Historic Dangers of Childbirth

[August]

There are studies that control for that possibility.eg http://www.ecmaj.ca/content/176/4/455.full Note the increased risk of cardiac arrest In an emergency they're worth the risk, but at least half of current cesareans are unnecessary and the VBAC rate is far too low. Each cesarean increases the danger to both pretty dramatically, mostly due to serious placental issues, while VBAC decreases the risks. http://www.medscape.com/viewarticle/573948 http://www.deseretnews.com/article/8655 ... birth.html

Article on reasons for cesarean increase. http://www.childbirthconnection.org/art ... p?ck=10456 Note the common excuses contributed minimally but

was a bigger contributer.

Also, if you read enough cesarean birth stories, you'll see an unacceptably high number that are forced/manipulated just before OB vacations, major holidays & even weekends. And then there's the "pit to distress" phenomenon.So yes, cesareans are actually being routinely performed for doctor convenience, not medical reasons. Although you can be sure the records reflect accepted reasons. Many a victim of coercion to have a cesarean has been shocked to find her records say she requested it or some other lie/manipulation of the truth.

Doctors are human. Some good, some bad. A few great, a few horrifying. And like most humans, they sometimes choose self interest over what other people want/need. Especially when they believe they know better and the other person is not only a woman, but one who is "irrational" because of labour.

The major contributions to decreased mortality were antibiotics, blood transfusions & getting doctors to wash their damn hands

Just because c-section is over used and cause further issues down the road doesn't mean they're responsible for massive amounts of maternal mortality as the PP (was that you?) was claiming. it's the same as another phenomenom you might know about, the correlation between breech birth and bad outcomes for the baby. A proportion of the bad outcomes is that babies who are not 100% normal are more likely to be breech. Same goes for c-sections. Babies and mothers who are in trouble will be sectioned.

ETa: no,it was notaloserlikeyou

hen you read about women dying in childbirth in America these days they have almost all had complications due to Csections

Do you really agree that most women who die in the US from pregnancy die from c-section complications? Especially seeing as how the cause of death data refute that?

[grovelina]

My mother had three c-sections. The first (me) was due to fetal distress after she had been laboring for days. She also had pre-eclampsia during this pregnancy. The second we are unsure of the reason because the doctors started to panic and she was given general anesthesia for reasons of speed. Afterwards she was just too grateful to have a live baby she didn't inquire as to the reasons for the c-section. The third was planned. I am fairly certain that without modern medical interventions I and possibly my mother would not be here.

My sister also would have died along with her twins without modern medicine. She had pre-eclampsia as well as breach twins. She went in for her regular weekly doctors appt and that afternoon she had a c-section with flight paramedics on standby. The next morning she had eclampsiatic seizures. Thank god the babies had been already born and she was in the hospital with access to the proper medical response.

My own pregnancy was blissfully c-section free, but if it came to it, all I wanted was a healthy baby and to be alive afterwards. I do agree that there are advantages to a less medicated model of child birth, but am grateful to modern medicine for the lives of my family.

[ThatSnark]

I worked in a rural Alabama nursing home in the mid-1990s. Most of the residents there were women born in the 1890s-1920s who had minimal access to medical care during their childbearing years. For the most part, they'd had double-digit numbers of children; for many, at least half did not survive childhood, and I can recall at least a dozen women who suffered with fistulas but who were too medically fragile from other conditions to be candidates for repair surgery. Yet most of them worked on farms and/or in the cotton mill in town all their lives and could point to successful children and grandchildren. I never complained about anything the whole time I worked there-- I was kind of in awe of their strength and resilience.

[meda]

There are studies that control for that possibility.eg http://www.ecmaj.ca/content/176/4/455.full Note the increased risk of cardiac arrest In an emergency they're worth the risk, but at least half of current cesareans are unnecessary and the VBAC rate is far too low. Each cesarean increases the danger to both pretty dramatically, mostly due to serious placental issues, while VBAC decreases the risks. http://www.medscape.com/viewarticle/573948 http://www.deseretnews.com/article/8655 ... birth.html

Article on reasons for cesarean increase. http://www.childbirthconnection.org/art ... p?ck=10456 Note the common excuses contributed minimally but

was a bigger contributer.

Also, if you read enough cesarean birth stories, you'll see an unacceptably high number that are forced/manipulated just before OB vacations, major holidays & even weekends. And then there's the "pit to distress" phenomenon.So yes, cesareans are actually being routinely performed for doctor convenience, not medical reasons. Although you can be sure the records reflect accepted reasons. Many a victim of coercion to have a cesarean has been shocked to find her records say she requested it or some other lie/manipulation of the truth.

Doctors are human. Some good, some bad. A few great, a few horrifying. And like most humans, they sometimes choose self interest over what other people want/need. Especially when they believe they know better and the other person is not only a woman, but one who is "irrational" because of labour.

The major contributions to decreased mortality were antibiotics, blood transfusions & getting doctors to wash their damn hands

That first study does not say what you think it says. The women in that study did not have elective c-sections, they had what the researchers considered "low-risk" C's for breech presentation. Also interesting were the maternal morbidity vs mortality statistics.

"although those for hemorrhage requiring transfusion (odds ratio 0.4, p = 0.005) and uterine rupture (odds ratio 0.5, p = 0.048) were lower than those risks in the planned vaginal delivery group, and that for obstetric shock was slightly lower but nonsignificant (odds ratio 0.4, p = 0.07). No mothers died in-hospital in the planned cesarean delivery group, whereas 41 women died in the planned vaginal delivery group (mortality rate 1.8 per 100 000 deliveries; p = 0.87). The planned low-risk cesarean group had a significantly longer duration of hospital stay (adjusted mean difference 1.47 d, p < 0.001; Table 2"

So yeah....as someone who is currently carrying breech, I think I'll take a longer hospital stay over death. Just call me a another victim of my evil obgyn. And before I get a lecture about how a breech presentation can be turned/safely delivered vaginally... I know. So does my OB and the CNM working with him. Those methods will be tried. However if they don't work, my biggest concern will be my Ob's skill as a surgeon, not how "empowered" he made me feel.

Also, regarding the second bolded....I hate those sorts of sweeping generalizations about people's birth experiences. What you are accusing Dr's & hospitals of is widespread malpractice and falsification of medical records. While I'm sure you can find individual examples of this, malpractice claims and payouts do not bear out that assertion.

[PhiMuLady]

I will chime in here that I am extremely thankful that I had a scheduled c-section.

I delivered at 35 weeks (twins) because one was IUGR - intrauterine growth restricted. I just simply didn't have any more room for them to continue to grow.

I received my epidural in the delivery room and within 3 minutes my blood pressure had bottomed out to 80/30 and fetal heart tones were both in the 50's and didn't recover. My physician had both twins delivered within two minutes of the first incision. The first one out was crying and pink, the second one out a minute later was blue and limp and had to be resuscitated. It amazes me to think that less than 3 minutes of distress caused it.

I am thankful I had been in the delivery room when it happened. If I had been in a regular hospital room laboring when I got my epidural I'm afraid the outcome would have been much different.

[lilith]

To the poster who says young and minority women are at higher risk of intervention in American hospitals, would you really prefer it was the other way? That young minority women had LESS access to medical intervention that could save their lives?

Ideally there would be no difference in the data of how different mothers are treated. We aren't in that world yet. I do find it unlikely that Medicaid would be encouraging expensive surgeries and interventions for their clients if there wasn't a valid reason for the client to need them.

As to your two daughters having very different birth experiences - it could be discrimination, but it could also simply be the staff you encountered. I had one or two hellish midwives - one of whom refused to let my baby sleep next to me, even though she screamed whenever she was moved to her crib. As soon as the shift changed a lovely midwife brought her back to sleep in my arms.

[OkToBeTakei]

One thing I never considered when having my child was in any way the cost. There was none. That would have been the case for any birth choice I had. The fact that cost is a consideration for some in first world countries greatly saddens me. IF homebirth was a choice because of this then in my view it is not a good choice. It is not a choice really in the true sense.

QFT on lilith's views.

[LadyBlue]

Replying to this has reminded me why I usually don't comment, between parenting, writing, and hunting down links, this has taken me over 5 hours. Hopefully it's not too meandering.

That first study does not say what you think it says. The women in that study did not have elective c-sections, they had what the researchers considered "low-risk" C's for breech presentation. Also interesting were the maternal morbidity vs mortality statistics.

"although those for hemorrhage requiring transfusion (odds ratio 0.4, p = 0.005) and uterine rupture (odds ratio 0.5, p = 0.048) were lower than those risks in the planned vaginal delivery group, and that for obstetric shock was slightly lower but nonsignificant (odds ratio 0.4, p = 0.07). No mothers died in-hospital in the planned cesarean delivery group, whereas 41 women died in the planned vaginal delivery group (mortality rate 1.8 per 100 000 deliveries; p = 0.87). The planned low-risk cesarean group had a significantly longer duration of hospital stay (adjusted mean difference 1.47 d, p < 0.001; Table 2"

So yeah....as someone who is currently carrying breech, I think I'll take a longer hospital stay over death. Just call me a another victim of my evil obgyn. And before I get a lecture about how a breech presentation can be turned/safely delivered vaginally... I know. So does my OB and the CNM working with him. Those methods will be tried. However if they don't work, my biggest concern will be my Ob's skill as a surgeon, not how "empowered" he made me feel.

First of all, I'd appreciate if you didn't promote the bullshit spin OB's use. There may be the extremely rare woman who makes birth choices because they want to be "empowered" or "because of Ricki Lake" or whatever other derogatory asshat reason they can come up with, but the MAJORITY of women make birth decisions because they have no clue they have options and responsibilities (that would be a disturbingly high number of OB patients, although I'm sure some fundies are in there, too) or because they have researched and researched and are making what they feel is the safest decision for them and their babies.

My only issue with cesarean for breech is when women are lied to and coerced into a primary cesarean without even being given their options or the risks of those options so she can make the right choice for HER, not the doctor. And, in the spirit of helping with information, just in case you haven`t heard of it, studies have shown that chiropractors using the Webster Technique (requires special training, you can see if there`s anyone in your area here: http://icpa4kids.org/Find-a-Chiropractor use the drop down to search for Webster certified) can help turn breech babies. Anecdotally, so can moxibustion and handstands in a pool. :whistle: Although, if you`re less than 34 weeks, the baby is most likely to turn on it`s own, as I`m sure you`re already aware.

I'm not the one who didn't understand what they were reading or who doesn't understand medical definitions. There are only 2 classifications in the coding for cesareans; elective and emergency. Cesareans which occur before labour are classed as elective, unless it`s for an emergency like abruption. If a cesarean is planned, it`s elective. Every cesarean that occurs during labour for non-emergency reasons is also classed as elective in the medical coding. Breech is classed as elective both pre-labour and during labour. It's ridiculous and maddening, but that's how it is. http://en.wikipedia.org/wiki/Elective_caesarean_section for a brief summary

So yes, a planned cesarean for breech is an elective cesarean. Although that's somewhat besides the point, I only choose the study as the first I found that compares planned vaginal birth with planned cesarean; to prove I wasn't making up there are studies which do look at the difference in morbidity and mortality rates in situations that haven't already gone bad. In other words, there is no emergency requiring the cesarean and, in fact, the cesarean is for something which most countries other than the US recommend at least a trial of labour for, in certain circumstances and assuming the mother wants to labour.

I could post links to studies showing the increased risks of cesarean to the baby too, but I`m sure you can find them if you`re interested. The main risks, iatrogenic prematurity and respiratory issues can both be mitigated by simply waiting for natural labour to start and then having a cesarean. Obviously issues like pre-eclampsia can`t wait, but many things can.

As for your comment about the number of deaths, there were 46 766 women in the cesarean group versus 2 292 420 in the planned vaginal delivery group. The study even states "The difference in the rate of in-hospital maternal death between the 2 groups was nonsignificant (p = 0.87). "

Also, regarding the second bolded....I hate those sorts of sweeping generalizations about people's birth experiences. What you are accusing Dr's & hospitals of is widespread malpractice and falsification of medical records. While I'm sure you can find individual examples of this, malpractice claims and payouts do not bear out that assertion.

I'm sorry you don't believe me. I wouldn't believe it either, if I hadn't seen it over and over. I honestly wish some days I could go back to believing in the medical profession. Most women (and men) who are anti OB are that way BECAUSE they trusted them and were betrayed.

Did you know there's studies which shows medical education and practice causes decreased ethical sensitivity? I'm linking to a preview page in google books because it mentions the conclusions of several studies. You'll have to scroll up to page 33 for the relevant section. http://books.google.ca/books?id=DO_hg9kAVQkC&pg=PA38&dq=the+effects+of+medical+ethics+education+++edited+by+Fiona+Subotsky,+Susan+Bewley,+Michael+Crowe&hl=en&sa=X&ei=ZcKRUZ2BLKnE4APFn4CYAw&ved=0CDsQ6AEwAA#v=onepage&q=the%20effects%20of%20medical%20ethics%20education%20%20%20edited%20by%20Fiona%20Subotsky%2C%20Susan%20Bewley%2C%20Michael%20Crowe&f=false

I'm guessing you've never requested a copy of your medical records after a hospital stay, because everyone I've talked to who has, as well as my own,has found them riddled with exaggerations, mistakes and even outright lies. That's without even calculating in the medical cya "Patient claims" terms.

As for malpractice suits, that's a joke. Women can't even get a lawyer to look at a malpractice case unless there is evidence of permanent harm to her or the baby. No harm, no case. Not even the woman I know personally who was screaming "I DO NOT CONSENT" as they wheeled her off and put her under general for a cesarean as her baby was crowning. And that's not even the most egregious example.

Trigger warning for sexual assault: Do you think they put it in the records when medical students perform pelvic exams on unconscious women who not only haven't consented, they weren't even informed of the possibility? And yet, we know it's incredibly common. http://www.theunnecesarean.com/blog/2010/1/29/yes-its-true-med-students-perform-pelvic-exams-on-anesthetiz.html

If anyone would like an interesting perspective on cesareans and women's emotional recovery from them, check out the book 'Cesarean Voices". It's older, but it seems Amazon has released it for Kindle http://www.amazon.com/Cesarean-Voices-Krista-Cornish-Scott/dp/0976698609/ref=sr_1_1?ie=UTF8&qid=1368511742&sr=8-1&keywords=cesarean+voices Disclaimer: my voice is one of the many in the book. I don't get money from it, I have no idea who does, hopefully ICAN.

[Freyacat]

There may be the extremely rare woman who makes birth choices because they want to be "empowered" or "because of Ricki Lake" or whatever other derogatory asshat reason they can come up with, but the MAJORITY of women make birth decisions because they have no clue they have options and responsibilities (that would be a disturbingly high number of OB patients, although I'm sure some fundies are in there, too) or because they have researched and researched and are making what they feel is the safest decision for them and their babies.

I myself had an epidural in a hospital with an OB. That's exactly what I wanted and chose after reading about it. I try really hard to be respectful of other women's choices about what they want, if they want an unmedicated delivery with a midwife or what have you, even though I'd never choose that. So I have to say it really chaps my ass how many "natural birth" advocates assume I'm a stupid sheep who has "no clue" because I chose a doctor and an epidural. It is in fact possible to do plenty of reading and thinking and then choose the medical model.

[Mama Mia]

To the poster who says young and minority women are at higher risk of intervention in American hospitals, would you really prefer it was the other way? That young minority women had LESS access to medical intervention that could save their lives?

Ideally there would be no difference in the data of how different mothers are treated. We aren't in that world yet. I do find it unlikely that Medicaid would be encouraging expensive surgeries and interventions for their clients if there wasn't a valid reason for the client to need them.

As to your two daughters having very different birth experiences - it could be discrimination, but it could also simply be the staff you encountered. I had one or two hellish midwives - one of whom refused to let my baby sleep next to me, even though she screamed whenever she was moved to her crib. As soon as the shift changed a lovely midwife brought her back to sleep in my arms.

Considering that the statistics show that young and minority women are the most at risk of death, and so are their children I would say that the interventions they do receive aren't helping.

And um, yeah, complete and utter b.s. on the different staff. Some of them were the same staff. At least the Dr. was different, because her sister had a mid-wife. Who provided 10 times better care than the oh so educated O.B.,

And as someone who has dealt with medical staff and other authorities with my children, some of whom have a hispanic last name, and some an anglo last name -- HUGE F&))*&) DIFFERENCE IN TREATMENT. ALL THE TIME.

I'm sorry for ranting , but unless you have dealt with this sort of thing it is really, really easy to say that it couldn't possibly be prejudice on the part of the medical establishment that is a major factor in the differences in mortality rates for minority, young and poor women.

I find it really ironic that people can call out things they see as hugely racist like in the blackface thread, but fail to see the everyday grinding down not so subtle racism / classism and ageism that kills and injures people every day.

[apple1]

Is Elle back and I missed the memo?

[lilith]

Considering that the statistics show that young and minority women are the most at risk of death, and so are their children I would say that the interventions they do receive aren't helping.

And um, yeah, complete and utter b.s. on the different staff. Some of them were the same staff. At least the Dr. was different, because her sister had a mid-wife. Who provided 10 times better care than the oh so educated O.B.,

And as someone who has dealt with medical staff and other authorities with my children, some of whom have a hispanic last name, and some an anglo last name -- HUGE F&))*&) DIFFERENCE IN TREATMENT. ALL THE TIME.

I'm sorry for ranting , but unless you have dealt with this sort of thing it is really, really easy to say that it couldn't possibly be prejudice on the part of the medical establishment that is a major factor in the differences in mortality rates for minority, young and poor women.

I find it really ironic that people can call out things they see as hugely racist like in the blackface thread, but fail to see the everyday grinding down not so subtle racism / classism and ageism that kills and injures people every day.

I in no way said that your daughter wasn't discriminated against on the basis of race, I raised another potential reason.

[meda]

Replying to this has reminded me why I usually don't comment, between parenting, writing, and hunting down links, this has taken me over 5 hours. Hopefully it's not too meandering.

First of all, I'd appreciate if you didn't promote the bullshit spin OB's use. There may be the extremely rare woman who makes birth choices because they want to be "empowered" or "because of Ricki Lake" or whatever other derogatory asshat reason they can come up with, but the MAJORITY of women make birth decisions because they have no clue they have options and responsibilities (that would be a disturbingly high number of OB patients, although I'm sure some fundies are in there, too) or because they have researched and researched and are making what they feel is the safest decision for them and their babies.

My only issue with cesarean for breech is when women are lied to and coerced into a primary cesarean without even being given their options or the risks of those options so she can make the right choice for HER, not the doctor. And, in the spirit of helping with information, just in case you haven`t heard of it, studies have shown that chiropractors using the Webster Technique (requires special training, you can see if there`s anyone in your area here: http://icpa4kids.org/Find-a-Chiropractor use the drop down to search for Webster certified) can help turn breech babies. Anecdotally, so can moxibustion and handstands in a pool. :whistle: Although, if you`re less than 34 weeks, the baby is most likely to turn on it`s own, as I`m sure you`re already aware.

I'm not the one who didn't understand what they were reading or who doesn't understand medical definitions. There are only 2 classifications in the coding for cesareans; elective and emergency. Cesareans which occur before labour are classed as elective, unless it`s for an emergency like abruption. If a cesarean is planned, it`s elective. Every cesarean that occurs during labour for non-emergency reasons is also classed as elective in the medical coding. Breech is classed as elective both pre-labour and during labour. It's ridiculous and maddening, but that's how it is. http://en.wikipedia.org/wiki/Elective_caesarean_section for a brief summary

So yes, a planned cesarean for breech is an elective cesarean. Although that's somewhat besides the point, I only choose the study as the first I found that compares planned vaginal birth with planned cesarean; to prove I wasn't making up there are studies which do look at the difference in morbidity and mortality rates in situations that haven't already gone bad. In other words, there is no emergency requiring the cesarean and, in fact, the cesarean is for something which most countries other than the US recommend at least a trial of labour for, in certain circumstances and assuming the mother wants to labour.

I could post links to studies showing the increased risks of cesarean to the baby too, but I`m sure you can find them if you`re interested. The main risks, iatrogenic prematurity and respiratory issues can both be mitigated by simply waiting for natural labour to start and then having a cesarean. Obviously issues like pre-eclampsia can`t wait, but many things can.

As for your comment about the number of deaths, there were 46 766 women in the cesarean group versus 2 292 420 in the planned vaginal delivery group. The study even states "The difference in the rate of in-hospital maternal death between the 2 groups was nonsignificant (p = 0.87). "

I'm sorry you don't believe me. I wouldn't believe it either, if I hadn't seen it over and over. I honestly wish some days I could go back to believing in the medical profession. Most women (and men) who are anti OB are that way BECAUSE they trusted them and were betrayed.

Did you know there's studies which shows medical education and practice causes decreased ethical sensitivity? I'm linking to a preview page in google books because it mentions the conclusions of several studies. You'll have to scroll up to page 33 for the relevant section. http://books.google.ca/books?id=DO_hg9k ... we&f=false

I'm guessing you've never requested a copy of your medical records after a hospital stay, because everyone I've talked to who has, as well as my own,has found them riddled with exaggerations, mistakes and even outright lies. That's without even calculating in the medical cya "Patient claims" terms.

As for malpractice suits, that's a joke. Women can't even get a lawyer to look at a malpractice case unless there is evidence of permanent harm to her or the baby. No harm, no case. Not even the woman I know personally who was screaming "I DO NOT CONSENT" as they wheeled her off and put her under general for a cesarean as her baby was crowning. And that's not even the most egregious example.

Trigger warning for sexual assault: Do you think they put it in the records when medical students perform pelvic exams on unconscious women who not only haven't consented, they weren't even informed of the possibility? And yet, we know it's incredibly common. http://www.theunnecesarean.com/blog/201 ... hetiz.html

If anyone would like an interesting perspective on cesareans and women's emotional recovery from them, check out the book 'Cesarean Voices". It's older, but it seems Amazon has released it for Kindle http://www.amazon.com/Cesarean-Voices-K ... ean+voices Disclaimer: my voice is one of the many in the book. I don't get money from it, I have no idea who does, hopefully ICAN.

I was aware of the coding issue in the study. Your original post implied that "elective" meant "for no reason other than the Dr wants to play golf". Breech is a valid reason, even if it is coded as elective, and even if you do believe that chiropractors have super secret techniques for making the condition go away that are unknown to OB's and CNM's. Also, for what it's worth yes I have seen my hospital medical records, yes I have done research into my birth choices, and yes I will still be giving birth in a teaching hospital with an attached NICU. I have been very happy with the care I have received their this far. For every procedure, exam, and consult, the hospital and the practice group I am with gives me the option to decline the presence of a medical student. They have some of the best informed consent practices, and incidentally the lowest rate of c-section, in 4 states; despite being a regional trauma center.

Also, I'm a lawyer myself and I have several friends who take medmal cases. It is stunningly easy to get at least a settlement payout from an OB, It's one of the reasons why they have the highest malpractice insurance rates of any medical specialty. So I am calling bullshit on the millions of traumatized women who cant get a lawyer to talk to even talk to them.

I agree with Freya that it is really annoying to be told that the only reason I would make the choices I am making is because I am ignorant or selfish. It is even more annoying when I realize the people telling me such things really seem to believe that all Dr's are ethically challenged fiends who want to harm laboring women prior to making their tee time. For some women, childbirth can be dangerous. That is not automatically the Dr's fault. I happen to like my OB, I have received more comprehensive, compassionate care from him than I have in the past from several far more crunchy NP's and CNM's. Even with that said, his job is not to be compassionate, his job is to be competent and to practice according to the standards of his profession. In other words, If I and my offspring are alive and as healthy as possible after labor and delivery, he will have done his job.

[formergothardite]

I hate the idea that anyone who doesn't choose a drug free home birth and takes the advice of their doctor isn't empowered or informed. One of the reasons I chose my doctor is because I researched and felt like I could trust his opinion and advice. Some people might look at my charts and think that I was being lied to and tricked into unnecessary procedures because the evil doctor wanted to go play golf, but I lived it and I don't feel that way.

Plus, I kind of felt lied to by the natural birth crowd when my actual labor started. That was not waves that I could ride through with breathing, walking, and warm water. That was pain, horrible, horrible pain.

[Turtle]

I hate the idea that anyone who doesn't choose a drug free home birth and takes the advice of their doctor isn't empowered or informed. One of the reasons I chose my doctor is because I researched and felt like I could trust his opinion and advice. Some people might look at my charts and think that I was being lied to and tricked into unnecessary procedures because the evil doctor wanted to go play golf, but I lived it and I don't feel that way.

Plus, I kind of felt lied to by the natural birth crowd when my actual labor started. That was not waves that I could ride through with breathing, walking, and warm water. That was pain, horrible, horrible pain.

QFT.

The fact that a woman has the opportunity to be concerned about her birthing experience shows an enormous privilege. I couldn't care less in what situation a woman chooses to give birth, but I do feel that most of the "natural childbirth" rhetoric is incredibly degrading and damaging to women.

[belly_button]

I hate the idea that anyone who doesn't choose a drug free home birth and takes the advice of their doctor isn't empowered or informed. One of the reasons I chose my doctor is because I researched and felt like I could trust his opinion and advice. Some people might look at my charts and think that I was being lied to and tricked into unnecessary procedures because the evil doctor wanted to go play golf, but I lived it and I don't feel that way.

Plus, I kind of felt lied to by the natural birth crowd when my actual labor started. That was not waves that I could ride through with breathing, walking, and warm water. That was pain, horrible, horrible pain.

The part in bold. Yes. I can't agree enough, that's exactly how I felt. Well, labor was mostly ok, until the very end. It was awful and for days I cried every time I thought about it. Pushing didn't help at all, either.

[RosyDaisy]

My great-great grandmother was a midwife. All I have to do is read her journal, and the picture she paints of women giving birth is not pretty. Local doctors refused to attend births, miscarriages, stillbirths, and women dying. It's horrible to read at times.

[formergothardite]

The part in bold. Yes. I can't agree enough, that's exactly how I felt. Well, labor was mostly ok, until the very end. It was awful and for days I cried every time I thought about it. Pushing didn't help at all, either.

And then there is this underlying idea with the natural birth movement that if you do experience horrible pain and get medication, you aren't strong and you should have been tougher. The natural birth movement can heap tons of guilt on women when it comes to their birth choices.

[Katiebug]

Also, regarding the second bolded....I hate those sorts of sweeping generalizations about people's birth experiences. What you are accusing Dr's & hospitals of is widespread malpractice and falsification of medical records. While I'm sure you can find individual examples of this, malpractice claims and payouts do not bear out that assertion.

A-freaking-men. I get so tired of women judging others' birth experiences. Unless you are a trained OBGYN or certified nurse midwife and were the caregiver attending any given woman, you have NO way of knowing if she had an "unnecessary" C-section or induction or any other intervention. Yes, some doctors (and midwives) overuse certain interventions. That doesn't mean that all OBGYNs do C-sections for kicks or induce patients at 36 weeks barring compelling medical reasons to do so. I also absolutely hate the idea that women who choose a hospital delivery or seek an OBGYN's care are just not educated on how birth "should" be. I was very well-informed but I never wanted a homebirth for a variety of reasons.

With our first we hoped for a low-intervention hospital delivery (laboring at home as long as possible, intermittent monitoring, no IV, no pain meds, etc.). Then I developed preeclampsia and all of those plans went out the window. Yeah, I was in the hospital and had to have the IV, continuous monitoring, Cervidil, Pitocin, and eventually mag sulfate. My OB and the nurses still did their best to make it a family-centered experience and to honor my/our requests while still managing the preeclampsia. In the end I had the epidural-free delivery I had hoped for and our daughter was born safely.

I'm 35 weeks pregnant with our second baby. Because of my family history and my own personal history, where I went from normal pregnant lady at 38 weeks to preeclampsia less than 3 days later, I've had weekly prenatal visits starting at 32 weeks rather than the usual 36. It is my hope that I'll avoid a recurrence of preeclampsia, of course - but if it happens, we'll do what needs to be done to get the baby here with both of us safe.

I had a rabid homebirth advocate tell me that if I'd just "trusted birth", I never would have developed preeclampsia and would have delivered on my own with no issues. I wanted to punch her. "Trusting birth" is clearly not enough for the thousands of women in the developing world who lose babies or their own lives (or both) due to preeclampsia/eclampsia/HELLP syndrome. Thank God I live in a time and a place where I had access to modern obstetrics!

[dawbs]

I think the natural vs. hospital is an area where the extremists on both sides talk louder than the moderates--which is also why it seems so hard to get unbiased information (because extremists publish. moderates read :lol: )

I know I always end up reading the debate with an intense desire to say "EXACTLY, thank you" and "Oh FFS, you're being a twit" about equal number of times to each 'side.'

The faulty medical care in the US and the over-use of c-sections (which strips power from patients just as surely as other medical 'abuses' do) is definitely cause for alarm. Women's concerns can be routinely dismissed while painful, questionably necessary, difficult to recover from surgeries (which affect her fertility and her future L&D experiences) are done--the cost-benefit analysis may fail to weigh the desires/needs/recovery of the mother

The risks of home birth and the importance of pain management are things that shouldn't be pooh-poohed by the more crunchy advocates. Women's concerns can be routinely dismissed while pain medication is under-utilized, the life of the baby and the mother are at risk, etc--the cost-benefit analysis may fail to weigh the desire/needs/recovery of the mother.

There isn't an easy answer. C-sections and medical interventions should be done exactly as often as they are necessary (not more or less). But 'necessary' is a moving target and hindsight is hard to come by in the moment.

(and I say this w/ all the innate bias of someone who exclusively breast fed, cloth diapered, got an epidural, had induced labor and had a quite uneventful, textbook, hospital birth for her kid)

[August]

Plus, I kind of felt lied to by the natural birth crowd when my actual labor started. That was not waves that I could ride through with breathing, walking, and warm water. That was pain, horrible, horrible pain.

Sing it, sister. That is no 'muscles doing hard work'. It is agony.

Every time I get gas now I think "oh my god I'm glad I'm not pregnant". Because it means I never ever have to give birth again (and yes, I've done it unmedicated beginnning to end, by choice).

[Nothing2CHere]

Evidently I'm the only woman in America who had OBs pushing FOR me to have a vaginal birth and NOT a c-section. I feel like I've written about my birthing experience on FJ one thousand times, but here I go with one thousand and one. I had gestational diabetes during my pregnancy, so I was monitored pretty regularly, especially with ultrasounds to monitor LittleBabyNothing's growth. At, I think it was 34 weeks, 35 weeks (I don't remember when exactly off the top of my head) he was already estimated to be about 7 lbs. Due to this, the specialist OB told me they did not want me to carry the full 40 weeks - they were afraid LBN would get too big in the womb. If labor did not happen on its own, I would be induced.... or I was told I could opt for a c-section, but it would be considered "elective" and not "medically necessary" because even though he was large, my baby was not estimated to be weighing above the number of grams for what would considered medically necessary. When I asked more about a c-section, he told me that the hospital's goal was to have women try to deliver vaginally.

I went in for another ultrasound at 38 weeks. This time it was a different specialist OB, and my baby was estimated to be around 9 lbs. I remember the OB commenting something along the lines of I could still try to have have a vaginal birth, that my baby wasn't above the grams "limit," but he was close. It was close enough that they would approve me for a c-section if I chose one, but it would still be "elective."

I was worried about how I might recover from a c-section, but I was more worried about going through a long labor where something might happen to my baby in the process, and then needing an emergency c-section in the end anyway. Nothing the OBs said to me made me think these things - it was my own nerves, research, and gut feeling. I opted for the c-section, which was to be performed by my regular OB.

As they weighed LBN while he wailed shortly after being pulled out, he tipped the scales at 10 lb 6 ounces. My OB said, "I think you made the right decision." He ended up being larger than anyone predicted he'd be. Could I have still delivered him vaginally? Possibly. If the OBs had had their way, that's exactly what I would have attempted. I, however, am glad that I didn't have to find out if I would have ended up with that c-section anyway.