Statistics anyone? - Page 2

[myhoneyswife]

Originally Posted by doula mary

Sorry also, I used "abstracts" vs. studies...you ladies aren't very defensive are you?!

I did not mean to imply your numbers are not accurate, but there are indeed few studies done on UC's and I think there should be. Dont you? There is not much out there in terms of formal evidence based information supporting/not supporting UC.

Mary

I'm pretty sure what raised our hackles was this part at the end...

Seems MW attended homebirths might be the safest overall!

That statement really cannot be made (and I do realize you included the word 'might') regrding the stats that you were presenting because it wasn't a good study, and thus drawing any conclusions from it would be wrong. Yup, there is a shortage of studies of UC, and realistically it would be almost impossibleto get good studies of UC because of the fear of CPS that most of us have that motivates us to lie if we feel it's best


Cara

[doula mary]

Not trying to stir anything up, the OP was looking at stats for UC...not much out there but wanted to share the limited stats.

Based on research and evidence....so far that is available MW attended birth does seem to have the lowest infant and maternal mortality based on the abstracts posted earlier.

Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.
Mary

[littleteapot]

Doing ones own prenatal care also means that many of these deaths could have been the result of birth defects or missed miscarriage/stilbirth - things that these mothers likely would have terminated for in pregnancy.

I had a UP and hospital transfer for preterm labour, and my son died. He had a birth defect incompatible with life. A few weeks later and I would have had him at home.

Termination (by way of abortion or early induction) doesn't count as 'infant death' the same way. They tend to just speak of that as "failed pregnancy" or "product of conception".
So if I'd ended up doing a UC, cases like his could be included in a study for infant death.

[cottonwood]

First, Mary, it would be very helpful if you would use the quote tags when quoting someone else -- it is confusing otherwise.

Originally Posted by doula mary

Sorry also, I used "abstracts" vs. studies...you ladies aren't very defensive are you?!

Alison_in_oh, as far as I know, is not a UCer (this is the first time she's posted in this forum) so I don't know why she'd be defensive. In any case, accusing the poster of defensiveness doesn't make her point any less valid. I can't think why you'd have a problem with it unless you're feeling defensive yourself.

[cottonwood]

Originally Posted by doula mary

Based on research and evidence....so far that is available MW attended birth does seem to have the lowest infant and maternal mortality based on the abstracts posted earlier.

"Seem" would be the key word here. We've already laid out very clearly why these studies are seriously questionable and/or nonrelevant to what we're doing here.

Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.

No, it's not, which is why I don't understand why you keep bringing it up.

[myhoneyswife]

I'm pretty sure she was saying that we were all being defensive, and that's pretty much correct We believe UC is safe, and I *know* that *for me* it is safer than having a MW. I'd flip out at a midwife and would be really irritated having her here while I birth, that's just how I am

I think that we are defending UC against some questionable stats just the same way that majority of MDC defends not vaccinating against the questionable stats that we're all bombarded with on a daily basis as to why vaccination is a good thing and it's bad for our kids if we don't vax. Same deal

I'm pretty sure that if I went onto the vax board here on MDC and posted some abstracts of studies that showed that vaccinations do indeed coorolate with a lower childhood mortality then I'd get people to be defencive also. Same with if I went to the homeschool board and posted studies about how kids do better when they go to classes with peers in a school environment. We're a pro-UC board here, it would be expected that we'll defend and pick apart any study that's posted that says that UC isn't as safe as MW attended births, ya know?

I'm not picking on you, I think it's good to discuss things, but if you're posting stuff that shows that MWs are safer than UCing, then it would be logical to expect us to pick it apart.

Cara (who is saying all this with a smile, I'm not angry at all, just talking... sometimes this doesn't come across well on the net)

[doula mary]

Thanks Cara,
Sorry..I'm an old lady...when I push the quote bottom, it still doesn't do what I want it too.. tell me how to do the "tags" Also, usually when I'm posting I have a 4.5 year old on my lap nursing and am typing with one hand..it's a trick, sorry my posts are not clear.


"Seem" would be the key word here. We've already laid out very clearly why these studies are seriously questionable and/or nonrelevant to what we're doing here. ..

Lets not play the semantic game..evidence thus far, does show that MW attended births have better outcomes and I will maintain this position until I see evidence that suggests otherwise...not trying to be snappy but honest. However, if YOU want to UC...cool...but I'm not sure research thus far is proving it as safe as births with a experienced attendant.

Quote:
Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.


"No, it's not, which is why I don't understand why you keep bringing it up."

I mention it because since there IS so little evidence or studies on UC...one must look at what is available...WHO does track infant and maternal mortality. It is not relevant to compare the US vs. a third world country...it IS relevant to compare countries such as Canada, UK, Sweden, Norway who happen to have BETTER infant and maternal outcomes and recognize that these countries have a MW model of care.
Mary

[2bluefish]

Hi, lurking UCer here, I've been keeping up with this thread, and what kind of made me feel defensive was Doulamary bringing up how "other" UCers have reacted to research. Are you prejudging unassisted birthers as a whole, Doulamary?

Studies based on birth certificates *are* problematic, because they may not truly reflect the practice of educated unassisted birth. In areas where midwifery is regulated a woman may have a birth with a midwife who is "illegal" and will declare that birth "unassisted" to the gov't. There are alot of factors that can influence the reporting.

[2bluefish]

I feel what the evidence indicates in that midwife attended birth is safer than the alternatives that have been looked at - what has not been looked at is educated unassisted birth as we know it in the developed world, so no statement can made about its safety - period.

[myhoneyswife]

Yeah, that. Exactly

[doula mary]

Ok, back to typing with one hand.

Well...you gotta know that UCing is pretty radical and only a small % of women birth this way...

Just as in the US...nursing a child my daughters age is considered pretty radical too.

I'm totally "prejudging"..if you will... women who UC, my "limited" experience with them has NOT been positive....many of these experiences were before I really had any feelings or opinions one way or another. I know some incredible women who have chosen to UC...but also have heard rationales and justifications that don't really make sense. HOWEVER, NOT approaching this generally from a Judgment place..just trying to understand why a woman chooses this as an option to "birth"...having been witness to obstetric emergencies..it is concerning to me.
Mary

[cottonwood]

Originally Posted by doula mary

Sorry..I'm an old lady...when I push the quote bottom, it still doesn't do what I want it too.. tell me how to do the "tags"

Select the text you want to quote, then click the "quote" button -- it looks like a text balloon like you might see in a cartoon. Or, you can set off the quoted text by putting quotation marks or arrows or asterisks around it.

Originally Posted by fourlittlebirds

"Seem" would be the key word here. We've already laid out very clearly why these studies are seriously questionable and/or nonrelevant to what we're doing here. ..

Originally Posted by doula mary

Lets not play the semantic game..

I'm not doing any such thing.

evidence thus far, does show that MW attended births have better outcomes and I will maintain this position until I see evidence that suggests otherwise...

You are for some reason missing the point that the "evidence" is either invalid or irrelevant. Invalid because of how the studies were done, or irrelevant because they're not looking at anything like the kind of unassisted birth that we are talking about on this forum.

I'm not sure research thus far is proving it as safe as births with a experienced attendant.

No one is saying that it has.

it IS relevant to compare countries such as Canada, UK, Sweden, Norway who happen to have BETTER infant and maternal outcomes and recognize that these countries have a MW model of care.

Fair enough. What exactly do they have to say about unassisted birth?

[doula mary]

"I feel what the evidence indicates in that midwife attended birth is safer than the alternatives that have been looked at - what has not been looked at is educated unassisted birth as we know it in the developed world, so no statement can made about its safety - period."

Not necessarily, the first abstract in particular did measure planned vs. unplanned UC's I'm assuming that parents who planned their UC were "educated" about birth, hence the differences recorded. It would be interesting to see if the study recorded or measured the amount of planning parents had.

What I would like to see is not only comparing a UC with a MW attended HB but with a OB attended hospital birth??!!!

Mary

[myhoneyswife]

I'll bite on the MW attended vs UC, and perhaps get flamed...

I think that for the general population a MW assisted birth is safer than a UC. For most of us on MDC I think that we're well researched as to obstetrical emergencies, have someone willing to help us if the need arises, and wouldn't hessitate to go to a hospital if our baby was in danger. I don't know what a MW would be able to tell me that I couldn't research myself and figure out, and that's why I think she would only inhibit the normal process of birth for me.

My feelings of the general population are that they are not interested in researching for themselves the different complications that could arise in birth, so they may not know that if baby's shoulders are stuck then get on your hands and knees, but rather would keep trying to push baby out flat on their back, as that's all they've seen. They might not know that muconium could signal fetal distress, breech baby, or that it's important to keep baby from breathing it in, ya know? The general population seems to like to rely on professionals to do things for them, and would probably panic in a lot of normal birth situatons, so having a MW there to reassure them would in fact be safer.

I'd never really recommend that anyone UC unless they were the kind of person who did research a ton. I don't think UC is for people who would rather blindly follow. But that's just my opinion. I know there are plenty on this board who think that UC is for everyone and you have intuition that will happen at the birth (and never having given birth, I can't really comment on that).

This all sorta goes beyond statistics and is more thoretical, I guess.

[cottonwood]

Originally Posted by doula mary

I'm totally "prejudging"..if you will... women who UC, my "limited" experience with them has NOT been positive....many of these experiences were before I really had any feelings or opinions one way or another. I know some incredible women who have chosen to UC...but also have heard rationales and justifications that don't really make sense. HOWEVER, NOT approaching this generally from a Judgment place..

You're prejudging and you're not approaching this generally from a judgement place? -- which is it? You've got me confused.

So how many UCers have you known?

just trying to understand why a woman chooses this as an option to "birth"...

If you'd like to understand, try asking questions.

having been witness to obstetric emergencies..it is concerning to me.

Hospital-based birth attendants say the same thing about midwife-attended homebirth. Their perception is skewed because of the environment they practice in, which affects what they see and understand about birth. The same could be said about OBs or homebirth midwives commenting on UC.

Not necessarily, the first abstract in particular did measure planned vs. unplanned UC's I'm assuming that parents who planned their UC were "educated" about birth, hence the differences recorded.

Why would you assume that?

[littleteapot]

Myhoneyswife -

[doula mary]

"I think that for the general population a MW assisted birth is safer than a UC. For most of us on MDC I think that we're well researched as to obstetrical emergencies, have someone willing to help us if the need arises, and wouldn't hessitate to go to a hospital if our baby was in danger. I don't know what a MW would be able to tell me that I couldn't research myself and figure out, and that's why I think she would only inhibit the normal process of birth for me."

*I DO appreciate your willingness to discuss this, but the difference between you and a MW is indeed training. There is a BIG difference between reading about shoulder dystocia and possible solutions and actually coping with one. A true SD...you would not have time to get to the hospital or call 911

"My feelings of the general population are that they are not interested in researching for themselves the different complications that could arise in birth, so they may not know that if baby's shoulders are stuck then get on your hands and knees, but rather would keep trying to push baby out flat on their back, as that's all they've seen. They might not know that muconium could signal fetal distress, breech baby, or that it's important to keep baby from breathing it in, ya know? The general population seems to like to rely on professionals to do things for them, and would probably panic in a lot of normal birth situatons, so having a MW there to reassure them would in fact be safer. "

*That is probably true to some extent...but every MW I know has a story that maybe added a gray hair or two...as parents do YOU want that experience?

"You're prejudging and you're not approaching this generally from a judgment place? -- which is it? You've got me confused"

*Well..me too..that's why I'm trying to glean more info! Overall, I think UCing is taking unnecessary chances...the majority of women I know who UC are women who are fairly inexperienced with birth..they have some pretty strong feelings but very little experience. I have NOT had much experience with women who choose to UC..probably 20-25.



Quote:
having been witness to obstetric emergencies..it is concerning to me.


Hospital-based birth attendants say the same thing about midwife-attended homebirth. Their perception is skewed because of the environment they practice in, which affects what they see and understand about birth. The same could be said about OBs or homebirth midwives commenting on UC.

*Yes, but we do have HISTORY to examine what happens when women birth alone, and as a doula with ten years experience..I certainly have seen emergencies occur with non-medicated and not interventive births..including home births..you are naive to think birthing alone "saves" you from any potential problems. Have you seen a birth emergency?

One woman I have had contact with, who was very birth wise..having had 5-6 UC's..admitted to me that she WAS taking more of a chance birthing alone...and was OPEN to discussing risks vs. benefits which I found very refreshing. She was also open to understanding that birthing alone "might mean a loss of a child". I think she had a realistic perspective. One might argue that walking into a hospital potentially increases risks too...however, if you have a baby that is "crashing" you at least have an option of receiving emergent care.


Quote:
Not necessarily, the first abstract in particular did measure planned vs. unplanned UC's I'm assuming that parents who planned their UC were "educated" about birth, hence the differences recorded.


Why would you assume that?

*Why would you assume they did *not have* education or plans?
Mary

[littleteapot]

Originally Posted by doula mary

*I DO appreciate your willingness to discuss this, but the difference between you and a MW is indeed training. There is a BIG difference between reading about shoulder dystocia and possible solutions and actually coping with one. A true SD...you would not have time to get to the hospital or call 911

But how likely is a true SD occurance in an unhindered, healthy, birthing mother who is not laying in a prone position, stressed out, or pumped full of drugs?
I don't mean third world.
I don't mean uneducated.
I don't mean terrified mom who didn't know she was in labour.

Most serious accidents happen in the home, sometimes people even die from them, but we don't put on full body armor to make breakfast.

[myhoneyswife]

Originally Posted by doula mary

*I DO appreciate your willingness to discuss this, but the difference between you and a MW is indeed training. There is a BIG difference between reading about shoulder dystocia and possible solutions and actually coping with one. A true SD...you would not have time to get to the hospital or call 911

So, what would a 'trained' midwife do to me for SD that I couldn't do myself or have my DH do?

I didn't come to UC arbitrarily Three years ago I was spouting off how safe and painless giving birth in a hospital flat on your back with an epidural was. Then I decided to do my own research on what the benefits versus risks are of hosp/midwife/UC were and for me UC came out on top. If I had an ideal midwife, one who would agree to stay in the livingroom and away from me unless I wanted her, I'd be fine with having a midwife, but in talking to 'trained' midwives, part of their training seems to be to look for bad things to happen, and in that they require a certain amount of interventions because they are more comfortable if you have them, yes, lower interventions than at a hospital, but still interventions that I'm not okay with and would not be safe for me.


Cara

[littleteapot]

Originally Posted by myhoneyswife

So, what would a 'trained' midwife do to me for SD that I couldn't do myself or have my DH do?

This is my question too.
Homebirth midwives don't exactly bring along scalpels, forceps and vacuum extractors in their birth kits. In a case of true SD they'd do a hospital transfer.