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Historic Dangers of Childbirth


Swamptribe

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Quick math: If the historical risk of dying in childbirth was 1-2% and the average woman had 8-10 pregnancies then the risk of a woman dying in childbirth comes to between 7.7 and 18.3%. :(

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Historic dangers! Lots of African women, if they don't die, walk around with fistulas for life. That's where a little tunnel connects your rectum to your vagina. There's charities focused on nothing else.

Yeah.

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My roommate was in medieval studies and one day brought home what was essentially a midwifery guide from the era. It amounted to several variations of "pull the baby out using this terrible instrument, generally ripping the mother to shreds". We both agreed that it was very, very good to live in this era.

My aunt also has scrapbooks detailing our relatives along the line that goes all the way back to William the Conqueror, down to my farmer great-grandparents in Manitoba in the 1880's. It was truly astonishing how many of the women died before the age of forty - much more so than the men. If they didn't die from childbirth outright, I'm willing to bet that many died from complications that developed over several births.

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Even 50 years ago when my mother had her first couple of babies, it was pretty awful. Lie flat on your back or we'll strap you down. General anaesthetic for the actual delivery and nasty unkind midwives and nurses.

I read a book on this a few years back. Can't remember the name. But if you had rickets as a child, pregnancy was a death sentence for you and your baby. Distorted narrowed pelvises that a baby could never fit through.

This woman Louise Bourgeois was pretty visionary for her time.

http://en.m.wikipedia.org/wiki/Louise_B ... s_Boursier

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That was an interesting article. My family is very fortunate that there were few , if any, deaths in childbirth or child deaths as far back as we can find on the side we can trace ( about 300 years ) , or the 150 or so years back I know of on the other side of my family. Despite some relatives having well over a dozen children.

In reading that, I'm wondering if most of my ancestors being in a warmer climate with a culture that wouldn't have used physicians when they were they were a primary carrier of disease is a good part of the difference. Also, they weren't so poor as to have to go immediately back to work in the fields, but not so wealthy as to have wet nurses ( and I don't think their culture would have encouraged it anyway ). In more recent generations even when formula feeding became the norm I don't think any of them used formula as their primary feeding method, which would have helped to space pregnancies/promote recovery/increase child health etc...

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According to [link=http://www.amnestyusa.org/our-work/campaigns/demand-dignity/maternal-health-is-a-human-right/maternal-health-in-the-us]Amnesty USA[/link], maternal death rates in the US doubled between 1989 and 2006. :( For far, far too many women living in the United States, maternal and reproductive health care is becoming an unaffordable luxury.

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Quick math: If the historical risk of dying in childbirth was 1-2% and the average woman had 8-10 pregnancies then the risk of a woman dying in childbirth comes to between 7.7 and 18.3%. :(

Probably a lot higher than that for some. You're way way higher risk first time (unproven pelvis plus pre-eclampsia), then after number five or six your risk rises again.

As stated by the WHO in its 2005 World Health Report "Make Every Mother and Child Count", the major causes of maternal deaths are: severe bleeding/hemorrhage (25%), infections (13%), unsafe abortions (13%), eclampsia (12%), obstructed labour (8%), other direct causes (8%), and indirect causes (20%). Indirect causes are malaria, anaemia,[3] HIV/AIDS, and cardiovascular disease, all of which may complicate pregnancy or be aggravated by it.
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My grandmother's(born 1919) mother was a midwife. One thing that great grandmother told Nan was that when a woman gave birth she 'was a hairbreadth away from death." Can you imagine having that mindset every time you got pregnant?

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When we got married our minister told us (as part of the "til death do us part" stuff) that in the bad old days 50% of pregnancies ended in the death of the child or the mother. That's why it's harder today to stay married - it used to only be a promise for a few years.

The article above seems to bear this out.

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When we got married our minister told us (as part of the "til death do us part" stuff) that in the bad old days 50% of pregnancies ended in the death of the child or the mother. That's why it's harder today to stay married - it used to only be a promise for a few years.

The article above seems to bear this out.

I really doubt that's accurate. I've been working on my family tree for years, and I haven't seen anything like it. Just looking at the great-great-grandmothers I have info on... #1 had 11 children and lived to be 64; #2 had 10 children and lived to be at least 78; #3 had 3 children and lived to be 77; #4 had 6 children and lived to be 59; #5 had 14 children and lived to be 77; #6 had 6 children and lived to be 68. Most of their children survived to adulthood. There very well may have been stillbirths, but for the most part the births were too close together to allow that many. Going a couple generations back doesn't change much, either.

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In Afghanistan the infant mortality rate is 12 per hundred. In Chad the maternal mortality is 1 in 100. There is probably overlap, where both die. If maternal and infant death were random, and you had ten pregnancies in your life, your risk would be 1 in 10, and 100% chance of a baby dying. But it wouldn't be random.

From wikipedia

Lifetime risk of maternal death" accounts for number of pregnancies and risk. In sub-Saharan Africa the lifetime risk of maternal death is 1 in 16,
I found somewhere else saying in Afghanistan it has been 8 at one point recently.
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Life expectancy at birth per 1900 is skewed by a high infant mortality rate. If you look at the life expectancy of a 21 yr old in medieval Britain it's actually quite a reasonable age (around 60).

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In Afghanistan women can only see women doctors, even if they are dying, and there are not that many women doctors. I think I watched a documentary on this.

Our infant mortality rate in the US is poor compared to other industrialized nations, this is due to a variety of things, but mainly because doctors insist on so many interventions. First they induce, then its drugs and catheters and breaking your water for you and before you know it you have failed to progress and its surgery time (csection rate of 34% in the US). A csection has a higher mom and baby mortality rate.

For years the Netherlands had the best infant mortality rates and a majority of their births are attended by midwives, and like 1/3 are homebirths. Their csection rate was very low. Countries in Europe where midwives deliver a lot of babies (keep in mind these are very trained midwives) tend to have less interventions and much better outcomes.

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I disagree with NotALoserLikeYou. The reason the risk is increasing in the United States is because too many women don't have access to health insurance. Interventions are lower than they were in the 80s when I was born. If you look at the racial breakdown, infant mortality rate is highest among African American people, and Hispanic people, two of the demographics that skew towards poverty and being uninsured. In the U.S. we have this attitude that absolute freedom means having the freedom to die of being poor. I hope that the ACA (Obamacare) will start to reverse this trend, but it certainly doesn't go far enough.

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I disagree with NotALoserLikeYou. The reason the risk is increasing in the United States is because too many women don't have access to health insurance. Interventions are lower than they were in the 80s when I was born. If you look at the racial breakdown, infant mortality rate is highest among African American people, and Hispanic people, two of the demographics that skew towards poverty and being uninsured. In the U.S. we have this attitude that absolute freedom means having the freedom to die of being poor. I hope that the ACA (Obamacare) will start to reverse this trend, but it certainly doesn't go far enough.

Do you have a link to the bolded, because I am having a very hard time believing that is true.

I had my children in the 80's and there didn't seem to be any where near the number of interventions that seem to be routine with the birth of children now. I am thinking in particular that the rate of induction has skyrocketed - and with induction comes an array of further interventions. The jump to quickly go to a c-section for failure to progress also seemed very unusual in the 80's, and v-bacs were encouraged and now are difficult to obtain. Even just the terminology in general usage seems more intervention based. As an example - when people said they had a natural childbirth in the 80's that meant with no pain medication. Today I hear people use "natural" to mean vaginal birth vs a c-section ( don't know if that's common just what I've heard )

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In Afghanistan women can only see women doctors, even if they are dying, and there are not that many women doctors. I think I watched a documentary on this.

Our infant mortality rate in the US is poor compared to other industrialized nations, this is due to a variety of things, but mainly because doctors insist on so many interventions. First they induce, then its drugs and catheters and breaking your water for you and before you know it you have failed to progress and its surgery time (csection rate of 34% in the US). A csection has a higher mom and baby mortality rate.

For years the Netherlands had the best infant mortality rates and a majority of their births are attended by midwives, and like 1/3 are homebirths. Their csection rate was very low. Countries in Europe where midwives deliver a lot of babies (keep in mind these are very trained midwives) tend to have less interventions and much better outcomes.

http://www.skepticalob.com/2013/04/dutc ... -rate.html

Even with a system set up for homebirths, there can be a lot of problems. Childbirth can go wrong very fast.

Also, some deaths from c-sections will include women who started labour at home and were transferred to hospitals, perhaps too late to save mother or child. Those deaths would be listed as hospital deaths, but the fatalities may have been due to to lack of training/knowledge on the part of the midwife. I was quite happy to have three healthy babies delivered by c-section. The whole goal of getting pregnant is to have a healthy baby and mother; the method by which my children were delivered does not matter to me. We did not have any trouble bonding or any of the other "problems" which NCB supporters preach about.

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Even poor uninsured women have access to state healthcare for prenatal care and delivery. I had medi-cal for my first birth and it covered everything. That's what a huge percentage of people here have in southern CA.

But we also have a very high rate of premature births, and we try to save them at a young gestational age and they often die. That must contribute to it.

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In Afghanistan women can only see women doctors, even if they are dying, and there are not that many women doctors. I think I watched a documentary on this.

Our infant mortality rate in the US is poor compared to other industrialized nations, this is due to a variety of things, but mainly because doctors insist on so many interventions. First they induce, then its drugs and catheters and breaking your water for you and before you know it you have failed to progress and its surgery time (csection rate of 34% in the US). A csection has a higher mom and baby mortality rate.

For years the Netherlands had the best infant mortality rates and a majority of their births are attended by midwives, and like 1/3 are homebirths. Their csection rate was very low. Countries in Europe where midwives deliver a lot of babies (keep in mind these are very trained midwives) tend to have less interventions and much better outcomes.

Comparing different nations' infant mortality rates isn't really a great way to compare birth in those countries, though. First, it includes deaths all the way up to one year, so how can you be sure it reflects deaths due to things than happen in birth? It might be that a higher infant mortality rate indicates more about a lack of access to ongoing medical care during infancy. Plus, I've read that not all countries count deaths the same. If a baby is born in great distress and dies soon after, in the US that goes in our infant mortality stats, but in a lot of Europe a baby in that situation is counted as a stillbirth.

And now I'm depressed because in a perfect world there just wouldn't be a need for any methodology to count babies who die, because babies just shouldn't die. Ever. :(

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"My grand/great so and so had 10 kids' is commonly used to defend having large fmailies. They fail to see is was due to not only lack of birth control but hoping some of the kids would survive until adulthood.

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Both my grandmothers, who had their kids in the 30s and 40s in Greece, told us that when they would get close to delivery, they would go and receive Communion. After that they would make up a box of baby clothes, blankets, diapers, and a letter to the baby. The purpose of the box was so that in case they died in childbirth, the woman who would wind up taking care of their baby would have supplies on hand. The letter was to be kept in the husband's care and given to the child when they were old enough.

They were in two completely different parts of the country, and from different socio-economic classes. It was just accepted that they needed to plan as if they might die during delivery or shortly after.

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And even delivering the baby safely didn't necessarily mean you made it. My great-great grandmother had her first child and was then given an enema...with water infected with cholera. She died when her daughter was two weeks old.

One of my mother's friends had her second daughter six years ago at 45 and experienced some horrific complications that ended in her receiving 12l of blood transfusions and an emergency hysterectomy. All I could think was "20 years ago, you would have died. Living in the wrong part of the world today, you would have died." Send shivers down my spine.

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I disagree with NotALoserLikeYou. The reason the risk is increasing in the United States is because too many women don't have access to health insurance. Interventions are lower than they were in the 80s when I was born. If you look at the racial breakdown, infant mortality rate is highest among African American people, and Hispanic people, two of the demographics that skew towards poverty and being uninsured. In the U.S. we have this attitude that absolute freedom means having the freedom to die of being poor. I hope that the ACA (Obamacare) will start to reverse this trend, but it certainly doesn't go far enough.

While I was looking for stats, I found a report saying that the increase was among non-whites, and it's not that the incidence of complications was any higher, but that the outcome for a given complication was worse. Essentially, that if you are brown or black you're less likely to be sucessfully treated for a complication.

The reason might be as simple as assertiveness against authority figures. I would be interested if socioeconomic factors were controlled for, because prior medical care and nutrition could play a role. I hope prejudice doesn't.

One of my mother's friends had her second daughter six years ago at 45 and experienced some horrific complications that ended in her receiving 12l of blood transfusions and an emergency hysterectomy. All I could think was "20 years ago, you would have died. Living in the wrong part of the world today, you would have died." Send shivers down my spine.

Many of my friends, and I would have died or lost our baby if we were not in the first world. Both my oldest child and I would be dead, and that's without c-section or transfusion.

Our infant mortality rate in the US is poor compared to other industrialized nations, this is due to a variety of things, but mainly because doctors insist on so many interventions. First they induce, then its drugs and catheters and breaking your water for you and before you know it you have failed to progress and its surgery time (csection rate of 34% in the US). A csection has a higher mom and baby mortality rate.

C-sections have higher mortality rates because they're already in trouble.

The US infant mortality rate is mostly because there are a lot of black women, black women have preemies and preemies die more. I'd find a link, but here comes breakfast, I have to pretend to be asleep.

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Yep. Count me in as someone who also would be dead without ICU. The baby also died. Gross negligence.

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