giving birth the "most dangerous thing a woman will do in her lifetime" ?!

[CampbellScot]

My cousin is in medical school. She is doing her OB rotation. We were having a conversation about child birth (my husband and I are TTC) and I mentioned that I wanted to have my baby at home. Oh my LORD the look on her face. She's still in that mode where professors and residents are GODS in her eyes and she proceeded to give me a lecture about childbirth being the most dangerous thing a woman will do in her lifetime. She gave me facts and percentages and gruesome details about women who dared to try to give birth at home and nearly DIED doing so and thank goodness they were close to a hospital or both mom and baby would have died. *gasp* I also had to hear stories about women who have very difficult labors IN the hospital and had to have emergency c-sections and what if they'd tried to give birth at home?!

She didn't so much appreciate it when I pointed out that a lot of those women could have avoided all those complications had they birthed at home instead of submitting to a medically managed/mangled birth.

How dare I...a mere psychologist...tell the future MD about HER job.

I swear she is BRAINWASHED.

It makes me so angry that this myth of extreme danger being a major element in the natural process that is child birth. Sure there are exceptions to every rule, but if child birth was that dangerous how did humans manage to thrive before pitocin and vaccum assisted births and grabby smug doctors telling us what to do...? She then pulled the "selfish decision for a mom to make" card.

nice.

note to self: Keep my birth plans to myself. I'm SO not going to put up with this for nine months.

just wanted to vent.

[MeepyCat]

Here's the thing: your sister is right. When you crunch all the numbers, add 'em up, look at incidence per population and compare the number of times you give birth to the number of times you drive to the store, et-interminably-cetera, giving birth is the activity most likely to kill you. Also most likely to kill the baby.

Humans, as a species, did manage to survive before pitocin and vacuum-assisted delivery and so on, but the risk of dying in childbirth used to be incredibly much higher than it is today. And the mortality rates for unassisted delivery are higher than those for hospital birth.

The continuation of the species doesn't require the survival of any particular individual. Your sister, as an individual, has an investment in your continued survival, however, and being a doctor, she certainly has some ideas about how to improve your odds. (Improving your odds, however, is not her job and not her call.)

In places where women lack access to medical facilities and qualified caregivers, the mortality rates associated with birthing remain very high. Flip it around - if birth is safe, please explain perinatal mortality rates in Sierra Leone.

That said: you have the right to decide how you are going to respond to risk in your life.

[journeymom]

Agreed with the above.

Still, you do your research. Get yourself educated about what are safe scenarios, what are risky scenarios. High blood pressure, placenta placement, etc. etc. Monitor your own health and that of your unborn child through out pregnancy and make an educated decision: birth at home or in a hospital. And it's still a big risk, regardless of where your child is born or with whom attending.

I totally disagree with your cousin, it's not a 'selfish decision' for a mom to make, if it's a well thought out decision. If you go into this being willing to do what's necessary for the safety and well-being of you and your child, even if it means changing your mind about heading to the hospital if you learn something new about your situation, then you have been rational and logical, and your cousin cannot ask for more than that!

It's too bad she freaked out like that, but give her a break. She's still an enthusiastic convert.

[MsBlack]

We are not in Sierra Leone, or if we were, we would still be people with more knowledge toward good-self-care than the average Sierra Leone citizen. So to some extent we would likely still be subject to some of the conditions there, but we would not be NEARLY so subject to those conditions as the majority of the natives who are suffering the impact of imperialist western culture that has destroyed their own culture in so many ways and left them impoverished and unhealthy in general. Sorry, I can't accept that as a worthy piece of info to toss into this mix--the discussion of birth's safety. We are also told that a kid can 'die of the measles if not vaxed'--what we are not told is that the kids who die of the measles are kids whose lives were *already* greatly compromised by lack of food, shelter, sanitation, etc....just as the lives of Sierra Leone women are *already* compromised (generally speaking) by a whole complex of dire conditions that we do not face--and their birth stats reflect entirely upon those conditions, not upon birth itself.

Birth is safest where conditions for people are safest in general--good food supplies, sanitary water/sewage, general atmosphere of peace in the populace, adequate information, guidance and support of all kinds for pregnant/birthing women, respect and unhindered support for the birthing process...etc. There ARE more emergencies and other problems for moms and babies at home than in the hospital--because med maternity care doesn't practice with evidence basis, and generally practices a high degree of interference in a natural process, to no good end.

Yeah CampbellScott--don't waste your time, or just give yourself needless stress, talking with Ms Med Student about your birth plans! But maybe she'll learn more of the truth about birth later....when she hears your birth story!

[SubliminalDarkness]

I think there are elements of truth to what she is saying. Yes, birth can be dangerous. And yes, there ARE times when homebirthing mothers are truly "saved" because they had access to medical care. IMO, I would feel irresponsible to attempt a homebirth if I was unable to access emergency health care were it to be necessary.

The thing is, in *most* cases, with a healthy mother and healthy baby and healthy pregnancy, those things are not needed. And yes, many MANY mothers are "safer" at home than in the hospital. Yes, being in the hospital can create complications for a healthy situation that would not have occurred at home. You are absolutely correct there.

But to say that birth itself is inherently safe is simply shortsighted. Things DO go wrong. And before humans had access to things like c-sections and certain other emergency care, things did go wrong. And in places where women don't have that access, things still do go wrong.

It's a matter of finding a balance and finding what is safest, and most comfortable to you, for your specific situation. I would hate to see a day where women cannot go to the hospital for birth if that's what is medically indicated for them, because sometimes it is the best choice.

Just take a step back, realize where she's speaking from, take into account what she's being taught, and take what she says with a grain of salt. If you know differently, then do differently!

[MsBlack]

I like the saying, 'birth is as safe as life gets'

As with all of life, that safety factor is much improved by taking precautions, being prepared, healthy, alert, etc.

yet I would never want anyone to think that I believe 'birth is inherently safe, period'. It is just as safe...and only as safe...as life gets. It's an exceedingly wondrous design that most often is plenty safe enough--our human population would not be nearly so large if it were not. Today's population, after all, is as large as it is NOW, because of the amount of people who survived birth (and the rest of life) 100 or more years ago; that's when the foundation for today's population was laid. That is, long before modern obstetrics was in play...and btw, a relatively small proportion of the world's childbearing women have any access to modern obstetrics, but the world's population is still growing...because birth is plenty safe enough.

But no, there are no guarantees. Disease, disability and death are built into the plans: life's plans, and birth's plans. Seems to me that ppl like that Med Student look at those '3 Ds' as the MOST obvious factors of birth--when in fact, they are much smaller factors by far, because birth IS so safe, even though it has like the rest of life, risk of those '3 Ds' occuring.

[Sijae]

I don't buy it.

Here are the leading causes of death for females of all ages in the US from 2006 according to the CDC. I don't see birth injury on there.

All Females, All AgesPercent*
1) Heart disease25.8
2) Cancer22.0
3) Stroke6.7
4) Chronic lower respiratory diseases5.3
5) Alzheimer's disease4.2
6) Unintentional injuries3.5
7) Diabetes3.0
8) Influenza and pneumonia2.5
9) Kidney disease1.9
10) Septicemia1.5

If you break women down by ages you will see pregnancy complications pop up on the charts between 15-34 years of age but the percentage is very low and you are more likely to be murdered, commit suicide, die from an accident, from cancer or, believe it or not, die from HIV (25-34 years). http://www.cdc.gov/women/lcod/06_all_females.pdf

There are no guarantees in life, and yes, people die. People die for many reasons every day. We just got word that an acquaintance's daughter died in a river rafter accident (she had 6 live children). But pregnancy and birth are designed to work and be relatively safe. A small percentage of women and babies are biologically designed to die (we try to prevent this through intervention) but it is much smaller than people seem to think.

The medical system profits from birth being a pathological condition.

[mamabadger]

A client in my prenatal class was just told this by her OB. It seems to be a statement that is passed around in medical schools.

Originally Posted by MsBlack

I like the saying, 'birth is as safe as life gets'

I think that sums it up. We do a lot of potentially risky things, like driving, by managing the risks as best we can. Nobody is telling us never to get behind the wheel because people die in car crashes every day.

Birth may be dangerous in Sierra Leone (or wherever), but then, many things are dangerous in Sierra Leone which are not particularly dangerous here. Lots of toddlers die in Sierra Leone. Does that mean being a two year old is inherently dangerous? Drinking plain water or getting a cut on your foot might be dangerous there. Hospital birth in Sierra Leone is probably not much better than unassisted home birth for safety. That says less about birth than about Sierra Leone.

In wealthy Western countries, women still die in childbirth, but they are quite likely to have died from complications of surgery or reactions to anesthetic. Those things occur during childbirth, but are not risks inherent in childbirth - they are risks associated with hospital birth. Home birth outcomes continue to be as good, or better, than hospital birth outcomes, for mother and baby. Access to obstetric technology makes birth safer because it is available in emergencies; the routine use we have fallen into is one of the things that makes birth less safe.

[MeepyCat]

Originally Posted by Sijae

I don't buy it.

Here are the leading causes of death for females of all ages in the US from 2006 according to the CDC. I don't see birth injury on there.

All Females, All AgesPercent*
1) Heart disease25.8
2) Cancer22.0
3) Stroke6.7
4) Chronic lower respiratory diseases5.3
5) Alzheimer's disease4.2
6) Unintentional injuries3.5
7) Diabetes3.0
8) Influenza and pneumonia2.5
9) Kidney disease1.9
10) Septicemia1.5

If you break women down by ages you will see pregnancy complications pop up on the charts between 15-34 years of age but the percentage is very low and you are more likely to be murdered, commit suicide, die from an accident, from cancer or, believe it or not, die from HIV (25-34 years). http://www.cdc.gov/women/lcod/06_all_females.pdf

The reason you don't see birth injury on this list is because of modern obstetrics. Check out the top ten reasons why young women died 100 years ago - birth and related complications will pop up much higher.

Also, don't discount the relationships between kidney disease, septicemia, and childbearing.

But pregnancy and birth are designed to work and be relatively safe. A small percentage of women and babies are biologically designed to die (we try to prevent this through intervention) but it is much smaller than people seem to think.

Pregnancy and birth were not designed. These processes are the messy result of evolutionary trade-offs between upright walking, pelvic diameter, brain size, and infant head size (this is not a complete list), and the way that these conditions interact with environment and events.

And "biologically designed to die"? I prefer the notion that birth is risky to the notion that some people are *supposed* to die in childbirth. FWIW, I would be dead if not for modern obstetrics, but that's not an indicator of my general health or ability to bear children. I had placenta previa, which is kind of like having a passing plane drop a brick on your head - you can totally die of it, but it's just random lousy luck.

[MsBlack]

100 yrs ago, the reason most women died at/near birth was directly related to food supply/nutrition, water treatment/sewage, and a complete lack of understanding of germs...sometimes the horrible combination of these things. It really wasn't about the design of birth. The 2 things that have most improved birth outcomes in the century since then has been increased understanding of nutrition along with making more food available to more people--and sanitation (water treatment/sewage, germ theory/handwashing).

Whether one believes in a god who intentionally designed birth, or in messy evolutionary processes, what we have as a result is a 'design'--a way it works, and pregnancy and birth work exactly as well as they are able to, given the conditions. It is normal for woman to get septicemia at/near birth, if she is examined by someone with dirty hands, after all. And rare for women who are not internally examined, nor cared for by providers who both serve the sick and the birthing in the same day without so much as a change of clothing, much less washing hands (as was common 100yrs ago).

And whether you call it a design 'flaw' or part of a perfect design...death is necessary and yes, I do believe it's part of the plan. Not so much part of the plan for any individual, no--but a part of the plan on the whole. The planet can't support an unlimited number of individuals of any species, including humans. What if nothing/no one died?

Not saying you or anyone 'should have died'--only that death is part of life's plan. Just as it's part of the plan that we have a strong survival instinct and generally will do all we can to promote survival of self and loved ones!

Random is part of things in life. No way to stop that.

[lach]

Originally Posted by Sijae

I don't buy it.

Here are the leading causes of death for females of all ages in the US from 2006 according to the CDC. I don't see birth injury on there.

All Females, All AgesPercent*
1) Heart disease25.8
2) Cancer22.0
3) Stroke6.7
4) Chronic lower respiratory diseases5.3
5) Alzheimer's disease4.2
6) Unintentional injuries3.5
7) Diabetes3.0
8) Influenza and pneumonia2.5
9) Kidney disease1.9
10) Septicemia1.5

If you break women down by ages you will see pregnancy complications pop up on the charts between 15-34 years of age but the percentage is very low and you are more likely to be murdered, commit suicide, die from an accident, from cancer or, believe it or not, die from HIV (25-34 years). http://www.cdc.gov/women/lcod/06_all_females.pdf

And, according to the CDC, in 1920 the #10 most common way to die was complications in childbirth. And that list counts both men AND women.

Originally Posted by Sijae

There are no guarantees in life, and yes, people die. People die for many reasons every day. We just got word that an acquaintance's daughter died in a river rafter accident (she had 6 live children). But pregnancy and birth are designed to work and be relatively safe. A small percentage of women and babies are biologically designed to die (we try to prevent this through intervention) but it is much smaller than people seem to think.

The medical system profits from birth being a pathological condition.

I'm going to have to agree with MeepyCat that humans are actually pretty poorly designed to give birth. Walking upright means our pelvises must be very thick and solid. Childbirth in humans has always been riskier than in any other mammals, and our babies are born severely underdeveloped compared to most other mammals. I always thought that this was fairly common knowledge: I remember learning about it in junior high and high school biology classes. The very popular "Happiest Baby On the Block" book is based on the theory that babies are born about 4 months too early.

We're all biologically designed to die eventually, but I think it's a little dark to say that babies and women just should just accept the fact that death is a common part of childbirth instead of accepting that medical intervention can, and does, save many many lives.

[CherryBomb]

Originally Posted by lach

We're all biologically designed to die eventually, but I think it's a little dark to say that babies and women just should just accept the fact that death is a common part of childbirth instead of accepting that medical intervention can, and does, save many many lives.

[MsBlack]

Nobody said death is just a common part of childbirth.

Nobody said that people should avoid medical help if it's indicated.

I, however, said that disease, disability and death are, and always will be, a part of the plan for life--and birth. They are at times inevitable--for reasons, or due to random chance. This is true regardless of place of birth/provider, and regardless of all other life precautions a person takes.

I also said that part of the plan is for us to have a strong instinct for survival, and to do all we can to prevent those 3 Ds.

Let's try not to get too polarized here, shall we?

Listening to what people actually say really seems to help...as does agreeing to disagree where applicable.

Just sayin'....

[mamabadger]

Originally Posted by MeepyCat

The reason you don't see birth injury on this list is because of modern obstetrics. Check out the top ten reasons why young women died 100 years ago - birth and related complications will pop up much higher.

The trouble is, birth related complications is a big area. It includes women who died from natural complications of childbirth, as well as women who died from complications of modern obstetrics.
When doctors began attending births in large numbers, the maternal mortality rate rose, and most of the deaths were from "childbed fever" - attributed to doctors treating infectious diseases and then attending births without washing their hands. Some nineteenth century lying-in hospitals recorded a drastic decrease in maternal deaths when midwives filled in during a busy period, followed by an increase when doctors resumed their work.
Birth injury can be caused, as well as prevented, by modern obstetrics. Early obstetrics' fascination with new tools and techniques supplanted traditional, probably safer, methods of attending women in labour, and may have been responsible for a large proportion of those "birth related" injuries. We do not really know, since they are all placed in the melting pot of childbirth related injuries/deaths. We do know that, to this day, a leading cause of maternal death is infection, which is more common in hospital, and more common after a surgical delivery.
We also know that death rates are similar for home and hospital birth. If obstetric technology made childbirth safe, women who give birth at home or in low-tech birth centres should be dying like flies, and they are not. The factors which make a difference here are things like prenatal nutrition, something obstetrics largely ignores.

[MeepyCat]

Originally Posted by mamabadger

When doctors began attending births in large numbers, the maternal mortality rate rose, and most of the deaths were from "childbed fever" - attributed to doctors treating infectious diseases and then attending births without washing their hands. Some nineteenth century lying-in hospitals recorded a drastic decrease in maternal deaths when midwives filled in during a busy period, followed by an increase when doctors resumed their work.

Notice that I picked my time period - A hundred years ago, not two hundred. AFTER Semmelweis and Pasteur.

Also please note that infection was never the only cause of childbed mortality.

We also know that death rates are similar for home and hospital birth. If obstetric technology made childbirth safe, women who give birth at home or in low-tech birth centres should be dying like flies, and they are not. The factors which make a difference here are things like prenatal nutrition, something obstetrics largely ignores.

We know that morbidity and mortality rates for low-risk pregnancies, attended by well-trained midwives are similar at home and in hospital. It's a very different sentence when you include the bolded part.

I don't know what obstetricians you've been dealing with, but mine were the world's biggest cheerleaders for prenatal nutrition. I don't think the specialty is ignoring that particular issue.

[MsBlack]

The work of Semmelweis and Pasteur was essentially ignored by US docs until less than 100 yrs ago. My grandmother, who gave birth 12 times between 1911 and 1927, decided to have her babies at home--where she did so safely (in Chicago)--because so many women were still dying in American hospitals (primarily of puerpural fever). Even according to the present med maternity system, at least 90-95%% of women should be 'low risk'. Setting aside such personal choices as nutrition, drug use, other lifestyle issues, 90-95% of women have no underlying reasons for their births to be complicated. And of the remaining women, most do not have such dire complications as placenta previa or other things highly likely to lead to fetal or maternal death.

I don't argue against the real good that can be done for the very small number of women with previa or other life-threatening issues, by med care. I argue that birth itself is as safe as life gets--it's design, the process itself, for the vast majority of 'normally made, potentially normally healthy women having normal pregnancies.'

I also argue that 'the most dangerous thing a woman can experience' is highly impacted by a lot of variables! Living in gang territory, drug use, participating in abusive relationships, driving in a city like L.A., or near factories that produce toxic waste, or active volcanoes....I still think that the med student's argument is plain silly. Far too narrow in scope, obviously biased toward her chosen field of study--which is illness-and-pathology based, with no real notion of what 'normal birth' or even 'normal health' is. She is also clearly ignorant of the vast amount of iatrogenic harm of all sorts, caused to birthing moms and babies every day in the hospital--the vast majority of this damage being caused to otherwise healthy moms and babies!

[MeepyCat]

Originally Posted by MsBlack

I also argue that 'the most dangerous thing a woman can experience' is highly impacted by a lot of variables! Living in gang territory, drug use, participating in abusive relationships, driving in a city like L.A., or near factories that produce toxic waste, or active volcanoes....

I have driven on the freeways L.A. I have broken down on them. I have hitchhiked, I have hitchhiked with drunks. I once dated a guy who went on to murder his parents. I have walked, by myself, across many of the sketchier parts of my home city, at night. Without my contacts in. The most dangerous thing I have ever done is *still* giving birth.

I still think that the med student's argument is plain silly. Far too narrow in scope, obviously biased toward her chosen field of study--which is illness-and-pathology based, with no real notion of what 'normal birth' or even 'normal health' is. She is also clearly ignorant of the vast amount of iatrogenic harm of all sorts, caused to birthing moms and babies every day in the hospital--the vast majority of this damage being caused to otherwise healthy moms and babies!

Y'all have a really low opinion of doctors. I'm not going to claim that any doctor is perfect. I think that obstetrics could stand some improvements. But if I were a medical student, and I heard my own cousin express this opinion of doctors, I would be busy wondering how it was that I never noticed how badly my cousin misunderstands and mistrusts me. I might not produce my most logical arguments. There might, later and privately, be screaming and tearing of hair.

[mamabadger]

Originally Posted by MeepyCat

Y'all have a really low opinion of doctors. I'm not going to claim that any doctor is perfect. I think that obstetrics could stand some improvements. But if I were a medical student, and I heard my own cousin express this opinion of doctors, I would be busy wondering how it was that I never noticed how badly my cousin misunderstands and mistrusts me. I might not produce my most logical arguments. There might, later and privately, be screaming and tearing of hair.

It is not a question of thinking individual doctors are bad, dishonest, untrustworthy, or malevolent. Most of them are good people, and do what they can to help their patients, according to what they have been taught. If they were taught wrong, that does not make them evil, just misinformed. Obstetricians of past decades who insisted on separating mothers and newborns for 48 hours after birth; who did routine episiotomies and forceps deliveries; who strapped women to delivery tables, shaved off their pubic hair, or exposed them to X-rays during pregnancy - usually did it in a sincere effort to help their patients. Saying these things were misguided is not attacking doctors. Neither is pointing to the flaws in current obstetric thinking or practice.

[MsBlack]

Gosh, MeepyCat--sounds like we have a lot in common! I, too, have hitchhiked, survived the L.A. freeways, dated a violent man who came close to murdering me once (accidentally--but still!)...and various other death-defying things. I also (and my son) definitely benefitted once from needed medical care at birth. And remain grateful that it was there to help us!

But c'mon--we are not talking about what an individual woman does/does-not in her personal life that may be very risky; we are not talking about the small % of us who do benefit from medical maternity care. We are talking about the statement that 'giving birth is the most dangerous thing a woman will do in her lifetime'.

So I'm only saying that that statement, applied to 'all women' is simply both too sweeping, and too narrow. It really doesn't apply to all women, or to birth in general. And it was spoken from inside the mindset that modern medicine is the best thing for women and babies since...oh, I don't know, since the discovery of germs, maybe...from inside that pathology-and-impending-disaster belief system that really does not understand normal birth. And that does see it's methods and it's practitioners as nigh-on godly-- whose interference with birth is absolutely necessary to preserve everyone from this 'most dangerous' normal and well-designed process of birth.

[Banana731]

[QUOTE=MeepyCat;15823043]I have driven on the freeways L.A. I have broken down on them. I have hitchhiked, I have hitchhiked with drunks. I once dated a guy who went on to murder his parents. I have walked, by myself, across many of the sketchier parts of my home city, at night. Without my contacts in. The most dangerous thing I have ever done is *still* giving birth.



do you really think giving birth is more dangerous than driving drunk or driving while your texting, etc?