Did you see this? - Page 6

[seafox]

sounds like they need to re-engineer these things! I guess its true that a belt around a pregnant belly could fit badly pretty easily. but it seems like they could make them a bit more reliable. Its possible my hospital had a newer version that is a bit more robust. They were pretty natural-birth-friendly also, which is probably more what had to do with it. By the time my son started showing any distress at all I *was* lying down, (pushing) and I think they had a scalp monitor anyway.

[IwannaBanRN]

I never provided data or insisted that it happened with most women. But alot of women who do not have wireless monitoring are made to lie on their backs. I was providing my experience as proof that just because it's wireless doesn't mean you're free to roam about. And as far as fetoscopes, variability can be monitored during and after a contraction throughout labor. It's not THAT hard. And alot less effort than coming in more than once an hour to adjust the monitors.

[by-the-lake]

Originally Posted by IwannaBanRN 

I never provided data or insisted that it happened with most women. But alot of women who do not have wireless monitoring are made to lie on their backs. I was providing my experience as proof that just because it's wireless doesn't mean you're free to roam about. And as far as fetoscopes, variability can be monitored during and after a contraction throughout labor. It's not THAT hard. And alot less effort than coming in more than once an hour to adjust the monitors.

Sorry, your experience is not 'proof'.  Its your experience, and that's fine. but you then say

"EFM, in most cases also restricts mom to bed, on her back,"  Hummm..... You should have said "In MY case" not 'in most cases'

So what you are saying is variability can be tracked by fetoscope. That means listening and recording each fetal heart beat by hand for a period of no less than five minutes to determine is the variability is absent, minimal, moderate, or marked. This can mean a pattern difference, beat to beat, of less than 5 beats per minute. That's why technology has evolved to using a tracing to record this.

Do you understand the difference of variability verses accelerations/decelerations? Do you understand long term and short term variability in fetal heat tones are a much better determinant of fetal well being verses accelerations/decelerations?

[starrlamia]

by-the-lake there have actually been quite a few studies showing intermittent monitoring as just as effective as continuous monitoring. They listen before, during and after contractions, and yes they listen long enough to be able to detect anomalies.

[by-the-lake]

Thank you.. I know this. In fact, I take 4 hour classes every two years to keep current as this is part of my continuing education to do my job. What I am seeing are two issues being confused. You are describing listening for accelerations and decelerations in relation to the contraction pattern. This information can be used very effectively to assess fetal well being. The term 'variability' is being used here,in this thread, and variability is a different assessment. Determining variability to assess fetal well being needs to be graphed, because a longer period of time is needed to collect this data, as it is beat to beat dependent.

When using intermittent monitoring with a fetoscope, you can certainly detect deceleration. If deceleration is detected, the logical next step to gain more information is to get a strip of EFM, because not only will the deceleration be graphed, the beat to beat variability can be determined as a bigger picture of fetal tolerance to labor

[Imakcerka]

They had to fiddle with mine every 10 minutes. And flip me from side to side because DD1's heart beat kept slowing down. The cord was around her neck so I had to move a lot to get the strain off her. Happened with DD2 as well but that was worse.

[Turquesa]

Originally Posted by coocoocachoo 

The chance of dying in a car crash is 1 in 6500, or .0153%, where (this number is absent in your post, I did a quick search on CDC for these) the death rate within the first 28 days of birth is 18,782 and 4,138,573 live births in 2005, or .45%.  With the assumption that some of these deaths are not related to birth, taking a look at the death rate within the first 7 days is 15,013 out of 4,138,573 live births, or .36%.  For mothers, death rate is 15.1 per 100,000, or .0151%.   The mother is slightly less likely to die in labor than she is a car accident, but there's obviously more than one party involved in childbirth. Another thing to consider with the number you gave for the car crash is that is your chance in the ENTIRE YEAR.  I drive just about every single day, so 1/6500=.000153/365 days per year=.0000004191 or .000042% per day, and I could break it down even more as I drive more than once per day.  I do NOT, however give birth every day.  I am about as likely to die driving for an entire year as I was to die in a 12-hour event during the year.  My son was 24 times more likely to die in his first week of life than I was.  Here are my links if you care to see for yourself on the perinatal mortality rates, the CDC has some interesting perspectives. 

http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_08.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409165/

It's interesting that you bring up that a lot of OB guidelines are based off of weak data and opinion.  What data do DEM/CPM's base their guidelines?
 

I can't speak for or generalize about all CPM/CNM team, (neither can you, by the way), but mine always provided data and articles on request and were open to discussion when I found something different. 

The danger of posting an analogy is that it gets nit-picked usually because readers confuse an analogy with a literal comparison.  An analogy considers to things that are otherwise different.  This is to say, in short, that I stand by my original point:

There’s prevention, and then there’s overkill.  And even the world's most well-reputed, independent researchers know what constitutes overkill.

The world of obstetrics is full of example after example after example after example after example of these so-called "preventive," just-in-case" interventions to which Sympathetic Dad was referring.  (And yes, they really happen.  Just click around MDC or Google up Childbirth Connection's Listening to Mothers Survey for details).  In numerous cases, one has to wonder exactly what these doctors and hospitals are trying to prevent. 

And now comes the rant.......

Without taking issue with any specific member or post, I'm wondering what you, as anti-homebirth missionaries, are trying to accomplish in what was originally a homebirth support forum on MDC?  Are you hoping to "convert" women considering homebirth to your side?  Do you sincerely feel that it is your job to fix us? 

Are you hoping to affect wide-scale socio-political changes..........by spending your afternoon  posting anonymously to debate women who choose homebirth? 

Are you coming with the "noble" intention of "informing" us?  Because believe me, we know where to find information.  We get barraged with your "side" of this debate constantly.  We know what key strokes to enter to find our pros and cons, pros and antis.  There's really no need to "help" us. 

Are you just coming to stir the pot and hone your debating prowess....something you can do in the comment section of pretty much any news article about homebirth?  

If you want to talk us out of homebirth and woo us back into hospitals, there's a much more effective strategy: Do everything--EVERYTHING!--in your power to make childbirth in hospitals more evidence-based, more compassionate, and more respectful of women's autonomy (including what we choose for our babies).  Don't just argue that the status quo is A-OK because women who've been bruised by it (as well as countless medical researchers) won't be convinced.  The changes that you should demand aren't just in the interior decorating (Ooo, goodie!  A home-like birthing suite!), or adding CNMs who will just engage in the same anti-evidence practices as usual. 

Has it occurred to you that we're leaving hospitals in droves for darn good reasons?  Contrary to one sexist and demeaning explanation, it's not because we want some hip & cool Birth Experience.  We're not that shallow, thank you.  Figure out what we're trying to escape, and why we're trying to escape it.  Then fix it. 

Edited by Turquesa - 9/18/11 at 5:45pm

[by-the-lake]

Originally Posted by Turquesa 

I can't speak for or generalize about all CPMs, (neither can you, by the way), but mine always provided data and articles on request and were open to discussion when I found something different.

The danger of posting an analogy is that it gets nit-picked usually because readers confuse an analogy with a literal comparison.  An analogy considers to things that are otherwise different.  This is to say, in short, that I stand by my original point:

The world of obstetrics is full of example after example after example after example after example of these so-called "preventive," just-in-case" interventions to which Sympathetic Dad was referring.  (And yes, they really happen.  Just click around MDC or Google up Childbirth Connection's Listening to Mothers Survey for details). Anecdotes are not data In numerous cases, one has to wonder exactly what these doctors and hospitals are trying to prevent. 

And now comes the rant.......

Without taking issue with any specific member or post, I'm wondering what you, as anti-homebirth missionaries, are trying to accomplish in what was originally a homebirth support forum on MDC?  Are you hoping to "convert" women considering homebirth to your side?  Do you sincerely feel that it is your job to fix us?  Just as an observer, I saw some nice debate. Debate is OK, it leads to growth on both sides

Are you hoping to affect wide-scale socio-political changes..........by spending your afternoon  posting anonymously to debate women who choose homebirth? And you are doing what?

Are you coming with the "noble" intention of "informing" us?  Because believe me, we know where to find information.  We get barraged with your "side" of this debate constantly.  We know what key strokes to enter to find our pros and cons, pros and antis.  There's really no need to "help" us. Anyone can find whatever information to back up their point. Both 'sides' are guilty

Are you just coming to stir the pot and hone your debating prowess....something you can do in the comment section of pretty much any news article about homebirth?  Are you?

If you want to talk us out of homebirth and woo us back into hospitals, there's a much more effective strategy: Do everything--EVERYTHING!--in your power to make childbirth in hospitals more evidence-based, more compassionate, and more respectful of women's autonomy (including what we choose for our babies).  Don't just argue that the status quo is A-OK because women who've been bruised by it (as well as countless medical researchers) won't be convinced.  The changes that you should demand aren't just in the interior decorating (Ooo, goodie!  A home-like birthing suite!), or adding CNMs who will just engage in the same anti-evidence practices as usual. A more appropriate solution is to empower women to work with their health care providers. And who is 'you'? Are you not part of society? Why do we have to fix what you don't like?

Has it occurred to you that we're leaving hospitals in droves for darn good reasons?  Contrary to one sexist and demeaning explanation, it's not because we want some hip & cool Birth Experience.  We're not that shallow, thank you.  Figure out what we're trying to escape, and why we're trying to escape it.  Then fix it. Is 1% of births droves?

Really, taking a good debate so personally is not healthy. There are valid points to both sides. Instead of the great divide, mommy-wars, whatever, there is agreement to disagree.

I came to this public forum because the header caught my eye. I found the debate here stimulating and interesting. I contributed because there is some misconception regarding EFM. Not sure where this emotional rant came from. Oh well.
 

[sosurreal09]

Originally Posted by coocoocachoo 

Cite?  Any evidence I have seen that points to c-sections increasing death rates haven't been very credible.  Correlation is not causation.  Why are you so passionate about something that you won't even bother doing any further research on? Where are all these women dying at home after c-sections? It makes no sense.

I never did say "all these women are dying at home after c-sections"....Common sense says major abdominal surgery vs no surgery would certainly be an increased rate of risks and/or death. Same thing with drugs vs no drugs increased risks!

If you google "c-section rate linked to maternal mortality rate" a whole bunch of stuff comes up but since you have already discredited it all in this post you clearly have your mind made up period...

So I guess since c-sections are so safe and certainly could not be linked to our rising maternal death rate (and of course our rising c-section rates as well..) then I have no reason to fear getting one and should absolutely only birth in a hospital! Thanks for clearing that up I guess we could just blame the whole thing on weight and age then right? (which I think does play a part) I'll just call my HB MW and tell her the whole thing is off! I have been enlightened!

[olive&pimiento]

I am in complete agreement with Turquesa.  If the anti-home birth crowd is coming here to discuss certain issues that could and should be improved in US home births, then I would welcome that discussion, but I am getting sick of seeing a regurgitation of Dr. Amy's rhetoric here at MDC.  I'm sure many of you  know that there are place in this world where women have a 1 in 8 lifetime risk of dying in childbirth, and 1 in 5 children dies before age 5.  Surely this is an area of great need that could use some people with too much time on their hands who want to save some lives.

Originally Posted by Turquesa 


And now comes the rant.......

Without taking issue with any specific member or post, I'm wondering what you, as anti-homebirth missionaries, are trying to accomplish in what was originally a homebirth support forum on MDC?  Are you hoping to "convert" women considering homebirth to your side?  Do you sincerely feel that it is your job to fix us? 

Are you hoping to affect wide-scale socio-political changes..........by spending your afternoon  posting anonymously to debate women who choose homebirth? 

Are you coming with the "noble" intention of "informing" us?  Because believe me, we know where to find information.  We get barraged with your "side" of this debate constantly.  We know what key strokes to enter to find our pros and cons, pros and antis.  There's really no need to "help" us. 

Are you just coming to stir the pot and hone your debating prowess....something you can do in the comment section of pretty much any news article about homebirth?  

If you want to talk us out of homebirth and woo us back into hospitals, there's a much more effective strategy: Do everything--EVERYTHING!--in your power to make childbirth in hospitals more evidence-based, more compassionate, and more respectful of women's autonomy (including what we choose for our babies).  Don't just argue that the status quo is A-OK because women who've been bruised by it (as well as countless medical researchers) won't be convinced.  The changes that you should demand aren't just in the interior decorating (Ooo, goodie!  A home-like birthing suite!), or adding CNMs who will just engage in the same anti-evidence practices as usual. 

Has it occurred to you that we're leaving hospitals in droves for darn good reasons?  Contrary to one sexist and demeaning explanation, it's not because we want some hip & cool Birth Experience.  We're not that shallow, thank you.  Figure out what we're trying to escape, and why we're trying to escape it.  Then fix it. 

[by-the-lake]

Originally Posted by sosurreal09 

I never did say "all these women are dying at home after c-sections"....Common sense says major abdominal surgery vs no surgery would certainly be an increased rate of risks and/or death. Same thing with drugs vs no drugs increased risks!

If you google "c-section rate linked to maternal mortality rate" a whole bunch of stuff comes up but since you have already discredited it all in this post you clearly have your mind made up period... Google is research?

So I guess since c-sections are so safe and certainly could not be linked to our rising maternal death rate (and of course our rising c-section rates as well..) then I have no reason to fear getting one and should absolutely only birth in a hospital! Thanks for clearing that up I guess we could just blame the whole thing on weight and age then right? (which I think does play a part) I'll just call my HB MW and tell her the whole thing is off! I have been enlightened!

[Turquesa]

By-the-Lake, I don't have time to reply to the rest of your post, but Listening to Mothers is data.  It is a survey, and a sizable one at that.
 

[by-the-lake]

Originally Posted by olive&pimiento 

I am in complete agreement with Turquesa.  If the anti-home birth crowd is coming here to discuss certain issues that could and should be improved in US home births, then I would welcome that discussion, but I am getting sick of seeing a regurgitation of Dr. Amy's rhetoric here at MDC.  I'm sure many of you  know that there are place in this world where women have a 1 in 8 lifetime risk of dying in childbirth, and 1 in 5 children dies before age 5.  Surely this is an area of great need that could use some people with too much time on their hands who want to save some lives.

cool. What humanitarian efforts are you taking?  What are some organizations you are involved with to help this issue? What can we do right now to help these horrifying statistics? Can this discussion be steered to actually be productive? BTW, not being sarcastic, but really, to perhaps tone down this huge divide, maybe working together to make birth safer for women all over the world will give a focus for the common good.
 

[by-the-lake]

Originally Posted by Turquesa 

By-the-Lake, I don't have time to reply to the rest of your post, but Listening to Mothers is data.  It is a survey, and a sizable one at that.
 

Certainly, this subject is fascinating. I love surveys, they are fun to conduct!
 

[olive&pimiento]

Are you kidding me??  Many of the women who post here are not doctors and scientists.  They do not have access to medical journals and  databases, and many may not know how to determine the validity of one study vs another.  THIS DOES NOT MEAN THEY ARE NOT INTELLIGENT HUMAN BEINGS WHO DESERVE TO HAVE THEIR OPINIONS HEARD.  MDC has traditionally been a place where mothers can tell their stories and be HEARD.  By telling a woman that her experience is just anecdotal, you are saying that her story doesn't matter, it is a singularity that does not pertain to the area of almighty science.  This is the reason women are here.  They know the way they bring their babies into the world matters. To them.  To their families.  And to our community. 

As a side note, my social scientist husband told me to add that google the best search engine for doing literature searches for research topics. 
 

Originally Posted by by-the-lake 

[by-the-lake]

Originally Posted by olive&pimiento 

Are you kidding me??  Many of the women who post here are not doctors and scientists.  They do not have access to medical journals and  databases, and many may not know how to determine the validity of one study vs another.  THIS DOES NOT MEAN THEY ARE NOT INTELLIGENT HUMAN BEINGS WHO DESERVE TO HAVE THEIR OPINIONS HEARD.  MDC has traditionally been a place where mothers can tell their stories and be HEARD.  By telling a woman that her experience is just anecdotal, you are saying that her story doesn't matter, it is a singularity that does not pertain to the area of almighty science.  This is the reason women are here.  They know the way they bring their babies into the world matters. To them.  To their families.  And to our community. 

As a side note, my social scientist husband told me to add that google the best search engine for doing literature searches for research topics. 
 

Wow, thanks for putting the words in my mouth. Super cool. I do believe this thread was a review of a doctor presenting statistics and data regarding homebirth. Am i wrong? So, because this thread was started because of STATISTICS AND DATA, anecedotal stories are great, real, and not to be minimized, but should not to be presented as statistics or data.

As a side note, my university instructors do not agree with your social scientist husband. Thank you

[olive&pimiento]

What can we do? Lol, other than donating money, I don't know.  If I did, I would be doing more.  Here are a group of CPMs trying to make a difference

http://www.mercyinaction.com/

This is an amazing blog.  Unfortunately, she is not writing much anymore, but it is worth it to read from the beginning.  The non-profit is the one she started.

http://babycatching.blogspot.com

http://www.africanmothers.org/

And then, of course there's

http://www.pih.org/

Perhaps we could start an activism thread in Birth and Beyond.  I do think you are right in that helping others could bridge gaps. 
 

Originally Posted by by-the-lake 

cool. What humanitarian efforts are you taking?  What are some organizations you are involved with to help this issue? What can we do right now to help these horrifying statistics? Can this discussion be steered to actually be productive? BTW, not being sarcastic, but really, to perhaps tone down this huge divide, maybe working together to make birth safer for women all over the world will give a focus for the common good.
 

[olive&pimiento]

Yes, because you are at a University, where you pay money and have access to databases and journals.  For those without these privileges, google scholar is not a bad place to start.

Originally Posted by by-the-lake 

As a side note, my university instructors do not agree with your social scientist husband. Thank you

[Imakcerka]

And then theres the library.  And every book is correct because it's in print.  All data founded by doctors and scientists is also correct.  Never changes, does not fit their needs at the time.  Seriously?  At this point if we actually believed half of what was out there we'd be right here debating what was and wasn't correct by whatever standards are somehow more correct than others... oh wait that's what we're doing. 

It's best to take everything with a grain of salt and then use the brain we were all given to decipher what is garbage and what isn't.  For those who say they need to rely on information they deem more correct than others are selling themselves short.  Too often we get stuck in a rut of "well, I read in the most current and most accurate medical journal that peeing in the street will result in a sty in your eye".  Come on! 

Earlier I stated that we should all try to find some good middle of the road information, I was told by one person they were too busy to do that and I should pretty much just do that for them.  Really?  And this was a person with a pretty strong stance.  I never stop learning, I never stop searching.  This is an important issue and honestly we shouldn't be relying on what someone said or the few most accurate at the time journals.  I really think we can all do better than that. 

[by-the-lake]

Interesting point. This can be applied to both sides of the fence. What is your suggestion for doing better?