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"But women used to die in childbirth *all* the time" - Page 2

post #21 of 44
Quote:
Originally Posted by TinyMama View Post
Sorry, can't type--nak.
Just read Birth by Tina Cassidy. Lots of info a/b this topic, and a quick/easy read.
I read this book and photocopied the juicy pages, to have on hand for discussions like this....here's a quote from her 2006 book.

Quote:
Today, according to WHO:
-25% of maternal deaths are from hemorrhage
-15% from infection
-13% from unsafe abortions
-12% from eclampsia
- 8%from obstructed labor (a category that includes placenta previa
she cited this from World Heath Organization's Making Pregnancy Safer fact sheet no. 276 Feb 2004

She also sez
Quote:
Americans may feel smugly safe, but twenty-five countries--including Qatar and Slovakia--have better records when it comes to mothers surviving birth.
and points out
Quote:
for all the perils a woman might face, birth is more than one hundred times deadlier for the baby. It has always been this way.
Which, in my opinion, would be quite a zinger to throw back at someone in a debate when they're talking about how women die.

I highly suggest Tina Cassidy's book as a reference for this tiresome debate--it's an interesting, well-written book.
post #22 of 44
I was recently looking into international maternal mortality rates, out of curiosity to find where the worst maternal mortality rates were and what they were. I believe the worst were Sierra Leone, Afghanistan, and Sudan. The numbers ranged from 1 in 6 to 1 in 10, roughly. In one of those countries, a woman had a 1 in 3 chance of dying from childbirth-related causes during her lifetime. The data was published by Unicef or the WHO depending on what data it was, exactly.

I think there's a tremendous difference between understanding hygiene, basic prenatal care, the warning signs of pregnancy or birth problems and having access to clean water and plenty of nutrition and . . . what women are suffering through in extremely deprived nations with poor access to healthcare, midwives who *do not* have the benefit of any real medical knowledge, and little or no access to uncontaminated water and food supplies.

None of this is an argument against homebirth or UC. I actually think it supports the safety of homebirth and UC. However, there is a perception that anything outside the OB medical model is inherently and terribly dangerous, and I think this is one major source of that perception. The other, of course, is the main focus of this thread, which is women dying a much higher numbers prior to more MD intervention in birth. I haven't done extensive research on this, but again, I think it's more perception than reality, and that medicine didn't really improve birth stats until hygiene and antibiotics, among other things, became readily available/used.

I don't think pregnancy and birth are themselves especially dangerous enterprises, but I do think the conditions under which they take place, and the level of skill available to treat problems that may arise, makes an immense difference in who lives and who dies. I'm with arwyn that the most important thing is probably nutrition and clean water, followed closely by skilled midwifery assistance.
post #23 of 44
Quote:
Originally Posted by Romana9+2 View Post
I was recently looking into international maternal mortality rates, out of curiosity to find where the worst maternal mortality rates were and what they were. I believe the worst were Sierra Leone, Afghanistan, and Sudan.
These are all countries that practice female circumcision, at least in part, no? FGM is a known contributor to birthing problems.
post #24 of 44
Quote:
Originally Posted by Contented73 View Post
I am a doula and work with a range of different types of people, with different perspectives on pregnancy and birth. Often when I am talking to someone who is more "medically minded" this eventually gets said.
I would probably point out that women still do...in fact, the maternal mortality rate went up for the first time in decades here in the US. I'd also point out that we're ranked second worst in infant mortality rates as well.

Quote:
Originally Posted by Ironica View Post
The more times you do something that carries risks, the more likely you are to run afoul of those risks.
This is actually an interesting way to look at it - especially because the OBs are insisting that the rates for c/s are going up precisely because women are having less children than they once did. :
post #25 of 44
Quote:
Originally Posted by gcgirl
These are all countries that practice female circumcision, at least in part, no? FGM is a known contributor to birthing problems.
I'm fairly sure that Afghanistan isn't an FGM culture. Also, it's important to distinguish between the different types of FGM; Types I and II, the most prevalent (roughly 80%), are not likely to interfere with pregnancy/childbirth. Where the extreme forms of FGM are practiced, these obviously do have major impacts on safe childbirth, but there are other factors at play in terms of maternal/infant mortality in cultures that don't have Types III/IV FGM going on.
post #26 of 44
Quote:
Originally Posted by gcgirl View Post
These are all countries that practice female circumcision, at least in part, no? FGM is a known contributor to birthing problems.

They are countries that are ravaged by war.
post #27 of 44
I love when people say this because I know that it gives me a really great opportunity to correct their thinking.

I read Birth: The Surprising History of How We Are Born and I would recommend it to ANY birth professional. It is a little grizzly, but so was child birth back in the day. It tells all about how women died and most of the time, if the birth had no complication then they simply died because of medical practice at the time.

This book gives you amazing info to refute this common argument for how dangerous birth is.

I might not read it though if you're pregnant, FYI.
post #28 of 44
Quote:
Originally Posted by Quirky View Post
I'm fairly sure that Afghanistan isn't an FGM culture. .
You're right - I was looking at an article talking about Afghan wives of Arabs. My bad. But Sierra Leone and Sudan, that's a big yes.
post #29 of 44
I also read Birth by Tina Cassidy and thought it was great, even though I'm pregnant with my first. It gave me a lot of insight into how the obstetric profession works. It's like they find a new tool, then use it excessively and with little discrimination until decades later when someone wakes up to the fact that it's causing lots of problems, more than it's solving. I agree that nutrition and sanitation are the most important factors in reducing mortality, both sadly inadequate in countries like Afghanistan, Sierra Leone, etc.

Anyway, most of what I would say has been said, but I wanted to add that I am immensely grateful NOT to have rickets!
post #30 of 44
We are living in Nigeria at the moment, and UCs and homebirths are the norm, except for the very rich. It seems, anecdotally, that a lot of babies die during or shortly after childbirth. I'm surprised at how often I hear such stories from local people. I haven't heard any stories of a mother actually dying.
post #31 of 44
Quote:
Originally Posted by wagamama View Post
We are living in Nigeria at the moment, and UCs and homebirths are the norm, except for the very rich. It seems, anecdotally, that a lot of babies die during or shortly after childbirth. I'm surprised at how often I hear such stories from local people. I haven't heard any stories of a mother actually dying.
It's always that way - maternaty mortality is always measured at least an order of magnitude above neonatal mortality, even here. Some of the folk practices of many cultures contribute to this, by the cord practices (cutting the cord with unsterile instruments is a BIG problem), denying colostrum, etc.
post #32 of 44
Thank you for this wonderful thread!! I am pregnant with my second baby, and although the birth of my DD couldn't have gone better, and was intervention-free and midwife assisted, a family member has me on edge because women used to die in child birth *all* the time. They weren't aiming to upset me, it was all very much in context of what we were talking about (strangely enough). I am planning a home birth this time (last time, it was midwife assisted in a hospital), partially because the birth of DD went so incredibly fast, I fear I will give birth in a grocery store! So yeah, home is best

I googled statistics for Canada and found http://www.phac-aspc.gc.ca/rhs-ssg/matmort_e.htm from the Government of Canada website stating that in Canada, as of the 1990's, the maternal mortality was less than 5 in 100,000. That's pretty good! The slight rise in the chart in the 1930's leads me to believe a lot of the high statistics in the past is due to poor nutrition (the depression?).

Anyhow, I am very happy that I came across this thread, and I feel much better now
post #33 of 44
When I read A Midwives Tale I was struck at how Few women died. I think 4? I don't think we have odds that good today. I feel that if birth was so dangerous then we woudn't have the population we do today. Esp in the 3rd world countries where medical care and hygiene are non existent. Yes, Medical care has saved lives that once would have been lost but its also taken lives that wouldn't have been lost before so its a wash. Or worse, when drs weren't washing between patients and corpses and disease spread, I am sure more women died than were saved.
post #34 of 44
Quote:
Originally Posted by Full Heart View Post
Yes, Medical care has saved lives that once would have been lost but its also taken lives that wouldn't have been lost before so its a wash. Or worse, when drs weren't washing between patients and corpses and disease spread, I am sure more women died than were saved.
I'm not online long today, but I did recently read something somewhere about this. The article cited maternal mortality rates of about 25% in the "lying in" wards, and said some of them reached 100%. This was a long time ago, when birth first moved into the medical field...but it was also much, much higher than the maternal mortality rates that were occurring outside the wards. However, while I'm sure rumours were spread, those women simply didn't have access to the kind of information we have, and probably didn't really realize just how many other women were dying.

Sometime in the next few days, I'll try to find where I read this stuff, and post it. It wasn't that long ago.
post #35 of 44
There was a book about Semeilweis that had a bunch of info on that I just read. Also Birth as an American Rite of Passage, The American Way of Birth, and really pretty much any book on the history of midwives, unless it was written by an OB.
post #36 of 44
Quote:
Originally Posted by Arwyn View Post
It's always that way - maternaty mortality is always measured at least an order of magnitude above neonatal mortality, even here. Some of the folk practices of many cultures contribute to this, by the cord practices (cutting the cord with unsterile instruments is a BIG problem), denying colostrum, etc.
Not to mention that some babies are born with medical problems. Some of these babies would still die even with modern medical care, and others would become NICU babies, requiring oxygen, a feeding tube, and/or surgury before being healthy enough to go home. A baby who can't breathe or eat isn't going to live very long.

Not all neonatal mortality is related to birthing practices.
post #37 of 44
Well, of course. We're never going to have a 0% neonatal mortality rate. It's simply impossible. Anyone who says otherwise is kidding themselves. There are, of course, things we can do to affect the rate one way or another, but it will never ever be zero.
post #38 of 44
It seems that there are really 2 conversations going on here:

1.) Why people have a fear of birth, why our culture supports that fear, and how modern medicine contributes to this atmosphere

and

2.) Actual reasons for materal and infant mortality- historically and today

These are really 2 very different things.

In the US, birth is not something to be feared. Even home births are usually within close enough proximity to doctors and hospitals that with a trained midwife, a healthy mother, and adequate resources, the outcomes are overwhelmingly successful. Addressing our cultural fear of birth and why we view it as a medical procedure is important.

For the second aspect, I think that it is important to address that not everywhere, for everyone is birth "totally safe" and death is not the only possible negative outcome. For example, fistulas in very young women (girls) in many parts of Africa are not fatal (though usually the long and difficult labors are for their babies), but it essentially ruins their lives anyway. In many parts of the developing world, there are no doctors for when things do go wrong. Sanitation and nutrition are scarce. Girls are married at a very young age, before their bodies are ready for babies. In the chant for "no c-sections, no medicalized birth" we need to remember that who we are directing this toward are women in industrialized countries with adequate medical support and other resources. The foundation of the senitment is universal, but millions (billions, really) of women do not have the option, support, or facilities, a march against doctors and care is directly in opposition of their best interests. In addition, in sub-Saharan Africa in particular, AIDS is a HUGE issue, with some places having a 50% HIV positive population. Without drugs at or near the time of birth and accurate information and assistance, there is a much, much higher risk of mother-infant infection.

I guess what I am trying to say is that there are different issues and difficulties facing women in different parts of the world.
post #39 of 44
imho there are a LOT of issues being discussed here but I think having soundbites and quick one liners is the ultimate goal for the OP as a way to get the "hook" and then the cold hard facts as a means to back them up.

I don't personally have any of those case studies or statistics that were originally asked for (I'm a BIG citations gal, meself! ) but I am quite interested in what I am reading here.

For me the phrase is "you are so BRAVE to have a baby at home....I would be afraid of something going wrong." or something to that effect, as an aside.
post #40 of 44
Quote:
Originally Posted by alexsam View Post
In the chant for "no c-sections, no medicalized birth" we need to remember that who we are directing this toward are women in industrialized countries with adequate medical support and other resources.
I'm curious about your reference to the "chant for no c-sections...". I spend a lot of time (too much) here and on the ICAN support list, and I can't recall anyone in either place ever saying "no c-sections". I've seen a lot of people say that too many are being done, and that they're often medically unnecessary, but I haven't seen anyone say not to do any.
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