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Our UC Stats - Page 2

post #21 of 54
Both of my UCs were also VBACs. I was 38 at the time of my last baby's birth (UC).

Just for the record
post #22 of 54
Has anyone collected the stats on MDC midwife assisted homebirth? I'd like to see how those compare just for curiosity's sake.
post #23 of 54
Both of my UC's were VBAC's.
post #24 of 54
This is reallty interesting information. It would be wnderful to be able to have a real study done.
post #25 of 54
Just ducking in here quick, but I'm always glad to see threads discussing the stats. There's another big thread in the UC archives titles "Statistics" that's pretty good too.

Quote:
We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.
Also, the way UC birth is approached varies dramatically from fully spontaneous birth to managed birth, and people are affected to different degrees by cultural conditioning and notions about the way birth should be, what constitutes risk, what constitutes a complication, how you deal with it, etc. To have a really accurate picture, we'd have to know all that as well. And that's where the stories come in, how they are helpful.

Quote:
I'm considering a PhD program where I would do a dissertation on traumatic birth (PTSD, anxiety and depression after births that were scary/disappointing/abusive). It would be interesting to compare the incidence of trauma in UC and homebirths to trauma in hospitals. I have the theory that trauma in hospitals is much more likely to occur and that it should be added as a indication of morbidity (after the fact health conditions, illness, disease and wounds that are left over and do not include death).
(bolding mine) Yes, absolutely.

Quote:
with my stillbirth a birth story was the last thing i wanted to write. tho i think some women need to do it, i think its pretty common not to.
I'm sure you're right, but on the other hand, people who are part of a community tend to report back. With people who've been posting about their pregnancies for nine months, I think it's pretty uncommon for them to just disappear in the event of a poor outcome. Which is one reason why a requirement for being in the UC roll call due date section is being an established member of MDC.
post #26 of 54
Well now you can make that 486 births since I just very belatedly added my birth story to the roll call.
post #27 of 54
Just to add to the stats (as I'm not in the original stats) - DD was a planned UC with shadow care - after 45 hours of labor we transferred (I think DD was malpositioned and the car ride jostled her into the right position) my water broke as I stepped out of the car and I was at 8cm when they checked me 10 min later. She was born 2 hours later after 15 min of pushing. I truly believe I probably was in transition at home and hit the "I can't do it" wall - had I not been a first time mom, I probably would have stayed. I ended up with an epidural at the hospital and DD was born VERY blue and got bluer (don't know the apgars) and had to be taken away for a bit. I think that the epi contributed to it.

At any rate, #2 will be a UC.
post #28 of 54
I don't think I ever added my birth story but I did ask to have my stats added.My last birth was the UC after 2 military and one civilian hospital birth, all in different states.I was considered high risk by the hospitals but never felt like the care I received was better than my own knowledge( I'm too high risk to be treated by a MW but any resident can come in for the birth?).I did and still have problems after my hospital births (so bad that I still get a cold feeling when I see the hospital on the hill here) but my UC was very healing for me.
post #29 of 54
There are several reasons I don't get too wrapped up in statistics, especially when it comes to UC. Some of these things have been mentioned in previous posts.

1. Humanity is undergoing a change in consciousness. We are just beginning to discover the immense power of our own thoughts and feelings, as well as our connection with the "larger self" (or God/Goddess/All that is, etc.). Little by little we are letting go of our allegiance to and dependence on "the authorities" in many aspects of our lives, and instead learning to trust in the authority and intelligence of the Self. During this transition we are bound to make "mistakes," but in time this will change. This is not to say that we will never seek advice or assistance from medical professionals, but birth is a natural bodily function, not a disease (in spite of what most people believe).

2. When women grow up in a culture that fears birth, it can be quite a challenge to have a homebirth, let alone a UC. As Grantly Dick-Read and numerous others have pointed out, fear hormones shut off the flow of birth hormones. As a result, birth becomes painful and problematic. This is why UC, in and of itself, isn’t going to solve our problems in birth. We may eliminate one of the primary causes for the problems in birth – unnecessary medical intervention – but if we haven’t eliminated “inner intervention” (fear), we may still encounter problems. And of course not only do we have to overcome our own fears, we also have to deal with the fears of our friends, family and a society that thinks we’re nuts. The added stress of going against “the herd” can and does negatively impact labor. Once again, in time this will change.

3. Negative outcomes in hospitals are grossly under-reported. This fact was brought out in Jennifer Block’s book “Pushed” and has also been admitted by the Centers for Disease Control. We truly need to question the accuracy of hospital birth statistics.

4. As mentioned before, we cannot compare UC moms to low risk hospital birth moms, as many of us would not be considered low risk (myself included).

5. How do we define UC? In at least one of the “UC” deaths the labor had been induced (membranes stripped) by a midwife (twice). If the woman had gone on to give birth in the hospital and the baby had died, would a doctor blame the midwife who had induced the birth? Possibly. Or if a doctor had performed the procedure and the woman had gone on to have a midwife-assisted homebirth where the baby died, would the midwife blame the doctor? Also a possibility, as stripping membranes/induction is known to cause problems. I’m not necessarily saying the death was caused by the induction, but if we’re going to talk “statistics” we need to have a better definition of what constitutes a “UC.”

6. As was also mentioned, this is a self-selected study. I’ve gotten thousands of letters over the years from women who were either planning a UC or had had one. I know that many of these women don’t post on message boards. But even for those who do, there are numerous UC message boards and email lists these days. Trying to prove the inherent dangers of UC by taking one message board, where there have been 4 reported deaths in 30 years (or possibly 3 if we eliminate the midwife-induced birth), is not only unscientific it’s simply unfair.

Those who are waiting to have a UC until the statistics “prove” it’s safe may be waiting a very long time. I also question the sanity of living a life (or having a birth) based on statistics. Those who do this will never get married, as the majority of marriages end in divorce. Does this prove that the concept of marriage is inherently flawed and therefore it should never be attempted? I am not naive or misinformed. I’ve done my research and understand that the primary reasons for the problems in birth can be traced to 3 main causes: poverty, unnecessary medical intervention and fear. True physical deformities are rare. I don’t live in poverty, do not allow others to interfere with my natural bodily functions, and am not afraid of birth. Therefore I knew UC was the best choice for me.
Laura
post #30 of 54
"I also question the sanity of living a life (or having a birth) based on statistics."

post #31 of 54
Another thing to consider is that hospital stats include extreme life-saving measures that not all homebirthers or UCers would necessarily choose for their babies. If a baby is very ill or iatrogenically damaged and kept alive by artificial means, and eventually dies, at what point does that no longer count as a perinatal death?
post #32 of 54
Quote:
Originally Posted by Serenyd View Post
You're never going to get two perfectly balanced groups. It's impossible. This is a problem with any study. That is why they have limitations. Also, I know there are some people who lurk and UC with sucessful outcomes and never post. Some UCers are kind of shy about their private lives, YKWIM? Some don't care about being on the birth rolls. So I just used the information we already had. Maybe it is not perfect, but it is more information than we had before.
I wonder if you could ask lurkers to PM or email you with their birth stats to be added to the calculations, without publicising their birth stories.

Also, if you're looking for a control group, there are plenty of MDC mamas who have midwife-attended home births who may have posed in the Homebirth forum- there might be a way to compile their statistics as well.
post #33 of 54
Quote:
Originally Posted by fourlittlebirds View Post
Another thing to consider is that hospital stats include extreme life-saving measures that not all homebirthers or UCers would necessarily choose for their babies. If a baby is very ill or iatrogenically damaged and kept alive by artificial means, and eventually dies, at what point does that no longer count as a perinatal death?


Plus, do you count the deaths if the mother transferred to the hospital? Doesn't that then make it a hospital birth and NOT a UC? I think two of the mothers from our group ended up going to the hospital and having their babies there. Wouldn't that make it not part of the UC stats since the babies did not die at home during a UC? I think if the babies were lost during the home birth that it would count only then. Otherwise it's technically a hospital birth.
post #34 of 54
I think that would depend upon the reason for the death.

I've had two midwife-attended births before my UCs.

The first resulted in transfer and immediate c-section (for malpresentation, but really for caregiver distress, long story, it may give an idea to mention that I somehow chose a midwife who didn't know how to express her milk- I had to give her instructions while I was in labor).

The next went beautifully, with a very different (hands-off, very experienced) midwife. I am not the only ex-client of this midwife to go UC with further births (after she had retired).

I wish that there were some way to realistically get data for UC or all homebirth VBACs vs highly managed VBACs or scheduled repeat c-secs (where there is no reason for the repeat c-sec more than a previous c-sec, as in my case a section for malpresentation or another non-repeating (and valid) reason).

And again, just putting it out there, but my last birth was UC with immediate hospital transfer, and I did write a birth story shortly thereafter. I don't consider it to be a poor outcome though, his labor and birth went great, but I needed care just after, and for a couple of days. So, to me, the UC was successful, but then I had a complication which didn't involve the baby. He never left my chest in the 3 days' hospital stay, just as would have happened at home. So my goal (of a healthy, unmolested baby) was met, even though I had a bad hospital experience (not due to UC, as I had had prenatal care with a perinatologist at UCDavis so the "oops" card was exceedingly easy to play).
post #35 of 54
Thread Starter 
This discussion has gone on without me, which is wonderful. I didn't think I would be starting such a controversy. Truly, while I do not believe the adage "statistics are meaningless" I would not give them too much significance or seek to live life and make decisions based only on statistics. I only compiled them to give a little perspective to those trying to decide whether to UC or not. When I hear negative stories about UC and bad outcomes, I can feel my faith in the rightness of unassisted birth wavering. It's easy to get caught up the negativity and fear-mongering surrounding surrounding birth these days. I want mothers to be able to UC with confidence. I think it's important to realize that something *could* go wrong, make a list of fears/complications, and make an action plan to go with each one. Then once you have educated yourself and done everything possible to make sure you can handle whatever problems might arise, realize that a part of it is out of your hands and make peace with that. If you can't do that you shouldn't UC. IMHO.

I'm really impressed by the intelligent and thoughtful responses I've read here. I've been enriched by being a member of this forum and getting to know and hear from each of you. Thanks to all
post #36 of 54
Quote:
Originally Posted by amberskyfire View Post


Plus, do you count the deaths if the mother transferred to the hospital? Doesn't that then make it a hospital birth and NOT a UC? I think two of the mothers from our group ended up going to the hospital and having their babies there. Wouldn't that make it not part of the UC stats since the babies did not die at home during a UC? I think if the babies were lost during the home birth that it would count only then. Otherwise it's technically a hospital birth.
I would call that a "planned UC turned hospital transfer" and include it in the UC statistics.

A big part of why UC is safe is that women listen to their gut instincts and transfer care if something is wrong. To exclude hospital transfers from the stats would artificially inflate the safety- as most women with complications will find themselves in hospitals, and the healthy, normal moms and babes have stayed at home.
post #37 of 54
The MDC roll call stats are not statistically significant in any way, for the purposes of determining mortality rates. I'm surprised that some people are using them to claim that UC has a 20x higher mortality rate than CNM-attended hospital birth, since the data collection can even hardly be called such.

There is another collection of UC data on Unhindered Living, with a sample size of about 200, that has no infant or maternal deaths at all. So using that, you could argue that any deaths at all in a hospital are unacceptable, since UC has a zero death rate! (Ridiculous, of course, but so is using the MDC data to claim that the death rate is X amount and compare it to well-studied mortality rates among hospital-based CNMs).

Basically, we cannot use either UC data set to make any kind of accurate conclusion about the mortality rates of unassisted births. In order to do that with any kind of accuracy, you'd need a large prospective study with many thousands of women planning UCs who you followed from pregnancy to several weeks or months postpartum (similar in design to the CPM2000 study in the BMJ). You'd need to gather detailed information about their health histories, any "risk factors," their pregnancies, their prenatal care (self and professional), their labors and births, etc.
post #38 of 54
Add one more for me! My 2005 UP/UC was a full UP/UC w/ no transfer and everyone was/is wonderful w/ no complications.
post #39 of 54
Quote:
Originally Posted by fourlittlebirds View Post
Another thing to consider is that hospital stats include extreme life-saving measures that not all homebirthers or UCers would necessarily choose for their babies. If a baby is very ill or iatrogenically damaged and kept alive by artificial means, and eventually dies, at what point does that no longer count as a perinatal death?
Hmm, yes, you could potentially keep the child on a machine until the period of recording has passed, then allow the child to die.
post #40 of 54
I think what we have here is a very interesting, very valid set of statistics.
but I wouldn't extrapolate them to make statements about the relative merits or safety of UCing compared with hospital birth.
What we have is statistics that show, in women who post their birth stories on the MDC UC board, UCing is very safe
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