Home Births Rise in U.S. And It’s Not Because of Ricki Lake

[marmar]

via AlterNet:



Posted by RH Reality Check at 6:40 am
March 5, 2010

Home Births Rise in U.S. And It’s Not Because of Ricki Lake
Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.


For women who choose to go through pregnancy and childbirth, the freedom to choose where and with whom to birth is not always immediately accessible. Before childbirth in hospitals became the norm, women birthed at home, under the care of a midwife. It wasn’t until the 1950s that childbirth care shifted significantly from midwives and homebirth to physicians and hospital birth. However, birth for healthy mothers and their babies does not necessarily have to be medicalized. And because it was becoming increasingly clear that birth was drifting, quickly, from the hearts and hands of women to the more medicalized, economic model put forth by hospitals, women’s health advocates interested in natural birth created a movement.

There is nothing inherently wrong with hospital birthing, of course (written from the heart of a mother who birthed two beautiful children in a hospital birthing center). It is the focus on economics, while having lost our sense of what birth is all about by straying far away from trusting women and women’s bodies, that is the “wrong.” We now have a cesarean section rate in this country of 30 percent – one out of every three births in this country is via c-section – that dangerously exceeds the World Health Organization’s recommended rate of 5 to 10 percent of all births. With a cesarean rate of over 15 percent, the WHO says, we’re in the realm of doing “more harm than good.”

We are not providing women with the optimal enivornments for birthing, or giving women the chance to choose where they wish to birth and with whom. There are of course many reasons for this, not the least of which is access. Women who have no health insurance are not in a position to “choose.” Pregnant women who live in a small town with one hospital that forces c-sections upon women who have had a previous c-section are not in a position to “choose.” Women who live in a state where midwifery, essentially homebirth, is illegal are not in a position to “choose.”

This cannot be what our mothers want or what we want for our mothers. ..........(more)

The complete piece is at: http://blogs.alternet.org/speakeasy/2010/03/05/home-births-rise-in-u-s-and-its-not-because-of-ricki-lake/

[gmoney]

1. any correlation?

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7845112

[gkhouston]

21. Who knows? I suspect there will be correlations to drive-by deliveries, inductions,

and poor pre-natal care, but I'm just guessing.

[etherealtruth]

25. My guess would be poor/ absent pre-natal care

and the overall rise in maternal obesity.

[no_hypocrisy]

2. I'm waiting for some fundamentalist Christian state representative to draft bill that

charges a mother and her midwife with murder of her infant if the baby dies during a home delivery.

[Jamastiene]

9. and gets them the best legal representation in the world if they

wait until it is born then beat it or starve it to death. They want to beat women over the head with a Bible if she's pregnant, then beat the kid once it is born.

I think that is why they fight for as many babies to be born as possible. They want to beat them to death or starve them in their sadistic, twisted version of "spare the rod, spoil the child." and then they want some spare children to beat after they kill their own with overbearing, sadistic, cruel punishment.

You know how they are. :shrug:

[defendandprotect]

11. Or if she refuses a Cesarean . . . !!!

[CTyankee]

3. At first, I thought this post would be about women in denial about their pregnancy

delivering on the bathroom floor...until I read the text.

I was just reading about one of those this morning...baby was found dead in a dumpster...

Yup, best health care in the world...

[clowncar]

4. My wife and I had a homebirth with a midwife

It went flawlessly. No stress, low cost and we were not in a hospital when it was over, we were home.

[Commie Pinko Dirtbag]

16. Don't wanna sound sinister but you're DAMN LUCKY the umbilical chord wasn't around the baby's neck.

Mine was. TWO turns.

If we had chosen like you chose, OUR baby would be DEAD. Or at the very least, brain damaged.

Instead, she's not. She's healthy. Because we were in a hospital and the ob-gyn had the quick thinking AND the infrastructure to make an impromptu C-section.

Think about that if you plan to have another.

[clowncar]

19. I am glad yours turned out good in the end.

Very glad!

[MrCoffee]

5. We strongly considered home birth

but neither of us wanted to clean up afterwards.

[defendandprotect]

6. Healthy women are being encouraged to set "times" for delivery by Cesarean--!!!

And, since all of these obgyn's are surgeons it's reminiscent of someone with a

hammer thinking everything they see is a nail --

When women get together, they find the same stories -- MAYBE the cord is tangled

about the baby's neck -- MAYBE the baby won't turn -- be prepared for a Cesarean --

"We can't afford to wait!!" --

Appointments for Cesareans are better for the doctor -- no long waits for babies to

present themselves and mother's bodies to be ready.

We need to return to home births -- and stop making childbirth a medical condition!!!

Latest case I heard of went very much like other stories --

baby wasn't turning and very early on they began talking Cesarean --

As time neared, the mother was reporting that she sensed the baby was turning --

Nonetheless they scheduled a date for her to come in --

On and on the fear-creating statements went until they convinced the couple that a

Cesarean was necessary -- NOW!

This is a major operation -- and this young woman is now suffering a very serious

infection they are having trouble fighting. I think she will be fine --

but recovery from Cesareans don't leave a mother ready to deal with a new baby and

being up most nights taking care of the baby.

[MrCoffee]

8. MrsCoffee fired her doctor 10 days before the due date for that very reason

He would not stop pressuring her to have a Cesarian.

[defendandprotect]

10. Sadly, many young women not as wise as MrsCoffee are accepting this as normal ...

some not, of course --

And, I think there is still that fact hanging over the next pregnancy --

"Once a Cesarean, always a Cesarean"?

[sandnsea]

14. Our small town hospital follows that guideline

Not because they believe the women must have a c-section, but because the hospital doesn't have the emergency capability should something go wrong during the delivery of a previous c-section. I would say about half the women here drive 60 miles to deliver anyway, and those with previous c-sections could choose to do that too. The ones who don't, make the choice to stay here. Don't always assume that women make that choice because they don't know better. They often do.

[defendandprotect]

29. I'm not "assuming" anything - I'm reporting that many women are now accepting

as "normal" the idea of scheduling an appointment for a Cesarean, with no indications

that they would not be able to carry to term and delivery vaginally.

And my firm opinion is that these young women are making a poor choice for themselves

and their baby -- an underinformed decision, too often pushed by the doctor.

This is being approached as "convenient" for the parents -- and needless to say it's

convenient for the doctor.

When you say "here," are you saying that you work in a hospital and/or with deliveries?

And think you are saying that about "half" the women chose to drive 60 miles to try to

deliver vaginally elsewhere. I would imagine that would be difficult if one is planning

to let nature take it's course with the delivery and then have to travel 60 miles!

Obviously, there is something very wrong when one third of our deliveries are Cesarean --!!



In the case of someone who had a previous C-section, I would also say that would be

difficult -- and even more difficult if the prior C-section had been fairly recently?

[sandnsea]

34. Oh excuse me, "reporting"

that women are "accepting" that it's normal. And once again, no they aren't. Many smaller hospitals do not have the facilities to manage delivery or neonatal emergencies.

And yes, about half the women here choose not to deliver here at all because of that. My daughter and most of her friends travelled the 60 miles. The local hospital has not always had an OB, has terrible facilities and absolutely nothing if there's any kind of emergency.

I'm not arguing that there are too many cesereans, there undoubtedly are. I'm reporting that it's not always because women are being led to believe it's normal. Other issues are involved in their choices. You can't make the necessary changes unless you correctly diagnose the problem, completely.

[defendandprotect]

36. We are talking about two different things --

What I am discussing has nothing to do with available facilities --

[sandnsea]

38. We're talking about unnecessary c-sections

and doctors pushing them on uninformed women. Why would you not want to know the other circumstances that contribute to the large number of c-sections?

[liberalhistorian]

39. That is simply nothing but irresponsible

medicine, period. C-sections should only be used if absolutely necessary, not because the doc wants to make more bucks. She was not only right to fire him, I hope she told the jerk why.

I had kind of an opposite problem almost twenty years ago when I had my son. I was on Medicaid at the time (didn't like having to be on it, but really had no choice at the time) and had already been having contractions for sixteen hours before my water finally broke. When it broke, there was merconium staining, which means that the baby had had a bowel movement in the womb. That means that it should be delivered asap, to avoid any possibility of being poisoned or choked. But it was another fourteen hours (of pure hell, I might add-as painful as I had heard labor to be, I still had NO idea!!!!), and me not dilating past four for eight of those hours, before the high and mighty doctor finally came in and announced they were doing a C-section. The nurses were furious with the docs and I later found out why. Apparently, at that time, at least, the docs didn't get paid as much for C-sections; also, since I had to be in the hospital for longer than with a normal delivery, the hospital would lose money as well. So, they were prolonging the C-section for far longer than they should have simply for monetary considerations and concerns. Fortunately, my beautiful son didn't suffer any ill effects, but it still really pissed me off. My life and my son's life and well-being weren't important, money was.

That being said, I totally agree that the majority of C-sections in this country are not needed and are being pushed by surgeons for self-aggrandizing reasons. I am really concerned for this growing trend and disgusted that Big Medicine is only seeing dollar signs and not the health and welfare of their patients.

[BunkerHill24]

7. Hey listen to Mr. Gibbs on Foux News

Whites need to multiply...and he said it on the Clear Channel.

[Warpy]

12. Most of the women I know who had babies at home did so

because they either lacked health insurance or had health insurance that failed to cover women adequately by insisting they pay triple the rate should they "plan" to become pregnant at any time. Home birth was a lot cheaper and good lay midwives can generally detect complications long before the process really gets going. Lay midwives provide education and prenatal care, suggest the same prenatal vitamins, diet, exercise, and smoking/drinking cessation and the best of them have found physician backup.

FWIW, midwifery was technically illegal where I was when friends were having babies. Still, they managed to find friendly physicians who would provide backup at local hospitals. One question to ask a prospective midwife is whether or not s/he has backup. It can be important.

[PatSeg]

13. My daughter was born at home years ago

with a doctor and a nurse present. At the time, husbands weren't allowed in the delivery room in Chicago and this was the only way my husband could be with me during delivery. It was an amazing experience and one I've never regretted. I don't recommend it for everyone, but it was right for us at the time.

[LibertyLover]

15. My stepdaughter is a week or so away from delivering her first child

Her ob-gyn's office just told her that she needs to pre-pay for the delivery right f'ing now in the amount of $1300. That's the price if nothing goes wrong and she has no complications. She is furious that they neglected to tell her that at one of her first appointments and are only dunning her now. She and her husband are working on coming up with the money but jeesh, really? - and her ob-gyn has broadly hinted that unless she does pre-pay he cannot guarantee that he or one of his partners will manage to make it to the hospital to attend her delivery, unless of course she has a C-section, in which case, since they can gouge more money out of her health insurance, he or a partner would probably manage to be on hand. Yup - best medical care in the world. :sarcasm:

[Lars39]

17. So what would probably happen is that she would be left in limbo...

delivering without anesthesia whether she wants it that way or not. :grr:

[here_is_to_hope]

18. We birthed our little girl at home...

Oregon Health Plan covers midwives so we went that way knowing that pregnancy is not a disease!
The midwife was fantastic, weekly visits over lunch, we were so well prepared by her that when the time came for the baby, when the midwife was two hours late...we did it all ourselves!
She got there in time to help Grandma with her vapors...poor Grandma...
I delivered Stella, was the first to touch her, hold her and make her cry.
Would not have traded the experience for anything.
Labor was all of an hour and 22 minutes.
Mom was ready!
We, ahem, even fudged the birth date a few minutes to give Stella a Valentines Day birthday.
I mean, who knew besides us?
I think a child born into warmth and comfort is much better off than the bright lights and chill of a hospital.

[defendandprotect]

32. Thank you, wonderful story -- wonderful of Oregon, as well -- !!!

[liberal_at_heart]

20. How many babies are saved due to c-sections?

Infant and maternal mortality is pretty low in this country especially in historical context. I don't think c-sections should be done just for the hell of it but when there is a problem I am in full support of c-sections. My doctor told me that if there were any complications she wouldn't hesitate to take me to the operating room. There were no complications and I gave birth vaginally with both of my deliveries. But I was thankful to my doctor for telling me she would not hesitate to do a c-section if a problem arose.

[Hekate]

26. I also had two uncomplicated deliveries, but my daughter was not so lucky...

... and as you and I know (but apparently many others do not) there are some eventualities that simply cannot be planned for, like an umbilical cord wrapped around the baby's neck. That's luck. My idiot cousin lied to her midwife about complications during her first birth, with the result that when she home-birthed her second child she ended up with a split uterus and a 911 ambulance call.

There was no "birthing room" option with rocking chair and flowered curtains for me at my local hospital in 1975, but my OB and all the rest of the staff were totally on board with the LaMaze method, and offered the classes right there. That's all I needed for a good experience -- that and the excellent union-covered care I got. There was just no way in hell I would risk my life and that of my children by giving birth at home.

I wish with all my heart that the US would join the rest of the civilized world and provide high-quality pre-natal, birthing, and post-natal care for all of our mothers...

Hekate

[gkhouston]

27. Some, but the C-section rate in this country is ridiculously high.

When I was pregnant, I used a large practice of physicians and midwives where many of the doctors performed breech deliveries, something a lot of ob/gyns don't do these days. I sought out a practice with a good reputation and a low C-section rate (that information was published in my area) because I was 40 and didn't want to have "C-section" stamped on me simply because of my age. The C-section rate for the doctors in the practice who were willing to do breech deliveries was 5%. For the others, it varied between 12% and 15%. My little monster presented in the correct orientation but took her own sweet time about it -- I was in labor for 48 hours. Some other women seem surprised when I tell them that. Apparently a lot of doctors don't let them labor for that long and go to C-section but I was in good shape and my daughter had a strong heartbeat, so nobody was in a hurry.

Why any first time mom who doesn't have a genuine health-related reason to schedule a C-section would opt for one is a mystery to me. It's major abdominal surgery with a significant recovery period and infection risks.

[Commie Pinko Dirtbag]

28. See #16. -nt

[Manifestor_of_Light]

40. I and my child are alive because of a C section.

I knew I was having one, the doctor told me my pelvis was too small for a normal sized child.
The hole in your pelvis has to be four inches in diameter for the baby's head to get thru. mine was not nearly that large.

The baby was a huge eight pounds, and jammed in diagonally. Shoulder presentation, not enough room. I was miserable for several months, lying around the house for four months eating, sleeping and trying to breathe. I am a small person(five foot two) with small bones (6 inch wrists, I wear a size 6 ring and an 8AAAA shoe) and a narrow pelvis.

I went into labor right on time and am thankful I got a c section and a spinal and a beautiful healthy child. She's now a beautiful young lady in her twenties. I'm glad my doctor figured out I was too small for a vaginal delivery before I went into labor.

[hamsterjill]

22. Major drugs!

I'm sorry, to each her own, but I wanted and got major drugs! There was no way that I was going to go through the pain of delivery when there was something that would take care of the pain. That's just me. No one else need be the same. But I would never have considered a home birth because of that reason.

Yes, I was lucky in that I had good health insurance, which was worth something at that time.

I would certainly support a mother's right to give birth in whatever setting she chose, but I don't think there's any argument that if there are complications, it's better if the birth happens in a hospital.

[liberal_at_heart]

23. My second delivery went so much smoother than my first

During my first delivery I waited too late to ask for an epideral and I was in so much pain not to mention I tore during the delivery. The doctor had to stitch me up. My second, I had an epideral and it was sooooo much better.

[Stargazer99]

24. How about cannon fodder and cheap labor

the lower classes pay and pay dearly for the monied. What better way than to use the fundamentist crap to make sure there is a plentiful supply of sacraficial bodies.

[defendandprotect]

30. As well, the electronic monitoring machines also seem to be a cause of

fetal disturbance which creates more pressure for a Cesarean --

Those who study this say that as the machines increase so do the Cesareans --

It's said that it can be observed that the fetus is struggling to escape the

electrical monitoring --

Common sense would tell us that --

[happy_liberal]

31. homebirth is a beautiful thing

Nurse during my first hospital delivery (which was induced 5 weeks early) told me 'oh I would definately have a homebirth- too many interventions here"...so I did and it was a beautiful thing...in a hot tub, no pain, quick delivery (after a walk which helps speed things up but not real possible in a hospital) and did it mostly all by myself. Very empowering and of course rewarding. And the whole time my 2 year old was swinging in the yard where I could see him.

[defendandprotect]

33. Wow . . . wonderful . . .

and also love the JFK quote --!!

:)

[pipi_k]

35. I'm so glad women have that choice these days...

and even if they don't have a home birth, at least there are birthing centers in some hospitals that are "home like".

I don't know about anyone else, but when my children were born (1970, 72, 74) I didn't feel like I was participating in the process as much I felt like a puppet being pushed, prodded, poked, and directed. It was all pretty much impersonal.

[Shallah Kali]

37. Some women are going beyond homebirthing to unassisted - not even using a midwife

only the husband. I can understand women wanting to homebirth with a midwife who has medical training. If I ever have kids I would most likely choose a midwife at a birthing center near a or part of a hospital as so many females in my family have had severe complications. Ruptured uterus, hemorrhaging and more. Some doctors can be too quick on the extreme intervention route but I think going to the other extreme of NO assistance is just too far.

Do-It-Yourself Delivery
Despite Risks That Range From Fetal Distress to Hemorrhage, Some Women Are Choosing to Give Birth Without Medical Assistance
http://www.washingtonpost.com/wp-dyn/content/article/2007/07/27/AR2007072702164_pf.html

My Womb for His Purposes: The Perils of Unassisted Childbirth in the Quiverfull Movement
http://www.religiondispatches.org/archive/sexandgender/1618/my_womb_for_his_purposes:_the_perils_of_unassisted_childbirth_in_the_quiverfull_movement

Unassisted childbirth
http://en.wikipedia.org/wiki/Unassisted_childbirth

[KitSileya]

41. Talk about a subject that makes women defensive!

Whenever there's a lament about the rise in c-section rates, many women quickly jump up with their story of how their baby or themselves would have died without a c-section. Notice therefore that the article states that there's a recommended rate of 5-10%. They're not advocating outlawing c--section (which you'd think from some of the replies on this thread) they're recommending not using it unnecessarily, because a c-section carries an inherent risk that is greater than non-complicated birth (notice I said non-complicated birth.)