Someone is going to get hurt - Lay Midwives

[gilora]

I also think disingenuous "wondering" about why a woman would have an elective c section is thinly veiled shaming. Of the women I know who have had electives, most had a very short opportunity to be home with their child, or had some minor to medium late stage pregnancy complications that required pretty constant monitoring, and they lived far enough away from their healthcare provider that such monitoring was unfeasable ( not an uncommon situation in rural areas), or another reason that was important

Messed up the quote - Meda

I'm blown away by the tiny amount of maternity leave you get in the US. We get 6 months paid with an option for 3 further months unpaid. In Scandinavia they get 2 years!!

Yeah, the maternity leave sucks. Because I had c-sections with my kids, I got 8 weeks of disability, along with 12 weeks of unpaid FMLA leave. Of course they had to be taken concurrently, so I got 12 weeks of leave total with each kid. Here in the US we're all about family values, don'tcha know. :(

[meda]

I agree, maternity leave sucks, the only federal legal requirement is 12 weeks total a year, unpaid. That applies only if you are a full time employee at a company with more than 15 employees. A few states have better laws, and Many companies offer better, but often only for white collar employees.

That's why I wish we could stop the shaming and finger pointing over the birth choices of women, because those "choices" are bounded choice. It would be a hell of a lot more useful to change the underlying issues that new mothers have to deal with in this country (of which I don't think greedy evil doctors forcing epidurals on women is real high on the list)

[Esther]

I just can't imagine people only getting 12 weeks of (unpaid!) maternity leave. That's horrifying. What do people do????

I'd have to look up the exact facts, but we have more than that here and it's paid at 75-80% of the normal wage. Afterward, a mother can get an extension if she chooses to breastfeed. Fathers or lesbian co-moms (as in, the partner in a lesbian couple who didn't give birth to the baby) are also able to take some time off (also at a similar wage).

[freejoytoo]

We get a year of maternity leave in Britain.

[slickcat79]

Thank you for telling me that being a parent is not for me. I am pretty sure my kids will disagree with you on that one. Oh, and go jump in a lake while you're at it.

Umm...does that statement actually apply to you? Are you too cheap to pay for a hospital delivery, and do you care more about money than the health of your child? Or did you just choose to have a homebirth because it made sense for you at the time? There's a difference. You don't have to be personally, mortally offended by a comment if it doesn't actually apply to you, even if it's badly worded.

It makes me think about the Jeubs. Chris has bragged about the fact that the majority of their healthcare expenses consist of ten to fifteen dollars for homebirths. That's not a family weighing their options and finding a qualified midwife to assist with their homebirths, that's receiving no medical care at all. Wendy Jeub just had her 16th child at advanced maternal age, which is a riskier pregnancy by definition, but they still go the unassisted route. When their son injured his hand on a band saw last year, they didn't even know where to find the closest emergency room. Those are the kinds of people who seriously should not be parents because they can't afford to take adequate care of their kids, among other reasons. Most people are not like that.

It may vary from state to state, but where I live (NJ) any hospital accepting public funds must treat a woman in labor, regardless of whether she qualifies for Medicaid. As far as I know, it doesn't mean the hospital cannot try to collect down the road, only that a woman in labor cannot be turned away. This post is not meant to be a commentary on socialized medicine; only that at least in NJ, there may be an element of choice in whether a woman gives birth in a hospital.

I'm pretty sure that's a national guideline. The last time I was in a hospital (in NC) they had signs up that said you could not be turned away if you were in labor. But I don't think showing up in the ER in labor is a reasonable birth plan for most women. It shouldn't have to come down to that.

[Glass Cowcatcher]

ok I have a friend who experienced that:

She had to be induced (had to) labored with nothing advancing. She told via FB she was going to have a CS (yes labor was THAT intense that she still could be on FB). There were women arguing on that status that really she should try other positions, that she should not give up already. My friend was already away so she was not mad or anything. I was. I did not say anything on FB because it was inappropriate!

No it's not about shaming women to begin with, but some women take it to the level where they argue with laboring women about what they are doing wrong.

that's not shaming for you? I think that's pretty obvious here what some people think it is appropriate to say to someone having a labor different than theirs. And that,s the just the tip of the iceberg.

Now I don't like comparing epidural to shots in the gums (or even regular anesthesia) because it's not. It's something you can get if you want - whereas regular anesthesia is not optional or if it is, you'll still have anesthesia, and it carries inherent risks because it's in your spine. I don't care if you think it's riskless or that the risks are acceptable, the comparison just does not work.

The asumption that women who have hospital births with medication and "interventions" are ignorant or hoodwinked, besides being just stunningly condescending, reminds me of the arguments ant-abortion people make when insisting that women who want to terminate a pregnancy view ultrasounds of the fetus. "women should be educated" and "If they only knew what they were doing, they would change their minds!!!!" is a statement that comes from both camps.

I also think disingenuous "wondering" about why a woman would have an elective c section is thinly veiled shaming. Of the women I know who have had electives, most had a very short opportunity to be home with their child, or had some minor to medium late stage pregnancy complications that required pretty constant monitoring, and they lived far enough away from their healthcare provider that such monitoring was unfeasable ( not an uncommon situation in rural areas), or another reason that was important to them.

Not everyone can or wants to be a stay at home mother with appropriate crunchy granola assistance a 5 minute drive away.

That does not mean they are deficient parents making wrong choices about their babies.

This and this.

It's not on the same level as trying to outlaw abortion and birth control, but I definitely think that there is an anti-choice strain in the homebirth movement. Hospital births are not seen as a valid choice. Nevermind that some women and babies may develop life threatening conditions and actually need the doctor.

[MrsYoungie]

The above posts are why I now refer to the pro-life movement as pro-foetus. If they actually cared about mothers and babies there would be free pre-natal check ups and whatever delivery expenses required would be covered 100%.

No woman should be in a difficult delivery and have the added worry that if she has to go to hospital, she might end up bankrupt.

Canadian here. Health costs covered 100%. Maternity leave (21 years ago) ws 6 months. Can't imagine going back to work before the baby is even sleeping through the night or before one's body has fully recovered from the delivery.

[Wolfie]

Thank you for telling me that being a parent is not for me. I am pretty sure my kids will disagree with you on that one. Oh, and go jump in a lake while you're at it.

So you're worried about money more than your children?

[She Who Laughs]

I agree, maternity leave sucks, the only federal legal requirement is 12 weeks total a year, unpaid. That applies only if you are a full time employee at a company with more than 15 employees. A few states have better laws, and Many companies offer better, but often only for white collar employees.

That's why I wish we could stop the shaming and finger pointing over the birth choices of women, because those "choices" are bounded choice. It would be a hell of a lot more useful to change the underlying issues that new mothers have to deal with in this country (of which I don't think greedy evil doctors forcing epidurals on women is real high on the list)

It's 50 or more employees, not 15.

[Juliakitty]

Umm...does that statement actually apply to you? Are you too cheap to pay for a hospital delivery, and do you care more about money than the health of your child? Or did you just choose to have a homebirth because it made sense for you at the time? There's a difference. You don't have to be personally, mortally offended by a comment if it doesn't actually apply to you, even if it's badly worded.

I do not care about money more than I care about the health of my child, but the reason I chose homebirth was, in fact, that I did not want to go $10,000 or more in debt to pay for a hospital birth. I chose midwives who knew what they were doing and would have transferred me instantly if need be, and I feel comfortable with this choice. So, I don't know whether this comment applies to me or not. It sounded like the poster was slamming EVERYONE who chooses homebirth and people who choose it for financial reasons in particular, which would, I think, apply to me. But, I could have read it wrong.

[meda]

It's 50 or more employees, not 15.

You're right, I was mixing up state and federal guidelines.

From the US dept of Labor:

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12 months. The 12 months of employment are not required to be consecutive in order for the employee to qualify for FMLA leave. The regulations clarify, however, that employment prior to a continuous break in service of seven years or more need not be counted unless the break in service is (1) due to an employee’s fulfillment of military obligations, or (2) governed by a collective bargaining agreement or other written agreement.

[Cran]

I think a birthing woman should have the CHOICE where to birth. All this shaming, in one direction or the other, is wrong.

If she wants to have an elective c-section, an epidural, whatever - fine. Why not? SHE has to birth that kid, not me. If her pregnancy is low-risk and she opts for a home birth with an educated midwife (no lay midwife) who knows her limits and accordingly when it is time to transfer to an hospital, this is fine, too.

[ExCatholic]

I'm a woman of childbearing age married for not yet a full year. I've had family, friends, work acquaintances, and in one memorable occasion a waitress tell me when I should start having kids and how I should have them. I'm not even pregnant and yet some people find it necessary to warn me that c-sections are painful (no duh?) and that breast is best (an argument for another day, but nothing is best 100% of the time).

To me, birth choices are just another area where society tries to exercise its "right" to have control over a woman's body. My mother does not get to decide if I homebirth. My best friend gets no say in if I breastfeed. My husband will not be voting for epidural vs. birth tub. To me this is an extension of my body, my choice. I will listen to my health practitioner's opinion on ME and MY circumstance before making the most informed decisions I can.

We all can agree, I think, that the crux of the matter is that every woman should have access to TRAINED professionals to assist her. Not faith healers, not witch doctors, not the woman down the street. And the woman should not be shamed for the informed decisions she makes about her body and her baby's life.

[FundiesInMyFamily]

I think a birthing woman should have the CHOICE where to birth. All this shaming, in one direction or the other, is wrong.

If she wants to have an elective c-section, an epidural, whatever - fine. Why not? SHE has to birth that kid, not me. If her pregnancy is low-risk and she opts for a home birth with an educated midwife (no lay midwife) who knows her limits and accordingly when it is time to transfer to an hospital, this is fine, too.

I agree with Cran - why can't people say 'this is what I choose for myself and my family but whatever you choose for yourself and your family is right and wonderful too'. We're all different (obviously) and the things we choose for our health and wellbeing are different, from the way we give birth to the food we choose to eat and the car we drive ect ect ect. I've never understood the mommy wars or why women can be so hard on each other. All of our choices are correct. For us. (unless you're giving birth unattended on your back deck!).

[ElphabaGalinda]

The above posts are why I now refer to the pro-life movement as pro-foetus. If they actually cared about mothers and babies there would be free pre-natal check ups and whatever delivery expenses required would be covered 100%.

No woman should be in a difficult delivery and have the added worry that if she has to go to hospital, she might end up bankrupt.

Canadian here. Health costs covered 100%. Maternity leave (21 years ago) ws 6 months. Can't imagine going back to work before the baby is even sleeping through the night or before one's body has fully recovered from the delivery.

Maternity leave is now a year, and the company I used to work for gave 18 months, which isn't unheard of. All women should make their own choices how/where they give birth, but I don't think money should be a factor in those choices. In the US I imagine it is, but if a birth is attended by a qualified professional of any kind, the reason for the choice should be because it's what the woman wants and it's better for her, not because she can't afford anything else.

[Lala29]

I see the natural birth/homebirth movement not from a 'restricting rights' background, but more of a reaction to inane hospital rules. Things like moms being forced to lie on their backs throughout labor, discouraged from getting out of bed, denied something to drink or eat (yes, surgery can become an issue, but rarely is it an emergency 'rush mom into the OR and start the c/s before anesthesia fully kicks in), VBAC bans, continuous fetal monitoring (which hasn't shown a difference in outcomes compared to intermitten monitoring), and on & on. I'm sure one contingent sees childbirth in the 'women's sin payment' way, but I think the majority of them are more concerned with the practices that are widespread and not really evidence based.

I've had 2 c/s, and I wouldn't wish them on anyone. If it's needed, hell yes, thank Jeebus it's available and safe. However, if it's not warranted, there are increased risks, from infection to secondary infertility, etc etc. It's MAJOR abdominal surgery. I don't like how it's treated as a minor, everyday procedure, when it is not. There are life circumstances that won't allow for letting a labor go its normal course, but I think that rather than default to the 'c/s it is' view, it would be better if we were able to fix those issues. Little to no time off should not be a worry in the US, for example.

[jenny_islander]

The problem with informed choice is that a large subset of health care providers tend not to want to give either accurate information or choices to pregnant or laboring women. This is due, IMO, to a strong strain of misogyny in OB/GYN and nursing practice and a less institutionalized but still present strain in midwifery.

*Provider says something inaccurate in the course of care. Pregnant woman catches it and provides accurate info with citations. Provider flat out denies that it is accurate even if (or for a bad midwife, especially if) the info comes from the AMA, ACOG, or other reputable mainstream source, orders woman to stop reading(?!), or tries to browbeat her into proceeding on the basis of the inaccurate information anyway. Some providers have specifically ordered women not to attend childbirth classes because they might get ideas.

*Provider frames a non-emergent situation in terms of a potentially dead baby. The point is to frighten the woman into compliance. Diets, elective inductions (which must happen or the baby will die, which is why we are calling you Friday afternoon to book you in for Monday morning--gee, really?), etc., can be urged on women by means of the dead baby card.

*Provider assumes that a woman in labor is stupid, crazy, or not actually there. Provider talks right across the woman to her husband to get his consent to an elective procedure to which she expressly denied consent before going into labor. Provider cuts an episiotomy, even while the woman is shouting No. Provider administers drugs without explaining what they are or gaining consent.

*Provider assumes that because he/she finds the pregnant woman unattractive, there must be something wrong with the pregnant woman . . . because it's a woman's job to be attractive. A classic is assuming that a woman can't possibly be pregnant--because she's fat. Older women and disabled women also get this type of treatment.

[meda]

The problem with informed choice is that a large subset of health care providers tend not to want to give either accurate information or choices to pregnant or laboring women. This is due, IMO, to a strong strain of misogyny in OB/GYN and nursing practice and a less institutionalized but still present strain in midwifery.

*Provider says something inaccurate in the course of care. Pregnant woman catches it and provides accurate info with citations. Provider flat out denies that it is accurate even if (or for a bad midwife, especially if) the info comes from the AMA, ACOG, or other reputable mainstream source, orders woman to stop reading(?!), or tries to browbeat her into proceeding on the basis of the inaccurate information anyway. Some providers have specifically ordered women not to attend childbirth classes because they might get ideas.

*Provider frames a non-emergent situation in terms of a potentially dead baby. The point is to frighten the woman into compliance. Diets, elective inductions (which must happen or the baby will die, which is why we are calling you Friday afternoon to book you in for Monday morning--gee, really?), etc., can be urged on women by means of the dead baby card.

*Provider assumes that a woman in labor is stupid, crazy, or not actually there. Provider talks right across the woman to her husband to get his consent to an elective procedure to which she expressly denied consent before going into labor. Provider cuts an episiotomy, even while the woman is shouting No. Provider administers drugs without explaining what they are or gaining consent.

*Provider assumes that because he/she finds the pregnant woman unattractive, there must be something wrong with the pregnant woman . . . because it's a woman's job to be attractive. A classic is assuming that a woman can't possibly be pregnant--because she's fat. Older women and disabled women also get this type of treatment.

And this is the sort of thing I don't get. I will grant you that every single situation you have described has happened. I'm sure it has all happened too often, and certainly was routine in the not so distant past. However, .when you start off with "a large subset of providers tend to not want to give accurate information....." then you sound like you need a tin foil hat. Why? Why would doctors and nurses today deliberately withold information or deliberately provide bad care? What would be the point? That is how doctors get sued. I realize this is ancedata...but I am in my mid thirties. I have a group of friends my age who are either doctors, PA's or nurse practitioners, most of whom are Ob/GYNO . We live in a part of the US not known for being progressive or cutting edge about anything...and yet they love educated,proactive patients. They will certainly correct an expectant mother if she brings in something from woo.com; but they are not in the business of shaming people. Is it a generational thing? I just don't get the "all doctors want to hurt me!! thing.

[ShesCrafty]

The problem with informed choice is that a large subset of health care providers tend not to want to give either accurate information or choices to pregnant or laboring women. This is due, IMO, to a strong strain of misogyny in OB/GYN and nursing practice and a less institutionalized but still present strain in midwifery.

*Provider says something inaccurate in the course of care. Pregnant woman catches it and provides accurate info with citations. Provider flat out denies that it is accurate even if (or for a bad midwife, especially if) the info comes from the AMA, ACOG, or other reputable mainstream source, orders woman to stop reading(?!), or tries to browbeat her into proceeding on the basis of the inaccurate information anyway. Some providers have specifically ordered women not to attend childbirth classes because they might get ideas.

*Provider frames a non-emergent situation in terms of a potentially dead baby. The point is to frighten the woman into compliance. Diets, elective inductions (which must happen or the baby will die, which is why we are calling you Friday afternoon to book you in for Monday morning--gee, really?), etc., can be urged on women by means of the dead baby card.

*Provider assumes that a woman in labor is stupid, crazy, or not actually there. Provider talks right across the woman to her husband to get his consent to an elective procedure to which she expressly denied consent before going into labor. Provider cuts an episiotomy, even while the woman is shouting No. Provider administers drugs without explaining what they are or gaining consent.

*Provider assumes that because he/she finds the pregnant woman unattractive, there must be something wrong with the pregnant woman . . . because it's a woman's job to be attractive. A classic is assuming that a woman can't possibly be pregnant--because she's fat. Older women and disabled women also get this type of treatment.

I'm sorry, but what the fuck are you even talking about?! While there are, of course, bad doctors ( and bad nurses, and cops, and teachers, etc.) I think it's a wrong to say that a "large subset of health care providers" engage in these practices. In fact, I would say posts like yours feed into the the condescending attitude towards expectant mothers that many people on this thread are condemning.

Providing drugs or medical treatment without consent is malpractice in most cases and my understanding is that most health care providers will go out of their way to avoid being sued. As for a doctor "ordering" a woman to not attend childbirth classes or telling a woman that she can't be pregnant because she is unattractive (?????), most women are quite capable of advocating for themselves and telling that doctor to fuck off.

[phereby]

"If she wants to have an elective c-section, an epidural, whatever - fine. "

She can want what she wants - but unless there's a MEDICAL reason for a C-section, the doctor should refuse. This is surgery, for pete's sake. What if I were paranoid about the possibility of a ruptured appendix, and demanded that my doctor just take out my healthy appendix so I could avoid that? I hope the answer would be no.

Upthread, someone mentioned getting an induction because the baby was 1 week, 1 day past the due date. Unless something else was going on, that is NOT a reason to induce. Yet, from what I've heard, that's pretty common now - doctors pressure patients into an induction once they go past that (un) magical 1 week mark. Every time I hear nonsense like this, I'm thankful I had a common sense OB: "I start to get nervous once you've gone 3 weeks past the due date." Due dates are notoriously unreliable. (I had one 8 pounder at 2 weeks, 1 day past the due date and one 6.5 pounder at 1 day before the due date - too bad the little one didn't go a week or two longer.)

[Witsec7]

most women are quite capable of advocating for themselves and telling that doctor to fuck off.

And these same women have the ability to make their own informed choices. This whole 'woman are at the mercy of the ebil medical establishment is a bunch of paranoid bullshit.

[valsa]

"If she wants to have an elective c-section, an epidural, whatever - fine. "

She can want what she wants - but unless there's a MEDICAL reason for a C-section, the doctor should refuse. This is surgery, for pete's sake. What if I were paranoid about the possibility of a ruptured appendix, and demanded that my doctor just take out my healthy appendix so I could avoid that? I hope the answer would be no.

I had an elective surgery to remove a healthy kidney that didn't need to be removed. I'm grateful the doctor didn't refuse. Likewise, a healthy appendix may never need to be removed from a person.

However, a baby must be eventually "removed" from the mother and I think her wishes about the manner of its removal should be taken into consideration, if not be paramount.

ETA: Also, what I'm hearing from you doesn't sound so much like pro-natural-birth as it does pro-forced-natural-birth. That's fucked up. If women are supposed to trust their bodies and make informed decisions when choosing natural birth, why can't they listen to their bodies and make an informed decision to choose a C-section?

[meda]

"If she wants to have an elective c-section, an epidural, whatever - fine. "

She can want what she wants - but unless there's a MEDICAL reason for a C-section, the doctor should refuse. This is surgery, for pete's sake. What if I were paranoid about the possibility of a ruptured appendix, and demanded that my doctor just take out my healthy appendix so I could avoid that? I hope the answer would be no.

Upthread, someone mentioned getting an induction because the baby was 1 week, 1 day past the due date. Unless something else was going on, that is NOT a reason to induce. Yet, from what I've heard, that's pretty common now - doctors pressure patients into an induction once they go past that (un) magical 1 week mark. Every time I hear nonsense like this, I'm thankful I had a common sense OB: "I start to get nervous once you've gone 3 weeks past the due date." Due dates are notoriously unreliable. (I had one 8 pounder at 2 weeks, 1 day past the due date and one 6.5 pounder at 1 day before the due date - too bad the little one didn't go a week or two longer.)

There is no medical reason for elective epidurals and pain management....I guess doctors should refuse those too? How are you folks different from the anti-choice crowd?

[bouncyball]

She can want what she wants - but unless there's a MEDICAL reason for a C-section, the doctor should refuse.

Should they now? You'd better hurry up and give your expertise to the National Institute for Clinical Excellence who have approved elective c-sections on the UK National Health Service for women who, for whatever reason, wish to go that route instead of a vaginal delivery.

[phereby]

"If women are supposed to trust their bodies and make informed decisions when choosing natural birth, why can't they listen to their bodies and make an informed decision to choose a C-section?"

They can make an informed decision to choose a C-section. And a doctor can make an informed decision not to perform it. I'm simply pointing out that doctors shouldn't perform surgery at the direction of the patient.