Reply to Story about the "free birthers." Anyone read it?

Forum Index » Health and Medicine

Reply to "Story about the "free birthers." Anyone read it?"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I am not a freebirther but I did have three homebirths with certified nurse-midwives and a hospital less than 10 minutes away.

I do think though that it's important to recognize as well the risks to women and babies both*from* the hospital. Some non-zero number of babies are born still due directly to medical interventions/malpractice. And a much larger than necessary number of women are harmed --many permanently -- or even killed by medical malpractice as well. One of the reasons that maternal mortality is so much higher in the US than in other developed countries is that women become secondary to babies in the labor and delivery process. Like so many of the PP upthread -- you cast aspersions and yes, hatred towards women who choose to freebirth (and/or homebirth) and accuse them of caring about their experiences more than their babies' lives, but there are very real risks to modern obstetric practices.

Women die *because* of medical practices -- and malpractice and not always for lack of them. In fact, half the maternal deaths are preventable! That's not about how dangerous childbirth is inherently -- it's how screwed up and flawed our obstetric system is.

Yes, a live mother and baby at the end of the process is absolutely the goal, but the mother should not have to sacrifice her own physical well-being because of the laser focus on delivering her baby rather than keeping her safe and comfortable throughout the process.

See this story just published today in the NY Times:

https://www.nytimes.com/2018/11/16/opinion/sunday/maternal-mortality-rates.html?action=click&module=Opinion&pgtype=Homepage

And of course this landmark series from ProPublica earlier this year:

https://www.propublica.org/series/lost-mothers

So instead of hating on freebirthers, maybe you could be a little more critical of our truly poor healthcare system and try to imagine why women would object to being part of that system. It's not a choice I would make -- but it's also not appropriate IMO to dismiss all concerns about the medical system as whacko.
[/quote]

Completely illogical. The women who died in those stories needed more medical care, not less.[/quote]
If by “more care” you mean “the most basic care available” then yes, they needed more care.

Because what’s really happening in Westernized countries is obstetrics providers (OBs and midwives) becoming too dependent on technology ($$$$$) to tell them if something is wrong. Modern women dying of 16th century childbirth killers is making them wake up to the fact that we’ve reached the point of over-dependence on technology to the exclusion of basic medical care. More isn’t always better.

I read through all the Lost Mother stories and have been following these articles on maternal mortality. Most of the deaths and near deaths detailed there were from complications that are treatable, but the providers missed something they would have picked up on had they paid more attention to the new mom’s symptoms instead of dismissing everything but a beeping monitor or a positive lab result. The miraculous medical advance California started implementing to reduce deaths from severe postpartum hemorrhage? Crash carts to weigh bloody pads on a scale rather than the old method of care, which was to assume a woman was bleeding normally until she started going into shock. Oh, and reducing elective inductions and c-sections to reduce the risk of severe postpartum hemorrhage happening in the first place. Novel approach medical community!

And doctors are generally hugely dismissive of the risks associated with the technology they use, believing that if something is life-saving in some circumstances it must be harmless when applied to everyone, even healthy people. It’s not! Especially not when you are getting the stellar combination of ultra-technology + minimum basic care.[/quote]

Can't you even see the contradictions?  You first write, that OBs are "too dependent on technology" and then you acknolege the proven efforts to reduce mortality (crash carts and other techniques to ACCESS technology).  There is some role for reducing c-sections, but again, that's STILL dependent on modern technology to monitor the labor.  And I don't believe there is any evidence about inductions increasing maternal mortality -- the research I've seen indicates the reverse.

Women need MORE and BETTER medical care. Not less.  [/quote]
I wrote that inductions increase the risk of severe postpartum hemorrhage, which is more likely to kill you in the modern U.S. than the non-severe kind that sometimes happens after spontaneous labor for which the treatment is usually one or two shots of pitocin (both kinds of hemorrhage are extremely dangerous in under-resourced areas where hospitals don't typically have supplies of pitocin or blood banks).

Here are some articles that make a strong or significant association between induction and severe postpartum hemorrhage:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054858
https://www.sciencedirect.com/science/article/pii/S0002937810000220
https://www.sciencedirect.com/science/article/pii/S0002937810010264
https://europepmc.org/abstract/med/21366123
https://www.tandfonline.com/doi/abs/10.3109/00016349.2010.514324
https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0412.2011.01298.x
https://link.springer.com/article/10.1007/s00404-015-3725-y

Also, extra high-tech monitoring during labor does not reduce the need for c-sections, in fact, continuous fetal monitoring has been shown in study after study to do nothing but increase intervention without improving outcomes at all. What California did to reduce c-sections was to train nurses to provide more one on one labor support to the mom, to urge doctors to exercise patience during labor (and gave them tools for how to know when it is appropriate to intervene, to minimize errors of judgment) and to use intermittent rather than continuous fetal monitoring for low-risk patients.

So yes, more attentive, personalized, low-tech care combined with judicious use of technology is what is needed as demonstrated by California reducing maternal mortality by half with these simple measures… and if you do that stuff at baseline then you won’t need as much of the high-tech care, and those resources can be focused on those who need them the most.[/quote]

Once again, you completely miss the point.  Women die because they don't get the high tech care they need, FFS!  Women get induced due to conditions that will hurt them or hurt their babies.  Just waiting it out does not actually improve infant or maternal health. https://www.washingtonpost.com/national/health-science/should-pregnant-women-be-induced-at-39-weeks/2016/06/27/e1bb9d16-27fe-11e6-b989-4e5479715b54_story.html?utm_term=.f08fbe2960d9

The problem is that high-risk women are being ignored and not getting the advanced medical care they need.  Particularly women of color.

[/quote]
There’s actually a mountain of evidence that a lot of the things they induce for don’t improve outcomes.
http://www.childbirthconnection.org/giving-birth/labor-induction/research-evidence/research-and-evidence-q-a/common-reasons-given.html

At the end of the day, a 55% reduction in maternal mortality in the span of a few years by implementing a low-tech/low-intervention care model pretty much speaks for itself.[/quote]

That article is worthless.  The ARRIVE trial (a randomized trial) showed fairly conclusively that induction at 39 weeks improves outcomes.  It's REALLY shameful how you try to scare women away from getting adequate medical care.  And that's just for low-risk women.  https://www.nejm.org/doi/full/10.1056/NEJMoa1800566[/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics