Is there any hope for improving maternity care?

[Youngfrankenstein]

Just seeing friend after friend be induced and sectioned has got my head in a whirl. I didn't start this thread to debate how necessary these inductions/sections were, but by the sheer number of them, I doubt it was all.

What is it really going to take to educate women and men about what they are "signing up for"? So many times I've talked to families who are turning to midwives after a first "bad" experience. It shouldn't take a tough first birth for moms to have the information.

I chose a homebirth for my last child. I knew it was best for us; however, I DON'T think it's the best choice for everyone. I just want the care a woman wants and needs (within reason) will be there for her.

One of the truest lines from The Business of Being Born was "'Come to us (hospital), we'll do whatever kind of birth you want.' And then when you get there you realize they only "do" birth one way."

I still can't understand why this hasn't crossed over into a women's rights issue.

[new2texas]

It is depressing isn't it? This is not something that will change overnight. I absolutely believe this is a feminist/women's rights issue, we need more high profile ladies to take up the cause. But on a smaller personal level it's people like you and I, talking to our friends about alternative choices in maternity care, sharing what we've learned, without being pushy or militant, and trying to affect small amounts of change. Baby steps. I know I was influenced in the direction of home birth by my SIL, who just recommended looking into having a midwife for prenatal care, and she suggested some books to read. Sometimes all it takes is a little seed being planted.

[MegBoz]

Originally Posted by Youngfrankenstein

I didn't start this thread to debate how necessary these inductions/sections were, but by the sheer number of them, I doubt it was all.

Well, the necessity of your friend's interventions is honestly irrelevant. The fact of the matter is that interventions of all kind are being done in the US at much higher rates than evidence tells us they ought to be. That is a fact. There's a chart showing evidence-based rates vs. reality in the beginning of the book, "Born in the USA" - it's frightening.

Originally Posted by Youngfrankenstein

I still can't understand why this hasn't crossed over into a women's rights issue.

I completely agree. It truly ought to be. Perhaps because women's rights for so long were so wrapped up in AVOIDING birth (contraception & abortion) it's difficult to embrace the right to birth as we want (& as evidence shows is best).

One way you can get involved to make a difference is with CIMS - the Coalition for Improving Maternity Services. Lots of info on their site.'

& yes, planting little seeds to educate others.

[Sam*]

Seriously its is people like you that are changing things. I had my twins via C Section 7 years ago. It was a terrible terrible experience and looking back on it I shudder. When I found out I was pregnant again, I thought I would have no choice in how this birth would be. I assumed I would have to have another C Section in another terrible hospital when I would feel like crap. But Im so lucky. One of the customers in my store is a doula. She was so nice and sat down with me and explained my options and how what happened before didnt have to happen now. She wasnt pushy. She just put the idea out there and I started to look into it. I now love my midwife and this pregancy has been so much easier and less scary than with the girls and not because this is a singlton. I feel so much support and to tell you the truth I feel like family when i go for my visits or when I can call when ever and get questions answered by my midwife and not be put on hold only to talk to a secretary and told to write it down and ask at my next visit.

Im so happy now and I plan on letting everyone I know that it can be such an amazing experience. Seriously people like you guys are changing things. Im so happy to have found this site with so much information and experience.

[donutmolly]

It does seem like an almost impossible task. I was feeling really discouraged after a friend of mine ended up with a c-section after the typical cascade of interventions... the depressing part was that I told my DH when she announced her pregnancy that she would end up with exactly the kind of birth she got. I'm not a psychic, but I do know my friend, and she is a "good patient" who trusts her doctor and takes the advice of the professionals. But in this climate, it almost guarantees a highly managed birth where the doctor saves the day.

I've been encouraged by the mainstream attention given to the high c-section rate, and how non-medically indicated inductions contribute to the number -- but frustrated that the doctors most often quoted pass the buck for blame onto supposedly high-maintence women who need to schedule every detail of their lives and force their doctors into these inductions. Whatever. I'm sick of women being blamed for the inherent faults of the highly-managed standard of care.

[CI Mama]

Originally Posted by donutmolly

I've been encouraged by the mainstream attention given to the high c-section rate, and how non-medically indicated inductions contribute to the number -- but frustrated that the doctors most often quoted pass the buck for blame onto supposedly high-maintence women who need to schedule every detail of their lives and force their doctors into these inductions. Whatever. I'm sick of women being blamed for the inherent faults of the highly-managed standard of care.

Systemic change is desperately needed. After all, births aren't divided into "good" births by well informed women who don't trust the medical system and "bad" births by uninformed women who do trust the system. It's way more nuanced than that.

Birth would be so different for so many women if doctors, hospitals, insurance companies, and malpractice law embraced non-induced, non-medicated vaginal birth as the best outcome from both a patient care and a financial perspective.

Personally, I think longer paid maternity leaves would also go a long way towards helping working women have better birth experiences.

I don't know how we get to systemic change. Any ideas?

[MyFullHouse]

I think it's the combination of things.

For one, we're an outcome-based society. We don't tend to value processes, only the results. When we see healthy babies born whatever way, we figure it must be just fine. Intervention, infection, even short NICU stays are "fine", as long as you're bringing a baby home.

For another, we don't talk about our bodies. I didn't even know (or remember) my mother breastfed my two sisters until I weaned #4 at about a year, after two disastrous experiences with #2 and 3. My sil was recently surprised to understand that c-sections are typically more difficult to recover from than vaginal births. And one of my sisters (who hasn't given birth) goes in the opposite direction, believing that ANYONE who wants a natural birth desperately enough can automatically achieve one.

We're also an overly busy society. I know many moms (including me with my first) who scheduled births around other plans, all the way from military plans to overeager grandparents' flight schedules. But, most commonly in my circles, it revolves around maternity leave.

I have no clue what the answer is.

[Galatea]

Originally Posted by Youngfrankenstein

I still can't understand why this hasn't crossed over into a women's rights issue.

B/c as with all women's rights issues, we women begin attacking each other, rather than working together. Just watch - it'll happen with this thread, too.

[Phoenix~Mama]

It most definitely is a women's rights issue... and slowly some people are taking up that notion.

I feel the same way... and that is why I'm a board member to a non-profit local group that is helping to educate and get research based evidence into the hands of pregnant women, as well as targeting hospitals and care providers to embrace the Mother-baby friendly birth initiative.

It takes a lot of people to make a change... but it all starts with one person who decides enough is enough. Small waves will get bigger.

[Youngfrankenstein]

Originally Posted by Galatea

Just watch - it'll happen with this thread, too.

I hope that doesn't happen! I agree that women being judgmental and looking down on one another for other choices is horrible and unproductive. I have my own opinions about birth. I'm not a believer in a "no reason, just by choice c-section" for example but frankly, I don't need it to be off the table either if I knew women were being offered the truth and optimal, evidence-based care.