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The price of being the best.....is having to BE the best - Or: On how to make Homebirth even... - Page 4

post #61 of 107

BC= British Columbia :)

 

While I agree most studies do have merit, not all studies are going to be treated equally, nor without bias (some more and some less). The biggest trouble comes from the interpretation of the study. For example, ACOG's homebirth study, stating that home birth had worse outcomes. However A- ACOG has a financial stake in this study, unlike most countries, the USA is more focused on the economical outcomes of their medical studies, birth in the US is a billion dollar industry and it has always had more focus on making money rather then having good outcomes. ACOG doesnt make money from homebirths therefore it is more likely that they would speak out against them. B- The study included accidental homebirths, which is not an accurate portrayal of homebirth statistics. C- It is very easy to take a study that does not have an extremely clear cut outcome and bend the facts to how you wish to portray them. ESP when it comes to the general public who will be reading newspaper articles with an overview and not reading the actual study itself.

 

There isnt going to be an unbiased study in the realm of childbirth, because most people involved are very passionate on one side or the other and for many reasons. However it is extremely important to look at how the study was conducted, who conducted it and the conclusion that they have drawn from it. The very best thing to do is not look at the individual studies but look at a meta-analysis which combines many studies into one to look at the overall outcomes.

 

here is one:

http://www.ncbi.nlm.nih.gov/pubmed/9271961 

and here is a rebuttal of a meta-analysis

http://www.bmj.com/content/341/bmj.c4699.full.html?ijkey=izCkjyeF7HV0CCG&keytype=ref

 

The biggest problem I have found USA vs other countries, is that the USA publishes these studies in an attempt to discredit other providers, it's a power struggle. Whereas other countries, such as Canada, uses them as guidelines to review and improve maternity care.

 

Quote:
Originally Posted by Kanna View Post






criteria (probably) not being as vigorously enforced in the US as in a Canada (at least for the purpose for the study):

a long list of things that excludes a mom from a homebirth: no GD, no twins, no breech, no over due-dates, no VBA2C.

 

What "BC" are you referring to?

 

Btw, I'm german, so about the only thing I know about ACOG is what the acronym stands for. lurk.gif

 

Also, if I'm not mistaken, one of the studies here was done in cooperation with NARM, and THEIR members probably are a bit biased on the subject too (since they also depend on their income from attending births)

 

Still, I think that, even if a study is funded by a certain group, in most cases the findings will be mostly valid regardless. To quote (from an entirely different thread):

 


(taken from page 2 of this thread: http://www.mothering.com/community/forum/thread/1325057/do-you-think-there-is-common-ground-in-vax-discussion-effective-communication-101/20 )

 

On the other hand "evaluating the actual points someone is making" can be tricky, since our own psychology can get in the way:

 

http://motherjones.com/politics/2011/03/denial-science-chris-mooney?page=1

 

Quote: Sure enough, a large number of psychological studies have shown that people respond to scientific or technical evidence in ways that justify their preexisting beliefs. In a classic 1979 experiment , pro- and anti-death penalty advocates were exposed to descriptions of two fake scientific studies: one supporting and one undermining the notion that capital punishment deters violent crime and, in particular, murder. They were also shown detailed methodological critiques of the fake studies—and in a scientific sense, neither study was stronger than the other. Yet in each case, advocates more heavily criticized the study whose conclusions disagreed with their own, while describing the study that was more ideologically congenial as more "convincing."

 

 



 

post #62 of 107
Thread Starter 
Quote:
Originally Posted by MidwifeErika View Post

So, what I did was chose all years, residence for place of birth, full term for age of baby, and then at the bottom you can choose a row or column variable and I chose "attendant at delivery" for a column variable. Then it shows the rate for MD, CNM, Other Midwife, and Other each in a different column.

 

If you want to see something frightening, go back and remove the "full term" criteria and choose all ages and then the results come out as:

MD: 7.81/1000

CNM: 4.72/1000

Other midwife: 2.89/1000

Other: 10.68/1000

 

YIKES!!

 

Hmm....to fully interprete the "including NOT full term" data though, we'd have to know how many percent of the births each type of attendant had were of pre-mature babies. It could be that doctors have had a higher percentage of those than CNMs or other midwives, which would make for worse outcomes without negligence or bad care being the cause. Similar speculation is valid for the CNM's.

 

If that's NOT what it is, then we can say that docs and CNM's probably simply suck at attending births at a residence (most likely for lack of practice - low n.o.b. they attend there)....but they're pretty good at attending births at the hospital, since there (for full term) they still have better results than the folks from the "other midwife" category attending births at the residence.

 

P.S.: Thanks, I hadn't figured out the trick with the rows and columns before. This makes looking at the data much easier!

 

neonatal mortality - check

all years - check

delivery method - vaginal (no prev. c-sect.)

residence for place of birth

full term for age of baby

column variable "attendant at delivery"

 

MD - 2.1

CNM - 4.92

OM - 1.96

O - 4.92

 

Number of births attended by doctors in residence - 476

NoB attended by CNM - 610

NoB attended by other Midwife - 8694

 

neonatal mortality - check

all years - check

all for place of birth

delivery method - vaginal (no prev. c-sect.)

full term for age of baby

column variable "attendant at delivery"

row variable - place of birth

 

MD at hospital - 0.87

CNM at hospital - 0.79

CNM at residence - 4.92

other midwife at residence - 1.96

 

Number of births attended by doctors in hospital- 898,403

NoB attended by CNM at hospital - 58,302

NoB attended by CNM at residence- 610

NoB attended by other Midwife - 8694

post #63 of 107
Thread Starter 
Quote:
Originally Posted by Gena 22 View Post

Me too!
 


Those are very interesting suggestions, and I think you're definitely on the right track.  Yes!

 

----------------------------

 

Tangentially, here are some thoughts in response to Kanna's question:

 

...can you maybe add links with the original information, please?  I know zilch about delayed cord clamping and the thing about the reliability of oGTT tests sound interesting (and I'd also like to read up on the reliability of 2hr oGTT).

 

Right of Passage, you're right (no pun intended), I should be using the term physiological cord clamping, or refer to the current practice as immediate cord clamping.  I brought this aspect of OB-directed standard of care up because it is so widespread, and so obviously harmful.  Immediate cord clamping deprives an infant of up to 20% of its blood volume, and has other important effects.  It seems to have become routine purely for the convenience of providers, intervention for intervention’s sake.  Waiting to clamp may be most important in surgical and preterm births, but these are the births for which many doctors are quickest on the draw.

 

Here are two decent links:

http://www.sciencedaily.com/releases/2007/08/070816193328.htm

http://www.cordclamping.info/publications/LIT%20REVIEW%20ARTICLE-MERCER.pdf

 

And two good quotes to looks at:

Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases.  As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.

Erasmus Darwin,  Zoonomia, 1801

 

Immediately after delivery of the neonate, a segment of the umbilical cord should be doubly clamped ...”

ACOG Practice Bulletins #127, #216, #348, 1989 – 2006

 

What I don’t get is how doctors, and I do have some lingering respect for their training and qualifications, how thinking scientists could get so caught up in a culture of tradition based practices that they insist on actions which are counter-intuitive, and well proven to do harm?  I’d bet this is one of the many areas OBs and pediatricians differ vehemently on (gestational age being another).  One considers their job done once the OR door swings closed, the other has 15 years of thriving child to worry about.

 

---------------------------

 

OK, on gestational diabetes and the GTTs.  I don’t have time to delve deep into the strategy and research on this, especially since I think the fault lies more with the providers and protocols.  Standard care in the US is to have pregnant women tested with the 1-hr 50-g GCT.  Results on this test turn around a huge number of false positives depending on the cut-off blood sugar level used.  Lower cut-off = more false positives but also = more cases of GD identified.  Many different things affect the 1hr values.  There is some thought that the higher the 1-hr number, the more chance of GD.  There is also a school of thought (backed up with studies) that a normal diet prior to the test will return more accurate results.  The reliability of this test is seriously questioned.  (http://www.jstage.jst.go.jp/article/internalmedicine/47/13/47_1171/_article )  It may be that the 2 hr test is more reliable.  There have been calls for the US to switch to universal 3-hr tests instead of the two step 1-hr, and then 3-hr if high values on first test.  Might be a good idea.

 

In my case, I believe there was a problem with different providers in a practice disagreeing.  One OB said I could schedule the 3 hr test whenever was convenient  for me.  Another OB told me I had to go for the test immediately following his appointment or I was risking fetal death (a direction that showed a fundamental misunderstanding of the test, you need to fast before the 3-hr OGTT and he saw me mid-day.)  So, I’m going to chalk this one up as poor, inconsistent practice rather than bad science.  And it’s worth considering whether putting all pregnant women through a test that returns an approximate 85% false positive is a good idea.  Maybe, maybe not when a false positive is itself a predictor of adverse outcomes.  (http://journals.lww.com/greenjournal/Abstract/2004/01000/False_Positive_1_Hour_Glucose_Challenge_Test_and.25.aspx )  Wouldn’t it be smarter to look for indications first?  OK, that would be me – twin moms have more GD.  But I would have liked to get real info from my doctors, and I’d at least like them to understand how the tests worked and why.  More studies to develop a more reliable protocol and more accurate practitioner understanding is clearly needed.


Thanks for the info! I was especially interested in the OGTT bit, since here in Germany, for pregnant women, the 2 hour test is standard. Adding another step at 3 hrs, to further improve values if the 2 hr result is on the brink, sounds like it would increase reliability even further.

 

And yes, there IS a fasting period before an OGTT (if you want to do it right, even with a specific minimum of carbohydrates before that) and doing an OGTT now or a week or two down the road is not going to make a big difference I believe. So yeah, second OB sounds like he needs a reapeat course in lab medicine.

And I agree, an 85 % false positive sounds a bit too high.

Since GD does affect birth and babe negatively though, I wouldn't completely ditch the test....but I WOULD look for ways to improve reliability as you mentioned.

 

And yep, if a patient want info, any good care provider SHOULD be able to provide answers.

 

post #64 of 107

Well, wouldn't one generally claim that it is negligent to attend premature births at home rather than in the hospital?
 

Quote:
Originally Posted by Kanna View Post



 

Hmm....to fully interprete the "including NOT full term" data though, we'd have to know how many percent of the births each type of attendant had were of pre-mature babies. It could be that doctors have had a higher percentage of those than CNMs or other midwives, which would make for worse outcomes without negligence or bad care being the cause. Similar speculation is valid for the CNM's.

 

post #65 of 107
Thread Starter 
Quote:
Originally Posted by starrlamia View Post

BC= British Columbia :)

 

While I agree most studies do have merit, not all studies are going to be treated equally, nor without bias (some more and some less). The biggest trouble comes from the interpretation of the study. For example, ACOG's homebirth study, stating that home birth had worse outcomes. However A- ACOG has a financial stake in this study, unlike most countries, the USA is more focused on the economical outcomes of their medical studies, birth in the US is a billion dollar industry and it has always had more focus on making money rather then having good outcomes. ACOG doesnt make money from homebirths therefore it is more likely that they would speak out against them. B- The study included accidental homebirths, which is not an accurate portrayal of homebirth statistics. C- It is very easy to take a study that does not have an extremely clear cut outcome and bend the facts to how you wish to portray them. ESP when it comes to the general public who will be reading newspaper articles with an overview and not reading the actual study itself.

 

There isnt going to be an unbiased study in the realm of childbirth, because most people involved are very passionate on one side or the other and for many reasons. However it is extremely important to look at how the study was conducted, who conducted it and the conclusion that they have drawn from it. The very best thing to do is not look at the individual studies but look at a meta-analysis which combines many studies into one to look at the overall outcomes.

 

here is one:

http://www.ncbi.nlm.nih.gov/pubmed/9271961 

and here is a rebuttal of a meta-analysis

http://www.bmj.com/content/341/bmj.c4699.full.html?ijkey=izCkjyeF7HV0CCG&keytype=ref

 

The biggest problem I have found USA vs other countries, is that the USA publishes these studies in an attempt to discredit other providers, it's a power struggle. Whereas other countries, such as Canada, uses them as guidelines to review and improve maternity care.
 


I share your concern on bias where the interpretation of studies is concerned, but I feel that even if one knows a study is biased, one can gain some insight into the subject by looking a the data present and the way it was handled.

 

While I'm overall a great fan of Meta-analysis, I'm not quite sure if, regarding the subject of homebirth, it is really useful to lump data pertaining to the Netherlands together with data pertaining to the US without looking at the specifics of hb in the respective countries (e.g. prenatal care provider, training of birth attendant, etc.) No idea if they differentiated such things in the metaanalyis you posted though.

 

*g*

 

I guess I can chalk you up with the "More and better data would be nice, thank you very much" group?

 

post #66 of 107
Thread Starter 
Quote:
Originally Posted by MidwifeErika View Post

Well, wouldn't one generally claim that it is negligent to attend premature births at home rather than in the hospital?
 


 

Depends on the circumstances. If it's e.g. the family physician, and he got called because he was the next best medical professional available when birth unexpectedly started early, and he came to help the mom until the paramedics arrived....then no, it wouldn't be negligent. But that's pure speculation on my part.

 

You have more experience with the US system than me. Much as I figure, it is pretty rare to attend a homebirth, full-term or no. Under which circumstances do you think would a doc attend a premature birth at home?

post #67 of 107

I guess my biggest point in showing those numbers as far as MD, CNM, other midwife for residence in comparison is that so often now people (people online in these sorts of threads) are demanding that CPMs need to become CNMs or MDs in order to produce better outcomes. However, in these Wisconsin numbers that higher level of education did nothing to improve outcomes.... it made it worse. Now, who knows what that reason is.... is it that some of the MDs who were attending births felt they could handle a larger scope of practice in the home then what they should have been? Were they simply unfamiliar with birth outside the hospital? Bad luck? Whatever the reason, it is what it is. I am not bringing it up to take nasty swings at MDs or CNMs as I have nothing to gain by doing so. I have NO problem with CNMs or MDs at all. It did make me start to wonder though what would happen if non-CNM midwives practiced in the hospitals? What would those outcomes look like?

 

Another thing I wanted to point out that hasn't come up yet is that the CPM as a credential didn't become available until 1994 and this data goes back to 1989. With Wisconsin not granting anyone a license until 2007, there was no need for a midwife to even take the exam. It is expensive and if they didn't need it to practice, then what would be the point for many? I was in the state at that time and there was a LOT of midwives who did the CPM process starting 2006/2007 to meet the requirement of the new law.... and many who retired rather than sitting the exam. So, not only did this category of "other midwife" include non-CPM midwives.... I would be willing to put money on the fact that the vast majority were attending by non-CPM midwives over that 20 year period of time. That is what makes the comparison even more fascinating.... that the little old Amish lady catching babies by candlelight after learning about maternity care from another little old Amish lady had pretty awesomely good outcomes when you compare to a university trained MD attending birth in an old farmhouse. Again, that is not a dig at any MDs, it just is interesting to me.

 

So often when we want to make something better we start throwing "more" at it. More classes, more regulation, more titles, more demands, etc. Sometimes throwing "more" at something doesn't improve anything and just makes it all worse. Sometimes everything needs to be completely restructured and rebuilt from the ground up.

post #68 of 107
Thread Starter 
Quote:
Originally Posted by MidwifeErika View Post

I guess my biggest point in showing those numbers as far as MD, CNM, other midwife for residence in comparison is that so often now people (people online in these sorts of threads) are demanding that CPMs need to become CNMs or MDs in order to produce better outcomes. However, in these Wisconsin numbers that higher level of education did nothing to improve outcomes.... it made it worse. Now, who knows what that reason is.... is it that some of the MDs who were attending births felt they could handle a larger scope of practice in the home then what they should have been? Were they simply unfamiliar with birth outside the hospital? Bad luck? Whatever the reason, it is what it is. I am not bringing it up to take nasty swings at MDs or CNMs as I have nothing to gain by doing so. I have NO problem with CNMs or MDs at all. It did make me start to wonder though what would happen if non-CNM midwives practiced in the hospitals? What would those outcomes look like?

 

Since the outcomes for MDs and CNMs in a residence setting ARE bad, it totally would be worth to find out the reasons. Because if it was preventable, then something needs to change so it doesn't happen anymore.

 

Non-CNM's in the hospital sounds interesting. As far as I know, that's not possible these days, but maybe someone knows a former CPM / DEM, who "upgraded" and who might be able to give us an insight into the differences?

 

Another thing I wanted to point out that hasn't come up yet is that the CPM as a credential didn't become available until 1994 and this data goes back to 1989. With Wisconsin not granting anyone a license until 2007, there was no need for a midwife to even take the exam. It is expensive and if they didn't need it to practice, then what would be the point for many? I was in the state at that time and there was a LOT of midwives who did the CPM process starting 2006/2007 to meet the requirement of the new law.... and many who retired rather than sitting the exam. So, not only did this category of "other midwife" include non-CPM midwives.... I would be willing to put money on the fact that the vast majority were attending by non-CPM midwives over that 20 year period of time. That is what makes the comparison even more fascinating.... that the little old Amish lady catching babies by candlelight after learning about maternity care from another little old Amish lady had pretty awesomely good outcomes when you compare to a university trained MD attending birth in an old farmhouse. Again, that is not a dig at any MDs, it just is interesting to me.

 

*can't help but picture Granny Weatherwax*

 

Wonder if any of those "old Amish ladies" are still around. Certainly would make for an interesting interview for a midwifery / OB journal!

 

So often when we want to make something better we start throwing "more" at it. More classes, more regulation, more titles, more demands, etc. Sometimes throwing "more" at something doesn't improve anything and just makes it all worse. Sometimes everything needs to be completely restructured and rebuilt from the ground up.

 

And of course, before you start making anything "better", you need to find out what the actual problem is (instead of plunging right in, just assuming you know. There might be factors you haven't taken into consideration or are not aware of).

 

What, in your experience, are the top factors for bad outcomes?

I've stumbled across a lot of personal stories with HB deaths.

What do you think went wrong in those cases?

 

(If we can get an OB in here, we could ask him / her the same thing about hospital births, which would be great).



 

post #69 of 107

To be honest, there are few enough deaths in the out-of-hospital grouping that I cannot really answer what the overall issue is and whatever I would say would be totally anecdotal. I would need to dig up some of the bigger studies that go into what the babies died from in each group.... and time right now is limited (back-to-school season, trying to squeeze in that last bit of summer with the kiddos!). I don't feel right commenting on the personal homebirth stories of women who have lost their babies either..... I don't know enough details to see clearly what the problem was in each case. Sometimes what the mother reports having happened and what the midwife and medical examiner and police and who ever else may be involved all are stories that don't match one another.

 

I believe you and I are completely on the same page as far as the idea of needing to know what the problem is before a solution can be found.

 

The thing about using data like what Wisconsin has available is that there are FAR too many unknowns to really make a lot of sense out of it and it would be a poor idea to base policy on it, correct? Much like you were pointing out that we don't know the back story on the MDs who attended the homebirths and if those deaths were preventable or not, we don't know that about the Other Midwife category either. That is where studies that break down the exact reasons for deaths are very helpful as well rather than just data that may or may not be very meaningful.

post #70 of 107
Thread Starter 
Quote:
Originally Posted by MidwifeErika View Post

To be honest, there are few enough deaths in the out-of-hospital grouping that I cannot really answer what the overall issue is and whatever I would say would be totally anecdotal. I would need to dig up some of the bigger studies that go into what the babies died from in each group.... and time right now is limited (back-to-school season, trying to squeeze in that last bit of summer with the kiddos!). I don't feel right commenting on the personal homebirth stories of women who have lost their babies either..... I don't know enough details to see clearly what the problem was in each case. Sometimes what the mother reports having happened and what the midwife and medical examiner and police and who ever else may be involved all are stories that don't match one another.

 

I believe you and I are completely on the same page as far as the idea of needing to know what the problem is before a solution can be found.

 

The thing about using data like what Wisconsin has available is that there are FAR too many unknowns to really make a lot of sense out of it and it would be a poor idea to base policy on it, correct? Much like you were pointing out that we don't know the back story on the MDs who attended the homebirths and if those deaths were preventable or not, we don't know that about the Other Midwife category either. That is where studies that break down the exact reasons for deaths are very helpful as well rather than just data that may or may not be very meaningful.



Looking at the data overall, it is indeed NOT enough to base a policy on. But it is enough to ask some more questions, since when I look at the data (and yes, I know, still biased ^_~) I get the impression that overall, there's still some room for improvement for lowering neonatal mortality rates in a homebirth setting.

 

To do that would, of course, require getting more data / information on things going wrong and most above all a critical analysis of WHY they go wrong. In other words: we need the back story. Which (at least for us) is kinda hard to get at right now.

 

I know you're strapped for time right now, but if you have an interest in taking this further AND can spare a few minutes:

 

How do you think a midwifes' training for "emergency" situations should look like?

What are the factors she needs to consider when she plans for a specific homebirth, especially pertaining to the possibility of an emergency?

post #71 of 107
Quote:
Originally Posted by MidwifeErika View Post


 

So, what I did was chose all years, residence for place of birth, full term for age of baby, and then at the bottom you can choose a row or column variable and I chose "attendant at delivery" for a column variable. Then it shows the rate for MD, CNM, Other Midwife, and Other each in a different column.

 

If you want to see something frightening, go back and remove the "full term" criteria and choose all ages and then the results come out as:

MD: 7.81/1000

CNM: 4.72/1000

Other midwife: 2.89/1000

Other: 10.68/1000

 

YIKES!!


 

 


bigeyes.gif

 

post #72 of 107
Thread Starter 
Quote:
Originally Posted by xzaviers_mama View Post


bigeyes.gif

 

 

First you're rude, when confronted about that you're evasive, and now you're entering the discussion in an unproductive way. eyesroll.gif..........shrug.gif

Geez, if you'd like to seriously discuss the implications of the data....I suggest you use words. And maybe not only refer to the data on one side so far, but also to the possible interpretations.

post #73 of 107
Quote:
Originally Posted by Kanna View Post



 

First you're rude, when confronted about that you're evasive, and now you're entering the discussion in an unproductive way. eyesroll.gif..........shrug.gif

Geez, if you'd like to seriously discuss the implications of the data....I suggest you use words. And maybe not only refer to the data on one side so far, but also to the possible interpretat


I'm not being evasive.  I simply don't agree with you, so there was no point in acknowledging all of the dramatic things you kept saying.  Agree to disagree, no arguing necessary.  

 

I thought that little bit of info that MWErika posted was pretty crazy, and didn't really feel like I needed to elaborate.  I have 3 young children to care for, I'm very much pregnant, I'm prepping for the start of our homeschool year, and I have a home to maintain.  I honestly do not have the time to sit here for hours, copying/pasting info, and typing out mile long replies.  I enjoy popping in and attempting to catch up on some of the information provided (on either side of the discussion).  Simple as that.

 

post #74 of 107

deleted


Edited by brovie - 11/13/12 at 10:01am
post #75 of 107
I'm just wondering why someone who doesn't even live here, hasn't birthed here, and I'm guessing probably won't have a home birth ever is so interested in debating the topic. Why not focus on improving things in Germany?

I'm not trying to be rude, but honestly wondering...
post #76 of 107

My understanding was that MDC has many international members and that HW is not limited to just middle class Americans.  Debate makes life interesting.

post #77 of 107
Quote:
Originally Posted by Alenushka View Post

My understanding was that MDC has many international members and that HW is not limited to just middle class Americans.  Debate makes life interesting.


Just curious that's all, there was nothing behind the question. I agree that it does.
post #78 of 107

A PEP Process application is as rigorously reviewed by the staff at the NARM Application Office as a MEAC Process application.

 

As a NARM PEP mentor (CPM since 1999), I can tell you that mentors must verify by a witness signature, the competency of a

myriad of necessary skills (41 pages of skills criteria) preformed by the PEP applicant to meet entry-level proficiency.

 

Both the PEP and MEAC applicant have to have their skills verified twice during the evaluation process for their training.

 

Both the PEP and MEAC applicant have to take the SAME written exam.

 

PEP is the ideal, first line of education/training to CPM, with MEAC considered to be equivalent to PEP.

"All certification candidates must demonstrate the essential competencies identified by the NARM Job Analysis, either through completion of the Portfolio Evaluation Process or through a route determined by NARM as equivalent."

post #79 of 107
Thread Starter 
Quote:
Originally Posted by rah0315 View Post

I'm just wondering why someone who doesn't even live here, hasn't birthed here, and I'm guessing probably won't have a home birth ever is so interested in debating the topic. Why not focus on improving things in Germany?

I'm not trying to be rude, but honestly wondering...


Because I accidentally stumbled across a few stories of HB deaths in the US and they seriously upset me, especially since stuff like that is virtually unheard of over here (The "Bild" Zeitung would have a field day with that kind of fodder.....)*.

 

And then I wanted to know more about the "whys" and "hows" and kinda got sucked into the discussion....

 

 

* Plus, our docs / hopitals seem to be WAY more mother / baby friendly than US ones and here, every birth has to be attended by a midwife** (which btw, have some hard-core educational requirements and exams to pass in order to do so.) My birth was attended by midwives too and they were excellent, and I loved my pre/post care midwife too. Together with the OB/Gyn at the hospital and the OB/Gyn who took care of my pre/post partum care, they were a hell of a team.

 

It kinda baffles me that you get midwives and docs working together as a team and better care and less dead babies in Germany, and midwives / docs fighting tooth and nail against each other and dead babies and grieving moms in the US. It doesn't make sense to me.

 

** Granted, the mom can UC if she wants to, but if something happens to the baby if she does (and it's no accident that she UC'd) then the mom can get sued for man-slaughter.

 

 


Edited by Kanna - 8/19/11 at 6:39am
post #80 of 107

That actually does sound like an ideal sort of maternity care...although I'd like to see some numbers from Germany as far as the claim that the mortality rate is much lower?  I'd not denying it is I just don't know where I would find that info. 
 

Quote:
Originally Posted by Kanna View Post




Because I accidentally stumbled across a few stories of HB deaths in the US and they seriously upset me, especially since stuff like that is virtually unheard of over here (The "Bild" Zeitung would have a field day with that kind of fodder.....)*.

 

And then I wanted to know more about the "whys" and "hows" and kinda got sucked into the discussion....

 

 

* Plus, our docs / hopitals seem to be WAY more mother / baby friendly than US ones and here, every birth has to be attended by a midwife** (which btw, have some hard-core educational requirements and exams to pass in order to do so.) My birth was attended by midwives too and they were excellent, and I loved my pre/post care midwife too. Together with the OB/Gyn at the hospital and the OB/Gyn who took care of my pre/post partum care, they were a hell of a team. It kinda baffles me that you get midwives and docs working together as a team and better care and less dead babies in Germany, and midwives / docs fighting tooth and nail against each other and dead babies and grieving moms in the US. It doesn't make sense to me.

 

** Granted, the mom can UC if she wants to, but if something happens to the baby if she does (and it's no accident that she UC'd) then the mom can get sued for man-slaughter.

 

 



 

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