Excellent health of a mother doesn't guarantee/ increase her chances to have a healthy baby? - Page 2

[AlexisT]

Yep. I've heard people say that if I'd just done X (eaten a particular diet, taken supplements, even had midwifery care instead of obstetric) I would not have had high blood pressure and preeclampsia. The fact is, no one knows why I got sick, and if you don't know why it happens you can't prevent it. There is a trend I see where so much emphasis is placed on the mother's actions that she becomes responsible for the outcome, good or bad. There is so much that is not dependent on anything we do.

[philomom]

No, unfortunately it doesn't. I was 26 years old, had an excellent diet and was in the best shape of my life and only took long walks for exercise while carrying..... and I had a stillbirth close to term. No drugs, no alcohol... not even cough syrup or Tylenol. Nothing.

Sometimes these things are not in our control.

[caedmyn]

Originally Posted by GuildJenn

No, it really doesn't make sense to say that.

There are lots of cord accidents that are NOT related to low amniotic fluid. Cord compression can relate to amniotic fluid levels, but a tight 2x nuchal cord is a problem regardless. (A recent review of the literature suggests that the deciding factor in nuchal cord deaths isn't the nuchal cord, but the amount of slack left in the cord.)

Just because low amniotic fluid can be a risk factor in some kinds of cord accidents it does not follow that you can avoid cord accidents by drinking a lot. Your risk might go down for the particular kind that occur with low amniotic fluid, but your risk will not go down for the random kind.

That's not quite what I was saying. I got the impression that some of the earlier posters were saying that the mother's health NEVER has anything to do with certain types of complications (like shoulder dystocia or cord issues). I was pointing out that that just isn't true. It's likely RARE for mother's health to play a part in some complications, but I don't think you can say it NEVER plays a part. I just don't think it's accurate to speak in absolutely (this is ALWAYS caused by something mom did, nor this is NEVER caused by...). I'm not trying to blame the victim at all. Really the only thing I can think of off the top of my head that probably has nothing at all to do with anything mom does is placenta previa (and for all I know it's been shown that a previous D&C increases risk or something else).

[Storm Bride]

Originally Posted by CherryBomb

It's rare that I hear someone say outright "if you do xyz, you're guaranteed a healthy baby" but I hear it implied often.

This, exactly.

Outside the natural childbirth community, it plays out a little differently, but it's still there. All through my third pregnancy when I was arguing with my OB and GP, who were both insisting that I had to have a c-section, because I'd already had two, I got the same two same phrases over and over again. Those phrases were "all that matters is a healthy mom and a healthy baby" and "we just want you and your baby to be safe". My GP also threw in a "I'm so worried about you that I can't sleep", just for good measure.

There is no way to look at those statements without realizing there's an implied promise there. They were telling me, not quite in so many words, that if I just did what they told me, and scheduled the section when they told me, I would be healthy, and my baby would be healthy. The GP wouldn't be worried once I scheduled, because the risks would be gone. If I just stopped fighting, I'd be healthy, and the baby would be healthy. If I just did what I was told, baby would be "safe".

They never flat out said "do this, and we guarantee your baby will be healthy", but that was their entire argument for the c-section.

It's prevalent here, too. Lots of "what did you do wrong?" when things don't turn out well. That also carries a strong implication that mom must have done something (eaten something, taken something, felt something - whatever), because if there were nothing wrong with her, then her baby and birth would have been perfect.

Oh - and fwiw, I know a woman who has had two stillbirths. After autopsy, it turned out that there's some kind of genetic problem on the father's side, and she's basically never going to have a living girl, unless she goes elsewhere for the sperm. She's healthy as can be, and her boys have been healthy, happy babies. I didn't meet her until after her second stillbirth, so I have no idea how many people piled guilt on her shoulders for the death she couldn't have possibly prevented...but my experience says that it's almost certain someone did.

[expatmommy]

Originally Posted by caedmyn

I'm not trying to blame the victim at all. Really the only thing I can think of off the top of my head that probably has nothing at all to do with anything mom does is placenta previa (and for all I know it's been shown that a previous D&C increases risk or something else).

Have you known many people who have had losses? Really? You seem to be trying very hard to find some reason, some explanation to prove that stillbirth or loss has definable reason. You know what the crappiest part of stillbirth and loss is? That most medical people don't know why it happened, can't explain it, and money isn't spent to research it. It is this great big unknown that well meaning people then try to explain away by some ill informed "it must be because of X or because of Y". It can't just happen for no reason at all. Someone or something must be to blame.

My son might have died because of how his placenta formed. He might have died because of how the umbilical cord inserted. He might have died because of a blood clot. He might have died because of some unknown unexplainable reason. I could and have spent a long time, as part of my grief process, trying to figure out the why. The reality is, no matter how hard one tries to be healthy and to do all things right, bad things can and do happen to good well intended people. It is a false notion that we have any sure measure of control over the outcome, be it a large or small potiential that something may go wrong.

[Jane]

I think that for populations of people, it works. For these 10,000 "healthy" women and those 10,000 "unhealthy" people (we could argue over the definitions) the "unhealthy" people will have more bad outcomes, whether we're dealing with babies, heart disease, etc.

But for individuals, it doesn't work out that way. What holds true for populations doesn't hold true for any one individual. Certainly, using crack cocaine increases the risk of placental separation and death of mom and/or baby. But not all crack smokers will have catastrophic outcomes. By far, most will be "fine". But on one would recommend smoking crack, unless they had a big life insurance policy on you.
I have certainly seen a lot of shit happen to good people. Miscarriages, as the foremost example, are shockingly common. 1 in 4 pregnancies end in the death of the fetus. There's really no way to make sure it doesn't hit you. Stillbirth is rarer, but devistating and many time, completely unable to be explained.

[flitters]

Originally Posted by CherryBomb

Being healthy just means you're probably going to avoid complications associated with poor maternal health. It does not, in anyway, mean you're going to avoid complications in general.

I really like your wording above.

[MsBlack]

Just for perspective here....

In research I conducted a couple years back on stillbirth, I discovered that 70% of cases of stillbirth have no known/knowable cause (even on autopsy w/cellular studies). Apparently healthy babies die, either late in pregnancy or during labor, and a solid reason cannot be found. Often the ones who show no actual cause, are written down as 'cord accident'--but in most cases this is basically a guess (yes, *sometimes* 'cord accident' is true, can be seen, but mostly NOT). We just hate to have no idea why this happens--'cord accident' is the most common diagnosis when another COD can't be discovered.

Just saying--health of mothers in these births is not necessarily implicated.

[GuildJenn]

Originally Posted by caedmyn

That's not quite what I was saying. I got the impression that some of the earlier posters were saying that the mother's health NEVER has anything to do with certain types of complications (like shoulder dystocia or cord issues). I was pointing out that that just isn't true. It's likely RARE for mother's health to play a part in some complications, but I don't think you can say it NEVER plays a part. I just don't think it's accurate to speak in absolutely (this is ALWAYS caused by something mom did, nor this is NEVER caused by...). I'm not trying to blame the victim at all. Really the only thing I can think of off the top of my head that probably has nothing at all to do with anything mom does is placenta previa (and for all I know it's been shown that a previous D&C increases risk or something else).

Excuse me, but a nuchal cord has nothing to do with what the mother does.

It is accurate in some cases to say that.

[laohaire]

I see, so this is an implied myth.

OK, so we're basically looking at a backlash here.

You have the mainstream line of thought that goes like this:
"I'm pregnant and I'm following doctor's orders. I'm all set because I have a doctor and he'll tell me if anything is wrong or if I have to do anything. If something actually goes wrong, which surely it won't because I'm in good hands, then it will just be completely random and unavoidable. I'm not worried because my doctor will take care of everything."

And now you have us NFL crunchies coming around saying this:
"Stop putting all your trust in the doctor! Your OB knows how to do surgery but he doesn't know or care about diet, exercise, avoidance of toxins or anything like that. Not only that, birth without a doctor (with midwife or even unassisted) is safe! It's safe for a lot of reasons, but among them is that an informed, proactive mother is less likely to have complications!"

Unfortunately, like probably ANY countermovement, we go too far. In our efforts to show that we mothers have a lot of impact on the success of the pregnancy and birth, we may imply that she has ALL the impact.

Homebirth is broadly as safe as hospital birth (though of course the details are different for both places) but in our efforts to convince everyone of this, we may go too far and imply we're COMPLETELY safe. Which we're not.

I think this is totally about the countercultural aspect. If everyone had the same assumptions we did, then there would be no need to exaggerate ("if you are informed and proactive you can avoid all the complications") to counteract the exaggerated assumptions of the mainstream ("if you have a homebirth without a doctor, you and your baby will die").

I think it behooves us all, in every way, to try to look for the truth and express our findings in a fair and accurate manner. Implying that the excellent health of a mother guarantees a healthy baby puts mothers and babies at risk, and undermines the message we're trying to put out.

[wombatclay]

~~~~~~moderator moment~~~~~~~~

I'm so sorry for the losses, pain, and regrets that have formed the basis for this thread. I think the idea of a "guarantee" is, indeed, a myth that needs to be explored and expanded on.

When writing your posts, please keep in mind that every person here has a different story... some mamas know first hand the personal pain (emotional, physical, spiritual) that can be caused by the myth of an implied "guarantee". Others have never even thought about it, have never had the myth fail them.

PLEASE KEEP IN MIND that the mdc user agreement asks members to disgree gently, to discuss the ideas and not the person sharing those ideas, and to choose our language carefully so as to share information/understanding instead of offending/alienating members who have different stories to tell.

I realize it can be hard when the topic is so potentially painful, and I'd like to thank everyone for taking the extra time to share their experiences and take in others' experiences as respectfully as you all have!

Please let me (or any moderator) know if you have questions or concerns.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[GuildJenn]

Originally Posted by laohaire

I think this is totally about the countercultural aspect. If everyone had the same assumptions we did, then there would be no need to exaggerate ("if you are informed and proactive you can avoid all the complications") to counteract the exaggerated assumptions of the mainstream ("if you have a homebirth without a doctor, you and your baby will die").

I think it behooves us all, in every way, to try to look for the truth and express our findings in a fair and accurate manner. Implying that the excellent health of a mother guarantees a healthy baby puts mothers and babies at risk, and undermines the message we're trying to put out.

Well as personal experience, I also think it's about people in general (often mothers) being unwilling to accept that if X bad outcome can just happen to anyone then it could happen to them. There is a certain kind of thinking that is self-protective like "if I don't do that, I'll be ok."

After my daughter died I was pretty surprised at the number of people -- many of them about my age and in their main childbearing/rearing stage -- who just had to find a reason, whether it was grounded in reality or not. One person speculated that the cord got around my daughter's neck because I took aquafit classes and she was really glad she hadn't.

We're just in an era where people -- read, mothers -- are supposed to be able to control our kids' environments to the point where risks become zero. But that is just not the case.

I also think there is a lot of misunderstanding outside of scientific and medical communities (and sometimes within them) about how research and risk factors work.

Just because one study or even 5 show that something may be a factor in an outcome doesn't mean it's the defining cause and that avoiding that will avoid the bad outcome. There is a serious difference between lowering risk factors and achieving outcomes. *

The cord accident discussion is a perfect example. Cord accidents are badly understood and understudied. There are at least 30 different "standard" types of cord accidents so lumping them together is kind of sketchy if you're trying to find causes.

For some of those there have been studies that looked at a few maternal factors. However, because cord accidents are not well reported, nor well studied, even those few areas where there have been some differences in something to do with the mother are pretty much speculation - the kind of thing where it's "this is interesting but more research is needed." And even in those cases those factors haven't been very significant. It's nothing like, for example, the link between HPV and cervical cancer which has not only had better information but where the percentages are startlingly high.

I kind of feel like we live in an age where everyone is chasing the latest study to do everything "Right" whereas in the past people may have spent their time in prayer or sacrificing goats.

There definitely are outcomes that are impacted by maternal health and I'm just as into no drinking or smoking or toxins and eat healthy and exercise and don't eat raw fish and deli meats and clean the cat box as everyone else.

But the OP specifically said "Mainly complications during the birth which would require medical intervention." and there I really don't think the answer can possibly be yes, you can control meconium and baby's heart rate and baby's delivery position and whether the cord is around baby's neck in a dangerous way by maternal health.

* remember there's a strong correlation between birth rates and storks, in certain areas. http://books.google.ca/books?id=QySy...page&q&f=false

[bri276]

I'm perfectly "healthy" but I happen to have a chromosomal disorder. It doesn't affect me at all, but when I reproduce, it can affect the chromosomes of the baby and cause them to have birth defects, developmental delays, etc (like my DD has) or a miscarriage because their defects are incompatible with life (several of those, too). This is something that was determined at the moment of my own conception by a healthy mother and what I eat, drink, exercise doesn't matter. In fact, the baby I'm carrying now is the first "healthy" baby -at least concerning her chromosomes- and she was conceived while I was drinking plenty of alcohol, eating plenty of sugar (holiday season, hello!) and even started smoking cigarettes for the first time in nearly a decade!

[laohaire]

You're right. I think what you're describing and what I tried to describe are probably two sides of the same coin. My side is about convincing others - your side is about convincing oneself. But your side is the more profound one and I didn't really consider it when I wrote my post.

We have a belief. Something is said or even happens that challenges this belief. This causes us pain and confusion and worry. So we reframe the event rather than challenging the belief.

From what I said, being countercultural makes this worse. "Everyone" believes that giving birth in a hospital is the only safe and rational choice (and that it's entirely safe and entirely rational). Defensively, we explain away any homebirth complications to protect our beliefs and choices. More, we attack hospital birth complications for the same reason.

And as this movement increases, mainstream people do the same - defend hospital complications and attack homebirth complications.

Admitting that your position is not unassailable is difficult enough when you're just talking academically or theorectically. I can't imagine how it would be when it's personal.

[MyFillingQuiver]

I agree with the backlash theory, as well...

I know, for a fact, that if I were to lose this baby or any future children, as a result of my choices to homebirth, it would be blamed on me by most people we know, for making "risky" decisions. They likely laugh at all our choices now-to eat healthfully, not to vaccinate, to supplement and avoid doctors, etc., but if a loss occurred, those would be the very "healthful" choices that led me to the nut job ideas that resulted in death for a baby.

Rather, what isn't understood, is that there is an implicit desire for health and good outcomes by most mama's-it's often just based on different theories of what health is, due to life experiences and personal ideas. I haven't come across a single mama on MDC who isn't striving for good health. It's implied-particularly by those who are mindful, and taking responsibility for their bodies and birth choices.

I also haven't come across a single mama on MDC who, if they lose a child, has done so by neglecting some facet of their health. Full term babies of healthy mama's die sometimes and that's a horrible realization I've recently faced through reading the nightmares of others here. The idea that these tragedies only happen to poor, uneducated, high risk groups is a fallacy.

It's as if we are expecting those with life-long uncontrolled diabetes, or being in other high risk categories to lose their babies..and somehow that's just OK..but a mom who lives on water and high protein, and exercise and NFL-she's just invincible? I guess it comes down to Who we believe is in ultimate control.

I think as humans, we just don't like to admit we can't always have all the answers, and sometimes no one is to blame. Of course, when there is someone to blame, that is a particularly cruel addition to the situation.

Nevertheless, any of the mama's I've read who've had birth loss, and myself and others who've experience pregnancy loss, ALL were healthy and doing the right thing for their babies.

[lalemma]

My husband calls this the "Shoulda had a doula" view of the universe.

I had a super-healthy pregnancy and consider myself a sturdy, healthy person. I am almost never sick. I am just - I don't know, I am very healthy. I was swimming laps the night before I had my baby - in the morning I woke up and went into eclamptic convulsions. There was no warning for this. Nothing I did caused it.

It's very hard to accept that (even for me!) because there's something really comforting about the idea that the universe is non-random. If bad things only happen to bad people, then if I just avoid doing bad things, nothing bad will ever happen to me. And if that mom's baby died at birth - well, because the universe is non-random, that obviously means that she did something to deserve that terrible outcome. How sad for her, but what a relief to know that that can't possibly happen to me as long as I color inside the lines.

I agree with PP that natural-living people can go completely overboard in their attempts to normalize birth or women's bodies or breastfeeding or whatever:

"Every single woman can breastfeed!"

"Every C-section is unnecessary and you could have avoided it if you had a doula."

"You only had pre-eclampsia because you didn't follow the Brewer Diet."

But I think this worldview is nigh-on universal to humans. Not just crunchy moms, not even just moms.

My husband is a soldier; before we were married he went to war. Once he told me a story about how soldiers will be mean about their fellow soldiers - guys from their unit - getting killed.

"He wouldn't have gotten shot in the face if he was a better soldier. I did not get shot in the face, ergo I am a better soldier than he is. Because I am a good soldier, nothing bad will ever happen to me. I will make it through this and go home."

It's very hard to accept the fact that life isn't fair, I think. Some people get through it with hard introspection or with faith in God. Other people just can't get through it, and cling to this idea that nothing bad will ever happen if they just follow the rules. For myself, I wish I had come by this life-isn't-risk-free insight in an easier way, but hey, an insight is an insight!

[olstep]

I did not mean to touch the painful subjects like stillbirth or miscarriage.
The only intention I had was to hear some encouragement that one can kind of prepare herself to have a positive outcome.
I am tempted to go UCed but find it difficult to block my brain that tells me that it may be unsafe.
I do not argue that things happen no matter how hard we try (in childbirth or life in general) but fatalism is not my philosophy. I do believe that we have responsibility and certain control for what happens in our lives.

[JessicaS]

Originally Posted by olstep

How true is this statement? Obviously, the better a mom takes care of herself the better start her babies will have. Is it a rule? How common are the exceptions?
Even though the birth is considered unpredictable, is it possible to predict the outcome for the baby with more or less small error? Or are there too many factors that need to be taken into consideration to make any grounded judgement?

I do think the health of the mother has an impact on the health of her child.

I also think that even healthy moms have complications and losses.

Being healthy isn't a garauntee but it does help. Obviously someone that is drinking, using drugs, or smoking is more likely to see issues in her baby than someone who does not.

My first pregnancy was extremely easy and I was in good shape. I had no complications until labor. My dd's cord was too short and in a true knot. Shortly after my daughter was born my SIL had a stillbirth due to an umbilical cord issue. Two umbilical cord issues in young healthy women in the same family (we are not related, our husbands are brothers) within weeks. It was a lightening strike we couldn't possibly have avoided.

Umbilical cord accidents lead to more losses than SIDS, but like SIDS there is little certainty of cause or prevention.

[GuildJenn]

Originally Posted by olstep

I did not mean to touch the painful subjects like stillbirth or miscarriage.
The only intention I had was to hear some encouragement that one can kind of prepare herself to have a positive outcome.
I am tempted to go UCed but find it difficult to block my brain that tells me that it may be unsafe.
I do not argue that things happen no matter how hard we try (in childbirth or life in general) but fatalism is not my philosophy. I do believe that we have responsibility and certain control for what happens in our lives.

Well with all due respect -- and if you want to UC go for it -- if all you want to hear is "if you are healthy and responsible you will be fine!" then don't ask a group of real women with real experiences about it, because statistically you are likely to find that is not the case.

And frankly, it wouldn't serve you well to ONLY hear that if you're healthy everything will be fine. I have been there and it wasn't true. Part of having an empowered birth experience is understanding what can go wrong as well as what can go right, and to be prepared to make decisions on that basis.

The advice that I would give any woman no matter which choices she is making in how and where she will labour is to be aware that there are risks and there are no guarantees. What is important is that you are able to live with the risks you choose to take.

[CI Mama]

Originally Posted by GuildJenn

The advice that I would give any woman no matter which choices she is making in how and where she will labour is to be aware that there are risks and there are no guarantees. What is important is that you are able to live with the risks you choose to take.

Great advice.

All I would add is...no matter how or where you give birth and what the outcome is, you won't be alone.

One of the benefits of sharing our real experiences...all of them...with each other is that we start to realize the huge variety of experiences that women have during labor & delivery. The sharing leads us to others who can celebrate with us and help us find our way through grief, whatever we need.

That's why I think we have a responsibility to share our stories and to listen to each other. There are no guarantees, but at the very least we can reach out to each other and help each other through the tough parts.