Monday, February 19, 2007

Pregnant in America.

A documentary entitled Pregnant in America is being released later this year. If you're in medicine, or have a brain, or have a decent amount of common sense, check out the preview, and see if you're offended as I was.

I will definitely be seeing this film when it comes out, and I had several knee-jerk reactions to the trailor. I would like to preface the following comments by saying I respect the work that midwives do and I think midwives and obstetricians can make a fine partnership to offer individualized care for each patient's delivery. I also believe it is 100% a woman's right to choose if she wants to give birth at home, as long as she's informed about the risks of delivering at home without immediate access to pediatricians, an emergency cesarean section, or neonatal resuscitation. But if it was me, or my mom, or my friend, or any woman whose life I gave a rat's ass about, I would strongly recommend delivering at a hospital.

This film is apparently about the commodification of prenatal care and childbirth in America. Let's examine the trailer quote by quote, shall we?

SLIDE: In a country where we expect everything to be better...

...the U.S. scores 2nd worst in newborn death rate among all indistrialized nations.

First of all, it's spelled "industrialized." Jackass.

Now there's a shot of a newborn with nasal cannula in place. She looks a little tachypneic. Is the nasal cannula supposed to scare me? You might have my interest if this baby was actually intubated (tube down her throat attached to a mechanical ventilator).This kid looks like she might have transient tachypnea of the newborn, or maybe they stuck it on her because she was born having already produced meconium (baby's first poop) and breathing a little fast and there was concern she might have aspirated some of the poop into her lungs. She looks full term so I'm thinking she's not in fulminant respiratory distress (also because nasal cannula's kind of wimpy...if there was a real concern she'd be intubated). I am not impressed.

Some old man who wrote a book called Magical Child is now telling me that "Hospitals lose an awful lot of their babies." I'm not sure what this means. Is he talking about pediatric tertiary care centers? Actually, I didn't have too much time to look into his book either, because I'm supposed to be studying for the Boards right now. I.e., learning real medicine.

SLIDE: Is childbirth a medical event?

This KILLS me. I love when people say, "Childbirth is NATURAL," and that "profound" statement is usually followed by, "You don't need to be in a hospital or have a doctor!" Well motherfucking DUH. Childbirth is natural, but you kind of still want someone who knows their way around, in case something goes wrong. Because it's kind of a big deal, and 95% of the time it goes off beautifully without a hitch and you probably could have done it at home in your own bed, but 1/20 is still high risk for some disaster, so I'd kind of want an expert around, especially because the disasters can be devastating. Also, the miracle of life is a beautiful thing, yes of course, but the miracle of life involves a lot of poop, blood, and amniotic fluids and can be somewhat messy. Perhaps not what you'd typically enjoy having in your bed.

Some woman (the founder of "Hypnobabies") now tells me that "Childbirth itself is perfectly normal. Complications are CAUSED because of INTERVENTION." Incredible! TELL ME MORE. (Incidentally, Hypnobabies is a project advocating hypnosis during childbirth in place of epidurals. If that's your cup of tea, cool. Personally, I'm going to go for the epidural. Let me know how the hypnosis works out when you're passing a cantaloupe through your vagina.)

Now there are flashes of some online news articles:

Article #1: Routine epidural turns deadly. I remember when this was on Dateline, and it's totally tragic and I'd be fucking pissed if this was my family member. A woman contracted meningitis from unsterile epidural placement and died shortly after childbirth. That really, inarguably sucks. But..um, it didn't really have anything to do with obstetrics, or bad neonatal care, or some weird American birthing tradition. Any invasive procedure done in an unsterile fashion can cause dramatic infections. I guess the point is she didn't really "need" the epidural to have the child, but the overwhelming majority of the time, the anesthesiologist kinda knows how to keep a sterile field and can place an epidural without complications. It's sort of his job. This one just sounds like he sucks.

Article #2: Dosing error kills 2 premies, 3rd in critical care. Again..wow. Another isolated incident of egregious, horrendous patient care. Anytime an IV (intravenous line ... it's used to draw fluids, or give fluids...very standard in hospitals) line is placed, some heparin is flushed through the tubing to prevent blood from clotting around the tube. It seems that vials filled with the adult dose somehow made it onto the neonatal floor, and the babies received adult doses of the heparin flush. It was a really stupid, irresponsible error. Again....not really something caused by the "American birthing system." [Also, I hate to sound too cavelier about this because it was totally preventable, but I'd like to point out that 6 babies received the adult heparin flush, and only the 3 premature neonates were affected. Because they're really, really tiny....and not to be cavalier but had those babies NOT been born in the hospital where they had access to neonatal resuscitation, they wouldn't have survived at all. AT ALL, because babies born before 28 weeks haven't yet produced enough surfactant, a chemical that decreases the surface tension of the lung's alveoli thus increasing compliance and allowing the lung to stay expanded while breathing and not collapse in on itself.]

So...yeah, both of those articles speak to the incompetence of some healthcare workers and are kind of scary. But really, they deserve more to be in a documentary about stupid hospital mistakes, and not about how obstetrics in the US is practiced wrong.

Now we have an irate man talking about how's been to England, and Germany, and Holland, and how their cesarean section rates are much lower than ours is at 33%. This actually isn't true -- we do C-secs at the drop of a hat here in the states, and many of them are probably unnecessary, for a multitude of reasons, but Europeans actually tend to do MORE sections. And the trend is for women to request C-sections. I have really mixed feelings about this, but a lot of the European literature supports elective C-sections. It's more convenient, more cost-effective, carries less long-term complications (it has the complications of any abdominal surgery -- adhesions, hernias etc but the complications associated with vaginal birth -- like pelvic floor relaxation, incontinence, dyspareunia are nonexistent, and some small European study had shown that impairment of quality of life from these complications was far less with the c-secs. Eh. I don't have a strong opinion yet on this, but I'm sure I will in a year.) Europeans also tend to have less kids, and their obstetricians are more amenable to performing what could be termed medically unnecessary c-sections, because they know they won't be needing to operate on these patients again and are comfortable with causing some adhesions.

Ok, not to go off on a tangent, but this is a subject I've really thought long and hard about. Some might argue the whole "natural process" thing again; ie vag births are how it's supposed to be. On the other hand, if we found an intervention to achieve the same results painlessly and more efficiently with less complication, why would it be wrong to do that just because it's "unnatural?" Some studies have shown that babies delivered by C-sec produce less epinephrine and norepinephrine (adrenaline hormones, ie the "fight or flight" response) than babies born vaginally, thus concluding that these babies experienced less stress during delivery. These babies were followed for a year and were found to be less easily agitated and more socially adapted. Who knows, I'm not really passing judgment one way or the other. Just thinking about myself though, I know I'll probably be super-busy with my career by the time I get around to having kids, and I will probably really appreciate the option of a scheduled C-sec, so I can actually plan my life around my child, instead of being overwhelmed and stressed out and resenting the kid for not showing up on time.

Now the man wishes to know, "Why is that?" Hate to say it, but we live in a litiginous society. People are so quick to bring a malpractice suit against an obstetrician for a suboptimal outcome that no one's going to take a chance and let a mom continue laboring if there's any indication at all that baby's not getting enough oxygen. Isn't it incredible that we use tocometers (they monitor uterine contractions from outside the belly) and fetal heart rate monitors to track the baby's wellbeing and we use these indicators (along with maternal power, and her energy reserves to keep pushing) to decide when to do c-sections? We do way more sections than we used to, but our fetal mortality rate is still exactly the same, despite these advancements. However, we still adopted them, because it's the best we've got right now.

Alright, I'm getting pissed off and need to get back to work. If anybody has any comments I'd actually really like to hear them.

65 comments:

scarletta said...

Its a shame that documentaries such as this make it on to the air. They create mass hysteria and a belief among people that may not neccessarily be true. I mean O&G requires at least 12 years of training, these people know how to give birth and how to deal with all the possible complications that arise. One or two mistakes in the field does not negate this fact, its a shame that the successful births of complicated cases aren't celebrated in such a manner. I could almost guarantee that there would be 100x more successful cases (of complications where obstetric intervention is needed) than there are misfortunes. I'm just scared for the mothers-to-be that may watch this and decided not to undertake medical care who may end up regretting it forever. Contrary to what this document may suggest there is just so much more benefit in consulting an expert than harm. Its sooooooo biased that it is ridiculous - I hope people realise this.

Happy studying for the boards - hope you keep us all entertained with you awesome blogs.

Ooooh what happened to flirty dude with girlfriend?

Anonymous said...

So, are you even going to spend time with your children or just pop them out and go back to work? What an odd way of thinking. In Canada, you get a year of maternity leave to spend with your children so that you don't have to resent them for not popping out when it's convenient for you.

square peg said...

That is awesome that you get so much paid maternity leave in Canada. Here in the US it's 6 weeks.

Redspiral said...

I haven't read through your whole post yet, and I haven't seen the trailer, but I wanted to point out that neonatal resuscitation is absolutely available at a homebirth. Midwives are certified, assistants are certified- as a doula, I have even chosen to be trained/certified and will keep that cert current for as long as I am practicing.

square peg said...

I stand corrected. Thanks for the info, Redspiral. Most ob residencies include neonatal resuscitation training for their ob/gyn residents as well; however I would still want a neonatalogist and intubation equipment nearby just in case something were to go wrong.

Redspiral said...

Again, I can't speak on the documentary.

I can say that when you introduce more intervention to the natural course of labor (routine NPO, routine continuous EFM, routine lithotomy, routine episiotomy, etc etc-- I say routine and not medically necessary because that is my whole point), you are screwing around with the woman's ability to give birth. When you screw around with that, you get decels. You get arrested labor, FTP, cesareans.

You (not YOU, dear square peg :)), but the medical profession is so terrified of the 5% that they are interfering with the 95%. Instead of treating birth like something normal that is meant to happen, the medical profession (of which I intend to be a part) tends to treat it like a disaster waiting to happen. That mindset makes a HUGE difference!!! If your intention is to find problems, then guess what- you'll find them! If your intention is to trust the process and be prepared for problems- well, you get what you put in, in my opinion. Not many OBs (who are trained to look for problems, are they not?) trust birth as an organic process to happen without interference. If they do, they can't not interfere because of hospital policy, past bad experiences, or fear of being sued. None of these reasons have anything to do with the birthing woman!

I know that there is a country in Europe (Holland?) where most babies are born at home and they have much less infant mortality than we do. I don't have statistics, but it's worth looking at. I mean really- how are we not looking that over with a microscope to see what we could be doing differently?!

I'm not going to argue the merits of this video because again I haven't even seen the trailer- but I will say that an increasing number of women are wanting a change. I know this, because they hire me. ;) I am a 'hospital doula', I work best in the hospital, I know the routines, I get along with and support the nurses, but I will always stand beside my client. (I'm feeling a little riled after reading some anesthesiologist putting down/insulting women who want unmedicated birth in his blog... please forgive my passion lol.)

If women wanting home vs. hospital birth wasn't so adversarial, we might be able to *gasp* improve both situations! Less interference at hospital births and more availability to medical assistance at home births? I guess this is why we have birth centers, sort of a hybrid of the two.

No care provider can look at our state of maternity care with a sense of contentment and satisfaction- there is SO MUCH we can strive for if we can stop being so egotistical about all we have accomplished. We can NOT rest on our laurels here, there are human beings at the end of our care, humans who are directly affected by the decisions the care providers are making! We have amazing science but we have forgotten the humanity along the way. I don't know if this video is on target or not, but I can say that it's a sign that women are not content with what we're being sold by the current maternity care. We deserve more than science. Our babies NEED us to FIGHT for more than just science!

FTR: I had two hospital births and will likely again due to history of pre-eclampsia. I'll make the best out of what my health will allow. I'd much rather give birth at home and give my BABY the full benefit of an unmedicated birth but I accept that that scenario is unlikely. Will I accept routine care? Sure, in some ways... but I will not be a docile patient waiting for the nurses to guide me in how I should be in labor.

Try not to be judgmental of women who want unmedicated birth. We are normal, not crazy. We want our babies to pass into the world without having been drugged or pulled into the world or cut out. There is no shame in wanting our babies to be alert, ready to breastfeeding, to avoid a nursery visit. You can want something different for yourself, but by judging women who want to 'pass a cantaloupe through their vagina', you lose any possibility to see the other side, or to have the other side hear yours.

It's not a cantaloupe, by the way- it's a tiny little person. ;) A little snarky, I grant.. but truly, this is a rite of passage for many woman, and it does not make us lesser than those who want to view it otherwise. :)

Blessings square peg, the world needs you! Don't lose your passion!

Jenny said...

Isolated incidents do not mean the whole field is out to get patients. i dont think we can even compared the infant mortality rate in the US with other industrialized countries. they have universal health care! better access to prenatal care may contribute to the lower infant mortality rate. How ‘bout they do a documentary about the health care system in the US and all the uninsured Americans and compare our mortality rates with those of other industrialized countries?

Anonymous said...

I agree that the documentary does appear to be totally biased. With that said... the idea of certified nurse-midwife is one that jives well with many women’s lifestyle and values.

Anonymous said...

Well said, Redspriral!

Amber Hardman HCHI said...

I just wanted to add that this Hypnobabies thing is not so crazy. I have used hypnosis for pain management in birth, and guess what, it truely honestly works.. not the same as an epidural.. much differently, you are in control of your body, your movements, you can feel everything going on in your body, and it is truely an amazing experiance to not be stuck to a bed, or have little to no sensation at all in parts of your body. The anesthesia hypnosis creates just simply takes the "pain" away. There is still amazing pressure, don't get me wrong, but it does not hurt. There are so many wonderful things to be said for having a choice to birth where you want and how you want. I don't think this movie is going to be guilt tripping mothers who have had cesarean. I feel it is needed, it will help women understand that they are not alone, thier feelings of having that cesarean that may have not been needed can be validated in this movie. You can not tell me that every Cesarean is needed, every single one is necissary. Yes, I am so thankful we have this technology available when it is needed, but why is it only needed in 10% or less of birthing mothers in other countries? Why are most Midwives rates usually less then 10%?. I am a proud doula, hypno-doula and Hypnobabies Instructor. So, maybe I do see things from another side... I assist mothers who want all kinds of birth senerios, not just moms using hypnosis. Fortunately I have not had a mother who has needed a Cesarean yet. I have been to home births, which I do believe with a well trained midwife, and a emergency plan in place can be completely safe, especially if you are located close to a nearby hospital facility if needed. I don't feel that staying home to have your baby is any less safe. I have seen studies on both sides and outcomes of homebirths are very faverable.

Anonymous said...

I find it interesting that someone who has not birthed children yet has such strong opinions about the matter.
the fact is the US DOES have a really terrible neonatal mortality rate in a country where thousands of dollars is spent on healthcare. I find it quite sobering that hospitals make HUGE amounts of money off of L & D, and you are also wrong in your statistics about c/s, the cost is WAY more and docs get paid a lot more and frankly, the child is much more likely to end up with complications delivering by c/s than a vaginal birth. I do a lot of reading about this "to posh to push" phenom and I have never once read a word about what you are saying about Europe, I am going to look into it. Birth is good for babies, good for their lungs and the recovery is 1000x faster, generally, than from a c/s. c/s are major surgery and should be treated that way. Once you step foot in a hospital your chances of being cut open and something dire happening to your child is also a lot greater. women are generally NOT empowered with information and are treated like children and told what to do and how to do, patronized and patted on the head like the good little children they are suppose to be.
I had a c/s with my first and a homebirth with my second. I looked into all of my options and felt it would be much more risky to try and have my baby at a hospital. hospitals are infections, and doctors treat everything like a dire emergency. I know the doctors would not have had the expertise (because that is not their area) to get my baby out the way she needed to come out, or the various positions to try and move her down the birth canal. my midwife did.
I realise there will always be women who buy into the hysteria that our society has over child birth that can be easily seen on TV when a woman goes into labour and has her baby in like an hour. right. but the fact is, women's bodies are CREATED to deliver babies. and we are lucky enough to have the best of both worlds: if something DOES go wrong at home, we can easily transport where stuff can take place to "fixit". Hospitals are not safer, contrary to popular opinion to have babies in, I am of the opinion they are more dangerous actually. and believe me, I researched this topic obsessively when it came to my second birth.
I think that women need to take back the power for their own birthing experience and not continue to be patronized by the medical community who "delivers" thier baby, no I delivered my baby thankyouverymuch.

CNM Stephanie said...

Thanks all for bringing this issue to light. Square Peg, I am a fellow Chicagoan as well. This issue is so important and as a Certified Nurse Midwife who has worked in different settings in the area I believe that each individual woman should choose the setting that works best for her and her family/situation. I have personally helped women birth over 100 babies and assisted surgeons with over 50 cesarean sections. I also worked as an RN for 6 years in labor and delivery, postpartum, high risk antenatal,OR, pediatrics,and the newborn nursery in a tertiary care center.

The unmedicated birth is a wonderful option for women at home or in the hospital. Women should have the option in the hospital of less intervention if desired unless medically necessary.

Thanks for discussing this trailer. The Pregnant in America trailer, albeit biased, brings up the strong feelings that people hold surrounding the culture of birth. I will be interested in seeing the full length feature this year.

As far as elective c-sections are concerned,check out the NIH STATE-OF-THE-SCIENCE Conference Statement on Cesarean Delivery on Maternal request. It is available at http://consensus.nih.gov. Currently, there is not enough evidence to support elective c/s, especially primary c-sections. And, it is not recommended for women desiring several children due to the risk of placenta previa and accreta. I also have mixed feelings about elective c/s, but think arguments have consistantly been made for both sides.

Anecdotally, I can tell you that I have seen women recover beautifully in a few weeks from c/s and I have seen women months later still suffering from wound seromas that require packing and removing every few days (not fun-believe me). Not to mention, uterine prolapse and urinary incontinence are not only consequences of the vaginal birth, but are due to pelvic relaxation during pregnancy itself.

It sounds like, similar to me, you may be family planning yourself. I will be interested to hear (and share myself as women love to) your birth story. I personally would recommend a vaginal birth if you want to get right back to work as the recovery is MUCH easier (especially for those who have an unmedicated birth! Wink Wink!). The wonderful fact is that the option is yours. I would find a provider (MD or CNM)whose philosophy of care parallels your own. Thank you for talking about what is important to women!

Anonymous said...

Having "passed a canteolope out of my vagina" last week (one that weighed 9lb 12oz), without an epidural, I just want to say that it's not as bad as you make it out to be. If you haven't done it, don't comment on it! I just had my first baby in a birth center (not attached to a hospital) and did it all without any pain meds or epidurals. I didn't even ASK for anything! I would do it all over again in a heartbeat, because it was the best thing for me and my baby.

Harmony said...

I appreciate your point of view, but I think you are completely mistaken about the European rate of c-sections. According to this article (http://www.bmj.com/cgi/content/full/310/6978/487), the highest rate of cesarean in Europe is in Italy, and it's only 22%. That's the third highest in the world - after the US (which is the highest) and Brazil.

I know of a pregnant woman who lives in Sweden. According to her, she has gone to see a midwife because the Swedes (who have one of the most complete universal health care systems in the world, btw) ONLY use OB's for emergencies. She also has 1 scheduled appointment with her midwife at 20 weeks, which is the norm in Sweden. Nothing before, and AFAIK nothing very frequent after.

Now, if the problem in the US is inadequate prenatal care, why is it that the obviously less thorough Swedish medical system (most women in the US have seen their OB at least twice before 20 weeks) is able to produce such a better infant mortality rate (2.4 per 1000 vs the US 6.8 per 1000 - from http://www.infoplease.com/ipa/A0004393.html)?

Just a question for your consideration. :) Personally, I think that if these numbers are correct, the makers of the documentary have a pretty valid point....

Common Sense goes far, and you have a lot to learn little one said...

I really wouldn't want you for my Dr.
Having had both vaginal and sections I would rather have a non medicated vaginal birth over a surgical one any day.

You my friend have no clue, and I feel sorry for your future patients.

I don't usually call names but for all your education your really are ignorant.

Anonymous said...

you are really effing ignorant.

Anonymous said...

You make some good points about the articles cited in the documentary, however, on the whole you are spouting the same kind of defensive fear-mongering that the catastrophe that is the American Medical Model is known for. It would do you a great deal f good to actually read the studies that have been misconstrued and warped to create that same threatening attitude and develop an original thought based on the actual DATA and not simply spouting the 'party line' because you are a medical student.

Also, until you grow up and develop the maturity to accept the GIFT that is parenthood, please, please, PLEASE, keep yourself on GOOD birth control and seriously consider NOT inflicting that sort of shallow selfishness on a child. "Resent" them for being born when they were MEANT to and not based around YOUR schedule! Absolutely disgraceful!!

Anonymous said...

I too, find it interesting that someone who is childless would even attempt to have any strong commentary on the topic. Your detachment to the process of birthing your child worries me a bit. You really have no idea until you're going through it what its like.... And in case you were curious, it is a wonderful experience.

That said, I would like to share with you the fact that 7 months ago I had my daughter at home, all nice and comfy in my bed. I did not drown in bodily fluids and nothing went wrong. I needed no medical intervention, not even an internal exam. I had a midwife and her assistant whose job that day was to simply be there. After all, it was my body, my baby, my labor.

In all births, regardless of where they take place, there is the 10% factor of things not going completely smoothly. In a low-risk pregnancy, the chance of something going horribly wrong is even less than that.

In countries outside of the US, it is commonplace for women to birth outside of hospitals. This is mainly true because it is sick people who go to hospitals. Laboring mothers are not sick... they are on the last leg of pregnancy.

Anonymous said...

all you have to see is ONE botched home delivery--and one dead baby--to know that there is a reason that there is a benefit to delivering in a hospital with experienced obstetric and pediatric/neonatal staff. i hate to be crass, but i've taken care of many babies like that--in the neonatal ICU setting--and seen too many parents go through trauma and grief watching their baby(or -ies) die--when many times, these things are preventable with well-trained staff and immediate access to higher levels of care. for this reason, i cringe when people mention "home births". Even the most low-risk pregnancy, with well-trained staff, can go terribly awry with the death of one, or both, patients. Please don't think I am against midwives--because I'm not--just that I think these deliveries are often best in birthing centers or hospitals with access to ORs, NICUs, and their attendant staff--as immediate backup.

women have been doing it naturally for thousands of years--and never will i doubt that, and as someone who has resuscitated many a neonate, i will agree that the vaginally-delivered ones often do better than those born by c-section (especially elective c-section without the benefit of labor.)

but you know what? the 26 weekers never survived before. the only reason they do is because of experienced professional care. and if you look at the statistics, that is why our neonatal mortality rate is so high--we are saving babies that didn't have a chance in hell before. and try though we might, it is not a perfect system, and we do lose some of those babies. it is extremely hard to save a life that wasn't biologically designed to be saved. you can argue all you want, but the physiology of the fetus and neonate supports the assertion.

before you accuse square peg of being ignorant, realize that there is a whole breadth of knowledge and experience that physicians have acquired through our training. and perhaps your lack of knowledge, and lack of experience of this spectrum, would suggest that YOU are the ignorant ones. maybe you had good experiences, which is wonderful. For those of us whole have cared for patients through the bad experiences, we know what disasters are around the corner because we have lived and breathed and cried over them along with the families who grieve for their children.

Anonymous said...

You know..

Basically it comes down to the fact that no matter which way you go about your birth, whether it's au natural, or c/s, or in a tub of water whatever.

There is a chance of complications. It's fact of life. So long as you have SOMEONE who is trained for emergency situations. (not only for the health of the baby, but for the sanity of the parents, and the mother whose stress can affect the outcome) then I personally think that any method would turn out just fine.

natural birthie said...

Your whole argument is that you are scared to give birth naturally and are afraid that your body is not capable to perform a birth without complications. You may soon be a medical doctor and should take more responsibility for your rants. Are you speaking as a professional or some average Joe? If the former, have some dignity for your profession and provide argumentation and statistics for your point. There is good evidence that homebirth is just as safe as birthing in a hosiptal. You should seek out such information yourself before ridiculing it. Finally, many in the natural birth community are glad to have medical doctors who are trained for emergencies and complications help them in times of need. The movie you comment on says this explicitly. The movie makers are not trying to indoctrinate us into having a natural birth but are helping raise awareness that many things that occur in a medicalized birth are unnecessary.

Anonymous said...

just because birth is a natural process, doesn't mean it's benign.

just because YOUR "natural" birth went fine, mean it's the right thing for everyone.

it's pretty presumptuous to assume that one's individual experience, somehow trumps the experience of someone who deals with birth as a part of her career. and since when did having a baby become a requirement for having an opinion? that's the most ridiculous thing i ever heard...let me guess, you're not a health care professional?? or ANY kind of professional?

Anonymous said...

First let me say I have NOT seen this film, and I am sure it's dripping with bias and propaganda, as are most docs that are supporting a specific cause. I would like to add that just it seems nobody can come to a happy medium. It has been repeatedly brought up that specific case (pre-term, medically fragile primiparas etc) do better in a hospital setting.. DUH! Most of the time, those people ARE in hospital settings! second regarding the comment made something along the lines of only needing to see one dead baby from a home birth that could have been prevented.. There are plenty of dead babies in hospitals that ALSO could have been prevented. Like it was stated those are STUPID MISTAKES and can happen at home, or a birth center, or a hospital. Just remeber, mistakes and misfortune can happen in any setting, neither midwifery model of care or hospital model of care should be completely abolished. If its not for you, don't frickin' do it, on either side of the spectrum and accept the consquences of YOUR (birthing mothers) decisions, whatever they may be. I am not in the medical feild and have no specialized training, nor have I given birth. Its just common knowledge that all mistakes happen, regardless of the setting

Anonymous said...

It's of course, just your opinion and you are entitled to it, but you are clearly writing from a very fearful and defensive place which is understandable if you aren't pregnant, are afraid of 'mess' and very pro-medication. At some point you may decide to have children and you may find your attitude about all this changes. In the meantime your post should be understood as being very one sided itself, full of inaccuracies and not well researched enough to make me think that YOU know any more about the subject than the film you are mocking!

Ketty, London

Anonymous said...

My good friend had a baby just a few months ago and her obstetrician had a race with the obstetrician in a nearby room to see who would deliver their baby first. My friend's obstetrician won, but only because my friend had an episiotomy and ripped to her rectum. Bad luck, right? The answer is hell no. Dumb asses like her and YOU think there is nothing wrong with maternity care in hospitals in the US. No crap you ought to be defensive. My midwife hasn't had a tear since 2003 and it was a small tear and the number of her patients that had to have c-sections is marginal. Approximately 1/3 of hospital births in the US are by c-section, some hospitals have closer to a 50% c-section rate. However, you still defend the system in place. You'd be a great news reporter for Al Jazeera. Everything in the Middle East is just fine right? No human rights being violated there, right? It's pathetic people like you that can't recognize the faults in an obviously faulty system. My mother works for a hospital and part of her job is to ensure that lazy dumb shit doctors wash their hands, because they spread diseases going from one patient to the next. But you're the expert, right? 1 in 3 c-sections result in uterine infection. I bet you're looking forward to getting that just before you get all juiced up with your epidural and pitocin.

Oh yeah, let me b-slap you with this one: a vast majority of obstetricians have never witnessed a natural child birth. Obstetricians are taught to look for excuses to intervene. They’re taught that a woman's body is faulty.

It wasn't until the late 1990s that they discovered a drug that they were pumping delivering women with, actually caused the death of many babies. How can you criticize the trailer when you state that OBs commit "one or two mistakes in the field...?" I know how...you're in denial and are grasping at straws to defend a profession that you're dying to be a part of....most likely for status/money.

Have you heard of the term "if it isn’t broken, don't fix it?" Of course this won't happen because there's money to be made, right? Right! So, go make some greenbacks at the expense of an uneducated pregnant woman who believes everything that a doctor tells them so you can roll around town in your Benz!

Anonymous said...

Quote “….why would it be wrong to do that just because it's "unnatural?" Some studies have shown that babies delivered by C-sec produce less epinephrine and norepinephrine (adrenaline hormones, ie the "fight or flight" response) than babies born vaginally, thus concluding that these babies experienced less stress during delivery. These babies were followed for a year and were found to be less easily agitated and more socially adapted. Who knows, I'm not really passing judgment one way or the other. Just thinking about myself though, I know I'll probably be super-busy with my career by the time I get around to having kids, and I will probably really appreciate the option of a scheduled C-sec, so I can actually plan my life around my child, instead of being overwhelmed and stressed out and resenting the kid for not showing up on time.”

It’s not about a c-section child behaving better than a vaginally delivered child. It’s the fact that c-section babies have more lung and breathing problems because they were not squeezed through the birth canal aiding in removal of fluids from their lungs and the fact that the mother is at risk of serious complications while having a c-section. There are plenty of issues that come up for a baby born by c-section. More babies born by c-section are colicky. I believe it’s selfish of a mother to want an elective c-section just so her schedule isn’t messed up.

Anonymous said...

They did spell industrialized right in the trailer. You're weird.

Anonymous said...

Notes: Unneeded help isn't really help.
Script: One afternoon while working around his yard, a man spotted a cocoon. Looking closely, he noticed that something was struggling to get through a very small hole in the cocoon.

He sat and watched for several minutes before he was certain that what he was seeing was a butterfly attempting to get through the hole in the cocoon. As he watched, the insect inside the cocoon pushed and twisted but could not squeeze its way through the hole since the hole was smaller than the body of the butterfly.

Intending to help the butterfly emerge, the man took his pocketknife and very carefully cut the hole larger so the butterfly could pass through the opening. The butterfly emerged easily with no effort at all. However, the butterfly had a body that was far too big to permit its undeveloped wings to lift it.

The man waited with hope that the butterfly would continue to transform but this never happened. The butterfly needed to struggle to squeeze its body through the small opening. In the struggle, the wings would gain strength and the body would become smaller. Without this struggle the butterfly never developed into a beautiful insect that could fly from flower to flower. In fact, it died quickly, never able to develop.

The attempt to remove difficulties from the emerging insect left it unable to develop and grow in its next stage of life.

Amber said...

Red Spiral, your comment was so beautiful and non-judgemental. Thank you.

I think it is such a shame that there seems to be so much enmity between pro- and anti- homebirthers. Is it wrong to choose hospital birth? Is it wrong to choose home birth? Of course neither is. Every woman is responsible for understanding her own body and trusting her own intuition to help her understand which option is the best for her and her baby. Hooray for birthing centers - such a wonderful bridge.

I am glad to see some documentaries and movements such as Pregnant in America, biased though they may be. These sorts of films will help people to ask questions about the way things are and come to new conclusions. Perhaps the only truly bad reason to give birth in the hospital is to do it just because that's the way it's always done. Maybe the worst reason to have birth at home is because it's trendy or new-age. We all need to be able to see both sides to make good decisions.

I chose to have a home birth with my daughter. Sadly, my only support was my own faith that it was the right choice for me and a truly loving husband. Anytime anyone heard that we planned a home birth their response was "Are you sure? Don't you care about your baby?" I was instantly labeled a crazy hippie. However, I didn't choose homebirth because I'm a crazy hippie, I did it because I know the best situation for me to perform under the least stress and fear was at home, and my intuition assured me things would go right.

I was privileged to have a seasoned midwife who I had an excellent rapport with. My daughter was her 1000th (yes, thousandth) homebirth. She has never had to go to the hospital during or as a result of a homebirth and has never lost a baby or mother. During my (long) labor I was very frustrated several times because it seemed to speed up and nearly stop repeatedly. When my baby was born we found that she had a true knot in her umbilical cord. If my slow and irregular labor had been sped up with pitocin there is an excellent chance the knot would have tightened and caused her a great deal of distress. As it was, the pace of my labor was perfect for her. Also, my blood pressure was very high at the start of my labor - my midwife threatened to take me to the hospital if it didn't improve. As I began the most difficult part of my labor my blood pressure amazingly dropped back to normal. I feel absolutely certain that, had I been in the hospital my birth, perfect and resulting in a healthy, happy baby (she could lift her head independently and began singing and making undeniably happy noises immediately after birth), would have been fraught with problems. Interestingly, had I been in the hospital, I expect that the outcomes would have left all concluding that my daughter would have died or been at extreme risk at home.

On the other hand, I later met a woman who wanted very much to have a homebirth with the same midwife I did. Her insurance would not allow it. Though my midwife often arranges barters or payment plans for families who are not insured, this time she advised the couple to go ahead and find an OB who was covered, because sometimes these things have reasons we just don't understand. With no expectation of problems, her baby boy was born with a defect requiring immediate tracheotomy at birth. My midwife does have the training and equipment to perform this in an emergency if needed, but it would certainly have been a very bad situation.

I think if we want to improve birth in this country, we all need to respect each other's choices, and make informed and heartfelt decisions ourselves. Naturally, this carries on throughout motherhood and our own lives. If only we weren't afraid of birth, wherever it may be. I wish that every pregnant woman could understand and look forward to the empowerment and beauty of giving birth. If every woman saw giving birth as the chance to understand exactly why having two X chromosomes is truly god(dess)-like (we create life!), imagine how much healthier women would physically and emotionally be! Having a home birth left me feeling that I had just had the most fantastic experience of my life. I understood myself in a new and better way. When I speak to friends who have given birth in the hospital, I long to connect with them on this same level, but find that almost all of them seem to have missed out on this beautiful experience, though they seem to have caught glimpses of it. Is it impossible to have a truly empowering birth in the hospital? Certainly not! As America's "birth culture" improves, I hope that hospitals will create environments that support women in capturing this feeling, and that women will see birth as an exciting opportunity, not to suffer and earn a baby through pain and fear (or to bypass suffering through medical intervention), but to become a more enlightened and truly greater person. I feel that the problem with America's birthing system is not doctors and hospitals (though they may often contribute) but the culture surrounding them.

Incidentally, my mother gave birth (in hospitals) to four children without pain medication, but with her fifth she was strongly encouraged to have an epidural because of her age (40s) and history of (very) big babies (her fourth was 12 pounds). In retrospect she very much regrets the choice. She didn't feel the involvement in her labor, she hated the feeling of the drugs and the worry that it would affect her son, and she says it took far longer for her to recover from the epidural than the delivery itself (immobility until the drugs wore off following delivery, and then backaches throughout her postpartum period which were obviously in reaction to the epidural). Another friend, excited with her pregnancy after years of not being able to conceive, had an epidural and was thrilled with it. She was terrified of the pain of giving birth. I think without the option of such effective pain relief her fear would have caused her and the baby a great deal of unnecessary stress. Nevertheless, she now says that next time around she'd like to try it much differently, considering a birthing center with a midwife. If she'd been raised with a different concept of what childbirth is, I wonder what her experience would have been.

I do think it seems strange that OBs and most Nurse-Midwives aren't required to observe birth in a natural setting before being awarded expert-in-birth status. The Certified Professional Midwife is required to understand hospital birth and common interventions. I do think that every birth attendant should be familiar with birth in both natural and medical settings.

Anonymous said...

I want to thank Redspiral and Amber for their thoughtful and helpful comments.

I, though completely healthy and low risk, chose hospital births for both my babies. I did not want to live with the slim chance that my child would suffer because of the lack of equipment or expertise that might possibly occur in a homebirth.

I support all birthing care options as valid, and endorse a birthing woman's right to informed consent or refusal. Women in this country, however, will not be informed consumers until we all begin to speak openly about what is going on in this country right now, and what could be going on.

We mothers could become educated consumers, respected by the people who care for us. We could be informed of the risks and benefits of everything we do to care for ourselves and our child. We could then choose the risks that we can live with (all birth has risks).

Think about this: For what reason would a woman's right to make her own healthcare decisions be taken away? For what reason would a parent's right to make healthcare decisions for a child be taken away?

Incompetence? Child abuse?

Why should birthing mothers be denied the right to choose their care?

Anonymous said...

I have given birth three times. The first was in a hospital with an epidural. The next two were in birth centers with no epidural, using Hypnobabies techniques.

I can say unequivocally that the hospital birth ~with~ the epidural was the most painful and uncomfortable of the three. In the hospital I was restricted to bed, unable to move about freely. I was given pitocin to augment my "stalled" labor (which ironically was the shortest labor of the three- yes somehow I managed to give birth without augmentation the next two times!). When it came time to push, the epidural was turned down and so there was no escaping that pain! My only option for pushing was in the lithotomy position (which is pretty much designed for the benefit of the dr's ease of access, but works against gravity for the mother involved).

I know that hypnosis for pain management in childbirth sounds kooky on the surface, but you should really not knock what you don't understand. It is not some sideshow gimmick- it's a method of relaxation and self awareness that allows the laboring mama to be very focused on the task at hand, while respecting the body's incredible design and laboring processes. A mellow birth environment allows the hormones to stay at optimal levels and the body to carry on with it's own inate wisdom.

I am incredible grateful for skillful medical practitioners who are available when emergencies or complications arise. But there is no doubt that routine medical management of such a natural process in low-risk mamas contributes to unnecessary and interventions which can in turn lead to additional interventions that result in abnormally high c-section rates. In each of my non-hospital births, minor complications arose along the way that would have been handled much differently in hospital. In one, there is no doubt that due to routine hospital procedure, I would have been required to have a c-section. Instead, I birthed two babies, with never a thought of asking for pain relief (this after begging for one the first time, so I do understand and am no martyr!), with no episiotomies or tears (including an 8 lb,10 oz baby), and was up and about within hours feeling great.

Haven't been able to see this documentary yet, but there is NO indication that the filmmakers are advocating no prenatal care or rejecting the medical establishment in the case of any complicating factors. If it encourages women to question the procedures that are routinely done their bodies, sometimes without great merit, then I think it's a good thing. If we as women simply accept the establishment without question, then how can we hold them accountable when things go wrong. Informed consent and decision making!

Yep, one of THOSE women! said...

This was posted on many boards on the internet and like many other readers, I find it ingorant and sad. As someone else mentioned, a person who has never given birth having such strong opinions on birth is just bizarre. They do not have the same impact as when coming from women with actual experience. Sorry, but you just are not going to be taken seriously. Text books can't teach this stuff. The 2 births I had that were screwed around with and full of interventions had worse outcomes (ending up "needing" vacuum suctioning, etc) than my natural birth of a preemie. Yeah, it was great my preemie got care, but is sure as hell was not from an OB! I did not even have an OB deliver her : ) It was the neonatologists who cared for her after the birth. Keep in mind, as the last comments in your blog even admit, that doctors only do all this screwing around to avoid being sued! Do you go to a surgeon for a broken nail? Do you go to an OB/GYN to help you go to the bathroom? In other natural events that happen to everyone, such as death, do you feel there has to be a dozen people standing around with special equipment to help them die and to intervene if they do it wrong? Or don't do it on a certain time table? I'm due in Jan and fighting some ignorant doctors--and also have chosen never to return to their office again--who want to label me and look for problems just so they can justify hooking me up to every intervention known to man, all because I told them that I will have a natural birth barring any rare emergency, and they could not deal with that. I don't need some idiot telling me how or when to push or count it out for me. I don't need some idiot telling me to lie on my back, don't move, etc, while I'm giving birth. It's people like you who drive women to seek unattended births in their home. Keep that in mind. Reciting your text book definitions over and over do not make you look smart, by the way. They have the opposite effect. I guess the first thing they teach OB residents is how to talk to people in a way that distracts them from the real issue, which is all women are being lumped into one little box just in case they are the tiny percentage with problems. You even admit this in last paragraph. NO, it is not the best we've got as you claimed. Not even close. To me if a woman chooses to give birth in a hospital with an OB, he or she should just be there to watch and observe, offer encouragement IF NEEDED and be there in case of emergency. She will give birth on her own, as women have forever. There is no need to have someone there simply to catch a perfectly healthy baby from a perfectly healthy pregnancy and get paid $$$ for it. Don't overestimate your importance. As someone who can take measures when there is a problem, fine, but just realize that in most cases, you are useless.

Anonymous said...

They did spell industrialized right in the trailer. You're weird.
____
And yet, did you notice the blogger repeatedly wrote trailor? Just LOL on that one..

Anonymous said...

I do think it seems strange that OBs and most Nurse-Midwives aren't required to observe birth in a natural setting before being awarded expert-in-birth status. The Certified Professional Midwife is required to understand hospital birth and common interventions. I do think that every birth attendant should be familiar with birth in both natural and medical settings.
__________
I was asking my doctor about the interventions he uses. He insisted he only uses interventions when they are completely necessary. I said, "Oh good, then you must have lots of experience with natural birth!" He gets a certain look on his face that told me he has never before witnessed one and said, "Now, what I SAID was that I only use them when they are really necessary". I will never return to this doctor again. Upon seeing my birth plan his response: "You might as well give birth in a cave and bleed to death". : /

Anonymous said...

It’s not about a c-section child behaving better than a vaginally delivered child. It’s the fact that c-section babies have more lung and breathing problems because they were not squeezed through the birth canal aiding in removal of fluids from their lungs and the fact that the mother is at risk of serious complications while having a c-section. There are plenty of issues that come up for a baby born by c-section. More babies born by c-section are colicky. I believe it’s selfish of a mother to want an elective c-section just so her schedule isn’t messed up.
*********
Plus, lack of oxytocin=screwed up bonding process. The mother is immobilized along with that and given her baby later. She does not feel it is her baby. C-sections will never have the kind of positive outcome of a normal vaginal birth.

Anonymous said...

Anonymous said...
just because birth is a natural process, doesn't mean it's benign.

just because YOUR "natural" birth went fine, mean it's the right thing for everyone.

it's pretty presumptuous to assume that one's individual experience, somehow trumps the experience of someone who deals with birth as a part of her career. and since when did having a baby become a requirement for having an opinion? that's the most ridiculous thing i ever heard...let me guess, you're not a health care professional?? or ANY kind of professional?

__________
I think it is pretty obvious and sad that the blogger herself wrote this anonymous comment. Wow. Check out the first line. She has this same statement in her blog. Doh.

Yep, one of THOSE women! said...

Why oh why must some people, including blogger, insist on bringing up how NEONATOLOGISTS (hello?! NOT OB's!!) can now save preemies? Planned homebirths and having a preemie are 2 different things! I would not have a preemie at home. I don't think anyone would PLAN a hb with a preemie. That has nothing to do with a NORMAL pregnancy and birth needing unnecessary intervention! I wrote about the natural birth of my preemie. I had her in the hospital. I did not have an IV, was not on a monitor, did not lie flat in bed, had NO drugs nor inductions. She was cared for after the birth (after I was able to hold her and the cord cutting was delayed) by neonatologists. No OB was involved whatsoever. A wonderful general practitioner delivered her and respected all my wishes. Please get over yourselves. Oh, and she also did not get eye antibiotics because I am free of STD's. See how the medical profession insists that all are treated for the ones who truly need it? People are individuals. We do not have to go blindly into the pen like sheep and allow ourselves to be treated as such.

Michelle said...

wow...I just don't even know where to start.
Thank God I see gentle midwives at a birth center so I'll never have to worry about encountering biased, insensitive treatment from the likes of you. And yes, this documentary and others like it, like the Business of Being Born, are biased and they have every right to be.
There's a reason why my first two birthing experiences in a hospital were horrific and my last birth at the birth center (a waterbirth) was wonderful...

And they didn't misspell Industrialized. Pay attention.

Danielle said...

FYI, More women DIE during Cesareans than natural births.
FYI, Cesareans have many more complications resulting in serious medical issues that can be lifelong.
Get your head out of your ass. You are clueless!

Tanya said...

So let me get this straight: You have never given birth and you have never even seen this documentary. You felt qualified to write an entire blog dismissing it based on watching the trailer?? Wow. I would like to know where your statistics are showing that they do more c/s in European countries than America, because that is news to me. America has the second highest maternal mortality rate of all developed countries. Of those countries in the top 10, about 85% of births occur under the care of midwives outside of hospitals. There is vast evidence that many of the interventions used in the hospital cause more harm than benefit. IV's can over saturate cells and are not adequate replacements for food and drink. EFM machines have up to a 90% error rate. The common practice of making women birth on their backs decreases the pelvic opening by 30%. Many doctors still use cytotec despite the Black Box Warning on the box, saying not to. Breech births result in c/s despite them being perfectly safe to deliver vaginally, IF the doctor stays hands off which they don't seem to be able to do! Women are pushed into induction, sometimes the day after their due date (or sooner) despite the fact that stillbirth rate does not increase until after 43 weeks. Women are induced for "suspected macrosomia" when even the ACOG does not advocate for it and u/s can be off on weight estimates by up to 5 lbs! I could go on. The medical establishment is NOT working off of actual science but fear and myth. THIS is why more women are choosing to birth at home. We want what is safest for our children and ourselves. Choosing to schedule your child's birth so you don't "resent" them makes me pray that you will not have children until you have stopped being so selfish. Babies do not have clocks in the womb. They are not meant to fit nicely in our 9-5 world. They are people with needs and it is time for people to stop making them unless they are willing to put their child first!

zweedledee said...

It is sad that when someone points out the sad state of affairs of the maternal care system in the U.S. people in the medical field get defensive and start spouting off shaky inconsistencies. It is understandable why people like you would get nervous and defensive when someone made a movie that would scrap the kitty litter off of the big pile of poo that we call "modern medicine" as it relates to childbirth. I guess when you go to sleep at night you pray to your medical dogma that the medical field doesn't take a dent in their high dollar profits from harming and traumatizing birthing women.

Klorn said...

"Industrialized" is perfectly fine.

freddie said...

First off to the one commenting about Al Jazeera being biased and stuff. Actually Al Jazeeras reporting is quite unbiased and really good. Have you ever watched it?? If you gonna mention a biased network then go for FOX.
And someone else mentioned having a kid in sweden. Most ppl in sweden thats giving birth will go to a hospital to have it. Thats the norm. The reason we have lower mortality rate than the US is probably that we have good healthcare for EVERYONE not just the ones that can afford it..

sondrad said...

So, unfortunately I did waste 1:46 of my evening watching this film online (I know, I know).

Its even worse than the trailers depict.

IN one clip, Steven Buonaugurio, the father and producer of this film, is actually sitting in front of a white flip board sheet of paper, in which is written "The Hospital is not our friend."

The Magical Child author, is in one scene describing a birth he witnessed in Kenya (trite right?). The mother, in his words, "Squatted over the baby catcher in a hole, pushed the baby out, strapped the baby to her breast and then picked up her hoe and went back to work. It didnt hurt at all."
LOL!!! Right. From a man. And how often have we heard that story, placed in different geographic regions of the world (Rice paddies, potato fields, etc).

The movie continues in this vein. Barrage of rants against the system (Most hospitals are owned by big conglomerate corporations, strings of corporate cash cows, blah, blah blah, lies) and doctors are into the money only and care nothing about the patient (egregious).

And then there is the couple who gleefully tally up how much they "Saved" by going to Canada to have their child (40K). Hell, the should have gone to Kenya and had their baby in a hole, like the mother mentioned above. There's real savings. The irony is the car Steve drives costs more than what he was willing to pay for his child. hmmm.

In the end, they have their baby at home. And the midwife, their trusted friend, gets nervous about an hour after the birth because of the baby's condition and has to convince the Dad to take the baby to hospital. They are in ICU for three days. During this time, the Dad, Steve, says the hardest thing during his stay was to "Manage the Staff". Maybe it was hard because, um, that wasnt HIS job?!? Imagine how hard it was to manage the family from the staff's perspective. He seemed to beleive, in ajealous twelve year old boy kind of way, that the nurses just wanted to hold his baby all to themselves and not let him or his wife hold her (maybe it was the medical care they were giving Steve?)

All around, this is a Micheal Moore piece of trash, heavy handed, one sided, slanted toward the angry, resentful emotions of a disenfranchised paranoid alternative medicine crowd. They should have spent a year in therapy, rather than waste their money on this trash.

must love movies said...

responding to the last comment and overall. i think the film showed that having a set of beliefs can be squashed by circumstance. i mean after all their research and ranting the hospital helped them out in the end. had they had a successful birth and never stepped in the hospital they wouldn't have come to such a real conclusion.

films like these put some helpful facts out there as much as they put out biased views. the good in any situation that is considered bad is always going to be opinion based. (hopefully there are facts to back it up)

i'm not saying it was a great film or anything but i like that they learned and showed that the hospital is not a bad option in most cases. if you are talking money i can see the complaint. it is a business.

hamiltonmidwife said...

I have been a licensed midwife now for 25 years and have been involved in over 3000 births, I wish someone would make a film, on birth, natural birth, for low risk healthy women, who 95% of the time can deliver naturally, if we just let them. I was a labor and deliver nurse for 6 years before coming a midwife, I have been on both sides of the fence. WE are trained, WE can manage complications, WE do carry mal practice insurance, we are covered by most insurance companies and we assist women to deliver their babies at home. I would like to see someone follow me around for 10 births, and watch me manage them, from cords around the neck, to post partum bleeding, to stimulating newborns, to shoulder dystoica, to posistive GBS, to prolong ruptured membranes, just to name a few complications, that we manage to help women accomplish birth, a normal natural event in their life and I am honored and blessed to be a part of that.

Sarah C. said...

So, as a medical professional do you really expect people to take you seriously when you drop the f-bomb every other sentence... I would hope any doc working WITH me would be educated enough to express themselves in an adequately intense fashion using proper English, and would have the vocabulary skills to not need to curse so much. It is unfortunate that you don't see so clearly the relationship between hospital intervention and complications in birth. Ask if you want a few examples... I'd be happy to share. But I doubt you will. If you really want to go toe to toe about statistics, you should do your research a bit more thoroughly, as the holes in your argument are big enough to drive a mac truck through. I really hope that your insensitive and uneducated tirade doesn't get anyone hurt. Oh, and you either respect the other side of the argument, or you don't. Do everyone a favor, and don't pretend to,if you in fact do not.

jenilene said...

thank god you never had a kid a thousand years ago. You would have never been able to handle it! You might have died without your epidural!

jenilene said...
This comment has been removed by the author.
Mayari said...

I think you might be interested to read a book: The Thinking Woman's Guide to a Better Birth, by Henci Goer. It backs up many of the snippets you took umbrage to, but with research and peer-reviewed medical studies. Here in the US, we *do* have some of the worst neonatal and maternal morbidity and mortality in the developed world. In the Netherlands, where primary maternal care is performed by midwives, at least 30% of births take place at home, and OB's are fully available to take care of high-risk patients, their maternal and neonatal mortality is a little more than half of ours (http://www.unfpa.org/upload/lib_pub_file/717_filename_mm2005.pdf).
And you mentioned that cesareans have fewer complications than vaginal births. This is untrue- mothers and babies are more likely to die or be injured from c-sections (http://www.lamaze.org/institute/advancing/docs/elective_cesarean_consequences.pdf). You sound like someone who is interested in protecting women's and babies' health and debunking false information. So are those of us in the natural birth movement- and we have the science to back us up. I can provide you with lots of other references, if you're interested. Including a study that concluded that, for low-risk moms, homebirths are safer than hospital births (there's science behind this conclusion, too.)

I'd love to continue a conversation with you about this.

mayarivirginia@yahoo.com

Anonymous said...

Wow, this stirred up a lot of emotions in me. I had my daughter 2 months ago, she is wonderful :) I started out at a birth center with a midwife, but much to my disappointment I was "risked out" and had to go to an OB. The day I was risked out I was crying and terrified of having to go to the hospital due to my research on birth center/home birth vs. hospital births (yes I also watched the Business of Being Born and read Ina May's Guide to Childbirth).

My hospital experience turned out to be wonderful! I managed my care very closely throughout my pregnancy and every time I went for a visit with the OB reiterated what I hoped for the birth of my daughter, i.e. natural, no interventions, etc. My doctor was open to everything I wanted (basically to be left alone to go through the birth process). You can successfully have a natural birth at a hospital as long as you don't have an emergency situation (which typically people don't) and you have to choose your doctor wisely, some doctors are c-section happy because they do fear malpractice suits while others are open to most anything.

I went into labor at 1 a.m. had a dr. appt. that morning at 9 a.m. (I was actually overdue and set for induction with cervadil 2 days later which I was not happy about) and checked into the hospital that afternoon. I brought with me a birth letter (signed by my OB) and goodies basket for the nurses. I was free to walk around, even when the heart rate monitor kept falling off nobody came rushing in, they let me be, I was able to shower and do as I liked. The after birth procedures had me concerned, I wanted my daughter with me right away and not poked or prodded or even bathed. The nurses accommodated my every request. I was given my daughter and was able to have the bonding experience with her I wanted, she started nursing about 10 mins. after being born.

There are so many things about birthing naturally that no drug or procedure can mimic, they can only numb. In my opinion all these drugs and procedures can only inhibit our natural instincts as mothers.

Birthing my daughter was the most amazing experience of my life, it was painful, it was peaceful, it was empowering, and I am proud to be able to say I gave birth naturally and I tell everyone I can. We were made to birth, it is the medical community that has convinced us otherwise.

If I was able to give birth at home I would in a heart beat, and I envy those women who get to be at home for the most special time in our lives.

Anonymous said...

This is one of the angriest commentaries I have ever read. Your use of profanity and blatant disregard for evidence-based, outcomes-oriented practice makes me question your credentials to be a physician, especially one involved with child care.

I think the most flagrant example was "Motherf***ing DUH." Your discussion of the film in question would have been ameliorated at least 10 fold if you had simply refrained from cursing. Instead, you sound like a swarthy sailor on shore leave who has downed some swill and imagined himself (yes, you come across sounding masculine, too) to be a physician with an "informed" opinion on childbirth.

I'm not saying you ARE a sailor. I'm saying you sound like one, and since this is my first time reading you and first impressions, lasting as they are, are the most important, I figured I would let you know this is how you come off since you are blogging presumably for the purpose of drawing an audience. I am part of your audience and was disappointed by your lack of tact. Pretend like we're your patients in the future and demonstrate some bedside manner. They teach that at your medical school, right? And since allopathic medicine is CLEARLY the best thing since white bread and super glue, some of that bedside manner must be in order here, no?

Mercy me, now I'm shooting my mouth off. Well, God bless you for wanting what's best for children. I give you credit for that, at least, but less of the violent anger in the future, PLEEEASE!

Sincerely yours,
David Stratton

Anonymous said...

good luck "planning your life around your child". if that is still your attitude when you're ready to have kids i'd suggest rethinking the decision to become a mom. why does this movie tick you off so much? sounds like someone hit a nerve!

mabel said...

I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.

Lucy

http://maternitymotherhood.net

Sarah S., Student and Aspiring Midwife said...

To the author:

Words cannot begin to express my abhorrence for this post. Your emotions have obviously overridden your sense of...well, anything. You were studying to be a doctor, correct? You know how to do research, so I can't help but wonder why you didn't do any before writing this blog? Even if you had set out to prove yourself right or reinforce your beliefs, I know you would have been enlightened with the truth. I've seen the research and done some myself (no, we're not talking Google searches here). Shame on you for not using scholarly sources, you know better.

Every woman has the right to choose her own birth path and experience. There are pros and cons to both scenarios - homebirth vs. hospital birth - however, women (and people in general, especially those in the medical field) need to thoroughly understand both sides of this issue before making a decision. Every woman needs to understand her right to informed consent and informed refusal.

What about the prevalence of unnecessary intervention after an epidural is given? The negative effects of Pitocin? Women need to hear about the benefits and importance of the naturally occurring hormone, Oxytocin. We should not be scaring our women into taking the "just-in-case" route of hospital birth. OB/GYN's shouldn't be practicing defensive medicine (or the "Cover Your Ass" factor, as Cara Muhlhahn refers to it in "Labor of Love". A book that, by the way, I recommend EVERYONE read!).

Birth is not a disease! It's a beautifully natural, physiological process that women are privileged to and ought to embrace. It's a little scary for some and when it's a new experience, sure it's a little overwhelming! That's why we who share a passion for the beautiful bonding experience that is birth are here for; to help women find their inner strength and support them through their birthing experience. We do not deliver babies. No, we help mothers deliver their own babies.

I wonder where you stand now after watching the documentary? And, presumably, after working in the field?

P.S. Indeed, industrialized was spelled correctly. However, you did misspelled "litiginous" - it's litigious. And "trailor". You don't need to be phenomenal speller to succeed in life, but it would do you well to learn to use a dictionary.

Sarah S., Student and Aspiring Midwife said...

I'm sorry, there is a typo above.

Misspell not "misspelled".

Anonymous said...

I am so glad that someone finally mentioned the numerous malpractice lawsuits that doctors are faced with in our society, especially OB/GYNs. As a prospective medical school student, I have become aware of the amount of malpractice insurance that has skyrocketed and reached astronomical proportions. And the women featured in this documentary would probably be the ones more than willing to sue their doctors if something minor went wrong. I wish that more doctors would have had face time in the documentary to explain the shear reason why they HAVE to do C-sections: malpractice lawsuits. It is insane that one lawsuits could derail your career and ability to provide for your family.
Again Thank you for this reaction!

Anonymous said...

I just watched this last night. I thought it was great. There is a large focus in hospitals on patient flow-I know because I work there. As a women who has given birth naturally it was awesome. Hospital at 7am baby at 11 am. Baby number two is planned for a home birth. I know that I can birth my baby. I am not scared. Having a natural child birth was so cool. You should not have children if you are interested in shielding yourself from feelings and fitting it into your schedule. Please don't. But if you do it will keep me busy I guess.

Sarah-Sociologist

Anonymous said...

You are really ignorant.

MIG said...

I know this blog post is years old but I wanted to share a thought.

Although I too find your post ignorant I only attribute it to the fact that at the time you were a student. Please, rather than close yourself off to home birth, un-medicated birth, do a rotation with a Certified Nurse Midwife, or a birthing centre, even if it is part time during what little spare time you have as a med student. This way you can see both sides of birthing and provide direction based on experience. Please don't just automatically beleive that the Hospital is the best choice. You will be limiting yourself as a doctor.

I wish you all the luck in the world with your life and if you are still studying medicine I pray you are a great doctor.

Anonymous said...

Wow, you really are an ignorant idiot.

If I were studying medicine, I would be really sad to see the dictates of the lawyers and the malpractice insurance companies and the medical institutions. Why? Because you're not practicing medicine anymore, you're following dictates, policies, and protacols.

Perhaps that's ok for someone who is so egotistical that they believe they know more about how to give birth when they've never actually done it themselves.

Anonymous said...

Wow after reading your blog and the arrogant tone with which you presented yourself, I certainly hope you are NOT successful in your boards as you are the type this film was made to protect women from. I find it difficult to believe that one who claims to be so educated feels the need to state their case with such foul and inflammatory language. I find it even more absurd to believe that YOU, as a student, feel superior in knowledge to those whose credentials and EXPERIENCE in this field began well before your conception even took place. I am very leary of any doctor or medical student that feels they have all the answers. They are limited by their med school educations-completely at the mercy of institutional curriculums that are largely funded by drug companies. Good luck coping with your limitations when you are wise enough and mature enough to realize them.

гид в барселоне said...

The guy is totally just, and there is no skepticism.

Anonymous said...

My mother had 7 children at home. We all serve as real life examples of health at it's best! Growing up on organic foods, and having no shots we were hardly ever sick. Thanks Mom!
I had one and am about to have a other at home. I am sorry that you won't try and experience the Real beauty that a whole family can have when we all work as a team to bring even more love into the world...which could never hurt. My son had pooh in his nose and I pushed him out with no problems..except a tare which got sown up beautifuly without pain killer....the tare hurt more than the laber by far. The fear of pain is all in your control if you're calm and pray for power beyond what is normal.
God made nature, he made us and he loved us first and told us to love our neighbors even if we don't see eye to eye on matters.

Anonymous said...

I read Home Birth A Labor of Love ..awesome, must read. Just the information on Alfalfa is so useful. I wrote my experience at the bottom..my mother had 7 kids at home. Eight all together. All healthy till today. I am the second of the eight and I was born in the hospital. Seconds after taking me away from my mother they scrubbed my head for lice...if this girl is smart...explain how lice enters the womb. Years after, my mother couldn't comb my hair without me crying!