I don't understand why midwife = scientific birth, and an OB birth = technological birth.
I would argue OB birth = science + technological. Or maybe what she really wants to say (in the extremely long prose) is that there's an over-reliance on technology by OBs and not an openness to deliver simply?
It might be too late in the night for me to process this.
Post by scribellesam on Apr 22, 2015 22:49:19 GMT -5
Eh, I mean I get what's she's saying, but epidurals just kick so much ass I'm having trouble taking her seriously.
Kudos on your pain-filled "most pure" birth experience but I'm insulted by the implication that my own birth choices were due to ignorance and that if I'd known "the truth" I would have obviously chosen an unmedicated midwife birth also. Nope.
You should all meet my 60 year old, 30 years of practice, delivered thousands of babies OB. He's pretty...well....whatever the hell she's trying to say. Scientific?
3/4s of the internet needs to quit writing ridiculous parenting tangents and get an actual day job.
But I also got a little toooo druuunkkkkkk while relaxing to Nashville, so anything past the the first paragraph was lost on me. I get it though. I'm sure how I chose to birth my children was all wrong. Point taken.
I didn't read the article. I am just here to say that I know all the studies about interventions and midwives and blah dee blah blah and I don't give a rat's ass.
I'm just bummed my epidural was a ripoff. Contraction hell.
Same here. Mine stopped working about an hour before delivery. At that point, I didn't give a rat's ass who caught the baby. It actually happened to be a midwife, but it could have been the cafeteria lady, for all I cared.
I "wanted" a med-free birth with a doula as support. Then my water broke and I had no contractions, so I was given Pitocin. Fuck. That. Noise. Epidural NOW!
And this is why women have all sorts of guilt and shame about having c-sections.
I have to admit that you were the first person I thought of when it came to her comment about, and I'm simplifying here, ultrasounds not helping outcomes. And I truly believe that I would have ended up with a c/s without an epidural bc once I had one, I was actually able to relax and dilate. So, epi for life.
I am sure there are plenty of pregnancies where minimal interventions are necessary...but you can't KNOW that until after....easy to say that what ever % of USs weren't needed because the baby was fine...you wouldn't have known the baby was fine without the USs...KWIM?
The reality is that we HAVE technology and science and medicine that we didn't have before. I don't understand why so many people are so reactionary about it now. Yes, I wanted USs to see if my baby had any number of issues before she was born so I could prepare myself mentally for that reality should it exist. And yes, I had an epidural, and it failed. Shit happens. And there was meconium in my fluid and I have no idea what the docs did with her because I couldn't see but frankly, I trust them.
If you want to have a birth at home with a doula or midwife and no doctors and no med, that's fine...it doesn't mean my decision to have a hospital birth and a pregnancy that involved sonograms and testing is wrong. Different =/= wrong, it just = different.
Stop this noise. Not every OB is old school. I would guess that most are moving forward with the times. Most people here talk about their progressive OBs with 'newer' ideas. The number of VBACs is a good example. I had a high risk OB. You would think he would be full of technology. Wrong I didn't have a single vaginal exam. I had a million ultrasounds. and an amnio but science worked there. I will agree about compensation. Just like insurers don't compensate preventive medicine, there should be some kind of 'bonus' for no costly interventions. However I don't think compensation is driving csections.
Stop this noise. Not every OB is old school. I would guess that most are moving forward with the times. Most people here talk about their progressive OBs with 'newer' ideas. The number of VBACs is a good example. I had a high risk OB. You would think he would be full of technology. Wrong I didn't have a single vaginal exam. I had a million ultrasounds. and an amnio but science worked there. I will agree about compensation. Just like insurers don't compensate preventive medicine, there should be some kind of 'bonus' for no costly interventions. However I don't think compensation is driving csections.
Same here, high risk OB, my only vaginal exam was at 38 weeks for a sweep. I had lots of ultrasounds with #1 but am getting only my 3rd with #2 (same high risk OB) sometime next week to look at positioning and size. I also had very few checks at the hospital...I had to ask them to check me to see how far along I was!
The problem with this discussion, like most topics about motherhood, is that it is so hard to talk about without people taking it personally (me included). I was reading this not as an assault on the choices woman make, but an argument that Dr.s and insurance companies are making the process harder and I think in some ways they are. I loved my ultrasounds and would not have given them up, but how many stories have you heard where a woman is told that her baby is huge and can't possibly be born vaginally, only to give birth to a 7.8 lb baby? For me, I don't think the risk of that outweighs the the benefit of knowing about more severe problems, but it is certainly a downside of technology.
Hm. I read lots of studies about risks before DD was born, and I was not at all swayed toward an intervention-free birth. I mean, I didn't want my OB standing over me salivating with a scalpel or something just waiting to cut the second I was admitted or something, but I read studies, talked to my OB about various interventions and why they would be done, and discussed risks and benefits. I don't like the implication that I was not informed because I chose a medicated hospital birth.
I was really trying to be open-minded (despite the purposefully loaded language) until I got to "not bothering with a sonogram."
You don't get to blow off the ability to find out about birth defects and abnormalities which can allow you to plan ahead accordingly and make choices or prepare for the rest of your life. Nooooope.
She may have had other points, but she shot herself in the foot for me and I didn't read them.
ETA: Okay I finished it. I still stand by what I said. They breezed over all of that and the choice that women are fortunate enough to have WRT ultrasounds detecting possible abnormalities, further testing to confirm/narrow down, and then being able to decide to terminate if they choose. None of that is possible without an ultrasound.
I agree. I was willing to concede her other points, even about women choosing medical pain management not being a real choice when alternatives aren't available. But a low risk pregnancy has nothing whatsoever to do with birth defects. A pregnant lady can be as healthy as all get out and her baby might need life saving in utero heart surgery or what have you. You just don't know the foetus is healthy until you look. If she were to harp on the subject properly it would have been on the routine monthly sonograms.
And this is why women have all sorts of guilt and shame about having c-sections.
Exactly. This woman implies we could have avoided our c-sections if we'd just believed in our own capabilities and "chosen" the less technical path. Bullshit.
Post by jeaniebueller on Apr 23, 2015 7:04:43 GMT -5
As someone who was very low risk, until she wasn't, this woman can GTFO with her implications that sonograms are just for funsies. I wish my DD's sonogram and echo were just for funsies, but they were actually needed to ensure that she didn't have the same fatal heart defect that my other DD had.
Walking during both my labors was a horrific experience. I've never heard of an OB doing vaginal checks save for when the woman is almost due- and usually it's due to trying to give the patient some hope. Sonograms- it's not the tool it's how you use it. As for squatting during labor- LOfuckingL because I couldn't squat past 30 weeks if my life depended on it.
Hmm, I guess I'll be the dissenter. I didn't see it as she was saying no one should ever have a c section Or interventions. I did see she was anti drugs. But overall I saw it more as her saying we should be better informed about those decisions, how they improve outcomes or not, the risks and benefits etc.
I don't have the specific statistics but the U.S. has more birth interventions than most developed countries and yet we have one of the highest infant and maternal mortality rates. I think there is something to that.
I also understand how this can be hard to read if you have had a c section. I get that because I have had one. But, while I still have negative feelings surrounding my c section I am also confident that it was the best choice for me and my baby because it was an informed choice. Just as my choice to have a VBAC was informed. I had a team of midwives, OB'S and MFM for my twin pregnancy so I felt like I received positive advice from a variety of points of view. That combined with my own research made me comfortable in my choices of intervention etc.
Throughout the article she says low risk or uncomplicated pregnancy. So she isn't talking about the woman with Blood pressure issues, GD, breech presentaton, or even someone like Brie who noticed decreased fetal movement and spoke up which lead to the us which discovered the low fluid and then the induction and so on. (Just to name a few of the many complications possible). Or maybe not even someone of ama as that can be a complicating factor at times.
I'm not sure I completely agree with not having any sonograms during the pregnancy. I do see value in being informed (obviously since that is my whole point). But, we likely do not need as many as we believe. I opted our of the NT Scan with J. It was not presented as something I needed to do and knowing that we would not choose to do an amnio, and CVS was still newer, we decided that it only had the potential to make us worry. Obviously this isn't a choice everyone would make, but it was what we were comfortable with and again making an informed decision. We opted to have the NT scan with the twins because we knew from the beginning it was a riskier pregnancy and by that point MT21 was available rather than an amino etc.
I guess the point of my post is that I do see value in making informed decisions in childbirth and I think too often in this country the decisions made arE done so without all of the information regarding risks and benefits etc.
Hmm, I guess I'll be the dissenter. I didn't see it as she was saying no one should ever have a c section Or interventions. I did see she was anti drugs. But overall I saw it more as her saying we should be better informed about those decisions, how they improve outcomes or not, the risks and benefits etc.
...
Throughout the article she says low risk or uncomplicated pregnancy. So she isn't talking about the woman with Blood pressure issues, GD, breech presentaton, or even someone like Brie who noticed decreased fetal movement and spoke up which lead to the us which discovered the low fluid and then the induction and so on. (Just to name a few of the many complications possible). Or maybe not even someone of ama as that can be a complicating factor at times.
...
I guess the point of my post is that I do see value in making informed decisions in childbirth and I think too often in this country the decisions made arE done so without all of the information regarding risks and benefits etc.
This is where I'm at. For the most part, I agree with her article. It's hard not to get emotionally charged when reading something like this but she isn't saying that people should avoid interventions when they have a known problem. I have seen firsthand the push for unnecessary interventions in a low-risk pregnancy and that needs to stop. I truly believe that a more natural (in her terms "scientific") approach could actually prevent many interventions, and it was true for my births. But we have to remember that this is a broad generalization and there will absolutely be cases where it's not true, and the article even states that this thought process is for the "medically uninteresting pregnancy". The problem comes that we don't know in advance which births are one of those exceptions and when there is any indication that a mom or baby's life is at stake, low intervention kind of flies out the window. Because really, who wants to risk it just to claim a "natural birth"?
FTR, both of my births involved (unnecessary) interventions.
I truly don't understand how not monitoring can have the same outcomes. I do know that this is true and has been proven, but I don't understand it. If someone was reading my strips and monitoring me correctly, I'd have two babies here today, not one.
I also will never agree when someone talks about how not risky and natural childbirth is. It is natural, but it is also extremely risky and dangerous.
I don't think it is not monitoring, it is monitoring intermittently vs. continuously. So, in my situation I had intermittent monitoring which basically means the midwife listened frequently. A quick google tells me very 15 minutes during labor and every 5 minutes during pushing, but I know for a fact it was more frequent than that for me. They monitored me while pushing and after pushing. I was onyl with the midwives about an hour before I started pushing, but I am pretty sure it was more frequent than every 15 minutes, but maybe that is because I was was in transition when I got there?
Again, I had a no intervention birth, but my midwives did a cervical check at 36 weeks. They also did one when I got to the birth center. I could have declined both if I wanted I suppose. But I was curious.
I also squatted during labor and found it very helpful, but then again I have birth on my hands and knees (well technically squatting on my knees with my arms wrapped around a yoga ball. BUt my prenatal class also makes us squat for like the first 30 minutes of class each time so I feel like I was a squatting pro lol.
So my birth center does not require ultrasounds (although I would say they are semi encouraged). I asked my midwife what consequences of this she has seen and it didn't seem to be anything too detrimental. They have had surprise multiples and some birth defects (but nothing requiring immediate medical treatment). She advised me that in her experiance most big birth defects or other issues are detected through other means during the pregnancy and they recommend an ultrasound. For example, slow growth, irregular heart beat, irregular or decreased movement. And that point they send the woman off for an ultrasound (because again, they only permit low risk births).
And I agree with @starry. I mean it makes sense that a no intervention birth is technically going to have the least amount of risk since each intervention comes with its own risk. But again, that is if we are talking about a normal as basic as can be birth situation.
And this is why women have all sorts of guilt and shame about having c-sections.
I have to admit that you were the first person I thought of when it came to her comment about, and I'm simplifying here, ultrasounds not helping outcomes. And I truly believe that I would have ended up with a c/s without an epidural bc once I had one, I was actually able to relax and dilate. So, epi for life.
Right. The thing about ultrasounds is that 99 out of 100 may be completely unnecessary, but that last one? That might save a baby or a mother's life. There are some things that just can't be quantified by statistics. The value of that is one of them.
I'm not a fan of the article, despite being a fan of non-technological birthing.
And I agree with others that her blanket statements about MW = Science and OB = Technology to be annoying. I had MWs that "predicted" how big my baby would be based on foot size. And I had an OB that realized that technology = higher risk in my case, even for a breech baby. And while maybe making generalized statements works in some situations, when it comes to changing maternity care, you need to start talking about the OBs that ARE doing things in the most scientific way possible, even if they're the minority. I think you'd be a lot more likely to improve outcomes by getting OBs to agree to less intervention when possible than to get women to give up their care providers and go to midwives and homebirth.
However, the quote of her doula REALLY resonates with me. "Birthing a baby requires the same relinquishing of control as does sex -- abandoning oneself to the overwhelming sensation and doing so in a protective and supportive environment." This was spot on. And this helps explain to me why I find birthing to be a pleasurable experience, despite the tremendous amount of physical pain.
The thing is... it's not fine for me to home birth with my doula.
Because my health system refuses to hire enough midwives to actually provide me with a midwife. I wanted one. I was denied one because too many other women wanted one, too, and they somehow had better reasons to get one.
The thing is... it's not fine for me to home birth with my doula.
Because my health system refuses to hire enough midwives to actually provide me with a midwife. I wanted one. I was denied one because too many other women wanted one, too, and they somehow had better reasons to get one.
Don't pretend women have choices when they don't.
Yeah, I will say this is a good point. I mean think of meltoine situation. I am lucky to be a a place where CNMs for home births are possible. That is not the case in a lot of places. Many places also have laws in place banning some midwives from attending home births, forcing people to operate illegally.
The history of the battle between states and midwives is actually pretty interesting. I just don't get the reason behind a lot of the laws. Some states ban CNMs from attending home births and then don't allow direct entry midwives to have many tools that make home birth safer (oxygen, pitcoin, antibotics, etc). And then like meltoine was saying, she couldn't even get an OB who wanted to give her an US because they didn't want to work with midwives.
I truly don't understand how not monitoring can have the same outcomes. I do know that this is true and has been proven, but I don't understand it. If someone was reading my strips and monitoring me correctly, I'd have two babies here today, not one.
I also will never agree when someone talks about how not risky and natural childbirth is. It is natural, but it is also extremely risky and dangerous.
This was my huge thought while reading the article. Technology has saved so many lives - both mother's and babies. Just because HER great-grandmothers were able to give birth easily and naturally, doesn't mean that everyone's great-grandmothers could. I hate when people forget that so many babies and moms died in childbirth before some of these great technological advances were made. Does every situation need technology? No, but I'm so fortunate it's available and I will continue to use it because I believe the risks of using it are less than the risks without.
I am now coming to a place where I am taking everything natural birth advocates say with a very large grain of salt. I read and thought a lot about natural births during my first pregnancy. I have now had two pregnancies and births under the care of OBs. Those experiences were so drastically different than what the natural birth movement told me to expect, that it is hard for me to take them seriously.
On that note, are there any studies that support that pitocin contractions are so much worse than natural ones? I have had one pitocin induced labor and one un-induced labor and the contractions felt exactly the same. I realize that I may be the outlier, but I did google it and only found message boards talking about how pitocin induced labor is so much worse, no actual sources.
Also, I am very tried of the whole "labor pain is special, productive pain not like all that other regular pain". You know what? THAT DOESN'T MAKE IT ANY LESS PAINFUL. Labor was excruciatingly painful. No amount of positive thought changes that.
Has anyone here been denied the epidural they want?
No?
Fuck, I get so annoyed when we discuss these articles because posters here are OUTRAGED that someone has an opinion like "if we did OB care by evidence-based practices, it would look very different". Meanwhile, it really is the women who want to go another - safe and supported by reasearch and actually less costly to the system - way that are told they can not.
I could not have the prenatal care I wanted. I could not have the birth provider I wanted. Unless that was your case, too, I'm just over hearing about how opinions threaten you.
The thing is... it's not fine for me to home birth with my doula.
Because my health system refuses to hire enough midwives to actually provide me with a midwife. I wanted one. I was denied one because too many other women wanted one, too, and they somehow had better reasons to get one.
Don't pretend women have choices when they don't.
I don't think in order for a woman to have a choice, there need to be unlimited people available. I mean, it could be that for some reason, it is a recent trend that women have wanted more midwives, but they haven't had enough train in that area. How long has your health system "refused" to hire enough midwives? Who defines what enough is? Do you think women should get all the midwives they want hired if it impacts other hiring decisions for other types of medical specialties? I mean, if your government is paying, they get to decide how to spend the money - that's just rationing care and I wouldn't really jump to the "WOMEN DON'T HAVE A CHOICE!"
I don't know. To me, the situation meltoine is not having a choice. Having too low a supply given the demand is just scarcity.
Obviously, you know the situation in Canada 1,000 times better than I do. But I am uncomfortable with the idea that anyone would expect to have 100% access to whichever provider they want at all times. I mean, if people wait for a specific cancer doctor for 6 months, and that is considered normal, why wouldn't waiting for a midwife for 6 months (and thus not be able to get one) be normal? Again, I don't know what UHC is like since I live in bootstrap land, I'm just talking in generalities and principles.
Listen: midwives are more cost effective than doctors and the situation has existed for years. Years before I had my kids and now years after. Enough is enough to support the women that want them when you've got to pay for those babies to be born, one way or another. It costs LESS money to give me what I want, not more.
I am way too angry to continue this. Like, shaking angry. So backing out now.