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Nurses pushing on stomach after birth - help. - Page 5

post #81 of 229

Eh, at least WHO is honest about why they recommend it right? Never mind that it is not FDA approved for such use nor that the manufacturer has stated very clealry that it should never be used in such a manner, that it was never tested for such purpose but that there are clear risks, and that they have no idea what the long term effect is, but hey it's cheap, so we're totally cool.

post #82 of 229

OKay...re: cytotect: I don't know whether to puke in my lap or punch myself in the face. Are you people on heroin? That doesn't even make SENSE...yeah, that's exactly what we need, more mothers taking cytotec. Ahhhhh!!! Where is a pulling your hair out while you smash your face into a brick wall over and over again smiley when you need one?? Same goes for pitocin after every birth...are you people crazy?? That's CRAZYYYYY talk..I mean, REALLY!

 

 

Holly: I was not saying the WHO has anything to gain by tricking mothers. I was merely speaking to the shitty state of research these days.

 

 

As for everything else. Gulp. Well, okay guys..I guess you just see birth in a completely different light than I do. drink.gif Cytotec and cord traction for all, I guess. drink.gif

I think now I've *officially* seen it all on MDC.

post #83 of 229

I had a hospital birth with no intervention in the third stage, which surprised me.  The CNM who delivered my older dd used traction on the placenta, and administered pitocin, and I recall quite a bit of fundal massage.  The OB who delivered my younger dd didn't touch the cord until it stopped pulsing, waited for the placenta, and we proceeded without pitocin or fundal massage. 

 

Given a treatment location at a US hospital, I would definitely decline cytotec in favor of pit, but I would only accept either if I was bleeding excessively or if delivery of the placenta was taking an unusually long time.  WHO recommendations are not always the best options to apply in care settings in the developed world.  I can see how cytotec is a great option for active management of the third stage for a midwife who is biking around rural Southeast Asia, but I think the risk/benefit analysis on waiting for the placenta and using pitocin are different in hospitals in the US. 

 

 

post #84 of 229

 

Quote:
Originally Posted by BroodyWoodsgal View Post

 drink.gif Cytotec and cord traction for all, I guess. drink.gif

I think now I've *officially* seen it all on MDC.



This made me laugh! Especially with the little avatars. Thanks Broody - you brightened my day. 

post #85 of 229


I guess I'm missing where in the thread anyone advocated for "Cytotec for all"? I never said that. I don't think the other poster did either. Cytotec takes longer to work than Pitocin, so Pitocin should always be your first line drug if it's available. I don't give Cytotec unless there is excessive bleeding. You can do 200 sublingual or 800-1000 per rectum. I prefer the 1000 per rectum, which will produce a good amount of cramping but will so a great job at stopping the bleeding. Methergine and hemabate are really third line drugs. They have contraindications that the other drugs don't have and hemabate, especially, can have some nasty side effects (massive uncontrollable diarrhea for hemabate).

 

The issue is that Cytotec is cheap and has very little contraindications/side effects, so in a third world country it's easier to store, carry and administer compared to an IM injection of pitocin. So the WHO says that in those situations it's okay to use Cytotec routinely instead of pitocin. But we have pit readily available here so there's no need to go to Cytotec as your first line. Pit works better anyway.

Quote:
Originally Posted by BroodyWoodsgal View Post

OKay...re: cytotect: I don't know whether to puke in my lap or punch myself in the face. Are you people on heroin? That doesn't even make SENSE...yeah, that's exactly what we need, more mothers taking cytotec. Ahhhhh!!! Where is a pulling your hair out while you smash your face into a brick wall over and over again smiley when you need one?? Same goes for pitocin after every birth...are you people crazy?? That's CRAZYYYYY talk..I mean, REALLY!

 

 

Holly: I was not saying the WHO has anything to gain by tricking mothers. I was merely speaking to the shitty state of research these days.

 

 

As for everything else. Gulp. Well, okay guys..I guess you just see birth in a completely different light than I do. drink.gif Cytotec and cord traction for all, I guess. drink.gif

I think now I've *officially* seen it all on MDC.



 

post #86 of 229

First of all, I think there are a lot of people who would beg to disagree with your assertion that cytotec has very little side effects. A ton of those people would be women who almost died, women missing a uterus who may or may not have been done having kids and families missing a mother/daughter/sister/aunt. Second, okay...so you prefer pit. You still said you prefer it for every birth.

THAT. IS. CRAZY. drink.gif

I don't care what "evidence" you have to point to...it's just freaking nuts. Every birth absolutely DOES. NOT. NEED the type of "care" you've described and CERTAINLY doesn't need pitocin. Frankly, of the women who do end up benefiting from such an over-"managed" third stage, I can only BEGIN to guess at what percentage of them have had their births completely screwed up (physiologically speaking) from the word go, by drug and intervention happy "care providers" (like you?). Yeah, it stands to reason that an overtaxed, drugged half to death uterus is going to have a hard time performing its function in the third stage. I'm not saying that the only women who ever experience PPH are women who have had intervention heavy births....obviously that's not the case. But in a time when the GIGANTIC majority of women giving birth are doing so with some form of synthetic hormone severely augmenting their "progress" and putting the uterus through a completely atypical birth experience, I have to wonder really hard at the sanity in saying that the fact that so many women "need" such active management in the third stage points to broken birth. I think it speaks more to broken birth management.  You can disagree...in fact I know you do.
But when I look at the numbers around this issue, that's what stands out at me.

 

I can't see where you have posted exactly what kind of birth professional you are...but I'm guessing from some of what you have said that you are some sort of midwife or OB. I've got to be honest, that scares me a little. I'm just imagining a new mom sitting in front of you, asking you questions about how you operate....and having the pants scared off of her as you tell her all about how you are going to pump her full of powerful drugs to save her from the wretched death-in-a-box that is birth. A birth professional with a perspective on the process which makes you feel most comfortable with EVERY mother receiving the care you've described as "optimal" in the third stage makes me shiver...like, with an *actual* cold chill up my spine.

My research, core values and personal experience with birth (both my own two *awesome* out of hospital births and others I've witnessed/attended as a lay person only) have led me to a perspective that is so far away from yours, we may as well be on different planets. So...you know, who am I to say you're wrong. But man, I really REALLY feel like you are wrong on this.

I'm not saying that there is not a potential for death, injury or drama in every birth......but there is also potential for natures perfect work to be done. And really, when left alone...the properly nourished, supported mama really does have a better chance of meeting success than she does danger in birth. I've had two 90 minute births that started with my waters breaking and then thirty hours of absolutely *nothing*, before active labor sprung upon me and got the whole job done in one and a half hours. My mother before me had all four of her babies in the *exact* same way.

A birth worker with your perspective would never have given me those 30 hours my body, apparently, needed. I can only imagine what would have happened to me in your hands. Makes me sick, when I think of the perfection my body displayed during my births, to think that had I been in your care....you would have been telling me that something was wrong, that something was broken...as you pumped me full of some shit and told me "Don't worry, we doctors are gods and can make everything happen just as we think it should" - it's a disgrace, really. It's a mockery.

post #87 of 229


Well, the only way to really know that I'm wrong is by conducting a study on active management of third stage versus expectant management of third stage. Only they already DID that (multiple times), and they determined that active management of third stage led to superior outcomes. The "evidence" that you so abhor is the ONLY way to determining what works and what doesn't. Anecdotes, intuition, etc. they aren't at all quantitative. N=1 is meaningless. You can say to me, "I had an UBA8C and I didn't rupture!" and that does nothing to tell me that UBA8C is safe. You need a sample size with sufficient power. You must have evidence to back up your claims or your claims are nothing. That's the basis of science. And if we're not applying science to our management plans, you just live in a world full of magical thinking. I don't believe in magic. I believe in science.  And Science. Works. If Science is KoolAid, then I drink at the fountain. If science is wrong, I don't want to be right. All hail evidence based practice.

 

Originally Posted by BroodyWoodsgal View Post

First of all, I think there are a lot of people who would beg to disagree with your assertion that cytotec has very little side effects. A ton of those people would be women who almost died, women missing a uterus who may or may not have been done having kids and families missing a mother/daughter/sister/aunt. Second, okay...so you prefer pit. You still said you prefer it for every birth.

THAT. IS. CRAZY. drink.gif

I don't care what "evidence" you have to point to...it's just freaking nuts. Every birth absolutely DOES. NOT. NEED the type of "care" you've described and CERTAINLY doesn't need pitocin. Frankly, of the women who do end up benefiting from such an over-"managed" third stage, I can only BEGIN to guess at what percentage of them have had their births completely screwed up (physiologically speaking) from the word go, by drug and intervention happy "care providers" (like you?). Yeah, it stands to reason that an overtaxed, drugged half to death uterus is going to have a hard time performing its function in the third stage. I'm not saying that the only women who ever experience PPH are women who have had intervention heavy births....obviously that's not the case. But in a time when the GIGANTIC majority of women giving birth are doing so with some form of synthetic hormone severely augmenting their "progress" and putting the uterus through a completely atypical birth experience, I have to wonder really hard at the sanity in saying that the fact that so many women "need" such active management in the third stage points to broken birth. I think it speaks more to broken birth management.  You can disagree...in fact I know you do.
But when I look at the numbers around this issue, that's what stands out at me.

 

I can't see where you have posted exactly what kind of birth professional you are...but I'm guessing from some of what you have said that you are some sort of midwife or OB. I've got to be honest, that scares me a little. I'm just imagining a new mom sitting in front of you, asking you questions about how you operate....and having the pants scared off of her as you tell her all about how you are going to pump her full of powerful drugs to save her from the wretched death-in-a-box that is birth. A birth professional with a perspective on the process which makes you feel most comfortable with EVERY mother receiving the care you've described as "optimal" in the third stage makes me shiver...like, with an *actual* cold chill up my spine.

My research, core values and personal experience with birth (both my own two *awesome* out of hospital births and others I've witnessed/attended as a lay person only) have led me to a perspective that is so far away from yours, we may as well be on different planets. So...you know, who am I to say you're wrong. But man, I really REALLY feel like you are wrong on this.

I'm not saying that there is not a potential for death, injury or drama in every birth......but there is also potential for natures perfect work to be done. And really, when left alone...the properly nourished, supported mama really does have a better chance of meeting success than she does danger in birth. I've had two 90 minute births that started with my waters breaking and then thirty hours of absolutely *nothing*, before active labor sprung upon me and got the whole job done in one and a half hours. My mother before me had all four of her babies in the *exact* same way.

A birth worker with your perspective would never have given me those 30 hours my body, apparently, needed. I can only imagine what would have happened to me in your hands. Makes me sick, when I think of the perfection my body displayed during my births, to think that had I been in your care....you would have been telling me that something was wrong, that something was broken...as you pumped me full of some shit and told me "Don't worry, we doctors are gods and can make everything happen just as we think it should" - it's a disgrace, really. It's a mockery.



 

post #88 of 229

OKay Holly....and I'm telling you, that science can take what "they" call birth and poke it and test it and draw all kinds of conclusions...but the "birth" that science is testing, is not the birth I had in my kitchen...it's not the birth I'm about to have under my trees on my back porch. The research you think is so freaking rad, is based MOSTLY on the experiences of:

1. Malnourished women living in third world scenarios, and

2. Women with physiologically completely atypical births

 

So...okay. Whatever. Cling to that science. Lap it up. I'm not sitting over here "thinking magically" - I'm looking at the science and I'm saying "That science sucks".
 

As for drinking the kool-aide...well, all I can say about that is that I love science too....but you should be sure not to let science become a religion for you.

post #89 of 229
I'd like to point out that the Cochrane review (I looked at
http://summaries.cochrane.org/CD007412/delivering-the-placenta-with-active-expectant-or-mixed-management-in-the-third-stage-of-labour )
does not in fact state that active management leads to superior outcomes. It looks to me that the reason they recommend informed choice is because:

The risk of PPH and anemia was not decreased for low risk women, although it was for the larger group of all women;

Active management led to increased risk for a number of other outcomes, including "maternal diastolic blood pressure, vomiting after birth, after-pains, use of analgesia from birth up to discharge from the labour ward and more women returning to hospital with bleeding".

Where risks are complicated and conflicting it is clear that women should be able to assess them for themselves. If they are at low risk for bleeding and want to avoid the negative effects of active management, then it seems like a reasonable decision. Equally, if they want to stick with mixed management and avoid, say, early cord clamping or other procedures that may be questionable or more problematic, then that would make sense too. Or, of course, if bleeding is a big concern or risk for them they may opt for active management. The point is that not every case, nor every set of risks, is the same.

On a separate note, I would also like to express my concern at the frequent referrals to certain (unspecified) countries as "third world" or "non-western" with the implication that they are war-torn, famine-stricken, and generally terrible and uncivilized. While of course there are plenty of places with dreadful problems for all sorts of reasons, I do not think it is helpful to just write off half the world and lump it together in contrast to our supposed first world paradise. I'm sure I don't need to tell anyone here that there are plenty of women in the USA, for example, who are malnourished and lacking education, resources and access to health care.

It could perhaps be more useful to talk about specific factors that may influence risk factors such as income or education levels, and avoid sweeping statements about how terrible everything is for women in the 'third world". It feels a bit imperialist.
post #90 of 229

Appreciate your thoughts Miranda, just a quick response sine this is getting way off topic but references to women in other countries were not made in a we are better than them sort of way but to point out that you can not take a study from a country where the birthing culture and health infrastructure is vastly different than our own and apply to everyone across the board with no account of the differences whichmay includes things like war, famine, malnourishment, lack of clean water, lack of prenatal care, no access to emergency care, etc... When I stated that the ountries in a study were not western it was because they were places I am not really familiar with in regards to their birth culture, again only only pointing out that cultural differences are indeed relevant when deciding if a study applies to me or not. The same sort of issues would apply if we were to try to take a study done in one very high risk US hospital and apply it equally  to all low-risk home birthing mothers. I am also certain that if you went and studied some hospitals here that you would find many that were practicing in ways that put women at higher risk for pph, though the bulletin I referenced to did not specify what practices they had observed. We have several friends who have or are practicing middwifery in other countries and the problems the women face in birthing, wwhile not the same in every single one, do have at least some of the elements listed above, things I have never encountered and in all likelyhood never will. 

 

To Holly and (was it?) Katie, I appreciate the conversation even if we vastly disagree on the issues. My background is in the homebirthing community as a mother and sincerly your ideas are completely outside the midwifery model of care that I am familiar with. This discussions has gonea little too far and gotten pretty heated so I am bowing out but plan to follow up the issue with some of the women (and men) who I am more familiar with in homebirth and maternity care to get their opinions. I think we all, obs included, agree that whatever practices are done mustb be in the best interest of mom and baby and that reducing pph and maternal mortality is necessary.

post #91 of 229
Quote:
Originally Posted by mirandamiranda View Post

<snip>
On a separate note, I would also like to express my concern at the frequent referrals to certain (unspecified) countries as "third world" or "non-western" with the implication that they are war-torn, famine-stricken, and generally terrible and uncivilized. While of course there are plenty of places with dreadful problems for all sorts of reasons, I do not think it is helpful to just write off half the world and lump it together in contrast to our supposed first world paradise. I'm sure I don't need to tell anyone here that there are plenty of women in the USA, for example, who are malnourished and lacking education, resources and access to health care.
It could perhaps be more useful to talk about specific factors that may influence risk factors such as income or education levels, and avoid sweeping statements about how terrible everything is for women in the 'third world". It feels a bit imperialist.


I agree entirely with this statement, Miranda...however, some of the research that was referenced DID in fact contain studies conducted by groups which were operating *specifically* with women in famine stricken, war torn areas...which is why I made the remarks I did. I don't think anyone was equating "third world" (I don't even really like using that term) with "impoverished, uneducated and war weary". It's an unfortunate habit of many, myself included, to "short hand" people living in desperate situations as living in the "third world".

And it IS true that many, many women giving birth in our country are extremely malnourished. Even if actual starvation/famine situations are not so wide spread as in some places in the world....there is such a thing as having "plenty" to eat...and at the same time, eating SO poorly, that your body has next to nothing of what it actually needs to operate on a healthy, nourished level.

We do have people in our country who are actually hungry, with not enough to eat.....but our more wide spread nutritional challenge involves people who fill their bellies all day with such incredibly nutritionally lacking "food stuffs" that they are malnourished despite having "plenty" to eat. This type of nutritional deficit creates a lot of risk for a pregnant woman and shouldn't be ignored.

 

post #92 of 229

Quote:

Originally Posted by mirandamiranda View Post

On a separate note, I would also like to express my concern at the frequent referrals to certain (unspecified) countries as "third world" or "non-western" with the implication that they are war-torn, famine-stricken, and generally terrible and uncivilized. While of course there are plenty of places with dreadful problems for all sorts of reasons, I do not think it is helpful to just write off half the world and lump it together in contrast to our supposed first world paradise. I'm sure I don't need to tell anyone here that there are plenty of women in the USA, for example, who are malnourished and lacking education, resources and access to health care.
It could perhaps be more useful to talk about specific factors that may influence risk factors such as income or education levels, and avoid sweeping statements about how terrible everything is for women in the 'third world". It feels a bit imperialist.

My rantings on this end were more in reaction to another thread here not too long ago where pps were likening Somalia and Afghanistan as showing what "true natural birth" outcomes would be. I live and birthed in a developing nation. 
 

Broodywoodsgal, I pretty much agree with everything you have said. Perhaps I'm going to crawl over to the UC boards and stay there. This whole thread ... huh.gif

post #93 of 229
Quote:
Originally Posted by slmommy View Post

Quote:

My rantings on this end were more in reaction to another thread here not too long ago where pps were likening Somalia and Afghanistan as showing what "true natural birth" outcomes would be. I live and birthed in a developing nation. 
 

Broodywoodsgal, I pretty much agree with everything you have said. Perhaps I'm going to crawl over to the UC boards and stay there. This whole thread ... huh.gif



I'm coming from this exact place(bolded)....I can think of two or three heated, recent threads where birth outcomes in *specifically* war torn, famine suffering, "third world" areas have been pointed to as the example of "what happens" when women birth "naturally"....yeah, because humans would be crowding the earth right now if , before the age of modern medicine, one in eight women could be expected to die at some point in their life from childbirth related complications (as is the case in Afghanistan).

That sentiment drives me up a wall.

post #94 of 229
Quote:
Originally Posted by BroodyWoodsgal View Post



I'm coming from this exact place(bolded)....I can think of two or three heated, recent threads where birth outcomes in *specifically* war torn, famine suffering, "third world" areas have been pointed to as the example of "what happens" when women birth "naturally"....yeah, because humans would be crowding the earth right now if , before the age of modern medicine, one in eight women could be expected to die at some point in their life from childbirth related complications (as is the case in Afghanistan).

That sentiment drives me up a wall.



Yes! If theres unreassuring FHTs, I can go to the hospital. (And I have a midwife who can check them) symptoms of infection, hospital and antibiotics. Unexplained (in labor) or excessive(pp) bleeding, we can go to the hospital. excessive meconium, hospital. And even if I get exhausted and choose to go to the hospital for an epidural and a nap, I can. If my baby doesn't look well after the birth or is having trouble breathing, we can call an ambulance and in the meantime my midwife, with neonatal resuscitation certification, can administer oxygen and/or suction the airway if necessary. My MW can wash her hands with clean water and soap before examining me or my baby, and she can also use a new, clean pair of gloves before every exam. Nothing third world about any of that! 

post #95 of 229
Quote:
Originally Posted by LiLStar View Post



Yes! If theres unreassuring FHTs, I can go to the hospital. (And I have a midwife who can check them) symptoms of infection, hospital and antibiotics. Unexplained (in labor) or excessive(pp) bleeding, we can go to the hospital. excessive meconium, hospital. And even if I get exhausted and choose to go to the hospital for an epidural and a nap, I can. If my baby doesn't look well after the birth or is having trouble breathing, we can call an ambulance and in the meantime my midwife, with neonatal resuscitation certification, can administer oxygen and/or suction the airway if necessary. My MW can wash her hands with clean water and soap before examining me or my baby, and she can also use a new, clean pair of gloves before every exam. Nothing third world about any of that! 


Unless you are doing complete shadow care with an actual midwifery office that has actual hospital privileges, there's no such thing as "just go to the hospital". I've personally dealt with trainwreck transfers and there is no such thing as simply "going to the hospital" with these kind of transfers. We first have to get you in a room. Then, like it or not, we have no choice but to completely discount anything you or your midwife says as you have no medical training and therefore we can't trust your assessments or historical account of what happened. So we have to start from square one and do our assessment, put your babe on monitor, draw your labs, do our cervical check, get you to sign admission paperwork, etc. Then, if we determine there is a problem, we have to prep an OR for you. Then we ahve to get a team available. This may take anywhere from 30 minutes to an hour. Some homebirth midwives like to perpetuate this myth that "the hospital is just five minutes away", as if she can call on her way there and the team will prep an OR for you while you are in route and you can just be whisked back there no questions asked. It doesn't work that way. Unlike many lay midwives, we have licenses to protect and we have rules and standard protocols that we must follow. That's why we have such superior outcomes. Anytime you transfer to the hospital from a homebirth (unless you are homebirthing with a CNM practice who has a good relationship with the hospital and a working back-up relationship with a physician group), it's a nightmare for everyone involved and it always takes a lot, lot, lot longer than you expect. ETA: And no, I'm not anti-homebirth. I had a homebirth myself, so I do support homebirth with a CNM who has a working relationship with a back-up physician.

 

post #96 of 229

I was a "trainwreck transfer" in 2009. My admission to the hospital went more quickly than my admission in labour with ds1. When I had ds1, I had pre-registered with the hospital and had been in contact with my doctor's office while in early labour (at home). The assessment during my transfer was very quick...just as quick, if not quicker than when I went in with ds1.

 

As for having to discount anything the pregnant woman or midwife says, because we/they have no medical training...this is exactly why I avoid doctors now. Giving a historical account of what happened during one's own labour doesn't require medical training. Some details might, but a whole lot of them don't require any special training at all. I've never gone in to the hospital for a baby, in any circumstances, without being asked questions about my labour/pregnancy/whatever is applicable. They seemed to trust me on most things...although I've found very few medpros who can wrap their brains around the idea that I might actually know date of my last period...or the date of the only sex I'd had in over six months, for that matter. I guess figuring those things out also requires special medical training? (And, to this day, I sometimes run into "experts" who say that what happened in my first labour can't happen, yet they expect me to trust their "expertise".)

 

ETA: Anyway...yeah - I did just go to the hospital. It ended up being a trainwreck, partly because the medpros at the hospital were more interested in their "high standards" than in actually listening to anything I had to say.

post #97 of 229

You're also in Canada. It's a different system.

post #98 of 229
Quote:
Originally Posted by holly6737 View Post

You're also in Canada. It's a different system.



What about our system could possibly affect whether you have to discount everything the woman and/or her midwife say?

 

And, for the record, stating that you have licenses you must protect in the same breath as "that's why we have superior outcomes" is very confusing. I hear all the time that unlicensed/illegal midwives are dangerous, because they have to look out for themselves before their clients...and then I hear how this decision was made by a doctor, because he/she doesn't want to be sued for malpractice, or that a licensed midwife has to do things a certain way, because she has her license to protect. Acting to protect one's insurance coverage or license is no more noble than acting to keep out of jail.

post #99 of 229

Actually, I CAN "just go to the hospital" my whole point is home birth, be it UC, CPM, or CNM with OB back up, in the country I live in, is *absolutely nothing like birthing in a third world country*. I can be on hospital property within 10 minutes. Mothers in less privileged areas of the world do not have those kinds of amenities when birthing. If we transferred due to nonreassuring heart tone, yes, I can see that it could take some time to receive treatment. I promise though, that if I walk in (actually, ambulance is much more likely in this scenario) with a prolapsed cord between my legs they aren't going to piddle around waiting for me to fill out paperwork and do lab work, they're going to prep the OR immediately!. Anything less would be glaring malpractice.  And I have transferred from a home birth before, with an illegal lay midwife. it was the non progressing labor with maternal exhaustion variety of transfer. around 6pm, we called to let them know we were on our way, then yes, I *just walked into the hospital* They took me straight to a room. There was no emergency, but they put on monitors, placed IV, drew labs, etc then did paperwork and I got the epidural as soon as I was able to. Nothing train wreck about that. The only bad thing about it is that it wasn't what I wanted for my birth. (eventual cesarean) 

 

I get that you disagree with home birth except for with a CNM who has back up. Thats not even the point I was making. All I was trying to say is, homebirth, even UC, is nothing like being in a 3rd world country where 1 in 8 women die in childbirth. Because at any point, we can go to the hospital. Those women can't. I dont even think it was you who said that anyway. I dont know who did. a pp referenced an older discussion. 

post #100 of 229
Quote:
Originally Posted by LiLStar View Post

Actually, I CAN "just go to the hospital" my whole point is home birth, be it UC, CPM, or CNM with OB back up, in the country I live in, is *absolutely nothing like birthing in a third world country*. I can be on hospital property within 10 minutes. Mothers in less privileged areas of the world do not have those kinds of amenities when birthing.



Yes, this - exactly.

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