What Women Aren't Told About Childbirth

[pamamidwife]

http://www.alternet.org/story/65608/?page=entire

The survey Listening to Mothers II (LM 2) was released in 2006 and reports on U.S. women's childbearing experiences. Conducted for Childbirth Connection by Harris Interactive in partnership with Lamaze International and Boston University School of Public Health, it is the first comprehensive survey of women's childbearing experiences. The survey population is representative of U.S. mothers 18 to 45 who gave birth to a single infant in a hospital, with 1,573 actual participants.

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."

The majority of women ended up attached to IVs, catheters and fetal monitors. They had their membranes artificially ruptured and were given epidurals. Most of these women had little understanding of the side effects of these interventions, including cesarean and medical inductions. The report also shows that though women understood that they had the right to refuse medical interventions, few did, and many received interventions, such as episiotomies, without their consent.

Just as troubling is what is not being done. A "very tiny minority" of women received all of the care practices that promote natural birth. "With 4 million U.S. births annually, a single percentage point represents about 40,000 mothers and babies per year," the report authors say. Despite the relative health of women in the United States, many women are not getting the uncomplicated births they might expect.

[gcgirl]

I would like to see women, at their very first prenatal visit with their provider, receive a detailed handout on what to expect and what to prepare for. Like "Here's what we do at week X, and week Y, etc.," and "Here's what tests we normally do and why," and "Here are the things you should start thinking about so you can decide what kind of birth to have..." Kwim? At least get people thinking, and realizing that they DO have options. But I guess it's easier to have a compliant patient when they aren't educated and don't know what to expect.

[jillmamma]

I'd also like to see doctors quit scheduling inductions because "you are just about 40 weeks anyway, and I will be out of town the week you are due, so that way I can be there instead of my backup".:

[AlpineMama]

I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.

[LoveChild421]

thank you for posting that Pam! I will definately be sharing it with all the women I know.

[tammyswanson]

The Food and Drug Administration (FDA) has never approved Pitocin for the use of augmenting labor and it has been suggested now that mismanagement of Pitocin is the leading cause of liability suits and damage awards.

Continuous electronic fetal heart monitoring is another seemingly innocuous medical intervention that is linked to adverse outcomes. Even though it requires women to be strapped to a machine and therefore limits their mobility -- movement in labor is listed as one of the recommended comfort measures by Lamaze International -- it may seem that constant feedback on a baby's heart rate would reduce unnecessary interventions and surgical procedures. Yet, some studies have shown CEFM to be an ineffective indicator of fetal distress and one of the causes of the increase in cesareans.

"There is no scientific reason do to any of this stuff," says Eisenstein.

EXCELLENT ARTICLE!!! THANKS FOR SHARING!

[laralee16]

Originally Posted by tammyswanson

The Food and Drug Administration (FDA) has never approved Pitocin for the use of augmenting labor and it has been suggested now that mismanagement of Pitocin is the leading cause of liability suits and damage awards.
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Could you post a link for me where it says this? I tried looking on the fda website but I can not seem to find it. (Its not that I dont belive you, I just would like to learn more )

[tammyswanson]

Originally Posted by laralee16

Could you post a link for me where it says this? I tried looking on the fda website but I can not seem to find it. (Its not that I dont belive you, I just would like to learn more )

It's in the article in the link that was posted here initially by PaMidwife, it's further down the page though.

http://www.alternet.org/story/65608/?page=entire

[laralee16]

Originally Posted by tammyswanson

It's in the article in the link that was posted here initially by PaMidwife, it's further down the page though.

http://www.alternet.org/story/65608/?page=entire

OHHHH, Ok, I feel like a dummy, lol. Im sorry!

[rmzbm]

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."


Really??

[Storm Bride]

Originally Posted by rmzbm

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."


Really??

Yeah...I'm shocked...really, really shocked...

*sigh*
I had the whole "I'm trying to avoid another section this time" conversation last night. The response..."Oh - so you have to be in the hospital". Naturally - the best way to avoid a section is to be really, really close to an OR...

[GISDiva]

Originally Posted by truemists

I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.

:

I find myself thinking about this all the time - if I never happened to find Mothering.com at a really key point in my life, would I have known that there's a whole other side to the coin? Or am I more inclined that way anyway? I can't remember a time when I didn't want a homebirth, so I'm not sure. Some of my not-as-close friends don't even seem to know that there are decisions to be made besides "breast or formula?"...and lots of them choose the latter anyway...another post...maybe if the same mainstream baby books would stop getting passed around from one woman to another...

I'm hoping I plant some seeds with my birth in other women's minds...because I certainly am not surprised by that study when I hear all the stories about inductions gone bad, pain medications making things worse, etc, etc...

On another message board that was formed for moms in my community someone asked everyone to share their birth stories and there was NOT ONE STORY that didn't contain some sort of intervention until a doula finally gave her great home birth stories. I personally wrote her and thanked her because all of the previous stories sounded so horrible to me and the women writing them weren't fazed by what had happened to them at all.

Sorry, that was long, apparently I needed to get something off my chest...

[GreenRose]

Originally Posted by truemists

I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.

:
Although DH is wondering where to put the new bookshelf we need for all my natural birth books...

[Storm Bride]

Originally Posted by truemists

I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.

Maybe so. But, a lot of women also believe that when their mothers, sisters, best friends, and doctors are all saying the same thing (eg. "get the epi - no need to suffer" or "labour is hell, and that's all there is to it" or "thank God for my OB - my baby/I would have died"), they tend to believe it.If they do start looking for info, they read What to Expect when You're Expecting from cover to cover. Or, in my case, they pore over the "official" provincial pregnancy/newborn guide, which is called Baby's Best Chance.

I didn't try to learn a bunch of other stuff, because I thought I already knew it. I thought I knew what to expect. I thought the doctors really wouldn't do a c-section unless it was absolutely necessary to save me or my baby.

I loved being pregnant. I was eagerly looking forward to labour. I didn't give a crap about maternity clothes (I've never owned any, except a pair of black pants for work), baby showers (mine was after the baby arrived, anyway) or registries! I was all about pregnancy/birth - I read the guide (I practically memorized it!), and talked to everyone I knew who had a baby about what it was really like. That was mostly women of my mom's generation, as I was one of the first in my entire circle to have a child. I didn't do a lot more research, because...honestly, it doesn't seem to me to be something that needs to be "researched"...it feels like something that should be intuitive. It actually was intuitive - I paid no attention to anything I'd "learned" about labour when I was actually experiencing it.

I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things. I've done a ton of research over the last few years, but that's because I don't want to end up cut again...and that scar means that I need to be armed with info. I use it as ammo - but it doesn't really add anything to being pregnant.

[Patchfire]

Originally Posted by Storm Bride

I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things. I've done a ton of research over the last few years, but that's because I don't want to end up cut again...and that scar means that I need to be armed with info. I use it as ammo - but it doesn't really add anything to being pregnant.

Yes! And honestly, some of us prefer to think about the 'marvelous process actually going on in [our] bodies' in less detailed ways. I purposely avoid descriptions of fetal development when I'm pregnant. I like the mysteries of it.

[~pi]

Originally Posted by Storm Bride

I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things.

:

Also:

1. I think it's ignorant to think that every woman has the time, ability, or know-how to do this research.

2. There is a huge range in the way people respond to information. Information empowers some people and overwhelms others.

3. Even if you do have all the right information and are a strong person, you can still get caught in the machine.

I think it's way too easy to suggest that the problem lies with individual women, when really, the issue is that we have a broken system.

[courtenay_e]

yessss...but those individual women who put themselves into situations where they are statistically more likely to end up cut because of who is attending and where the birth will take place are PART of the broken system. It is evident in woman after woman after woman after WOMAN who is raised up believing that, as a doctor has had so many years of learning, they are infallible, that the doctor always knows what is best for an individual (over said individual, who lives in their own body) (and, when it is actually, in obstetrics, OFTEN protocol set by lawyers that "knows" how to "treat" a "patient"), and that the staff always has the patient's best interest in mind (or that they have even been educated as to the alternative treatments available to whatever treatment is being offered, so they can help a patient to CHOOSE what might be in their best interest with true informed consent...).

I, too, have a difficult time with "ignorance is bliss" attitudes. NOT that everybody has it, or that anybody should be "punished" with cesarean because they blindly trust a doctor. The doctor does, of course take an oath that includes that they will "FIRST DO NO HARM." However, when information IS readily available, and women choose to ignore it because, oh, they have a cute doctor, or even though they are young, healthy, and KNOW the stats, choose to birth at a hospital because it's the one with the good NICU...it simply helps to perpetuate the brokenness of the system. And that bugs me.

*shrug*

Lets see how long it takes doctors to glance at this report and completely disregard it, just like they do every other piece of literature that supports the midwifery model of care. Sorry ladies, I'm tired and cranky tonight. : Maybe I'll feel better about it in the morning.

[~pi]

Originally Posted by courtenay_e

yessss...but those individual women who put themselves into situations where they are statistically more likely to end up cut because of who is attending and where the birth will take place are PART of the broken system.

This statement presumes a range of choices that many women may not actually have.

Consider:

- women whose choices are limited by geography.

- women whose choices are limited by financial realities.

- women whose choices are limited by illiteracy (which is way more common than you might think.)

- women whose choices are limited by the false dichotomy of risk categories (that would be me.)

- women whose choices are limited by lack of access to health care.

- etc. etc.

Blaming these women for their choices and feeling unable to "relate to" these women for their lack of empowerment does not fix a misogynistic, paternalist system that sets women up to fail.

Originally Posted by courtenay_e

I, too, have a difficult time with "ignorance is bliss" attitudes.

How do you reconcile this with the fact that for some people (not just women) health information can be truly overwhelming?

[GISDiva]

I know what you're saying Pi, there are some people that truly just don't have access (same goes for nutrition, finding good financial advice, etc), especially when the system is set up so strongly to point them down an unhealthy path.

I wonder more about the women I know though, who don't have any of those limitations, who are generally well-informed people. As a PP said, when your sister and your mother and your aunt are all telling you the same thing and those are people you trust, it's hard to ignore. *sigh* Not sure what the answer is...

[Storm Bride]

I guess the whole "you have to do your research" thing strikes me on a personal level...

I had an unwanted c-section in 1993. By the standards of this board, I was very uneducated. I chose a doctor - we didn't have legal midwives and I certainly wouldn't have had a clue where to find an underground one, even if I'd known they existed.

But, you know...my baby was frank breech when I got to the hospital - 8cm dilated. He hadn't been frank breech 20 hours prior when I went into labour. I've been told by doctors, midwives, L&D nurses and other women that a baby can't turn in a first-time mother, because things are too tight...that the breech was "missed". And, I frankly don't give a crap how much education, experience, etc. these people have...because I was there - I was the only one there (laboured alone for about 8-10 hours)...and that baby turned when I went into labour. If I'd been experienced with labour, or if I'd realized that a baby could turn at that point, I'd have known it. But, he turned - the pressure in my lower pelvis disappeared, and a hard lump appeared beside my navel, where there hadn't previously been one.

The hospital where I was cut didn't do routine sections for breech in 1993.

So...I was fairly uneducated about birth by MDC standards...and looking back, I don't think it would have made a damned bit of difference if I'd been educated to the max. My education wouldn't have told me that "no - I don't want a c-section" would be ignored. My education wouldn't have told me that my baby could turn breech at the last minute. My education wouldn't have told me that a breech would mean I was cut.

Maybe this is why I hesitate to put too much importance on researching the issues. I could have researched until my hands were all paper cuts...and I'd still have ended up being doped with general anesthetic and cut open over my protests.