Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
My theory is that WOC have a higher maternal mortality rate because they have a higher c-section rate, which is itself correlated with a higher mortality rate. Why doctors perform more c-sections on Black women than white women probably has to do with the overall lower standard of medical and particularly obstetric care Black women receive in the U.S (not just poor— read about Serena Williams, a wealthy athlete in fantastic health, being ignored by her medical providers) and the belief among medical practitioners that everyone— but especially women and ESPECIALLY WOC should just blindly do as they say— even if that’s just to get that medical student his first surgery.

Interesting. So you think that C-sections have a higher mortality rate, and a higher C-section rate in a given population is an indicator of lower quality of care.

Wouldn't that point toward the need for the obgyns to have tools and tricks OTHER than a C-section in their repertoire?

I don’t “think” anything, the data is pretty cut and dried on the subject.

But forceps and vacuums in the hands of people who are ignoring what their patients are telling them (again, read about Serena Williams’ birth and how long she had to wait for correct care) are just as potentially dangerous as a scalpel, just not as lucrative. I think the problems arise before the forceps or the scalpel. OBs for sure need more training, but on issues like collaborative decision making and perverse incentives. Forceps are not going to solve that, although if you said something like, OBs should be trained on uncomplicated breech presentation, I might be more inclined to agree .

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
My theory is that WOC have a higher maternal mortality rate because they have a higher c-section rate, which is itself correlated with a higher mortality rate. Why doctors perform more c-sections on Black women than white women probably has to do with the overall lower standard of medical and particularly obstetric care Black women receive in the U.S (not just poor— read about Serena Williams, a wealthy athlete in fantastic health, being ignored by her medical providers) and the belief among medical practitioners that everyone— but especially women and ESPECIALLY WOC should just blindly do as they say— even if that’s just to get that medical student his first surgery.

Interesting. So you think that C-sections have a higher mortality rate, and a higher C-section rate in a given population is an indicator of lower quality of care.

Wouldn't that point toward the need for the obgyns to have tools and tricks OTHER than a C-section in their repertoire?

70% of births are vaginal! What magic happens in that additional 10-15% do you think? The very nature of those 10-15 being the risky ones who need to learn elaborate maneuvers for?

Anonymous wrote:

Anonymous wrote:
My theory is that WOC have a higher maternal mortality rate because they have a higher c-section rate, which is itself correlated with a higher mortality rate. Why doctors perform more c-sections on Black women than white women probably has to do with the overall lower standard of medical and particularly obstetric care Black women receive in the U.S (not just poor— read about Serena Williams, a wealthy athlete in fantastic health, being ignored by her medical providers) and the belief among medical practitioners that everyone— but especially women and ESPECIALLY WOC should just blindly do as they say— even if that’s just to get that medical student his first surgery.

Interesting. So you think that C-sections have a higher mortality rate, and a higher C-section rate in a given population is an indicator of lower quality of care.

Wouldn't that point toward the need for the obgyns to have tools and tricks OTHER than a C-section in their repertoire?

Anonymous wrote:

Anonymous wrote:
My theory is that WOC have a higher maternal mortality rate because they have a higher c-section rate, which is itself correlated with a higher mortality rate. Why doctors perform more c-sections on Black women than white women probably has to do with the overall lower standard of medical and particularly obstetric care Black women receive in the U.S (not just poor— read about Serena Williams, a wealthy athlete in fantastic health, being ignored by her medical providers) and the belief among medical practitioners that everyone— but especially women and ESPECIALLY WOC should just blindly do as they say— even if that’s just to get that medical student his first surgery.

Interesting. So you think that C-sections have a higher mortality rate, and a higher C-section rate in a given population is an indicator of lower quality of care.

Wouldn't that point toward the need for the obgyns to have tools and tricks OTHER than a C-section in their repertoire?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who is this poster arguing for forceps? I had forceps and they were horrific. Absolutely horrific. A baby getting ripped out of me with BBQ tongs and ripping off my pelvic floor muscles from the bone in the process. Levator ani avulsion is permanent. It’s often caused by forceps, and there are boatloads of evidence about the damage forceps causes - anal incontinence, LAA, injuries to the baby, and prolapse. Literally there are European countries that don’t use them at all anymore and just use ventouse/vacuum. They represent less and 2 percent of US births because they are antiquated and dangerous and need to go away. There are better alternatives than a technology invented in the MIDDLE AGES!

One of the misogynist natural birth proponents. It is absurd.

Funny you think I’m a natural birth proponent. I’m a proponent for informed women giving birth and getting full information about risks and benefits for their health for the rest of their life. I don’t believe in one size fits all medicine or birth and I am not a proponent of natural birth by any stretch. But I do think forceps are an antiquated tool that has shown through much evidence statistically significant rates of maternal injury that to me, mean alternatives should be used or women need to be completely and totally informed of the many downsides of a forceps birth.

Anonymous wrote:
My theory is that WOC have a higher maternal mortality rate because they have a higher c-section rate, which is itself correlated with a higher mortality rate. Why doctors perform more c-sections on Black women than white women probably has to do with the overall lower standard of medical and particularly obstetric care Black women receive in the U.S (not just poor— read about Serena Williams, a wealthy athlete in fantastic health, being ignored by her medical providers) and the belief among medical practitioners that everyone— but especially women and ESPECIALLY WOC should just blindly do as they say— even if that’s just to get that medical student his first surgery.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
The c-section rate in Norway is between 15-17% so while I’m sure their surgeons train, they have significantly *more* training on vaginal birth. They also have an absolutely minuscule maternal mortality rate compared to the U.S, especially compared to the U.S maternal mortality rate among WOC. I don’t think “dead mother” is an imperfect outcome of which we should be tolerant.

I don't really understand your point. You said we shouldn't teach doctors non-Cesarean tricks and maneuvers because that requires much experience, and they'll just go and train on poor WOC and that's why we shouldn't do it. Did you mean that only for America? So, like, it's OK for foreign obs to learn and practice these skills because they learn and practice in a more ethical manner?

Or, do you believe that 85% of all births in Norway are perfectly uncomplicated vaginal deliveries where all doctors do is drink tea? Or could it be they were taught some midwifery skills and maneuvers to support vaginal birth before grabbing a scalpel?

And that really doesn't answer the question of how they train without a pool of WOC to experiment, as you say, on. Do you think they emerge from womb perfectly skilled in everything? How *do* they train?

I think you’re mixing me with another poster. I said that our current model does train on low income WOC— it just trains them to practice on c-sections on low income WOC who consequently have a dramatically higher maternal mortality rate.

So your theory is that poor WOC have a dramatically higher maternal mortality rate because doctors use them to practice C-sections?

What is the evidence for this?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
The c-section rate in Norway is between 15-17% so while I’m sure their surgeons train, they have significantly *more* training on vaginal birth. They also have an absolutely minuscule maternal mortality rate compared to the U.S, especially compared to the U.S maternal mortality rate among WOC. I don’t think “dead mother” is an imperfect outcome of which we should be tolerant.

I don't really understand your point. You said we shouldn't teach doctors non-Cesarean tricks and maneuvers because that requires much experience, and they'll just go and train on poor WOC and that's why we shouldn't do it. Did you mean that only for America? So, like, it's OK for foreign obs to learn and practice these skills because they learn and practice in a more ethical manner?

Or, do you believe that 85% of all births in Norway are perfectly uncomplicated vaginal deliveries where all doctors do is drink tea? Or could it be they were taught some midwifery skills and maneuvers to support vaginal birth before grabbing a scalpel?

And that really doesn't answer the question of how they train without a pool of WOC to experiment, as you say, on. Do you think they emerge from womb perfectly skilled in everything? How *do* they train?

I think you’re mixing me with another poster. I said that our current model does train on low income WOC— it just trains them to practice on c-sections on low income WOC who consequently have a dramatically higher maternal mortality rate.

Anonymous wrote:

Anonymous wrote:
The c-section rate in Norway is between 15-17% so while I’m sure their surgeons train, they have significantly *more* training on vaginal birth. They also have an absolutely minuscule maternal mortality rate compared to the U.S, especially compared to the U.S maternal mortality rate among WOC. I don’t think “dead mother” is an imperfect outcome of which we should be tolerant.

I don't really understand your point. You said we shouldn't teach doctors non-Cesarean tricks and maneuvers because that requires much experience, and they'll just go and train on poor WOC and that's why we shouldn't do it. Did you mean that only for America? So, like, it's OK for foreign obs to learn and practice these skills because they learn and practice in a more ethical manner?

Or, do you believe that 85% of all births in Norway are perfectly uncomplicated vaginal deliveries where all doctors do is drink tea? Or could it be they were taught some midwifery skills and maneuvers to support vaginal birth before grabbing a scalpel?

And that really doesn't answer the question of how they train without a pool of WOC to experiment, as you say, on. Do you think they emerge from womb perfectly skilled in everything? How *do* they train?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who is this poster arguing for forceps? I had forceps and they were horrific. Absolutely horrific. A baby getting ripped out of me with BBQ tongs and ripping off my pelvic floor muscles from the bone in the process. Levator ani avulsion is permanent. It’s often caused by forceps, and there are boatloads of evidence about the damage forceps causes - anal incontinence, LAA, injuries to the baby, and prolapse. Literally there are European countries that don’t use them at all anymore and just use ventouse/vacuum. They represent less and 2 percent of US births because they are antiquated and dangerous and need to go away. There are better alternatives than a technology invented in the MIDDLE AGES!

One of the misogynist natural birth proponents. It is absurd.

Funny you think I’m a natural birth proponent. I’m a proponent for informed women giving birth and getting full information about risks and benefits for their health for the rest of their life. I don’t believe in one size fits all medicine or birth and I am not a proponent of natural birth by any stretch. But I do think forceps are an antiquated tool that has shown through much evidence statistically significant rates of maternal injury that to me, mean alternatives should be used or women need to be completely and totally informed of the many downsides of a forceps birth.

ACOG disagrees with you. https://www.dona.org/acog-to-obs-consider-operative-vaginal-delivery-to-reduce-cesareans/

And I don’t agree with them because of the large body of evidence showing how much harm is caused by forceps. There are plenty of researchers who have done studies on this, Handa, Dietz, Shobieri, etc. Forceps births keep urogynecologists in business though. So the forceps birth might be cheaper than the C section in 2022, but the sacrocolpolexy and the months of pelvic PT years later is probably going to be at least 6 figures in health care costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who is this poster arguing for forceps? I had forceps and they were horrific. Absolutely horrific. A baby getting ripped out of me with BBQ tongs and ripping off my pelvic floor muscles from the bone in the process. Levator ani avulsion is permanent. It’s often caused by forceps, and there are boatloads of evidence about the damage forceps causes - anal incontinence, LAA, injuries to the baby, and prolapse. Literally there are European countries that don’t use them at all anymore and just use ventouse/vacuum. They represent less and 2 percent of US births because they are antiquated and dangerous and need to go away. There are better alternatives than a technology invented in the MIDDLE AGES!

One of the misogynist natural birth proponents. It is absurd.

Funny you think I’m a natural birth proponent. I’m a proponent for informed women giving birth and getting full information about risks and benefits for their health for the rest of their life. I don’t believe in one size fits all medicine or birth and I am not a proponent of natural birth by any stretch. But I do think forceps are an antiquated tool that has shown through much evidence statistically significant rates of maternal injury that to me, mean alternatives should be used or women need to be completely and totally informed of the many downsides of a forceps birth.

ACOG disagrees with you. https://www.dona.org/acog-to-obs-consider-operative-vaginal-delivery-to-reduce-cesareans/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who is this poster arguing for forceps? I had forceps and they were horrific. Absolutely horrific. A baby getting ripped out of me with BBQ tongs and ripping off my pelvic floor muscles from the bone in the process. Levator ani avulsion is permanent. It’s often caused by forceps, and there are boatloads of evidence about the damage forceps causes - anal incontinence, LAA, injuries to the baby, and prolapse. Literally there are European countries that don’t use them at all anymore and just use ventouse/vacuum. They represent less and 2 percent of US births because they are antiquated and dangerous and need to go away. There are better alternatives than a technology invented in the MIDDLE AGES!

One of the misogynist natural birth proponents. It is absurd.

Funny you think I’m a natural birth proponent. I’m a proponent for informed women giving birth and getting full information about risks and benefits for their health for the rest of their life. I don’t believe in one size fits all medicine or birth and I am not a proponent of natural birth by any stretch. But I do think forceps are an antiquated tool that has shown through much evidence statistically significant rates of maternal injury that to me, mean alternatives should be used or women need to be completely and totally informed of the many downsides of a forceps birth.