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Gloria Lemay's reaction to the UC piece on GMA

post #1 of 34
Thread Starter 
Just got this in my e-mail, thought you all would find it interesting! :


<<The baby could be born in a breach position, or with the umbilical cord wrapped around its neck. The mother could suffer from significant tearing or from a maternal hemorrhage and bleed to death in as little as five minutes.>>



Dear Women, the above quote is by a physician who was interviewed by Good Morning America for a program about Unassisted Birth on Jan 8, 2008.



http://abcnews. go.com/GMA/ TurningPoints/ story?id= 4098198&page=1



Please feel free to repost what I'm about to tell you. I think it's very important to address the statement that a woman can hemorrhage and bleed to death in as little as five minutes. This is a very horrifying comment for a dr to make and, for anyone who doesn't really know birth, it could be enough to send them running for the hospital.



First of all, yes, it's possible to hemorrhage and bleed to death quickly in birth IF YOU HAVE A SURGICAL WOUNDING. Women die from bleeding in cesareans and with episiotomies. The closest to death that I have ever seen a woman in childbirth was in a hospital birth where the ob/gyn cut an episiotomy, pulled the baby out quickly with forceps and then left the family doctor to repair the poor woman. We were skating in the blood on the floor and desperately trying to get enough I.V. fluids into her to save her life while the family doctor tried to suture as fast as he could. I have never seen anything like that in a home birth setting or a hospital birth that didn't involve cutting.



Think about it, would any midwife ever go to a homebirth if it was possible for the mother to die from bleeding in five minutes? I know I wouldn't go if that could happen. We had a visit here in Vancouver BC from an ob/gyn from Holland back in the 1980's. Dr. Kloosterman was the head of Dutch maternity services for many years and he was a real friend to homebirth and midwifery. He told us that you have AN HOUR after a natural birth before the woman will be in trouble from bleeding. Does this mean that you wait for an hour to take action with a bleeding woman? No, of course not. If there's more blood than is normal, you need to call 911 and transport to the hospital within the hour, but you're not going to have a maternal death before an hour is up. I have had 10 transports for hemorrhage in the many homebirths that I have attended (over 1000). Two women have required transfusions. The other 8 recovered with I. V. fluids, rest and iron supplements. Of course, no one wants to see blood transfusions in this day and age. We also don't like to see a woman anemic after having a baby because it makes the postpartum time very difficult. The most important action after having a baby is to keep the mother and baby skin to skin continuously for at least the first 4 hours.



What doctors won't tell you is that the most severe cases of postpartum anemia are in women who have had cesareans. Major abdominal surgery results in anemia. I have a friend who is a pharmacist in a hospital. He spends most of his days trying to figure out individual plans to help cesarean moms get their hemoglobin counts up. He finds these cases of severe anemia in post operative mothers very distressing.



I hope this information is helpful to you.



As far as the other nonsense this person is trying to frighten you with:



1. Significant tearing---if you look with a mirror at your vulva after birth and there seems to be skin that "flaps" away from the rest of the vulva structures, you can always go into the emergency ward and have someone suture the wound. Tears do not bleed like cuts do. This should not dissuade anyone from staying away from the place where the scalpels reside.



2. Breech position---you' ll know if your baby is breech. When the membranes release, you will see black meconium coming out the consistency of toothpaste. With a head first baby, the meconium colours the water green or brown but with a breech, the meconium is being squeezed directly out without mixing with water. The other way that you should suspect a breech presentation is if you have a feeling from about 34 weeks of pregnancy on that you have "a hard ball stuck in your ribs". Breech presentations are about 3 percent of births.



3. Cord wrapped around the neck---the smart babies put their cords around their necks to keep them out of trouble. If you have a baby with the cord around the neck, it can be unwrapped very easily either during or right after the birth. The most important thing is to keep the cord intact.



Gloria Lemay, Vancouver BC Canada



Advisory Board Member, ICAN



Contributing Ed. Midwifery Today Magazine
post #2 of 34
LOVE IT!

I do agree that uterine hemorrhaging is NOT the same as that quote by the doc. Praise the Lord too! I hemorrhaged during a 12 week loss and would have been dead 25 minutes before the ambulance arrived if his quote were true!
post #3 of 34
That's great!

My DH laughed when I told him what that doctor said.

I also wish more people were aware that a cord around the neck is not a medical emergency, and that OBs would stop trying to make us believe that it is! I have had numerous women acquaintances get bullied into a c-sec and say, "It's a good thing, too... his cord was around his neck. If not for the OB and the hospital, my baby would have died!"
post #4 of 34
"Bleed to death in 5 minutes"

So there are arteries inside the uterus?
post #5 of 34
Thank you so much for this!
post #6 of 34
Thank you for posting this! Although I laughed at the doctor's first three comments, I have to admit that his comment about hemmorrhage made me wonder how that could happen. I couldn't figure it out, and I am someone who has hemmorrhaged after a UC and obviously survived, even though we didn't have help come for an hour or so. So I was thinking maybe it had to do with the gushing sort of hemmorrhage "they" talk about. But the fact that it is related to surgical wounding makes perfect sense. And of course that ridiculous doctor would think it could happen anywhere, because truly natural birth is just exactly what happens in the hospital, right?:
post #7 of 34
I think it is fitting for a doctor to make blanket statements that are easily refuted. I just wish more people could hear the idiocy in them.
post #8 of 34
thanks for posting that
post #9 of 34
If a woman would bleed to death in 5 minutes, being in the hospital wouldn't do anything for her. Just to retrieve the medications used for hemorrhage takes a few minutes and once given the onset is not instantaneous. What a stupid thing to say.
post #10 of 34
Yes, thank you for posting that.

More women need to be exposed to the truth! It always irks me when doctors ABUSE women by LYING TO and SCARING them with information that is blatantly false.
post #11 of 34
Quote:
Originally Posted by sapphire_chan View Post
"Bleed to death in 5 minutes"

So there are arteries inside the uterus?
Per Wikipedia, the mother's blood passes into the placenta by means of 80 to 100 endometrial arteries.

At term, the total blood flow through the uterine arteries into the uterus is almost 1 liter per minute. A pregnant woman has 7-8 liters of blood in her body, so in cases of severe hemorrhage, it doesn't take long for blood volume to drop to critical levels.
post #12 of 34
In all reality women DO die from hemorrhage in the hospital plenty. The OB who did my ectopic had a mother die from hemorrhage in minutes (grand mulitipara) and there was NOTHING he could do to stop it. In the hospital. In the OR.

Birth will never be 100% safe.
post #13 of 34
Quote:
Originally Posted by NatureMama3 View Post
In all reality women DO die from hemorrhage in the hospital plenty. The OB who did my ectopic had a mother die from hemorrhage in minutes (grand mulitipara) and there was NOTHING he could do to stop it. In the hospital. In the OR.

Birth will never be 100% safe.
It's interesting that you say that because my dh is hesitant of a UC for that very reason. He doesn't think birth is safe either. He thinks I'm at my most vulnerable during and after.

I thought most proponents for UC and home birth say birth is safe....
post #14 of 34
Quote:
Originally Posted by Testifyer View Post
It's interesting that you say that because my dh is hesitant of a UC for that very reason. He doesn't think birth is safe either. He thinks I'm at my most vulnerable during and after.

I thought most proponents for UC and home birth say birth is safe....
There is always some risk involved with birth. Those of us who choose homebirth are aware that the risks involved during hospital birth put us at greater risk rather than reduce the risks.

What role does having an exhausted/ hyperstimulated uterus from pitocin or other drugs play in the frequency and severity of maternal hemorrhage? What role do narcotics and epidurals play? What role does having the baby taken away to be "inspected" and given all the routine procedures rather than given to the mother to nurse IMMEDIATELY play? Nursing helps the uterus contract. Nature gives us safeguards. Along with episiotomies and C-sections, these powerful drugs and unnatural procedures and policies will cause the uterus to not react the same way it would in a natural birth and I would argue that maternal hemorrhage, and more severe hemorrhage is more common in a hospital setting.
post #15 of 34
I don't think hemorrhage is unpredictable. In the case of my former OB it was the woman's 8th child and she had a history of it. Obviously her first hemorrhage was not fatal (nor those after) and were warning beacons. What I don't know is was the child induced? was pitocin used? was the placenta taken out by traction? was the mother exhausted due to no food during labor? Those are hospital-born risks that can make a tendency to hemorrhage worse.

I agree that hemorrhage and more severe hemorrhage ARE more common in hospital settings. The natural path of birth is not respected and the natural safeguards (letting placenta come on its own, nursing immediately, etc) thrown out.
post #16 of 34
Hoo boy, if hemorrage was a five-minutes-and-you're-dead deal, I wouldn't be here typing this right now. I would have been gone before I even hung up the phone with 911. Nevermind the hours it took them in the ER to even locate the source of all the blood, start a transfusion, and then send me to the OR to have my cervix stitched. What a crock.

Nasty scaremongering, nasty nasty nasty. It speaks volumes about his character that instead of offering reasons why the hospital is more safe, he flails out with lies about why homebirth/UC is horrible and deadly and no one in their right mind would do it.
post #17 of 34
Quote:
Originally Posted by Testifyer View Post
I thought most proponents for UC and home birth say birth is safe....
It's not that I, as a UCer say "birth is safe", it is that "Birth is AS safe or SAFER" at home than in a hospital setting.

Birth is a process and it does have natural risks, but so does everything in life. Us who advocate for UC and HB would not say birth is "Safe" at home with no potential for problems or bad outcomes. What we would say is that birth is natural and has been happening for thousands of year and though there are inherent risks to giving birth, the natural body can cope with most of those if given the chance. However, the hospital staff routinely force the body to stop it's natural processes in order for them to force it to do what they want it to do in their time table. This causes the natural coping mechanisms in the body to stand back and say, "Have it your way, I quit!" That is where many of the complications come in.

I think the worldwide statistics of birth speak for themselves. With the US being second from the bottom.
post #18 of 34
Quote:
Originally Posted by sapphire_chan View Post
"Bleed to death in 5 minutes"

So there are arteries inside the uterus?
I do believe there are - they supply blood to the placenta. If the placenta doesn't detach properly or the uterus doesn't clamp down, the arteries can literally continue pouring blood into the space where the placenta was attached and, as I understand it, women can die very quickly from a hemorrhage. It's not very common, but it can happen.

I have great respect for doctorjen on these forums, and she posted a story about this with one of her clients. As you probably know, she is a super-low-intervention family doc (& doctorjen, I apologize if I make a mistake at all in relating this anecdote). After the woman gave birth, she was just gushing, pouring blood. To save her life, doctorjen did bimanual compression - pretty rough, too - among other things. She did not have time to ask the patient's permission, but I believe she told her what she was doing. The patient did experience some trauma from the event (no surprise there) as it was both painful and frightening. But also necessary to save her life in that moment.

As I understand it, that kind of catastrophic hemorrhage is very unusual. Not impossible, just very unusual. I would think that might be one of the rare situations where a UC could result in a maternal death that could be prevented in the hospital or with an attendant, but also I feel that in a hemorrhage that severe, it might not be possible to save the mother at all.

As someone else said, birth is not without risk. Wherever you do it. A lot of choice in birthing depends on the way you evaulate the risks and what risks are and are not acceptable to you. The risk of severe PPH is so slight that, to me, it does not overpower the many other risks attendant to hospital births.
post #19 of 34
Quote:
Originally Posted by Romana9+2 View Post
To save her life, doctorjen did bimanual compression - pretty rough, too - among other things. She did not have time to ask the patient's permission, but I believe she told her what she was doing. The patient did experience some trauma from the event (no surprise there) as it was both painful and frightening. But also necessary to save her life in that moment.
Oh yes, now I remember. In Emergency Childbirth, Dr White talks about that. Compress the uterus with one hand against your other hand, which should be on the cervix. HARD.
post #20 of 34
Quote:
Originally Posted by barefoot mama View Post
Oh yes, now I remember. In Emergency Childbirth, Dr White talks about that. Compress the uterus with one hand against your other hand, which should be on the cervix. HARD.
Yes. One hand goes in the vagina, then becomes a fist. Other hand on the outside and you compress the uterus between them. Sounds very painful. I made sure my dh was aware of this and had looked at the diagrams in the Dr. White book, but honestly I think in that extreme kind of emergency it really is asking a lot of a spouse, who hasn't had any training and doesn't know exactly what to do, and is scared themselves. Fortunately, needing bimanual compression to stop a sudden, severe PPH is very rare. I don't know how rare, statistically . . . and I would think it would be less likely where there's no cord traction or other interference that could cause a hemorrhage.
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