Forced Medicalization of US Births?

I might be an odd case-I guess I am.  As I said above, I don't want VBAC, despite my doctor trying to talk me into it.  I honestly didn't want VB at all!  Just not interested...to be honest, rather turned off and creeped out by the whole process. 


And CSA Expatriate-I have seen the "Ican" website before, and I'll take another look at it before writing a longer response, but  don't think it will matter much.  I do know of the cancer patient case-if it's the one I'm thinking of, Angie C., I think her name was?  Susan Faludi told the whole story in Backlash.  While I think it was a horrible, horribly tragic case, I also think it was fairly isolated.  Again, I have not looked at the Ican site yet, but as far as I know, nobody can force you to induce (unless your are preeclamptic or something where there is a baby-health-in-jeopardy issue) and nobody can force you to accept pain meds.  I don't know anyone who didn't have pretty much the exact birth experience they were looking for, from my labor (though I really didn't want to do it, I did it) and c-section to a friend's completely natural hospital birth to another friend's epidural hospital birth.
Just goes back to my point about Naomi Wolf, which I was pleased to see your thoughts on.  She didn't do anything to educate herself, then blamed everyone else because nobody bent over backwards for her.  What kind of feminist is that?  The "hand me everything on a platter I shouldn't have to take responsibility for anything" kind I guess. 

Saf, I'm not interested in taking away the option of repeat c-section for moms such as yourself, what I am interested in is returning the option of many mothers to have VBAC's, or even a normal, low-risk, non-interventive births.   As the situation stands now, and as I posted on the other thread, there is a marked resistance on part of the obstetrical community to uphold the rights of many women to make these decisions.  As a result, many, many, MANY women are strongarmed, bullied, or coerced into accepting procedures, and yes, even c-sections they don't want.  The thing that really ticks me off, is I've read the research, and I've seen the studies.  So have many others.  And what we can't wrap our minds around is this fact that although VBAC has been shown to be safer than repeat c-section again and again, and while non-interventive, unmedicated vaginal birth has been shown to be safer than its alternative, the obstetrical community not only ignores it, they continue to practice just the way they've always done. 

Here are some basic statistics from 2000 published in a study done by the CDC:

80% of all women receive pitocin, either to augment or to induce labor.  This is despite the fact that fewer than 4% of all labors actually qualify as being "dysfunctional," in the sense of contractions either being ineffectual or sporadic and needing regulatation.  Pitocin has several risks associated with it, and the doctors who first studied it to be used for dysfuctional labor, strongly warned against its being used prolifically.  Dangers such as: tetanic contractions, fetal distress (because of severe decrease in oxygenation), hemmorhage, and uterine rupture in even previously unscarred uteri, are all associated with the overuse of pitocin in labor. 

60% of all women who give birth vaginally receive episiotomies.  This, despite all the research and the World Health Organization's own advisory that only about 20% of women suffer any perineal injury when initally left intact.  That means a LOT of women are receiving gratuitous cuts to their vaginal opennings, with the justification that they would "tear if not cut."  Not only that, but research also has indicated that tears heal much better than cuts do, since tears usually do not reach down to the muscle layer.  Often, superficial tears in the epidermal layer will compensate enough to avoid the laceration reaching deep into the muscle underneath.  However, with episiotomies, the cut almost always goes directly into the muscle, not just the skin, resulting in a more painful injury, along with thicker scar tissue which is more likely to tear again in future births.  The logic behind obstetrical use of episiotomies is as follows:
1.  If a woman is cut, she avoids a tear to her perineum, which is worse than a cut. (Studies have disputed this time and again.  Also, I love the fine reasoning that goes into electing a definite injury to "avoid" another which may or may not occur.)

2.  A cut is easier to stitch than a tear. (Yes, easier for the physician, but more painful for the patient.  Also, a good friend of mine who is a midwife, told me about a recent experience of a client of hers, who had to be transferred from home to hospital to repair a 2nd degree tear.  The OB was in a rush, and so instead of carefully piecing it together and repairing like he should, he just bunched up the ends, snipped off the EXTRA so that he had nice, straight, even edges, and sewed her up that way.  My friend was horrified, and felt sick to her stomach when she realized what he'd done.  Who cares about all those lost nerve endings and "extra" flesh???  Ok, getting angry here, gotta calm down.)

3.  An episiotomy often means the baby can be born faster, thereby pacifying the impatient OB who is ready for the delivery to be done and over with.  (Yes, this happens, A LOT.)  Other times, it's just done because that is what the OB learned in medical school, and really believes most women need to be cut.

4.  An episiotomy is a billable procedure.  Gentle massage of the perineum, and controlled, patient delivery of the head is not. 

As far as the charge that forced c-sections are very rare, I don't agree. But I am counting all the moms who wish to have VBAC's, but are told by their doctors that either 1.) the doctor's practice no longer does them, or 2.) the hospital the doctor delivers at has banned them.  Both situations are quite common in many states.  In fact, the two hospitals near me both have banned VBAC's from being allowed.  If you've had a prior c-section, or any type of uterine surgery, you must have a scheduled c-section.  The birth center I had my son at, can no longer permit VBAC clients since their back-up obstetrical practice decided not to take VBAC's anymore.  The birth center is contrained to follow the practices of their back-up doctors.   
So, as a result, most women who have had one c-section, end up having repeat sections because they cannot find even one doctor in their area, or hospital,  which will deliver them vaginally.  A few end up going the route of using illegal homebirth midwives to avoid unwanted surgery, or even going the route of unassisted birth (no attending doctor or midwife).  The rest resign themselves to surgery, with all the attending risks of increased chances of: secondary infertility, placental abruption, placenta previa, and placenta acreta in future pregnancies, and uterine rupture.  (I know of two women who experienced uterine rupture in their subsequent pregnancies--that is, they never even made it to labor.  The old scar openned up, and they both luckily caught it in time and their babies survived.)  Uterine rupture is not the result of VBAC, but is indicated because of prior c-section.  So, the ACOG's allegation that VBAC's are the cause of UR is really an avoidance of the real culprit: primary or previous c-section. 

Also, there have been two cases recently where hospitals have obtained court orders to try to force women to have c-sections.  One was in Utah, the other here in my state, Pennsylvania.   In the Utah case, the woman was a citizen of another country, pregnant with twins.  She was told if she didn't have a c-section, one or both babies could die.  She refused, stating that she'd already had one c-section previously, and had almost died.  Also, if she had another c-section, it would almost impossible for her to be able to deliver safely any future babies, since c-sections were very hard to come by where she was from and she'd most likely need access to section for future pregnancies.  Well, one of the babies did die, and she ended up with the surgery anyway because they court ordered her to have it done. 

The second case, here in PA, was of a woman who was delivering her 7th child, I believe.  She had had vaginal deliveries with all of her previous babies, some of them quite large.  Well, she was told by the hospital that due to a third trimester ultrasound showing her baby to weigh more than 14 lbs, she needed to have a c-section.  Nevermind that late ultrasounds are notoriously inaccurate, with an error margine of plus or minus 2 lbs.  Anyway, she and her husband refused, and while she was in labor, they left that hospital and went to another, to vaginally deliver a healthy girl, 11 lbs.  (Her other babies had been about this size too).  Come to find out, the first hospital had gone and obtained a court order for a c-section, expecting her and her husband to return.  I guess security was prepared to physically restrain and force her to go under the knife.  The couple are in the process of suing the hospital (good for them!!)

As far as "informed consent" and all of that, yes, doctors and hospital staff are supposed to inform and get consent for everything from an I.V. to an episiotomy.  However, what really happens is most women arrive at the hospital in labor.  They are told to sign lots of forms, which basically give the hospital carte blance approval for any and every procedure.  One scenario which oftens occurs when a woman is faced with a procedure she doesn't want, after being admitted, is say for example she doesn't want pitocin to augment her labor.  The baby is stable, she is stable, but the hospital wants to get her "on the clock."  She refuses, and is told she "signed the consent form" and must comply.  If she still refuses, the hospital staff informs her, if she does not follow their "medical advice" she will be discharged immediately "A.M.A.--Against medical orders" and left to her own devices.  Hopefully to find another hospital who won't strongarm her into doing what they want.  Or, to give birth at home unassisted.  Meanwhile, the hospital logs its protest to the womans insurance company, who promptly refuses to cover the charges, meaning the woman is left to pay for whatever care she'd recieved at the hospital, despite being discharged.  And you better believe hospital staff will use such actions as a threat to get a patient to comply with their "guidelines." 

Again, it doesn't matter that the hospital's "guidelines" that every woman receive a, an I.V., b, pitocin, c, internal or continuous fetal monitoring and so on, doesn't follow the evidence-based practice proved over and over by research over the last sixty years.   It is such a huge mess right now, that honestly, any woman who goes into pregnancy and delivery without the slightest knowledge of these procedures and attending risks has NO chance of recieving that information from the hospital or the doctors.  The "informed consent" which accompanies most c-sections or epidurals is a joke.  I've even heard "Oh, c-sections are as safe as vaginal birth, and you won't get incontinence this way."

GRRRRR!!!   First of all, unplanned c-sections have roughly 4 times the mortality rate as vaginal birth for women.  Planned c-sections pose twice the risk.  Second of all, it is mainly pregnancy itself, not vaginal birth which results in incontinence.  Not to mention during c-section, they literally peel your bladder off your uterus--I can't imagine how positive an effect that must have on urinary incontinence!  Also, the cases where women do suffer from incontinence after vaginal birth, are again, mostly caused by the handling of the delivery, itself, (forceps, episiotomy, vacuum-assisted delivery, forced pushing flat on the back), which ends up being the real culprit.

But, now you have a bunch of women out there believing that c-sections are as safe as vaginal birth, that epidurals have little or no effect on either the labor itself, or the baby, that giving birth vaginally means you will probably have urinary incontinence, and that if it wasn't for the doctor and his machines, drugs, and scissors, most women would certainly die, or lose their babies, in childbirth.  Talk about mispresentation of the facts!


Having said all that, I am not opposed to medicine, nor do I believe that it never has its uses.  I am also not saying that all women should have to go unmedicated or that women who desire c-sections should be denied them.  I actually support a woman's choice in how she wants to deliver, whether that be primary, elective c-section, or at home, unassisted, with just her and her family in attendence.  But, shocking as it may seem, the former woman is more likely to be uninformed of the risks posed to her and her baby, by her choice, than the woman goes unassisted.  Why is that?  Because the unassisted movement is a direct backlash of women who've felt sucked in, chewed up, and spat back out by the obestetrical system, and have learned as a result, of the poor outcomes so common with that mindset.  So, they have turned around and learned as much as possible about the birth process, itself, prepared as much as they can for the emergency, trust God and their own bodies for a good result, and accept the risks of something happening that they just cannot change.  They've made their choice, but in full knowledge of the risks.

I wish I could say the same for the majority of women in the U.S., but I know that's just not the case.  Women do need to be more responsible for learning and preparing themselves, but then, so do the doctors.  "First, to do no harm" is their mantra and their oath.  So why do they ignore it so often?  Doctors have a responsibility to divulge the full set of risks, as well as possible benefits of any procedure or practice.  And they are just not doing that.

Rebekah

Oh, I almost forgot--a very good book to read on this subject is: Lying-In: A History of Childbirth in America[/u], Dorothy C. Wertz and Richard W. Wertz.

It is a comprehensive history of the practices and philosophies surrounding pregnancy and childbirth since the founding of the country.  It is a valuable resource in many universities and medical schools.  I highly recommend it.

Rebekah

I never read this book, but if I understand correctly, it's a misguided pile of poo? 

Just for a US point of view, I recently gave birth in the US, and can tell you I was severly disapointed with the medical system.  It didn't help the my husband spent the whole pregnancy saying 'We don't do that in the UK' and 'The rest of the world doesn't run that test'.  For the record, I read 'What to Expect When You're Expecting' and enjoyed it.  It was great for the pregnancy, but it also gave me a heads up to what I would have to deal with if I gave birth in a hospital. 

I started out with a highly recomended OB/GYN that the ladies at work use and are still very happy with.   Early on I knew I wanted an unmedicated birth.  Telling my doctor this, she told me to talk to the nurses at the hospital.  This let me know that she was only going to be there to 'catch'.  The hospital said they would work with me, but with further research, I realized that the baby had to goto the nursery for 4 hours after birth and they wanted to run blood tests and give him a Hep B shot in the first 24 hour.  That was a deal breaker. 

Luckly, I found a birthing center near my house run by a wonderful midwife.  So after only 12 hrs of labor that I would rate as a 9-1/2 on the pain scale, and 45 min. of pushing, Sean Michael was born.     There were no pain meds, (she didn't even have any on site if I demanded them).  I did have an episiotomy,    but that was my own fault for not doing my streaches (and the baby was 2-1/2 weeks late (can you say big baby)).  I think the midwife was more disapointed about the episiotomy than I was, but the baby's heart rate was getting funky and he had to come out NOW.    For the record, I didn't feel the cut, but since she made a very small cut, I tore as well and that hurt like hell (pardon the expression).  She spent a whole 1/2 hour afterwards stiching up all of the flaps, peices, and holes.  We went home 4 hours after birth and took him to the pediatrician ourselves the next morning. 

I did have an IV (I needed antibiotics since I was a carier of a strain of bacteria in my intestinse that can harm newborns.  They do get kind of close to your butt hole).  And I did get pitocin after since I was bleeding a bit much.  I hope that people don't think that everyone has to deliver in a hospital or on you own at home in the US.  For those coming over here is a web site where you can search for midwives in you are.

http://www.acnm.org/

Goto find a midwife.  Some work with hospitals, and some work independent.  The US isn't all that bad, but to many people just don't know that they have an option. 

PS pardon my spelling, I wish this had spell checker.

I very much agree that women in the U.S. don't necessarily have to have a bad or poor experience, if they take the time to educate themselves and avail themselves of all their options.  (Sara, you hear that?  You'll do great over here, I'm sure!)  But, there aren't that many birth centers, nationwide.  If you live close to a large city, and lucky enough to have one around, that's great.  I gave birth in a birth center that was 50 minutes from here, without traffic.  With traffic, it's about an hour and a half drive.  And, I was due in January, so I was really praying not to go into labor during a snow storm in Pennsylvania!  I would NOT do the hospital scene though, because if I got things like an I.V. or pitocin (I got the shot after I gave birth, because I was bleeding pretty heavily), I wanted to make sure it's because I really needed it--like the poster above.  I had a really good experience, because I had my baby out of the hospital.  If I hadn't lived near enough to a birth center, though, I'd have given birth at home, pure and simple.  I also found it ridiculous how long they'd want to keep my son separated from me, and the whole bit about giving the Hep B shot right after birth.  Give me a break. 

Not every woman has the option of a birth center, and not every woman's insurance will cover it, even if available.  Most women have to go the hospital route if they can't afford to pay the midwife's fee out-of-pocket.  We have doctor's lobbies to thank for that.  It was the then-mostly male profession of OB's who decided at the beginning of the 20th century that midwifery was costing too much in terms of valuable training "material."  In other words, since most women still gave birth at home, it was depriving a new profession of valuable experience, not to mention money made.  So, the doctors lobbied successfully against midwifery, and succeeding in having midwives made illegal.  To this date, the only midwife which is legal in all 50 states, is the "Nurse-Midwife"--who cannot practice outside of the permission of a back-up O.B.  Interpretation: the only midwives doctors will accept mainstream are ones who've received "medical" training first as a nurse, and whose realm of practice as a midwife is still firmly fixed in their domain. 

It's why although I'm training to become a C.N.M. myself, it galls me that if I did open up my own practice or birth center, my ability to accept VBAC's for example, wouldn't depend upon the safety of it, or evidence produced by study after study, or even my own professional judgment.  It would depend solely on the OB who backs me up on whether or not he or she is going to "o.k." that practice.  So, I'd have to hope to find a benign O.B., who is not super conservative in regards to obstetrical practice.  And folks, that is VERY hard to find now.  I hope the U.S. will one day recognise midwives as professionals in their own right, as the U.K. does, and stop making them dance to the tune of the OB's and hospitals.  There is an American I know (she's from the Bay area, CA), who trained and works as a midwife in Brighton, U.K., trying to set up a birth center there.  She and I exchanged emails about this subject, and she although she'd like to come back to the U.S., she cites the anti-midwife, anti-evidence-based approach so prevalent in the U.S. as her main reason for staying in the U.K. 

Does birth in the U.S. have to be so medicalized?  No.  Do women have the power to change that?  They do have some power, if they would just bother to educate themselves (sorry, but "WTEWYE" is like a super-pro medical book--it's got good advice for proper dieting and learning about all the possible problems, but it is awful when it comes to discussing real risks.  It actually makes the statement that c-sections are as safe as vaginal births, gives absolutely no footnotes or cites it info for such claims.   It teaches women to trust their doctors' judgment with regards to almost any procedure.  Which is why so many OB's recommend it.) 

Which book were you referring to as being crappy?  The "Misconceptions" book or "Lying In..?" 

Some links to articles on this topic:

http://www.breastfeeding.com/reading_room/midwives.html
http://www.breastfeeding.com/all_about/all_about_midwives_study.html
http://www.midwiferytoday.com/articles/disinformation.asp
http://www.compleatmother.com/articles3/rogue.htm



Rebekah

P.S.  I'm sorry my posts keep getting looooonger, and loooonger.  As you can see, this subject is one I'm very passionate about.  Poor John always has to hear my rants and ravings about pregnancy and birth, he is a real sport though.  He even supports home birth now, telling his friends who have wives or girlfriends who are pregnant about it.  I think maybe I've gone too far this time in creating a home birth evangelist, lol.

I haven't read either, I was just trying to understand what everone else was getting at. 

You sound like my midwife.  I know what you mean about being backed up by a OB.  When I went past my due date, I wanted to wait it out.  She had to keep checking with her back up OB, and do a little fast talking.  Something alongs the lines that I was going to make my husband deliver the baby at home (he's a paramedic) if I couldn't deliver at the birthing center.      Not realy, but I kept telling him that if the US health system was so bad in his eyes, he could deliver the baby himself.  That usually stopped the complaining.   

Good luck becoming a CNM. 

Becca

P.S. I'm sorry my posts keep getting looooonger, and loooonger. As you can see, this subject is one I'm very passionate about. Poor John always has to hear my rants and ravings about pregnancy and birth, he is a real sport though. He even supports home birth now, telling his friends who have wives or girlfriends who are pregnant about it. I think maybe I've gone too far this time in creating a home birth evangelist, lol.

Precisely why I'm trying to stay out of this topic, Rebekah.  I'm too passionate about it.  I'm totally right there with you in everything you've said.  I think Peedal really said it best though about trusting her body to know what it's doing and that's half the battle right there - most women DON'T.  They don't trust their bodies to know what it's doing and the medical community has women believing that dysfunctional labours and various other things are practically common, hence the wide use of things like pitocin.  In a world, or at least a country like the US, where feminism has brought about a change in consciousness in the way women are viewed in society, it's amazing to me that so many women give their power over to others rather than empowering themselves.   What makes it even more interesting is that so many of these women who have things like pitocin, IV's, episiotomies, etc. truly believe that they absolutely needed them, and you know, perhaps they did.  As I'm not a doctor, who am I to judge?  But I always look askance at such things and wonder if they truly were needed or not.  It's like when I was pregnant with my third daughter, when I told people I wanted to breastfeed despite having trouble breastfeeding my second, so many women would say, "Well, maybe you can't breastfeed."  Nonsense, and that's a whole other subject all together. 

I'm in the realm of "it's all about choices" which is why whenever I start stepping on my soap box, what I'm really saying to people is that they should educate themselves.  Know ALL the facts, including the absolute gory ones you don't want to hear.  Gather the information and make an informed choice.  It's those who fly blind into one thing or the other (whichever end of the spectrum) that get my hackles up.  When I did sort of psuedo-childbirth education, I always said that in the end I supported a woman's right to choose, whatever that meant was right for her, even if I personally disagreed with the choice. 

Another good book that I've not seen mentioned, (or maybe missed the reference to) is Silent Knife by Nancy Wainer Cohen and Loise Estner.  http://www.ican-online.org/shop/book_sk.htm

Wow, I didn't mean to ruffle any feathers.  I totally agree with all of you ladies, that birth doesn't need to be so medicalized all the time.  My main point was that women like Naomi Wolf don't bother to look into their options, and then complain that they didn't have a "Bambi-and-his-Mom" birth experience (you know, surrounded by sweet little animals, chirping birds, etc.  ).  I'm not arguing for medicalization-although I do think it is necessary at times-but simply that if a woman is so certain of what she wants she needs to be a lot more active in making sure she gets it.  Even something as simple as asking to see the hospital's admittance forms, or filling them out in advance, as I did, might help these women to calmly read what they are signing.

And one person here, can't remember who it was, said something I LOVED.  Who spoke about the terrible aftercare, and how no wonder women get PPD?  Because that absolutely happened to me.  I won't go into my entire story-it's too long-but suffice it to say that my nurses ignored me, ignored my needs, and ignored my pain (and I'm speaking of my actual physical pain-one of my nurses even lied on my chart and wrote, "Patient denied pain," which was an absolute load of GARBAGE.)  It was an incredibly upsetting experience, especially after my L&D nurses had been so nice, and I had been honestly looking forward to my hospital stay, thinking I woud learn all about my baby and how to take care of her, I would rest and relax with lots of professionals around to help me, etc.   It was a nightmare, and I honestly believe it set off my depression.  Maybe I would have had it anyway, that's entirely likely.  But it might not have been so bad if I had had more support in the hospital.  I'm definitely not keeping my mouth shut this time-I'll ask for another nurse if I feel the nurse assigned me isn't right for me.  I finally complained when I was getting ready to be discharged (I was told I couldn't leave until the pediatric cardiologist OKd my dd.  Since nobody had said a word to me about a cardiologist, and nobody would explain to me why it was necessary this time, I had a FIT.  I marched up to the nurse's station and demanded to speak to the Nurse Manager, and let her have it.  I caused such a scene that they actually bought me presents to shut me up.    )  Next time I'll know to speak up right away.

Wow, I didn't mean to ruffle any feathers. I totally agree with all of you ladies, that birth doesn't need to be so medicalized all the time. My main point was that women like Naomi Wolf don't bother to look into their options, and then complain that they didn't have a "Bambi-and-his-Mom" birth experience (you know, surrounded by sweet little animals, chirping birds, etc. ). I'm not arguing for medicalization-although I do think it is necessary at times-but simply that if a woman is so certain of what she wants she needs to be a lot more active in making sure she gets it. Even something as simple as asking to see the hospital's admittance forms, or filling them out in advance, as I did, might help these women to calmly read what they are signing.

And one person here, can't remember who it was, said something I LOVED. Who spoke about the terrible aftercare, and how no wonder women get PPD? Because that absolutely happened to me. I won't go into my entire story-it's too long-but suffice it to say that my nurses ignored me, ignored my needs, and ignored my pain (and I'm speaking of my actual physical pain-one of my nurses even lied on my chart and wrote, "Patient denied pain," which was an absolute load of GARBAGE.) It was an incredibly upsetting experience, especially after my L&D nurses had been so nice, and I had been honestly looking forward to my hospital stay, thinking I woud learn all about my baby and how to take care of her, I would rest and relax with lots of professionals around to help me, etc. It was a nightmare, and I honestly believe it set off my depression.

You're not ruffling my feathers, SAF.  But like Rebekah, once I get going on the subject it's REALLY tough to shut me up. 

I do think you have a very good point in the above, and I think this in itself is part of the problem.  Women who are having a baby(ies) NEED a lot of TLC before, during and after.  It is a completely life changing experience whether it's your first child or your fifteenth. 

Medicalisation of births tends to take out much of that TLC, often treating the woman simply as a vessel for the baby to spew forth from rather than a human being.  That in itself is enough to make labour and delivery traumatic enough for a woman that her experience can cause PPD, or at the very least, take away the euphoria of birth and new motherhood, sometimes even affecting the mother's ability to bond with her new baby. 

It's kind of sad in the end.  I'm not anti-medical establishment.  I definitely think that there are times when it's absolutely needed.  Unfortunately, it's fuzzy as to know where exactly the line is that denotes absolute need. 

Can I just thank you ladies for having a brilliant discussion on this topic without getting into a all out spitting and punching fest?

I really do not have much to add other than I tend to agree with Rebekah on most things.  What scared me about Atlanta is that our nearest birthing center (a real one not the new ones some hospitals are calling birthing centers) was in Alabama. 

Even my dearest friend (a Doctor) was given an unneeded C-Section thanks to a different OB/GYN being on call when she went into labor.  Imagine being told after the whole process by your personal Dr. that you really did not need one.     The problem is for many women they get bullied into doing things they don't want to do under the pressure and worry of child birth.  For her it was an issue of being made to feel the child was at risk when in reality the Dr. just wanted to go play golf. 

Some Drs. are even scheduling in inductions and C-Sections to fit an exact delivery date. Now I am sorry but if you don't need it... then what's the point?

I can see Saf's need for a C-Section based on her previous experience.

Why should anyone be made to feel like the choices they make are not right barring gross negligence of the fetus and baby?

Some Drs. are even scheduling in inductions and C-Sections to fit an exact delivery date. Now I am sorry but if you don't need it... then what's the point?

Over here they call it 'too posh to push'. 

Hey everyone,

Sorry I've been out of the loop for a few days.  My son, Jackson, suffered from another recurrent bout of upper respiratory distress (basically, asthma) from catching a cold.  He ended up needing to be hospitalized for a few days this week, and so that's where I've been.  I have to say I LOVE the nurses on the pediatric floor at Bryn Mawr Hospital; absolutely fabulous care each time we've been there (now, three times).  So, see I'm not completely opposed to medicine!      Happy to report, he is home and feeling much better now, and his mother is relieved to be back home in her own bed.

Anyway, Saf, you're not ruffling any feathers at all.  I just really get into this subject and I'm sorry if it seemed I was irritated at you.  I'm not, in fact I enjoyed your post about Naomi Wolf.  We are 100% in agreement on that!  I was actually glad you started this thread, because I think the condition of U.S. obstetrical care needs to be scrutinized and improved upon.  Also, like I said before, I support the right of women to make the best choice for themselves as to what kind of birth they want, whether it be  unassisted homebirth, vaginal unmedicated hospital, medicated hospital, VBAC, repeat c-section, or elective c-section.  There is no risk-free choice, and even if one choice carries a higher set of risks than another, the woman reserves the right to make that call.  It's just that so much of the time, women are not informed, or barely informed, of the risks associated with different choices, or they are forced or coerced into making a decision they are not comfortable with.   

It just boggles my mind how on one hand, pregnant women are almost treated like they have to be protected from themselves by doctors and medical professionals, by the latter either keeping information away from the mothers, or by deciding for the women "what is safest" for them and their babies.  Yet, when she walks out of the hospital, she is suddenly the adult, responsible parent who is now "allowed" to make those calls for herself and her child again.  I mean, yes, there is trust for your doctor, but for me, part of that trust includes the understanding that he or she will give me all the facts, and then allow me to make my own decision, factoring in the doctor's own recommendation.  It's a whole other ballgame when the doctor starts mandating certain courses of action be taken, when no emergency exists, herding along his patient to his own foregone conclusion. Hope that all makes sense.

Elle, your restraint is admirable, lol!  You are right, too, I just can't shut up once I get going on this topic.  Oh well, I suppose it's a good thing I'm passionate about this subject, since it's my longterm goal to become a midwife.  (Thanks, btw, Becca for telling me I sound like your midwife--that is, if she's a nice one, of course.  )  Anyway, you are not kidding about the need for better care, both pre- and post- birth.  In such as transient society as today's, it's appalling how many women are pretty much expected to have a "drive-thru" birth experience.  Come in, labor for several hours, push a baby out, maybe room with another new, tired mom and her crying baby for a day or two, having nurses come in and out, in and out...visitors streaming in, and then get discharged and "See you, have a nice life!"  She comes home with the baby, and if she's lucky, she has a very helpful partner who can afford to take off work and help.  Otherwise, she is on her own.  I really think PPD rates would decrease significantly if post-natal follow-up care was standard for at least a few weeks. 

Vince, thanks for your opinion too! You're right, it is kind of hard for this topic to be discussed amiacably.  I guess it's all such a hugely personal experience, it's really easy for women to get offended or miffed by someone else's viewpoint.  And that's just crazy about the nearest birth center being a few states away!  Do you happen to know if direct-entry midwives are legal in GA?  Just curious.

Here's the site to the place I had Jackson at:
http://www.thebirthcenter.org/

Ok, must end this post before it grows into yet another huge, tumorous post.   Oops, too late.

Rebekah

I have had a few friends here who have been misled in such horrible ways, you want to punch the doctor!  My neighbor is going to school to be an RN/Midwife and she has really helped me with my birthing options.  I'm not pregnant now, but I know I will be in the next couple of years and I want to be prepared.  I always thought that I would have a epidoral and all that, but now, I'm so against it because of what I've seen with my friends.

One of them, she wans't even due until the end of August, but she wanted the baby now and her doctor was going out of town so what did they do?  Induce!  My midwife friend told me that when they induce, she'll have to get an epidural because the pain is so bad, and that after the epidural, that will slow down birth, and the baby might become distressed and they'll have to do a C-Section. I'll tell you, I think she is a fortune teller because that is exactly what happend!  She said that if you can stand the major pain, usually when you get the epidural, if you go without, you'll usually have the baby within the hour.  She also informed me that as soon as I find out that I'm pregnant, I need to start preparing for birth, as it is like a marathon    I'm scared to death of pain, but I also want my baby and I to be healthy and to take as little medication as possible.

I'm glad this post was here, I've learned alot about birth and I can add it to my research for my future kid!