during pregnancy. I hated being pregnant, yes. But I only had one u/s, never had high bp, anything like that. So when I say picture perfect pregnancy, that is what I am referring to.) I can find many ways in which it was managed medically and according to hospital policies and not in your or your baby's best interest. For one, there is no possible way that sitting around at the hospital the first day, (uh, and what was I going to do at home? Sit around and be bored? I would have been doing the exact same thing, the tiny little contractions I was having I could NOT EVEN FEEL. And no, I wouldn't WANT to be at home with a midwife. I already explained my stance on that - I think it's just icky FOR ME to picture giving birth at home. And FTR, when you are in the hospital in labor and haven't been given much yet, you don't just 'sit around' any more than you would at home. Don't talk about something you know nothing about.) not contracting and not progressing was helping you out. There are many ways a midwife could have helped you to help your labor progress and not stall out the way it did. (GAG. Not me, not a chance. I wouldn't WANT to be 'helped' by a midwife at home. So no, it wouldn't have happened.) Normally, I would not criticize another woman's labor experience or perspective, but honestly I think your own viewpoint is so skewed by your experience that you cannot even see how your were a victim of the very same system the movie depicts. I am not a victim, and I am trying really hard to not be completely ticked off and baffled at someone who would say this carp to me. Seriously. I'm sorry if that offends you, but THIS post was EXTREMELY offensive to me. I would NOT have done ANYTHING any differently than it was done. I really don't care if it is how you would have done it or not. I'm glad you had good experiences with your births, and guess what - I had great experiences with mine. So get off your high horse and accept that things don't have to be done one way only.

 

I'll be reading the rest of this thread while nursing during the night tonight, so I'm sure I'll be back to edit this thread or add more later. :D

 

 

ETA: I realize that my replies above are a little harsh. But TBH, someone doesn't have to be considered a 'victim of the system' just because they ended up with a c/s for reasons beyond their control. I wasn't someone who had a c section because the doctors didn't want to come back later. I wasn't induced or forced into labor. I would much rather be in labor at the hospital than at home. That is my choice, and as my other replies in the thread have (I think) explained, everyone has their own choice and I support that. What I DO NOT support about the movie is the glorifying of home birth while making hospital births out to be evil. They are not evil. Everyone makes a choice and they are all valid. So while I am sorry that I got a little feisty in my reply, I am also sorry that people do not understand that these choices are equally valid. These experiences are equally valid. I know that some women could have my experience and hate it. But I didn't. I felt that everything went the way I figured it would, and I was not surprised by the ending. (And please, don't tell me that I got a c-section because I figured I would have one. I have no control over my body choosing not to dilate or my son getting stuck in one spot. Because I have actually heard that before - if I had been more open minded to natural birth - which I was, by the way, though there was no way in HECK I was doing it without drugs - that I would have been less likely to have a c/s. Baloney and stupidity. Maybe you weren't even thinking that, but I just wanted to go ahead and get it out of the way.)

Anyway, your reply felt like an all out attack on something that I am completely happy with. It would be like me all out attacking your home births for some reason. Which wasn't what I was doing - just because I don't like the movie doesn't mean that I don't think that people have the right to choose to have a homebirth if they want it.

Edited by PeacefulChaos
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Is it possible that it's regional?

 

The hospital at which I've delivered all 5 of my children had the mandatory skin to skin time (The nurses even leave the room during that time to give privacy-I've gone as long as 2 hours before they come back in to clean everyone up and wash and weigh the baby), pushed breastfeeding, had complete rooming in (no baby in nursery for any reason other than medical), they'll even bring in all the equipment they need for hearing tests etc so the baby never leaves your side. My doctors were by my side during the entire delivery, even in the middle of the night, even when it took several hours.

I'm starting to believe I've found some sort of hospital/doctor utopia or something... :D

 

Yes, my hospital was like this. They had a very small nursery in case mom requested some rest or in the case of my daughter the baby had to have antibiotics administered. They came and took her to put the I.V. in, then every day about twice a day for 30m to administer the antibiotics. Once I fell asleep while she was gone and woke up 2 hours later. I panicked! Dh ran down to the nursery and the nurse promptly brought her back all apologetic. She said she saw I was sleeping and the baby was sleeping so they just kept her down there. It was ok, I knew they meant no harm by it. The rest of the time she was in my room. They helped me with BFing. Discovered I needed to use the football hold and worked with me on that. Everyone was super duper nice. All in all I had a good hospital experience.

I have been to a hospital with a friend where they insisted on keeping the babies in the nursery and bringing them down to "visit" with mom and dad. That would really irk me. It's my baby, she stays with me! I carried her, I pushed her out, she's mine. At my hospital they asked before they did anything. Bath? Vit. K shot? Eyes? Bottle? Paci? It was really nice to be the one to make decisions for my baby.

Well like this, except the Dr. part. Mine came in a few times to check on me, but pretty much left me alone. He came in towards the last hour of pushing and was taking his time getting dressed. Suddenly she started crowning and everyone was yelling at me not to push. LOL, I was like, "HUH?" There was no not pushing. Dh put his hand down there because he thought for sure she was going to fall out while he was getting his scrubs on!

I will say the only time I screamed was when he did the perineal massage to keep me from tearing. I had no idea what that was. He went in on a contraction and I screamed bloody murder. He was like, "NO! You can't scream! It's not helping. " The nurses were all like, "That's the most noise she's made all night." He then laughed and said, "OH, your ok then!" He even came back in later and apologized for being so stern with me.

Edited by happyhomemaker25
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Well, yeah! I guess that is why I didn't understand any need for pitocin after delivery.

 

Let me guess...they discourage or prohibit nursing right after birth in the hospital? On TV, they seem to whisk the baby away and do stuff right away.

 

At home, the midwife just plops the baby on your chest and tells you to start nursing immediately.

 

The hospitals where I had my kids were so pro nursing that dh and I called some of the nurses nursing nazis; I won't get into details, but a couple of them were really extreme, and I say that as someone who is very pro-nursing and loved nursing my babies. I nursed my first two before they went to the nursery, and both of them went directly from birth canal to dr to my chest. They were in the nursery for a short time before being brought to my room, and then they didn't go back to the nursery unless I requested it. I passed out after the 3rd one was born, but dh held her in the OR, then stayed with her in the nursery for a couple of hours until I started coming around. Before I passed out, dh held dd over to my side so I could touch her. Once I got to a regular room, dd roomed in with us and was only taken to the nursery if we requested it.

 

I checked the hospital where I had 3rd dd, and the c-section rate is 22%, not great, but lower than average. My c-section did happen after an induction, but it wasn't voluntary, and being in the evening, it wasn't for the doctor's convenience. I had HELLP syndrome, and when the doctor recommended induction sooner rather than later, we agreed without hesitation, because DD and I were both at higher risk the longer we continued the pregnancy. Even so, the doctor wasn't pushy; he told me he could send me home on bedrest if I preferred.

 

I never had pitocin after my deliveries, and I was surprised to find out that is currently standard practice in some hospitals. I had the old-fashioned method of nurses massaging my belly. Ouch.

Edited by LizzyBee
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....

Well like this, except the Dr. part. Mine came in a few times to check on me, but pretty much left me alone. He came in towards the last hour of pushing and was taking his time getting dressed. Suddenly she started crowning and everyone was yelling at me not to push. LOL, I was like, "HUH?" There was no not pushing. Dh put his hand down there because he thought for sure she was going to fall out while he was getting his scrubs on!

 

 

:D My 2nd dd came out with my first push but was stuck with just her head out because the cord was wrapped around her neck. Someone told me to stop pushing, and all I could think was that it would take a thousand horses pulling the other way to stop pushing. The doctor cut the cord with one hand and caught the baby with the other.

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I think you have to be very, very firm with doctors about some things, like removing the baby. And have a husband/mother/friend who is also firm. My husband was great for this on nearly everything (except random people in the room with me at the 11th hour).

 

Even if you are firm, a majority medical staff will say and do just about anything to get you to do what they want. They will describe every scary scenario, not matter how unlikely at the time, to get a mom to agree to what they want to do. If mom is firm, they play the dead baby card with the dad. It is hard to stand up to the dead baby card, especially if you are not thoroughly educated on the real vs. imagined risk. And it often doesn't even look like the full-court press at first glance.

 

Why do they do this? In many cases, it is ego. It is unfathomable to them that someone without a medical degree could actually know enough to be able to question them. Sometimes it is a power trip - all about the doctor or nurse's routine, not about the mom or the baby or even the life-changing event.

 

In other cases, it has to do with their perception of birth. It is not a "crunchy" vs. "medical" dichotomy, but a continuum. On one end are the people who trust that birth works most of the time, distrusting medical procedures. On the other end are the people who see birth as an imminent emergency - that something will go wrong at any second and they need to act to prevent anything from going wrong. Most fall somewhere on the continuum between the two extremes. It pains me to see so many NCB advocates treated as if they are at the extreme, when the militant ones are really the exception rather than the rule.

 

Obstetrics training tends to create those at the "birth is terribly dangerous" end because residents are not trained in normal birth. They are not trained to let thing happen on their own schedule. They do not get credit for not doing procedures. Normal birth is not on their checklist of things to learn. They simply don't see normality, they see potential emergency.

 

Back to the "why"s of fear-mongering. Like I said - some is power and ego. But, I bet most of it comes from fear. The doc or nurse is afraid when things move outside their comfort zone and will say/do what they need to to put things back into their little box. They actual vs. perceived risk may be out of whack, buy controlling the process (or attempting to) makes them feel less out of control. When you think about it, it is understandable why they may be that way. But that, in no way, makes it right. The system needs to be changed.

 

If you can stand a bit more of my soap-box ... we need balance in how we treat birth. It is heartening to hear that some of the people here do have decent birth options that respect the mother and baby as human beings. However, I don't believe that is the norm. Evidence-based maternity care is exceedingly rare in this country. (There are many things ridiculed in the practice of midwifery as having no evidence to support them, but we accept many things in obstetrics that rest on that same thin ice.) Things are so out of balance ... there are way too many providers on the "birth is dangerous" end of the continuum without enough people on the "trust that birth works until it shows otherwise" end. We need both.

 

Independent midwifery provides that balance. Where midwifery is treated as a respectable profession in the treatment of normal birth, not just as "poorly trained junior OBs". Where they practice in collaboration with, not subordinate to the obstetric profession. Where there is mutual respect between the two professions so that responsible coordination of care can take precedence over turf wars and egos.

 

Stepping down from my soap-box for now. It has been invigorating to participate in this discussion as I have missed teaching childbirth classes in the last couple years.

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I used a Independant RN midwife who owns a freestanding birthing center just a few blocks from a hospital. He was introduced to midwifery from his grandmother the midwife. I know, that has nothing to do with the movie. I haven't read this much about birthing for the two years since my last baby. This thread brought back memories. I wish insurance covered midwife births.

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I wish insurance covered midwife births.

I don't know if you were speaking about your own individual insurance, but many insurers do cover mw-attended births. In a few states, there are mandates that HB must be covered. My first was a hospital birth with a CNM, and my second was a CNM-attended FSBC birth. Both were covered by insurance. My HB was not covered, but my hb mw was having some luck getting covered as an out of network provider on some plans, IIRC.

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I don't know if you were speaking about your own individual insurance, but many insurers do cover mw-attended births. In a few states, there are mandates that HB must be covered. My first was a hospital birth with a CNM, and my second was a CNM-attended FSBC birth. Both were covered by insurance. My HB was not covered, but my hb mw was having some luck getting covered as an out of network provider on some plans, IIRC.

 

My insurance also covers in hospital midwife births. My home birth midwife was sometimes able to get insurance reimbursement, too.

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The differences in hospitals are so crazy!

 

But to the point the OP was first trying to make...are all hospitals as bad as those portrayed in The Business of Being Born? No. But....many, if not most, are. Statistics back this up. Aside from the incredible c-section rate that is unjustifiable medically, as of 2004 6o percent of women recieved induction or augmentation of labor with pitocin. There is NO medical justification for almost 2/3 of women to need help getting their labors going. So yes, most hospitals, as shown by these rates, are practicing unethically in these regards.

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I think a lot of midwives in places like that are scared that becoming integrated will just be a way for the medical model of care to subvert the midwifery model. It has happened in places before that when midwives become really regulated they are given standards to follow that basically force them to do managed care - they work under the authority of doctors and OBs, in essence.

 

I don't think that's the case here, as we have some excellent hospital midwives (they're 'my' midwives, btw) who are running their own practice pretty much as they please. They do have a back-up OB, but he doesn't even practice at the same hospital as they do. The head midwife at this practice switched hospitals after DD was born. The new hospital didn't do waterbirths. This midwife insisted, and the hospital relented. It's just not that scary a climate for hospital midwives here. We have one hospital with a decently low CS rate that has lots of midwives practicing there and hospital staff that's very supportive of natural birth, and another hospital with the midwife practice I mentioned above. So I personally don't see it becoming a problem.

 

But I can see how it might seem that way to HB MWs. The ones I see in our area are more distrustful of doctors and interventions and such than what I've heard of HB MWs in other parts of the country. (That said, I've never had nor wanted a HB... laboring at home was miserable for me with DD. All I wanted was to get out of there - think of how cats run away when they're in labor, and that's how I felt about being at home - and so I've never really had extended contact with HB MWs. I could be totally misreading this.)

 

Here's an example of what I mean. I'm going to try to be vague about this, because it's private information between a very respected local HB MW and her client, but someone I know is planning a homebirth and opted for the 20w anatomy ultrasound. The results of the ultrasound were that the baby might have a certain defect that could potentially affect the safety of homebirth (though it's probably nothing). The u/s tech strongly recommended she get a follow-up u/s to be sure. She asked her midwife about it, and the MW basically told her that yeah, since she had the first u/s she now needed to get the follow-up u/s. But, said the MW, that was the problem with getting ultrasounds, that it sort of opened that pandora's box of problems.

 

Okay, that's kind of true... but if the baby really has a defect that would put it in the NICU, wouldn't you want to know that before the baby was born at home and needed to be transported to the closest NICU? :confused: But most of this midwife's clients don't get any ultrasounds at all, so she's coming at it with a totally different perspective from mine, I know. And I could be wrong about this, but I thought that one of the whole foundations of a safe homebirth was making sure the high risk moms and babies delivered with an OB in a hospital?

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Okay, that's kind of true... but if the baby really has a defect that would put it in the NICU, wouldn't you want to know that before the baby was born at home and needed to be transported to the closest NICU? :confused: But most of this midwife's clients don't get any ultrasounds at all, so she's coming at it with a totally different perspective from mine, I know. And I could be wrong about this, but I thought that one of the whole foundations of a safe homebirth was making sure the high risk moms and babies delivered with an OB in a hospital?

 

The problem with that mentality is that ultrasounds have a high rate of false positives for defects. What happens with a positive finding?

 

For many, it is overt pressure to have an abortion. Yes, it happens. A LOT. I have many friends who have perfectly healthy babies that would not be here if these moms listened to their doctors who told them to abort their "deformed" babies. Many have told about the out and out harassment they received about bringing "burdens" into the world. I know one mom who is still traumatized by this years later.

 

For others, it may be a high-tech birth with lots of interventions, each of those carrying risks. If it turns out to be a false positive, then risks were introduced that were unnecessary. But people don't really hear it framed like that. They hear about the save, but not about what caused the need for a save in the first place.

 

Neither choice is without risk. It becomes a matter of what risk your are comfortable with.

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I don't know if you were speaking about your own individual insurance, but many insurers do cover mw-attended births. In a few states, there are mandates that HB must be covered. My first was a hospital birth with a CNM, and my second was a CNM-attended FSBC birth. Both were covered by insurance. My HB was not covered, but my hb mw was having some luck getting covered as an out of network provider on some plans, IIRC.

 

Both my MW assisted births were covered. One was in a hospital, and one at home with a CNMW, state licensed. (Both these births were in Arizona)

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Both my MW assisted births were covered. One was in a hospital, and one at home with a CNMW, state licensed. (Both these births were in Arizona)

 

Depends on your plan, though. I'm in Arizona as well. My HMO wouldn't cover my homebirth. We were on a PPO for my other three hospital births attended by CNM's. (They were all fantastic births by the way. No labor related complaints about either of the hospital's I delivered in other than that with my first I didn't have private recovery room.)

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The u/s tech strongly recommended she get a follow-up u/s to be sure. She asked her midwife about it, and the MW basically told her that yeah, since she had the first u/s she now needed to get the follow-up u/s. But, said the MW, that was the problem with getting ultrasounds, that it sort of opened that pandora's box of problems.

 

Okay, that's kind of true... but if the baby really has a defect that would put it in the NICU, wouldn't you want to know that before the baby was born at home and needed to be transported to the closest NICU? :confused: But most of this midwife's clients don't get any ultrasounds at all, so she's coming at it with a totally different perspective from mine, I know. And I could be wrong about this, but I thought that one of the whole foundations of a safe homebirth was making sure the high risk moms and babies delivered with an OB in a hospital?

 

I lived this. I got an U/S with my dd that revealed a *possible* problem with asymetrical brain development. The next 3 months were h*ll. Repeated U/S complete with the techs who can't say anything, the remote, hands off, sanitized clinical interaction. The worry; the wonder; the anxiety. The worry about all that and the effect on the baby.

 

It was a false positive and as a result of the stress, I would never do an U/S again in a pregnancy (declined them all with my youngest).

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that's how it was here 13 years ago, when I had my son. Changes have happened, and not for the better.

 

Our hospital is dirtier and you get less attention than my mother did (we birthed in the same one). But you definitely still get the baby back, and all babies still room in unless either mother really insists she can't handle it, or the baby needs to be in the NICU/detox area. I had a c-section under general, a c-section with an epidural, and a VBAC and I got the baby immediately twice and as soon as I woke up with the general.

 

I've had three births in the same hospital in fairly close succession, and it's funny to see a few things change from year to year. Now they test their hearing.

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I had soft markers with my first two. The first was terrifying. By the second, I knew the drill. BH neither turned out to be anything. Both times I got referred to medical genetics though. My next two pregnancies had no markers on the screening ultrasound, and I was surprised -- you mean this is it? You give me this picture of a ghost-baby and I go home?

 

I think ultrasounds are a situation where a little pre-ultrasound counselling would go a really long way. The terribly frightening part is after you know something is wrong but before you learn that most soft markers mean only a slight increase in risk and are generally nothing.

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During DD(baby)'s delivery (my 4th), the nurse chewed my OB out (in the room, in front of us) for not insisting on pitocin and an epidural. I'd been in labor, progressing slowly for about 7 hours (my water broke first). My OB knew I didn't want meds, and was totally fine with it. The nurse, however, was livid that my (total of 8 hours, it'd been about 7 hours at this time) birth was taking "so long". :huh:

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During DD4's delivery, the nurse chewed my OB out (in the room, in front of us) for not insisting on pitocin and an epidural. I'd been in labor, progressing slowly for about 7 hours (my water broke first). My OB knew I didn't want meds, and was totally fine with it. The nurse, however, was livid that my (total of 8 hours, it'd been about 7 hours at this time) birth was taking "so long". :huh:

 

Labor is hard enough work without this kind of stress. I hated just having to sign all the paperwork they shoved at me in hard labor, no one should have to be breaking up arguments amongst thee birth team. Good grief!

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The problem with that mentality is that ultrasounds have a high rate of false positives for defects. What happens with a positive finding?

 

I lived this. I got an U/S with my dd that revealed a *possible* problem with asymetrical brain development. The next 3 months were h*ll. Repeated U/S complete with the techs who can't say anything, the remote, hands off, sanitized clinical interaction. The worry; the wonder; the anxiety. The worry about all that and the effect on the baby.

 

It was a false positive and as a result of the stress, I would never do an U/S again in a pregnancy (declined them all with my youngest).

 

(This isn't a case where there would be any question of abortion, btw, more of a case where there might be a few scary hours until things got regulated - not that there would be any question of abortion with the person I'm referring to in any case....)

 

Anyway, I know that there are false positives - though, of course, the rate of false positives varies from test to test. This particular one should become much clearer with a second ultrasound. It's also not a case where it's either homebirth or c-section. In the worst case scenario, it would probably mean a natural hospital birth with a very natural birth friendly OB (the perinatologist who backs up a lot of midwives in our area, midwives and doulas alike sing his praises). It would be awful for this lady to have to give up her homebirth, but it probably wouldn't mean a cascade of interventions either.

 

Anyway, what struck me is more the attitude that it would be better not to know about this and risk the baby's health rather than to get the u/s. There's a huge difference between refusing all testing for a hospital birth vs. a homebirth, especially when it would be almost an hour's drive to the big NICU in the city. These tests are not perfect, of course, and the stress it places on mom is rough. I don't blame a mom for refusing any or all testing - I, personally refuse everything except the ultrasounds. That's mom's choice to make, and her decision to weigh the risks. But for the midwife - whose job it is to keep mom and baby safe and who is supposed to only be taking low risk pregnancies - to essentially tell the mom "that's what you get for doing the test" tells me a lot about where she's coming from.

 

Not that I think she's a bad or irresponsible midwife. Like I said previously, she's very well-respected here. But it does show me the attitude our HB midwives have towards medicine, and that is what I was trying to point out.

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Anyway, what struck me is more the attitude that it would be better not to know about this and risk the baby's health rather than to get the u/s. There's a huge difference between refusing all testing for a hospital birth vs. a homebirth, especially when it would be almost an hour's drive to the big NICU in the city. These tests are not perfect, of course, and the stress it places on mom is rough. I don't blame a mom for refusing any or all testing - I, personally refuse everything except the ultrasounds. That's mom's choice to make, and her decision to weigh the risks. But for the midwife - whose job it is to keep mom and baby safe and who is supposed to only be taking low risk pregnancies - to essentially tell the mom "that's what you get for doing the test" tells me a lot about where she's coming from.

 

Not that I think she's a bad or irresponsible midwife. Like I said previously, she's very well-respected here. But it does show me the attitude our HB midwives have towards medicine, and that is what I was trying to point out.

 

OBs should have this midwife's attitude. There is no evidence that routine ultrasound improves outcomes. Of course, as the midwife pointed out, once you have an ultrasound that indicates possible issues, the next ultrasound is no longer routine, but rather is considered medically indicated, and even she recommends it.

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Anyway, what struck me is more the attitude that it would be better not to know about this and risk the baby's health rather than to get the u/s.

 

This strikes me as odd too. Because I have VBACs, I need to know where the placenta is lying. It seems to me it would be important to verify the position of the placenta and the position of the baby.

 

Ultrasound technicians perform the tests requested. Couldn't the midwife just ask for an ultrasound to verify position, etc., and not to screen for soft markers?

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Gee, what did anyone do before ultrasound came into the picture? A midwife doesn't need ultrasound to verify position. She can use her hands to palpate for positioning and use uterine sounds to figure out where the placenta is located. (It seems that these low-tech, but effective skills are no longer taught to doctors these days.) If there is ambiguous information and there is history to indicate that there might be a problem, then she might choose to recommend an ultrasound.

 

Ultrasounds do not improve the health of the baby. They provide information. How that information is used and interpreted may or may not improve outcomes.

 

In the case of the midwife who didn't recommend the u/s, her professional opinion using the tools that have been used successfully for ages was likely that there was nothing to indicate that further screening was needed. Once a mom received the positive finding, her risk status could change (without any real increase in risk), thus making her birth different and possibly more risky.

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Do you also acknowledge that hospital births are risky? That women and babies die every day from procedures and practices that are only done in hospitals or from infections caught in the hospital?

All births have the potential to be risky. I choose hospital births because I feel like they are better equipped to handle the 'just in case'.

I'm glad you have that choice. I think all of us should weigh the risks inherent in our decisions. For me, the risks of having my long labors medically managed in a hospital outweigh the risks of delivering elsewhere. At least two of me out-of-hospital deliveries WOULD HAVE resulted in a c-section had I been in a hospital, due to common hospital regulations and practices. No question about it. However, I was able to deliver safely and vaginally in a birth center or at home instead. To me, what would have amounted to an unnecessary c-section, is far too risky. Not to forget, the maternal and neonatal mortality rates in the US are abysmal compared to other first world countries, which also does not give me the hospital warm fuzzies.

 

So, if a woman who chooses to have a medically unnecessary repeat c-section and her baby dies from the procedure or as a result of the procedure, would you advocate that she be charged with murder as well? I would certainly hope not!

Well, in my defense, the case I am referring to was a woman who would not have a c-section because she didn't want a scar. It was a case of pure vanity and honestly - that's dumb. I don't think the two things are the same at all.

I agree, that's pretty crazy. But I've heard of lots of women who decide not to deliver vaginally because they are afraid it's going to permanently stretch out their vajajay and ruin their sex life. Despite the fact that women DIE from c-sections, or have other life-altering consequences, including some of those elective ones. A friend of mine is permanently disabled from an epidural accident. So again, when a baby dies in this situation, would you really advocate that the mom be charged with murder? I find that repellent, both for the c-section mom and the one who refused it.

 

I know you describe your pregnancies as picture perfect, but just from your description of your first pregnancy, (interjecting here, my pregnancies WERE easy as pie. I didn't have any medical interventions during pregnancy. I hated being pregnant, yes. But I only had one u/s, never had high bp, anything like that. So when I say picture perfect pregnancy, that is what I am referring to.) Gotcha. However, pregnancies end in delivery, and for me, a 43 hour labor that stalls and ends in c-section due to medical mismanagement would not qualify as picture perfect. On the other hand, I'm sure your baby WAS picture perfect and am glad things ended up well for you in the end. I can find many ways in which it was managed medically and according to hospital policies and not in your or your baby's best interest. For one, there is no possible way that sitting around at the hospital the first day, (uh, and what was I going to do at home? Sit around and be bored? I would have been doing the exact same thing, the tiny little contractions I was having I could NOT EVEN FEEL. And no, I wouldn't WANT to be at home with a midwife. I already explained my stance on that - I think it's just icky FOR ME to picture giving birth at home. And FTR, when you are in the hospital in labor and haven't been given much yet, you don't just 'sit around' any more than you would at home. Don't talk about something you know nothing about.) My first baby was born in a hospital, with pitocin and an epidural. So, I do know a bit about that perspective as well. ;)

 

not contracting and not progressing was helping you out. There are many ways a midwife could have helped you to help your labor progress and not stall out the way it did. (GAG. Not me, not a chance. I wouldn't WANT to be 'helped' by a midwife at home. So no, it wouldn't have happened.) You wouldn't have had to go back home, although that certainly could have been an option offered to you. There are many ways to help labor progress right there in the hospital, besides waiting it out and finally giving you pitocin. They could have had you up walking around, rocking on a birth ball, doing squats, reflexology, nipple stimulation, etc. Outside the hospital, the "icky" options would have included having a massage, being adjusted by a chiropractor, sex, herbs that stimulate contractions, acupuncture, as well as many more. Many women leave the hospital in early labor and return when their labor is going stronger. Forget about homebirth, any or all of these methods could have helped your labor progress more effectively. How many were proactively suggested to you? My guess is very few because hospitals are not in the "business" of supporting women through labor naturally. Sure, a few will wait out a mom who's not too excited to get on pitocin right away, but ultimately their job is to use the tools they have at hand to help your baby be born right there in the hospital, in the most efficient way possible.

Normally, I would not criticize another woman's labor experience or perspective, but honestly I think your own viewpoint is so skewed by your experience that you cannot even see how your were a victim of the very same system the movie depicts. I am not a victim, and I am trying really hard to not be completely ticked off and baffled at someone who would say this carp to me. Seriously. I'm sorry if that offends you, but THIS post was EXTREMELY offensive to me. I would NOT have done ANYTHING any differently than it was done. I really don't care if it is how you would have done it or not. I'm glad you had good experiences with your births, and guess what - I had great experiences with mine. So get off your high horse and accept that things don't have to be done one way only.

 

I'm truly sorry that my response offended you. But, I don't think someone gets to post a rant, that they admit up front they understand that people will disagree with, and then expect folks to JAWM. Especially not when you refer to other people's beliefs and experiences and choices as "a piece of total fiction" and baloney and hogwash, and of course worthy of being "charged with murder." I'm pretty offended by all that to be honest.

 

I DO accept that things can be done many different ways. I'm honestly glad that you are happy with your childbirth experiences. However, you started a discussion of whether "The Business of Being Born" is really reflective of the hospital birthing industry in the US. My point was primarily that the experiences you related of your own births do not convince me in the least that your experience was less a result of the medical model of childbirth and the hospital childbirth business. In fact, for me, it is perfectly representative of what the film is trying to reveal (and I can make that point without using the word "victim").

 

You and many, many, many of my friends and acquaintances are perfectly at ease with the way the childbirth "business" works in the US, and that's fine. I'm not judging your choices or your comfort level, but I do judge the medical model and the business influences in hospitalized childbirth, because I think it ultimately does a disservice to both women and babies. 50 years ago, women were routinely knocked out for their deliveries and episiotomies cut so their babies could be pulled out with forceps. Fortunately, this is now considered to be inhumane for routine childbirth. I am hopeful that in the future, movies like this will help shed light on practices in modern childbirth that are not in the best interests of mother and baby, and we'll move beyond those as well.

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Gee, what did anyone do before ultrasound came into the picture? A midwife doesn't need ultrasound to verify position. She can use her hands to palpate for positioning and use uterine sounds to figure out where the placenta is located. (It seems that these low-tech, but effective skills are no longer taught to doctors these days.) If there is ambiguous information and there is history to indicate that there might be a problem, then she might choose to recommend an ultrasound.

 

Ultrasounds do not improve the health of the baby. They provide information. How that information is used and interpreted may or may not improve outcomes.

 

In the case of the midwife who didn't recommend the u/s, her professional opinion using the tools that have been used successfully for ages was likely that there was nothing to indicate that further screening was needed. Once a mom received the positive finding, her risk status could change (without any real increase in risk), thus making her birth different and possibly more risky.

 

What did women do before modern obstetrics? They died, just like they still do in much of the world.

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Not even close, actually. My hospital has a 1 hour minimum "skin to skin" time policy immediately after birth. They don't take the baby to even bathe or weight them during this time and they encourage breastfeeding right away.

 

My OB office has a poster of the hospital nursing policies posted. They encourage breastfeeding within 30 minutes of birth and roaming in, no pacifiers or bottles. DD only left my room to get her security monitor. I held her as I was wheeled to my postpartum room.

 

For my c-section with DS, I was in another state, DH went with the baby while I went to recobery. They told me they would take me to my room when I could wiggle my toes. I starred at my toes until they moved! They said it was the shortest time they have had anyone in.recovery. they took me to my room where baby, daddy, and my parents were waiting. My dad had DS and immediately have him to me. The nurse stayed with me for hours that night when my swelling caused nursing issues.

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This strikes me as odd too. Because I have VBACs, I need to know where the placenta is lying. It seems to me it would be important to verify the position of the placenta and the position of the baby.

 

Ultrasound technicians perform the tests requested. Couldn't the midwife just ask for an ultrasound to verify position, etc., and not to screen for soft markers?

 

mine does. I do an ultrasound at 20 weeks to find out placenta position (VBAC here as well...I want that sucker well away from my scar) and to look for heart issues that could be a problem upon delivery. Knowing the heart has 4 chambers that are pumping properly, intestines are on the inside, and placenta will not be impacted by my scar in any way is info I feel I want to have. I don't do a 12 week nuchal fold ultrasound or anything like that. And yes, I use a CPM ...non nurse midwife. She just writes a script for the local imagining center. Insurance covers it.

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I think a lot of midwives in places like that are scared that becoming integrated will just be a way for the medical model of care to subvert the midwifery model. It has happened in places before that when midwives become really regulated they are given standards to follow that basically force them to do managed care - they work under the authority of doctors and OBs, in essence.

 

But it doesn't have to be this way -- midwives have their own separate division in the l&d unit at the University of Michigan hospital -- they handle triage for their own patients, for example. No doctor supervises the birth.

 

I am a huge believer in trained birth attendants. For many women, there is no realistic option but homebirth anyway, even if they wanted it. But trained midwives make a huge difference, compared to untrained assistants or going it alone (please understand this is about women all over the world, not merely some slice of well educated women in the US who also have clean, running water at home)and by the way, have you seen this excellent program on a midwife in Mozambique. It's fascinating.

 

Birth of a Surgeon from PBS's Wide Angle

http://www.pbs.org/wnet/wideangle/video/birth-of-a-surgeon-video-full-episode/1795/

 

actually...in a lot of the world they die less than we do here.

Afghanistan was at 1/6 women in childbirth dying, at one point recently. I believe there has been a major effort to improve this and it's working.

 

95% of maternal deaths occur in Africa and Asia. 4% in Latin America. 1% of maternal deaths are in the so called developed world.

 

The most common cause is hemmorage. Most midwives and doctors can easily treat this. My mother in law, on the other hand, knows quite a few women who've died this way.

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But it doesn't have to be this way -- midwives have their own separate division in the l&d unit at the University of Michigan hospital -- they handle triage for their own patients, for example. No doctor supervises the birth.

 

If you are in the US then the midwives ARE under a doctor's control if they are CNM's in a hospital. It is the only legal way they can practice. They have written protocols decided upon by the doctor that they have to follow. A CNM cannot function legally without being under the authority of a doctor. CPM's can, but don't generally have hospital priviledges.

 

I am a huge believer in trained birth attendants. For many women, there is no realistic option but homebirth anyway, even if they wanted it. But trained midwives make a huge difference, compared to untrained assistants or going it alone (please understand this is about women all over the world, not merely some slice of well educated women in the US who also have clean, running water at home)and by the way, have you seen this excellent program on a midwife in Mozambique. It's fascinating.

 

Birth of a Surgeon from PBS's Wide Angle

http://www.pbs.org/wnet/wideangle/video/birth-of-a-surgeon-video-full-episode/1795/

 

thanks! And I agree, trained birth attendants are important.

 

Afghanistan was at 1/6 women in childbirth dying, at one point recently. I believe there has been a major effort to improve this and it's working.

 

95% of maternal deaths occur in Africa and Asia. 4% in Latin America. 1% of maternal deaths are in the so called developed world.

 

The most common cause is hemmorage. Most midwives and doctors can easily treat this. My mother in law, on the other hand, knows quite a few women who've died this way.

Sorry, should have clarified I meant in the developed world. Yes, the lack of trained attendants and even more so, the lack of nutrition, in developing countries leads to tragic maternal and neonatal outcomes.

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Ultrasound as a screening tool is a recent phenomenon - within my lifetime. Since its adoption, maternal and infant mortality rates have not been improved. There has been no evidence that routine ultrasound improves outcomes.

 

Yes, we are grateful for many of the advances of modern obstetrics. The problem is that many of those life-saving procedures have risks. They should be restricted to situations where the risk of using them outweighs the risk of not using them, not routinely on everyone.

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What did women do before modern obstetrics? They died, just like they still do in much of the world.

 

Before they had ultrasound, they used X-rays on pregnant women. And the US does have a fairly horrendous mortality rate compared to other developed countries with different birthing practices. (We're not talking about going back to before antibiotics and such. Just ultrasounds and CFM and whatnot, which have not proven to improve outcomes, just increase interventions.)

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Sorry, should have clarified I meant in the developed world. Yes, the lack of trained attendants and even more so, the lack of nutrition, in developing countries leads to tragic maternal and neonatal outcomes.

 

And most women in the developed world receive routine screenings and deliver in hospitals.

 

Don't get me wrong, I think homebirth is very safe, and part of that reason is because we have better equipped midwives. But trying to compare birth outcomes in the rest of the developed world to the US and then making broad applications is a bit odd, IMO.

 

Anyway, I wasn't trying to start a debate about ultrasound. :tongue_smilie: My point was just to illustrate the differences between what is considered routine to very naturally-minded hospital midwives to what HB midwives here in my state think of it.

 

I, personally, think the data on ultrasound is too limited to give us any indication of whether it improves outcome or not. The only study I can find about ultrasound and birth outcomes is from 1993. Ultrasound technology has come a very long way since then (as this study, done from 1998 to 2012 shows - though it also illustrates the fact that ultrasound diagnosis of chromosome defects does often lead to abortion, which is tragic), just like other areas of modern medicine have improved. Also, there have been no studies showing the effect of routine ultrasound use on the outcomes of homebirths specifically. I would love to see the data on this, because I really do think that's the situation where it could be the most useful.

 

Like I said before, I think it should ultimately be up to the mom to decide whether to get that screening or not. It carries risk, but then again it could also impact birth decisions. Especially for birth center or home births, where emergency care is much further from the mom and baby. In the case I mentioned previously, the entire reason the mom did the ultrasound was because she lives pretty far from a major hospital. There's a small hospital five minutes from her house, but it's not nearly as well-equipped as the hospitals 30+ minutes from her house. Her whole reason for getting the ultrasound was to determine whether there was any reason for her to deliver the baby in a hospital rather than at home, and it was an informed decision. She wasn't stressing over the diagnosis, because she knows that these tests have lots of false positives.

 

And FTR, my biggest problem with the way the midwife handled this is not that she doesn't do routine u/s on her clients. It was her attitude towards the mom who had done her research and decided she felt safer having a homebirth after having the u/s. As if she was 'getting what she deserved' for doing the test. :tongue_smilie:

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This movie is for real, but it really doesn't do enough justice to the fact that home births are dangerous for some and hospital births do save lives in many cases.

 

I've had 5 c-sections and one VBAC. My births have all taken place in hospitals, but they have taken place in 5 different hospitals in 3 different states. My first child was an emergency c-section that was botched, and my 2nd was a VBAC that should have resulted in a c-section but didn't. In both cases, at the same hospital, my children and I are both lucky to be alive. But, it was the only hospital in the area, and obviously if these were home births we wouldn't have made it either.

 

My experiences have ranged from horrendous, where my child and I are both lucky to be alive because of awful medical treatment, to wonderful experiences where I was taken very good care of.

 

My sister has had 3 home births, all of them wonderful. She has a great midwife who refers people to obgyn's almost as often as she takes patients on, she has such a high demand she can be very very safe and only choose patients who have no identifiable risks.

 

For those who are able, home births can be so much less stressful than staying in the hospital, and less risky. I have had some horrendous hospital stays, and some awful staph infections, but in those cases they were the only hospital in town, and there is no way I can home birth, so I had to grin and bear it. I would much rather have been able to deliver naturally at home. I do envy my sister, but I am also grateful for modern medicine, without which my children and I would not be alive today.

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Mine did the episiotomy. When I said I didn't want one (early in labor - this was my OB's backup who I first met at the hospital), she said she wouldn't unless I was tearing towards the urethra. Well, guess what she said happened :glare:.

 

(And I found out later that urethral tears are generally not a big deal, anyways)

 

Second birth - tiny 1st degree tear at the same spot. Third birth - no tear.

 

Ugh....and there's nothing you can do at that point, when you are at your most vulnerable. You can't see what's happening, you just have to trust the doctor. :glare:

 

Yes, we are grateful for many of the advances of modern obstetrics. The problem is that many of those life-saving procedures have risks. They should be restricted to situations where the risk of using them outweighs the risk of not using them, not routinely on everyone.

 

:iagree: Exactly! Perfectly worded.

 

I didn't choose homebirths because I wanted some sort of magical birth experience. I consider it *safer* experience *for me*. I felt there was less of a chance of something going wrong at my low-risk homebirth than there would be of me getting an unnecessary hospital procedure that could snowball into several more.

 

That was a very real possibility with my last birth, as my labor was 11 hours long (not very long for many of you out there, but my norm was 3-5 hours). I was very nervous about why it was taking so long. I was on the phone several times with my midwife, who reassured me I was doing fine. She didn't come over to my house until I was in transition. My contractions were very irregular all day, and I kept wondering, "Why doesn't she get over here?!!" but I see now that she knew if she came over my labor would have completely stalled. I'm a very shy person, and during my previous homebirth my labor slowed way down when my midwife got there, I think because I felt pressured to get things moving along (this was all in my head, nothing that the midwife did). So this last time, I labored all day, with just DH and me at home, and it was a comfortable environment. When my midwife arrived the baby was born 10 minutes later. I can imagine myself in that same scenario in the hospital, feeling worried about not progressing, and getting pressured into being induced. It might not sound plausible because I've had three non-induced births, but I'd never been in labor that long before, and was getting nervous. In that situation, I was so glad to be at home, and have a midwife to reassure me that everything was normal.

 

ETA: I realize that every situation is different. Other people might be more comfortable and safer in a hospital. I just wanted to point out that many homebirthers feel safer and more comfortable at home.

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I'm glad you have that choice. I think all of us should weigh the risks inherent in our decisions. For me, the risks of having my long labors medically managed in a hospital outweigh the risks of delivering elsewhere. At least two of me out-of-hospital deliveries WOULD HAVE resulted in a c-section had I been in a hospital, due to common hospital regulations and practices. No question about it. However, I was able to deliver safely and vaginally in a birth center or at home instead. To me, what would have amounted to an unnecessary c-section, is far too risky. Not to forget, the maternal and neonatal mortality rates in the US are abysmal compared to other first world countries, which also does not give me the hospital warm fuzzies.

That reminds me again - and I'm not being snarky or anything, totally honest - what is it that happens to all these people? :001_huh: And, to play the devils advocate a bit, are these neonatal mortality rates based on only full term babies? Because I'm just thinking about all the babies in the NICU and yeah, there are a few who don't make it. :( But a lot of them are preemies. Do we have the same number of premature births as other countries and stuff? Anyway, that's just a side note... I just have to wonder what is supposedly happening to all these women and children causing such 'high mortality rates'.

 

I agree, that's pretty crazy. But I've heard of lots of women who decide not to deliver vaginally because they are afraid it's going to permanently stretch out their vajajay and ruin their sex life. Despite the fact that women DIE from c-sections, or have other life-altering consequences, including some of those elective ones. A friend of mine is permanently disabled from an epidural accident. So again, when a baby dies in this situation, would you really advocate that the mom be charged with murder? I find that repellent, both for the c-section mom and the one who refused it.

Ok, I'm not really pro-elective c-section, either - I mean obviously, to each their own, but I do take pride in myself for giving it a try first, and kind of feel like everyone should if they can. And I don't know. I mean, honestly, anyone who is told 'if you do x your baby will die' and then does x ... how can they not be held responsible for that, kwim? Idk...

Gotcha. However, pregnancies end in delivery, and for me, a 43 hour labor that stalls and ends in c-section due to medical mismanagement would not qualify as picture perfect. On the other hand, I'm sure your baby WAS picture perfect and am glad things ended up well for you in the end.

It never really started. He was stuck (and honestly, he was not going to fit, IMO, based on the way his head had a ridge on it when we finally did get him out. My kids have huge heads, which doesn't mean anything for some, but Idk, it just really looked like there was no coming for him), he wasn't going to move, and there was fluid leaking - quite a bit - for that long. I never considered it medical mismanagement - these people would not give me a c-section even when we all begged for one. :lol:

You wouldn't have had to go back home, although that certainly could have been an option offered to you. There are many ways to help labor progress right there in the hospital, besides waiting it out and finally giving you pitocin. They could have had you up walking around, rocking on a birth ball, doing squats, reflexology, nipple stimulation, etc. Outside the hospital, the "icky" options would have included having a massage, being adjusted by a chiropractor, sex, herbs that stimulate contractions, acupuncture, as well as many more. Many women leave the hospital in early labor and return when their labor is going stronger. Forget about homebirth, any or all of these methods could have helped your labor progress more effectively. How many were proactively suggested to you? My guess is very few because hospitals are not in the "business" of supporting women through labor naturally. Sure, a few will wait out a mom who's not too excited to get on pitocin right away, but ultimately their job is to use the tools they have at hand to help your baby be born right there in the hospital, in the most efficient way possible.

But again, my water had broken. Big time. I couldn't just go home and wait for days on end for the baby to come. I walked all over the place. I highly doubt that I would have been encouraged to have sex in my case. :001_huh: I went to the chiropractor regularly up until that point. So I mean, I get what you are saying but no, I don't think a lot of those options were open to me because we were on a bit of a timetable. As it was, both Link and I had an infection and were on antibiotics because we went for so long. It wasn't a big deal. And in the end I got what I wanted, as far as the whole birth in a hospital thing. I honestly, for me, don't even like birth centers and wouldn't choose one. It really doesn't matter to me what others choose, but for me there was nothing I wanted other than a hospital birth.

 

I'm truly sorry that my response offended you. But, I don't think someone gets to post a rant, that they admit up front they understand that people will disagree with, and then expect folks to JAWM. Especially not when you refer to other people's beliefs and experiences and choices as "a piece of total fiction" and baloney and hogwash, and of course worthy of being "charged with murder." I'm pretty offended by all that to be honest.

I never said these choices were baloney or hogwash. I said that I didn't like the movie and that I felt their take on it - anti hospital and glorified home birth - was hogwash, because I believe there can be good and bad in both. I felt as though it wasn't so much a documentary as a special interest type piece that was written for people who already fully believe homebirthing is the number 1 option - rather than taking the information that is out there and presenting it in a logical fashion, showing the pros and cons of both. I don't think that any woman in a normal state of labor who loses a child should be charged with murder, and I never said that I did. I also never said people had to JAWM, but I notice that no one else attacked my personal experience, either. I'm sorry you are offended by my opinion of a movie. In fact, it actually seemed to me - and I may be mistaken - that you felt my opinion was skewed because it didn't line up with your personal views.

I DO accept that things can be done many different ways. I'm honestly glad that you are happy with your childbirth experiences. However, you started a discussion of whether "The Business of Being Born" is really reflective of the hospital birthing industry in the US. My point was primarily that the experiences you related of your own births do not convince me in the least that your experience was less a result of the medical model of childbirth and the hospital childbirth business. In fact, for me, it is perfectly representative of what the film is trying to reveal (and I can make that point without using the word "victim").

I guess we will just have to agree to disagree on this. I fail to see any way in which my experience lines up with the things that they showed on the movie as the norm for hospitals, unless you go with basics like I did at some point have pitocin (because the baby can't just stay in there forever, and obviously it was time for him to come out since my body started the whole process) and end up with a c section (which was medically necessary, with repeat sections that, yes, were my choice, because most likely I would not have a successful VBAC with my past. And those repeat sections weren't the choice of the medical providers AT ALL. When I saw other doctors, they tried to persuade me to have a VBAC.).

You and many, many, many of my friends and acquaintances are perfectly at ease with the way the childbirth "business" works in the US, and that's fine. I'm not judging your choices or your comfort level, but I do judge the medical model and the business influences in hospitalized childbirth, because I think it ultimately does a disservice to both women and babies. 50 years ago, women were routinely knocked out for their deliveries and episiotomies cut so their babies could be pulled out with forceps. Fortunately, this is now considered to be inhumane for routine childbirth. I am hopeful that in the future, movies like this will help shed light on practices in modern childbirth that are not in the best interests of mother and baby, and we'll move beyond those as well.

 

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Edited by PeacefulChaos
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