Speaking of having to advocate for ourselves and our babies as patients...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Damn, where are you delivering your babies? I had my vitals taken regularly and had both doctors and nurses palpate my uterus and check discharge (both asking about volume and looking at pad after palpating) a few times postpartum in the hospital. I also had a pelvic exam at my 6 week appointment with time to ask about any concerns. My delivery was very smooth and routine.

The pediatrician saw my baby very regularly, particularly because he was sent down to the special care nursery to go under the lights within 24 hrs of birth. He received great care and we didn't have any additional complications.

I delivered at Sibley and would recommend.

OP here.

I delivered at Sibley.

NP here - also delivered at Sibley by c-section. My OB checked in with me daily, and looked at my incision each time. Nurses checked my blood pressure and palpated me at least twice daily. They also asked me about pain levels regularly. My pediatrician came to the room and examined baby 2 times.

I have delivered 3X at Sibley, with same pediatrician and OB (who are both POC). I am also a POC and while I agree there are institutional problems with healthcare, one approach to self-advocacy is to find doctors that you feel you can trust to listen to you.

I’ve had three kids and I haven’t found the in-office relationship to have anything to do with how the relationship is iin the hospital. For one thing, it’s a roll of the die which OB you get unless you schedule a section or get lucky with a short scheduled induction and for another, you don’t see much of the doctors unless you’re actively birthing or having an emergency. Don’t put that crap on individual women to solve. (I’m white, btw, and face no additional barriers to care)

[Anonymous]

Anonymous wrote:I had a birth center birth and my experience is just so different. Specifically post-partum, immediately after giving birth, a midwife was in my room unless I asked her to step out. I stayed 10 hours and felt so well cared for. I was constantly monitored to ensure I was capable of going home (otherwise I would have had to transfer to the hospital).

I received a phone call the next day to review caring for my stitches and vagina. We also went over charting diapers and feedings, and generally make sure everything was okay.

A CNM and RN came our home at about 36 hours after birth (6 am Thursday delivery and they visited Saturday afternoon). Not only did they do all the newborn screenings, check baby's weight, blood sugar, and bilirubin, they also spent time checking on me. I know my stitches were checked along with making sure my uterus was contracting.

Because baby failed the hearing test on one side, they had us come back to the center at 1 week to re-test (he passed). While we were there, the midwife did another check of my stitches and spent a decent amount of time with us just making sure we were doing okay and chat with us.

Basically, I feel like I had way more attentive care from my health care team and I wasn't ever in the hospital! That's nuts. I wasn't being monitored 24/7. I had a very low risk birth and fortunately developed zero complications. And yet I had an entire team focused on me (and baby, but I really felt like they never shoved me aside for baby) and ensuring I was properly taken care of. WHY can't this be done in a hospital setting? For every single woman, regardless of her race, socio-economic status, relationship status? It's infuriating. I am grateful I had the option to go outside norm, but it is a luxury that most women don't have. And, yes, I very much recognize it was a luxury along with a damn good bit of luck to have a uncomplicated pregnancy and birth.

Was this in DC? Sounds fantastic!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had a birth center birth and my experience is just so different. Specifically post-partum, immediately after giving birth, a midwife was in my room unless I asked her to step out. I stayed 10 hours and felt so well cared for. I was constantly monitored to ensure I was capable of going home (otherwise I would have had to transfer to the hospital).

I received a phone call the next day to review caring for my stitches and vagina. We also went over charting diapers and feedings, and generally make sure everything was okay.

A CNM and RN came our home at about 36 hours after birth (6 am Thursday delivery and they visited Saturday afternoon). Not only did they do all the newborn screenings, check baby's weight, blood sugar, and bilirubin, they also spent time checking on me. I know my stitches were checked along with making sure my uterus was contracting.

Because baby failed the hearing test on one side, they had us come back to the center at 1 week to re-test (he passed). While we were there, the midwife did another check of my stitches and spent a decent amount of time with us just making sure we were doing okay and chat with us.

Basically, I feel like I had way more attentive care from my health care team and I wasn't ever in the hospital! That's nuts. I wasn't being monitored 24/7. I had a very low risk birth and fortunately developed zero complications. And yet I had an entire team focused on me (and baby, but I really felt like they never shoved me aside for baby) and ensuring I was properly taken care of. WHY can't this be done in a hospital setting? For every single woman, regardless of her race, socio-economic status, relationship status? It's infuriating. I am grateful I had the option to go outside norm, but it is a luxury that most women don't have. And, yes, I very much recognize it was a luxury along with a damn good bit of luck to have a uncomplicated pregnancy and birth.

Was this in DC? Sounds fantastic!

Unfortunately, it was not. I know there are very high quality midwives in DC-area hospitals (when I got pregnant I was still in DC and started off with the GW midwives!), and some people say that's why there are a lack of birth center options, but I don't buy it. In my current city, there are midwives that practice with OB groups and deliver at hospitals, but that hasn't reduced the demand for a birth center option. I heard recently that the demand is now so high they can no longer accommodate everyone who wants to birth there and are exploring opening a second location.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Women--of all races--are just not empowered in this country to make our own medical decisions about pregnancy and birth. And it shows in our absolutely dreadful maternal mortality and morbidity statistics.

Interestingly, the book All Natural has an excellent chapter on childbirth in which the author compared the data from the Family Health & Birth Center in NE DC and found that practice had significantly better maternal outcomes than the city's and country's overall dismal outcomes, despite serving a mostly low-income, non-white population. His hypothesis is because the midwives' approach is more woman-centered/high-touch/low-intervention.

It's not because it's "low intervention"!! What high-risk women like Serena Williams (and the moms/babies whose terrible care cause UMC to close its maternity ward) need MORE intervention, not less. Family Health & Birth likely has better outcomes due to just better and more attentive care -- which yes, includes in some cases eliminated unneeded interventions, but for the *life saving* cases, they'd be referred to WHC for lots of interventions.

High-risk people can benefit from a low-intervention approach, too. I don’t know anything about Serena Williams’ birth but if she’s anything like 99% of women who give birth in American hospitals, she probably had no one to provide individual hands-on support during labor, which studies have shown can reduce c-sections. Avoiding a c-section is especially important for someone who has a blood clotting disorder since c-sections put even healthy people at a higher risk of blood clots.

[Anonymous]

Agreed - many of the most tragic cases do not involve a lack of intervention as the root cause. It often is an issue of no one listening to and closely watching the mother, and an over-reliance on test results to show danger signs, when tests can be wrong, or totally ineffective if no one in authority looks at them. I think the midwife culture of large amounts of time spent with mothers (at appts, in labor and after) and a focus on listening to the mother and taking her subjective experience seriously, is something OBs could really learn from. Midwives can screw up like anyone else, but they at least are starting from the viewpoint that the mother’s experience matters and that a healthy baby is not the only goal.

[Anonymous]

Anonymous wrote:Agreed - many of the most tragic cases do not involve a lack of intervention as the root cause. It often is an issue of no one listening to and closely watching the mother, and an over-reliance on test results to show danger signs, when tests can be wrong, or totally ineffective if no one in authority looks at them. I think the midwife culture of large amounts of time spent with mothers (at appts, in labor and after) and a focus on listening to the mother and taking her subjective experience seriously, is something OBs could really learn from. Midwives can screw up like anyone else, but they at least are starting from the viewpoint that the mother’s experience matters and that a healthy baby is not the only goal.

I think Shalon Irving is a good example of this - she was known to be high risk and was pretty closely monitored through her pregnancy, but after giving birth even though she knew something was wrong and told doctors that repeatedly, they ignored her because her tests didn’t seem that abnormal. But had they listened to her and examined her more closely, they may have been able to save her life.

[Anonymous]

Anonymous wrote:

Anonymous wrote:So sad. There was an article I recently read about how black women die disproportionately to white women after childbirth and it does not matter what their socioeconomic status is. Another example.

That was this NPR series. The black woman who died was actually working in this health field and it didn't help her. https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why

Maybe there are more than just one story on this maternal health crisis? There was definitely a ProPublica story and there hve been many stories about DC’s own crisis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Agreed - many of the most tragic cases do not involve a lack of intervention as the root cause. It often is an issue of no one listening to and closely watching the mother, and an over-reliance on test results to show danger signs, when tests can be wrong, or totally ineffective if no one in authority looks at them. I think the midwife culture of large amounts of time spent with mothers (at appts, in labor and after) and a focus on listening to the mother and taking her subjective experience seriously, is something OBs could really learn from. Midwives can screw up like anyone else, but they at least are starting from the viewpoint that the mother’s experience matters and that a healthy baby is not the only goal.

I think Shalon Irving is a good example of this - she was known to be high risk and was pretty closely monitored through her pregnancy, but after giving birth even though she knew something was wrong and told doctors that repeatedly, they ignored her because her tests didn’t seem that abnormal. But had they listened to her and examined her more closely, they may have been able to save her life.

Don't forget Kira Johnson, who was lacerated during her elective repeat cs and it took the staff hours to respond to the blood in her catheter. She might have been saved if they had acted more quickly.

http://people.com/human-interest/charles-johnsons-support-mom-glenda-hatchett-wifes-childbirth-death/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So sad. There was an article I recently read about how black women die disproportionately to white women after childbirth and it does not matter what their socioeconomic status is. Another example.

That was this NPR series. The black woman who died was actually working in this health field and it didn't help her. https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why

Maybe there are more than just one story on this maternal health crisis? There was definitely a ProPublica story and there hve been many stories about DC’s own crisis.

The ProPublica article is part of a series being done jointly with NPR. There have been several installments as well as a page called "Lost Mothers" capturing the individual stories of as many of the women who died in 2016 whose families they have been able to track down.

[Anonymous]

I am a woman of color who has to have a c-section due to a myomectomy last year and all I can say is all these stories in the news lately (and this thread) terrify and sadden me. I keep telling my husband he will have to stay vigilant in the hospital. I don’t know what else I can do really, and that feels tragic.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Women--of all races--are just not empowered in this country to make our own medical decisions about pregnancy and birth. And it shows in our absolutely dreadful maternal mortality and morbidity statistics.

Interestingly, the book All Natural has an excellent chapter on childbirth in which the author compared the data from the Family Health & Birth Center in NE DC and found that practice had significantly better maternal outcomes than the city's and country's overall dismal outcomes, despite serving a mostly low-income, non-white population. His hypothesis is because the midwives' approach is more woman-centered/high-touch/low-intervention.

It's not because it's "low intervention"!! What high-risk women like Serena Williams (and the moms/babies whose terrible care cause UMC to close its maternity ward) need MORE intervention, not less. Family Health & Birth likely has better outcomes due to just better and more attentive care -- which yes, includes in some cases eliminated unneeded interventions, but for the *life saving* cases, they'd be referred to WHC for lots of interventions.

High-risk people can benefit from a low-intervention approach, too. I don’t know anything about Serena Williams’ birth but if she’s anything like 99% of women who give birth in American hospitals, she probably had no one to provide individual hands-on support during labor, which studies have shown can reduce c-sections. Avoiding a c-section is especially important for someone who has a blood clotting disorder since c-sections put even healthy people at a higher risk of blood clots.

the point is, more crunchy birth centers are not going to help Serena Williams (and other high risk women) who need to give birth in hospitals with more facilities, not fewer.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Agreed - many of the most tragic cases do not involve a lack of intervention as the root cause. It often is an issue of no one listening to and closely watching the mother, and an over-reliance on test results to show danger signs, when tests can be wrong, or totally ineffective if no one in authority looks at them. I think the midwife culture of large amounts of time spent with mothers (at appts, in labor and after) and a focus on listening to the mother and taking her subjective experience seriously, is something OBs could really learn from. Midwives can screw up like anyone else, but they at least are starting from the viewpoint that the mother’s experience matters and that a healthy baby is not the only goal.

I think Shalon Irving is a good example of this - she was known to be high risk and was pretty closely monitored through her pregnancy, but after giving birth even though she knew something was wrong and told doctors that repeatedly, they ignored her because her tests didn’t seem that abnormal. But had they listened to her and examined her more closely, they may have been able to save her life.

so basically ... she lacked inteventions!! failing to see here how "low intervention" is a solution.

[Anonymous]

Anonymous wrote:I am a woman of color who has to have a c-section due to a myomectomy last year and all I can say is all these stories in the news lately (and this thread) terrify and sadden me. I keep telling my husband he will have to stay vigilant in the hospital. I don’t know what else I can do really, and that feels tragic.

Take birthing classes and get a doula!! (Even for a C section, they can be great support.)

[Anonymous]

Anonymous wrote:DD was delivered at Inova Loudoun. I was examined repeatedly by both post-partum nurses and CNMs (initially by the CNM that handled delivery, then later 2 exams by the CNM on-call). They palpated the uterus, checked blood/discharge levels, discussed post-partum symptoms, etc. Nurses checked blood pressure every few hours and drew blood every few hours for the first 24 hours post-delivery (PROM, and I think they were monitoring for signs of infection with the bloodwork). We received excellent care. Reading some of these stories, I'm very thankful I had no complications. I didn't realize just how prevalent these issues are, even in this area.

I delivered 3 babies at Inova Loudoun, and I'm shocked for the posters who didn't have a dr. visit. My ob checked me everyday I was in the hospital (had vaginal deliveries) with each kid, including performing physical exams. I thought that was standard post delivery care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Women--of all races--are just not empowered in this country to make our own medical decisions about pregnancy and birth. And it shows in our absolutely dreadful maternal mortality and morbidity statistics.

Interestingly, the book All Natural has an excellent chapter on childbirth in which the author compared the data from the Family Health & Birth Center in NE DC and found that practice had significantly better maternal outcomes than the city's and country's overall dismal outcomes, despite serving a mostly low-income, non-white population. His hypothesis is because the midwives' approach is more woman-centered/high-touch/low-intervention.

It's not because it's "low intervention"!! What high-risk women like Serena Williams (and the moms/babies whose terrible care cause UMC to close its maternity ward) need MORE intervention, not less. Family Health & Birth likely has better outcomes due to just better and more attentive care -- which yes, includes in some cases eliminated unneeded interventions, but for the *life saving* cases, they'd be referred to WHC for lots of interventions.

High-risk people can benefit from a low-intervention approach, too. I don’t know anything about Serena Williams’ birth but if she’s anything like 99% of women who give birth in American hospitals, she probably had no one to provide individual hands-on support during labor, which studies have shown can reduce c-sections. Avoiding a c-section is especially important for someone who has a blood clotting disorder since c-sections put even healthy people at a higher risk of blood clots.

the point is, more crunchy birth centers are not going to help Serena Williams (and other high risk women) who need to give birth in hospitals with more facilities, not fewer.

I never said high-risk people should deliver out of the hospital. But what's wrong with a collaborative approach with a midwife-OB team, then you deliver in the hospital with a doula to assist? That's the ideal and not out of the realm of possibilities at all.