can we have an honest discussion? - Page 5 - Mothering Forums
Forum Jump: 
Reply
 
Thread Tools
#121 of 301 Old 02-28-2011, 11:46 AM
 
Sol_y_Paz's Avatar
 
Join Date: Feb 2009
Location: La Biblioteca
Posts: 1,924
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I am finding all of this very interesting as I am interested in a HB.  

Liz-hippymom, I am so very sorry for your loss.  Your story is personal and has really given me a lot to think about.  


happy family!joy.gif we winner.jpgfemalesling.GIFnocirc.gif

Sol_y_Paz is offline  
#122 of 301 Old 03-01-2011, 11:41 AM
 
WuWei's Avatar
 
Join Date: Oct 2005
Location: In the moment
Posts: 11,492
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I haven't read all 100+ posts; but I doubt that any regulatory agency could improve outcomes or safety.

 

Look at hospital births and "advanced" trained OB's outcomes. The US leads most countries in crappy birth outcomes. And we have fully regulated and "medically trained" providers attending 90% of all births in the nation. It isn't training or regulation which is the variable, imo. Birth is safe. Life has risks. I understand the desire to control the variables when life feels out of control.

 

 

Pat

 

 

 

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.

Helen Keller


I have a blog.
WuWei is offline  
#123 of 301 Old 03-01-2011, 12:26 PM
 
kythe's Avatar
 
Join Date: Dec 2007
Location: Tucson, AZ
Posts: 608
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by WuWei View Post

Look at hospital births and "advanced" trained OB's outcomes. The US leads most countries in crappy birth outcomes. And we have fully regulated and "medically trained" providers attending 90% of all births in the nation. It isn't training or regulation which is the variable, imo. Birth is safe. Life has risks. I understand the desire to control the variables when life feels out of control.


Comparisons in birth outcomes between the US and other countries can be misleading. Unfortunately, there are no universal guidelines to use as a control. For instance, the US differentiates between miscarriages and stillbirths at 20 weeks gestation. A baby could be born at 20 weeks and 3 days and have no chance of survival under any circumstances, but because of the date it adds to the hospital's stillbirth rate that they must report. Some countries define stillbirth (or prematurity related death) as anything after 24, 28, and even 30 weeks. Births that occur before that point are not reported stillbirths. This makes the US mortality rate look artificially high, when what it really reflects is our attempts to save all preemies.

I wish comparative stats existed for full term births only, but I don't believe they exist. If you read the WHO's website carefully you will notice there is not a universal standard for birth stats, and countries are responsible for self-reporting.
kythe is offline  
#124 of 301 Old 03-01-2011, 12:33 PM
 
IdentityCrisisMama's Avatar
 
Join Date: May 2003
Posts: 10,629
Mentioned: 5 Post(s)
Tagged: 0 Thread(s)
Quoted: 89 Post(s)

And, certainly, access to adequate education, economic stability and healthcare are issues to consider when comparing birth stats as well.  


Mama to DD September 2001 and DD April 2011 *Winner for most typos* eat.gif
IdentityCrisisMama is offline  
#125 of 301 Old 03-01-2011, 01:11 PM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Liz-I gave birth a couple of months before you in 2009 and I remember reading your birth story when it first happened.  My heart broke for you, Aquila and for your whole family.  I am simply ashamed at how some in NCB community have treated you.  I have heard the echo of your experience in the stories of other homebirth-gone-awry babylost mamas.  As a member of that community I hope you know that I admire your strength, courage and fortitude.  I understand why you want to reform homebirth-you don't want anything like what happened to Aquila and to you to ever happen to anyone else needlessly.  I'm so sorry for your tremendous loss and congratulations on Baby Willow (love that name, BTW!  It was very nearly Bridget's name)

 

 

Wow.  I just finished reading this whole thread.  This is an interesting topic but unfortunately I don't even know where to begin.  There is some terminology being thrown around incorrectly, IMO.  Several times I have read about a "CPM" practicing in a state that doesn't certify non-nurse midwives and getting into trouble for it.  Does this mean the midwife is certified in another state and crossing state lines to practice or is she not certified at all?  If she is not certified, she is not a CPM.  CPM's in my state have a standardized education and are required to pass the NARM exam.  They are then licensed through our state medical board.  There are midwifery schools that are MEAC accredited and some that are not.  If the school is not MEAC accredited there are more hoops to jump through to sit for the NARM and to earn a CPM.

 

Now, with all of that being said I would not feel comfortable attending births with the minimum requirements required to become a CPM alone.  I have thought about this a lot and every time this discussion comes up and/or I hear a story like Liz's it makes me take pause.  I want to become a midwife someday.  If I ever did I'm still not sure what route I would take.  There are so many different paths and they all have pros and cons.  If I were to take the CPM route, I would attend a MEAC accredited school finish up all the requirements to sit for the NARM and then I would intern at a place like Casa de Nacimiento.  My midwife who is a California Licensed Midwife, C.P.M. did an internship there and another local midwife interned there for 18 months.  She wrote about her experience here: http://www.casamidwifery.com/interns/13.htm.  There are many different midwives that have written about there internships at this busy birth center.  Midwives from Canada and Denmark have chosen to learn there.  Two seperate previous posters talked about what they feel would be important to be a better midwife and I believe they are both correct.  One mentioned seeing normal so many times that when something is abnormal it is very apparent and another posted about seeing and working hands-on with abnormal.  In a standard homebirth practice a midwife is going to see a lot of normal, low risk.  In a place like the birth center mentioned above she will see a lot of everything and have to work with that hands on.  As a birthing mother that is the experience I would hope my midwife would have and if I were to attend women duriing childbirth that is the experience I would require myself to have.  I think it is very possible to be an excellent CPM and to perhaps have more experience with complication than a CNM, but at this time no such requirements exist for a CPM and that is a shame.  At this point we have to just hope that CPM's will seek that extra experience in a learning environment before they start their own practices.  Quite obviously, not all CPM's are making that choice.

The ACNM (American College of Nurse Midwives) used to have two titles that were recognized.  Of course one was the CNM and the other was a CM.  A CM (certified midwife) received her education in hospital but was required only to learn about complications, assessments, and the normalcy of birth without becoming an RN.  To me, this was a very good way and was a step in the correct direction but that license was only available in one state and it was difficult to find a school that offerred programs in which one could earn a CM.  That title has fallen away now and is no longer available.  I'm really not sure why it didn't catch on in more states.  It seems to be closer to the model of midwifery education in other countries that some of you have mentioned.  So my purpose for writing all of that is that I disagree that the whole CPM title neds to be thrown out.  I would like to see more rigorous requirements, though.  Bring back the CM would be great, too!

 

In Florida, how does the malpractice insurance work?. I don't know much about malpractice insurance and maybe someone here can clarify for me, but aren't some states more litigious than others and in those states wouldn't malpractice insurance cost more? California has A LOT of attorneys and as such has a lot of court cases civil and otherwise.  My three youngest children were born at home with the same midwife each time.  At the first prenatal appointment I signed a piece of paper stating that my midwife had informed me that she did not have malpractice insurance and that I was taking financial responsibility for the outcome of the baby's birth.  That is a scary piece of paper to sign, but I did so I absolutely was informed of the fact there was no financial safety net.  I know in talking with my midwife that she would rather have malparactice insurance but in our state it is more than prohibitively expensive.  I'm not even sure if it is available here.  The reason that I believe this is true is because when I asked my OB to be my back-up for my first homebirth, she said that while she didn't have any issue with me having a homebirth(based on my obstetrical history), her malpractice insurance prevented her from providing any care for me.  If something did go wrong and she was associated with my homebirth not only would her malpractice insurance not cover anything but they would cancel her policy.  Obtaining malpractice insurance as a homebirth midwife isn't as simple as some in this thread are making it sound.  At least not in California.  Quite obviously things are different everywhere.  I'm not sure how, exactly, this could be changed.

 

Another thing that is bothering me is the incongruencies in the CPM model of care.  How many of you had only one midwife at your birth?  There were always two midwives at my births and a third was on alert if needed.  The reason my midwife practices this way is because one midwife is observing/treating the newborn and one is observing/treating the mother.  How in the world could one midwife properly care for two lives at the same time?  It is a VERY common sense protocol to have a care provider for each, the mother and the baby.

 

On the issue of peer review, I only know what I have heard from my midwife.  They have peer review every month.  I know there is some division in our homebirth community.  I know that some midwives practice too cavalierly for the liking of some of the other midwives.  If something happens, they all go over the chart and give recommendations for what could have been done to prevent the problem or change the outcome but ultimately I don't believe they have the power to strip any midwife of her license to keep her from practicing.  The state medical board is the issuing body, wouldn't that be up to them?  Liz, in your and Aquila's case you mentioned that no attorney would take it because of her lack of malpractice.  Did you ever call the district attorney to see if there was a criminal case that could be filed?  There has to be some avenue for situations like this.  Is the problem that all of the other peer reviewing midwives are protecting her and saying that she didn't do anything wrong?  Surely some other birth professionals could look over the chart and see where things went wrong.  I'm asking these questions out of curiosity and because it seems preposterous to me that there isn't any recourse for you if she was so negligent.

 

Again, this is such a complex issue but I do believe talking about it is the first step toward realizing safer births for mothers and babies.  That is what ALL care providers should be striving for.

 


Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#126 of 301 Old 03-01-2011, 01:37 PM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by WuWei View Post

I haven't read all 100+ posts; but I doubt that any regulatory agency could improve outcomes or safety.

 

Look at hospital births and "advanced" trained OB's outcomes. The US leads most countries in crappy birth outcomes. And we have fully regulated and "medically trained" providers attending 90% of all births in the nation. It isn't training or regulation which is the variable, imo. Birth is safe. Life has risks. I understand the desire to control the variables when life feels out of control.

 

 

Pat

 

 

 

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.

Helen Keller


If you read up on neonatal mortality rates in the U.S. instead of infant mortality rates you will see how much better the U.S. stats look.  Infant mortality includes all deaths in the first year.  Neonatal mortality is in the first 30 days so is much more telling of the safety of birth in the United States. 

 

Kythe is correct in that all countries have different ways of compiling birth data.  Data is funny that way.  We begin to compare apples and oranges.  It is very easy to manipulate numbers.  I'm not saying we don't have work to do but some of the countries that look really good on paper may actually not be.

 

Another argument I have heard is that in the United States we have more African American mothers and for some reason (the doctor who explained this to me told me they are not sure why this is) African American mothers and their babies have more complications.  Apparently compared to other industrialized nations we have a much higher black population and because they have more complications this inflates our neonatal, infant and postpartum mortality and morbidity rates.
 

 


Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#127 of 301 Old 03-01-2011, 01:39 PM
 
Rosegarden77's Avatar
 
Join Date: Dec 2007
Posts: 31
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Forgive me-I just stumbled upon this thread and your third point really resonated with me. I understand your point.

 

I hear from so many birth professionals-mainly doulas-that we, as birthing mothers, need to take responsibility for our decisions.  However, no one seems to really want it pointed out that so many of us young moms who are having our first child-who so sorely want to do what is best for our babes and ourselves-have any kind of "legacy of birth knowledge" to draw from. Let's face it-we are flying blind in this country until we have that initial experience for better or worse that leads us on a path for more knowledge.  For most of us-there is no neighborhood granny midwife to be directed to (or steered from) when we need knowledge.  Our cultural wisdom of birth has been hijacked for profit and expediency.  So-what is a new pregnant mom to do?  We are bombarded with so many messages-about doing it the "safe" way.  "Safe" means different things to different people-just ask a new mom with a traumatic birth experience.

 

IMO-We can't even have an honest and open discussion about sex while underage in a public school-let alone- childbirth choices!  We are left to wander into knowledge as opposed to being led by the wisdom of any matriarch.  Hey some of us are lucky and have a close female family member or friend who shares.  For most of us, I fear we are catapulted by our first birthing experience into finding more knowledge to carry into the next experience so it will be better. 

 

Most of the seminal questions that need to be asked before our first birthing experience don't get seeded until that first birth experience has been had--we are doing our girls and women a grave injustice by not allowing this topic to be relevant at the onset of puberty if not earlier.  This is such a huge part of our being-why are we not giving it more attention and nurturing well before we are on the verge of bearing our children?  This needs to change-and until it does we will have more damaged Mamas and babies who are trying to recover what has been denied them! Choice-something that should be a birth right for every one of us-KNOWLEDGE-about our bodies and choices in birthing children.  It was never my decision to deny this right to women-but I am trying to recover it for my children-by example-by home education.  This is very much a societal and human rights issue.  These are very important and necessary topics for discussion.  I could type so much more but I should stop now:)

 

Liz-HippyMom-I am so very sorry for your loss.  You trusted in the MWs ability and she failed you.  I wish you peace and comfort.  May you find the knowledge you seek.

 

Best, Rosa

 

Mama to 4 beautiful babes.
 

Quote:
Originally Posted by seashells View Post

...

 

3. We have a culture of giving up responsibility to the "experts" - this topic has been hashed out here plenty of times. But one key issue is that of a woman's first birth. I went into mine well read and educated, yet I was not a mother yet. I really didn't know what I was in for. I wasn't a mother bear yet. I had to learn that. I was still in a way, a girl, and the birth was my final passage into womanhood. The stakes are high. I thought I was taking responsibility for my choices, and I was, but I was not yet at the point where I could stand and roar and get things done. I looked to the midwife. I eventually was able to act, but it definitely was not immediate. I had no cultural background on how to choose a midwife, no encouragement from others on how to act, just nothing really to draw on. Basically, the message was that I should have chosen the standard OB route since nobody knew what else to do. Wow, I can't believe how disjointed I am with this point, I'm having trouble explaining it. I guess what I'm trying to say is that we have nothing to rely on except the standard route of care, and if we believe that is not the best, we're really on our own. I chose my midwife based on my very thin criteria (um... I liked her... our values meshed... she had delivered the baby of someone I knew... she called herself a midwife... eh, good enough). Imagine if my mother, grandmother, aunts, whatever had been able to prepare me all my life for what to look for, with their own stories. There's just none of that - we just go to the doctor, and our stories are about what the doctors saved us from and not about "look for this, don't get taken in by that, this is a red flag." We're just supposed to trust. I was a first time mom starting from scratch, and I was really on my own since I didn't want to just trust.



 

Viola likes this.
Rosegarden77 is offline  
#128 of 301 Old 03-01-2011, 01:52 PM
 
Marissamom's Avatar
 
Join Date: Dec 2009
Posts: 1,543
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


 

Quote:
Originally Posted by firewoman View Post

Another thing that is bothering me is the incongruencies in the CPM model of care.  How many of you had only one midwife at your birth?  There were always two midwives at my births and a third was on alert if needed.  The reason my midwife practices this way is because one midwife is observing/treating the newborn and one is observing/treating the mother.  How in the world could one midwife properly care for two lives at the same time?  It is a VERY common sense protocol to have a care provider for each, the mother and the baby.

 


I think there's a problem with a shortage of Midwives. I see a practice where there are two midwives and a student midwife. because they are the only midwives in the area, they take turns being on call, so there's one midwife and the student at each birth. the call schedule keeps them from getting as worn out, as they'll take on more births a month than could be covered if they were both going to each and every birth. (I think they have 8 due in March). I'm more comfortable than just one fully trained midwife plus a well-trained student who are well-rested than I would be with two midwives who are exhausted. now, if there were more midwives in the practice or they were able to take on fewer births because they weren't the only game in town, they would be able to manage two full midwives at each birth. I think there are a lot of areas where there is only one midwife to attend births, though hopefully in that instance they can find someone to be an assistant trained to do resuscitation etc. 


Marissa, Partner to J geek.gif, SAHM to A (05/09)fly-by-nursing1.gif and I (03/11)stork-boy.gif. we cd.gif
selectivevax.gifdelayedvax.gifnocirc.giffemalesling.GIFecbaby2.gif part-time and familybed1.gif through infancy. planning ahomebirth.jpg
Marissamom is offline  
#129 of 301 Old 03-01-2011, 02:04 PM
 
Marissamom's Avatar
 
Join Date: Dec 2009
Posts: 1,543
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


 

Quote:
Originally Posted by firewoman View Post

Another argument I have heard is that in the United States we have more African American mothers and for some reason (the doctor who explained this to me told me they are not sure why this is) African American mothers and their babies have more complications.  Apparently compared to other industrialized nations we have a much higher black population and because they have more complications this inflates our neonatal, infant and postpartum mortality and morbidity rates.
 

 



I have issues with this argument. yes, statistically in this country African Americans have a higher rate of complications, but I think it may point to some socio-economic issues in the US. African Americans as a whole have a lower level of education, are more likely to be low-income, have less access to good pre-natal care (all three of these factors are also linked to higher complication rates), and don't always receive the same level of pre-natal care as women of a different race would from a care-provider. 


Marissa, Partner to J geek.gif, SAHM to A (05/09)fly-by-nursing1.gif and I (03/11)stork-boy.gif. we cd.gif
selectivevax.gifdelayedvax.gifnocirc.giffemalesling.GIFecbaby2.gif part-time and familybed1.gif through infancy. planning ahomebirth.jpg
Marissamom is offline  
#130 of 301 Old 03-01-2011, 02:07 PM
 
slylives's Avatar
 
Join Date: Mar 2007
Location: Minneapolis, MN
Posts: 328
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I don't have anything to contribute to the discussion, but I wanted you to know how very, very sorry I am to hear of your loss. I have had a number of early pregnancy losses, but I can imagine that the devastation you have suffered must be even worse. I wish you healing.


Mama to my monkey since March 2008, wife to my husband since February 2004. After three early losses, we were successful with IVF!  joy.gif
***4***8***12***16***20***24***28***32***36***heartbeat.gif  
 

slylives is offline  
#131 of 301 Old 03-01-2011, 02:13 PM
 
MovingMomma's Avatar
 
Join Date: Apr 2004
Location: Eastern North Carolina
Posts: 2,340
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by firewoman View Post

Wow.  I just finished reading this whole thread.  This is an interesting topic but unfortunately I don't even know where to begin.  There is some terminology being thrown around incorrectly, IMO.  Several times I have read about a "CPM" practicing in a state that doesn't certify non-nurse midwives and getting into trouble for it.  Does this mean the midwife is certified in another state and crossing state lines to practice or is she not certified at all?  If she is not certified, she is not a CPM.  CPM's in my state have a standardized education and are required to pass the NARM exam.  They are then licensed through our state medical board.  There are midwifery schools that are MEAC accredited and some that are not.  If the school is not MEAC accredited there are more hoops to jump through to sit for the NARM and to earn a CPM.

 

 

To address this one point:  Yes, that is precisely the situation in my state.  All the CPM's I've known here are, in fact, licensed in another state, usually a neighboring one, since all our neighboring states license CPM's.    

 


-Shannon, momma to H reading.gif 8/03, N heartbeat.gif 9/06, & P homebirth.jpg 8/11, missing S brokenheart.gif born at 11 wks 1/09 

 


 
   

MovingMomma is offline  
#132 of 301 Old 03-01-2011, 02:20 PM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)



 

Quote:
Originally Posted by Marissamom View Post


 



I have issues with this argument. yes, statistically in this country African Americans have a higher rate of complications, but I think it may point to some socio-economic issues in the US. African Americans as a whole have a lower level of education, are more likely to be low-income, have less access to good pre-natal care (all three of these factors are also linked to higher complication rates), and don't always receive the same level of pre-natal care as women of a different race would from a care-provider. 

Marissamom-I completely agree that socio-economic issues may very well contribute to the higher level of complication in the African American population.  When I heard this argument used I had all of the same reactions that you have.  The physician that used this argument in discussing U.S. birth statistics said that women of African descent in other countries also have higher rates of complication, it is not just black women in the U.S.  However, because we have a higher popluation of black mothers than say Ireland or England, our mortality and morbidity rates are higher, in part, to that fact.  That was the only point I was trying to make. 

 

 


Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#133 of 301 Old 03-01-2011, 02:26 PM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)



 

Quote:
Originally Posted by Marissamom View Post


 


I think there's a problem with a shortage of Midwives. I see a practice where there are two midwives and a student midwife. because they are the only midwives in the area, they take turns being on call, so there's one midwife and the student at each birth. the call schedule keeps them from getting as worn out, as they'll take on more births a month than could be covered if they were both going to each and every birth. (I think they have 8 due in March). I'm more comfortable than just one fully trained midwife plus a well-trained student who are well-rested than I would be with two midwives who are exhausted. now, if there were more midwives in the practice or they were able to take on fewer births because they weren't the only game in town, they would be able to manage two full midwives at each birth. I think there are a lot of areas where there is only one midwife to attend births, though hopefully in that instance they can find someone to be an assistant trained to do resuscitation etc. 

Marissamom-I just wanted to clarify that in all three of my homebirths, there was one LICENSED midwife and one student midwife just like yours.  I wasn't clear in my previous post.  In Liz's case, I didn't hear mention of a student midwife being present. 

 

 


Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#134 of 301 Old 03-01-2011, 04:10 PM - Thread Starter
 
liz-hippymom's Avatar
 
Join Date: Jul 2003
Location: deep in the heart of texas!
Posts: 1,262
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)


yep, no other midwife of any kind was there, or was planned on being there.

 

 

Quote:
Originally Posted by firewoman View Post



 

Marissamom-I just wanted to clarify that in all three of my homebirths, there was one LICENSED midwife and one student midwife just like yours.  I wasn't clear in my previous post.  In Liz's case, I didn't hear mention of a student midwife being present. 

 

 



 


mdcblog5.gif   Liz mama to DS 10, DSS 9, DD 6, DS 3, DD 2 , Aquila- dec 19th 2009 died at my homebirth, and....welcome Willow born 9-16-10 (9 weeks early)  nut.gif
liz-hippymom is offline  
#135 of 301 Old 03-01-2011, 04:46 PM
 
Marissamom's Avatar
 
Join Date: Dec 2009
Posts: 1,543
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


 

Quote:
Originally Posted by firewoman View Post



 

Marissamom-I completely agree that socio-economic issues may very well contribute to the higher level of complication in the African American population.  When I heard this argument used I had all of the same reactions that you have.  The physician that used this argument in discussing U.S. birth statistics said that women of African descent in other countries also have higher rates of complication, it is not just black women in the U.S.  However, because we have a higher popluation of black mothers than say Ireland or England, our mortality and morbidity rates are higher, in part, to that fact.  That was the only point I was trying to make. 

 

 


I've just heard that argument from someone as a way of completely explaining why the US has worse birth statistics than other countries. "we have more black women, it's not our fault". I am curious how the rates compare between countries, because if (I'm just pulling numbers out of thin air here) most countries have a .05% increase in complications among black populations as compared to other races, and the US has a .5% increase, then obviously there's an issue. 

 


Marissa, Partner to J geek.gif, SAHM to A (05/09)fly-by-nursing1.gif and I (03/11)stork-boy.gif. we cd.gif
selectivevax.gifdelayedvax.gifnocirc.giffemalesling.GIFecbaby2.gif part-time and familybed1.gif through infancy. planning ahomebirth.jpg
Marissamom is offline  
#136 of 301 Old 03-01-2011, 05:17 PM
 
raelize's Avatar
 
Join Date: Jun 2006
Posts: 819
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Well Cuba has a very large"african american"community and their birth rates are better than ours
raelize is offline  
#137 of 301 Old 03-01-2011, 06:37 PM
 
IdentityCrisisMama's Avatar
 
Join Date: May 2003
Posts: 10,629
Mentioned: 5 Post(s)
Tagged: 0 Thread(s)
Quoted: 89 Post(s)

Interesting articles about the African American infant mortality question: 

 

http://www.arc.org/racewire/030210z_kashef.html

 

http://journeytowellness.com/childhood-health-article/infant-mortality-and-african-americans.html


Mama to DD September 2001 and DD April 2011 *Winner for most typos* eat.gif
IdentityCrisisMama is offline  
#138 of 301 Old 03-01-2011, 07:12 PM
 
CBEmomma's Avatar
 
Join Date: Oct 2010
Location: MN/IA
Posts: 213
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by firewoman View Post



 

Marissamom-I just wanted to clarify that in all three of my homebirths, there was one LICENSED midwife and one student midwife just like yours.  I wasn't clear in my previous post.  In Liz's case, I didn't hear mention of a student midwife being present. 

 

 



Same here, one licensed Midwife and one student.

 


~Attatchment and Natural Parent from instincts not from books to my 2 boys~ Childbirth Educator & Placental Encapsulation Professional
homeschool.gif familybed2.gif homebirth.jpgribbonpb.gif
CBEmomma is offline  
#139 of 301 Old 03-01-2011, 07:55 PM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by raelize View Post

Well Cuba has a very large"african american"community and their birth rates are better than ours


 Why did you put African-American in quotations?  When you say birth rates what do mean?  We are talking about neonatal and maternal morbity and mortality rates, not birth rates.  If their neonatal (not infant mortality) mortality rates are seemingly low, you may want to dig a little deeper to see how early they count a fetus as a birth.  As some mentioned above, we include still born babies from 20 weeks on in our statistics which makes our neonatal and infant mortality rates look worse in comparison to country that count those babies as miscarriages. Cuba's maternal mortality rate is MUCH higher than ours is meaning you are more likely to die in childbirth or near that time in Cuba than you are here.   

Quote:
 I've just heard that argument from someone as a way of completely explaining why the US has worse birth statistics than other countries. "we have more black women, it's not our fault". I am curious how the rates compare between countries, because if (I'm just pulling numbers out of thin air here) most countries have a .05% increase in complications among black populations as compared to other races, and the US has a .5% increase, then obviously there's an issue. 

 I would not say that it completely accounts for the discrepancy in mortality and morbidity rates in the U.S. compared to other industrialized nations but it may have some bearing.  Just out of my own curiousity I looked at the total population of Ireland in 2000.  It had roughly 3.8 million inhabitants compared to the U.S. having 281,422,000.  The same year only 1200 of Ireland's nearly 4 million inhabitants identified themselves as black while in the U.S 36.4 million (or 12.9%) identified themselves as black.  If the demographics were similar Ireland would have around 490,000 of it's population identify themselves as a black person.  1200 is only a small fraction of 1%.  So you can see how such a large discrepancy may affect the neonatal, infant and maternal morbidity and mortality rates.  And that is just Ireland.

 

Please don't misunderstand me, I love homebirth and I think that we need to make changes in the way we care for pregnant women and newborns and how we treat them in birth.  I used to only look at infant mortality rates and believed that that was the gold standard in determining whether or not a country was treating its newborns and mothers well.  After researching and learning it has been proven to me that infant mortality is NOT a good way of making that determination.  As natural birth advocates, we have to be educated with facts and not just spout the natural birth "party line"  Look all this up.  Ask these questions and you will find what I have found. That doesn't mean that we can't do better, it just means we are not as unsafe as some would have us believe.

 

Liz-I'm sorry this thread has been sort of hijacked, but I think this information is important for everyone to know.

WuWei likes this.

Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#140 of 301 Old 03-01-2011, 08:04 PM
 
Hykue's Avatar
 
Join Date: Sep 2010
Location: Saskatchewan, Canada
Posts: 592
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I just wanted to chime in with a bit of a different perspective, perhaps.  I don't know a whole lot about this issue, as I am just learning about birth now.

 

Mostly, I just want to say one thing:  I live in a remote area of Canada.  There are licensed midwives in my province, but they are (not surprisingly) in the cities, where the demand for them is highest.  I understand that in a highly regulated environment, there will be less midwives.  That means that there are areas that lack access to them completely.  I am in one such area.  Reading Liz's story, reading this thread, and just thinking about it over the last few days, I've come to the conclusion that I prefer it this way.  I would rather live in a highly regulated environment with regards to birth than in one that is unregulated enough that negligence is ignored, even if that means that I have much less choice about where and with whom I birth.  I might feel differently about it if I didn't know that there was at least one really good doctor in town, though.

 

That's the only relevant point I have to make.  Thank you for having this discussion.


On a farm with our kiddo (nearly 2), two dogs, two cats, ten goats, two donkeys, nine sheep, a bunch of chickens, and a husband (in the winters). We have another on the way!
Hykue is offline  
#141 of 301 Old 03-01-2011, 09:01 PM
 
raelize's Avatar
 
Join Date: Jun 2006
Posts: 819
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by firewoman View Post





 Why did you put African-American in quotations?  When you say birth rates what do mean?  We are talking about neonatal and maternal morbity and mortality rates, not birth rates.  If their neonatal (not infant mortality) mortality rates are seemingly low, you may want to dig a little deeper to see how early they count a fetus as a birth.  As some mentioned above, we include still born babies from 20 weeks on in our statistics which makes our neonatal and infant mortality rates look worse in comparison to country that count those babies as miscarriages. Cuba's maternal mortality rate is MUCH higher than ours is meaning you are more likely to die in childbirth or near that time in Cuba than you are here.   

 I would not say that it completely accounts for the discrepancy in mortality and morbidity rates in the U.S. compared to other industrialized nations but it may have some bearing.  Just out of my own curiousity I looked at the total population of Ireland in 2000.  It had roughly 3.8 million inhabitants compared to the U.S. having 281,422,000.  The same year only 1200 of Ireland's nearly 4 million inhabitants identified themselves as black while in the U.S 36.4 million (or 12.9%) identified themselves as black.  If the demographics were similar Ireland would have around 490,000 of it's population identify themselves as a black person.  1200 is only a small fraction of 1%.  So you can see how such a large discrepancy may affect the neonatal, infant and maternal morbidity and mortality rates.  And that is just Ireland.

 

Please don't misunderstand me, I love homebirth and I think that we need to make changes in the way we care for pregnant women and newborns and how we treat them in birth.  I used to only look at infant mortality rates and believed that that was the gold standard in determining whether or not a country was treating its newborns and mothers well.  After researching and learning it has been proven to me that infant mortality is NOT a good way of making that determination.  As natural birth advocates, we have to be educated with facts and not just spout the natural birth "party line"  Look all this up.  Ask these questions and you will find what I have found. That doesn't mean that we can't do better, it just means we are not as unsafe as some would have us believe.

 

Liz-I'm sorry this thread has been sort of hijacked, but I think this information is important for everyone to know.


Their neonatal and perinatal rates as reported by the WHO are lower or equal to ours.  yes, maybe they count them differently, but according to the WHO, they are lower or equal to ours.  i put african-american in quotes because they don't have african americans there.  that is a US of A term.  i don't know what the term for people of african heritage would be there as we use african american there. 

 

I know the difference between peri-natal and neonatal.  there is an interesting article from AJOG that i linked in an earlier post.  they found that peri-natal deaths at a planned homebirths are the same as perinatal deaths at hospitals.  no difference.  They also found that there were less interventions and less birth injuries to all at planned homebirths.  homebirths did have higher rates of neonatal deaths.  so - what does that mean? hb mamas don't take babies in when they should? they skip ped appointments?  midwives don't know when to send a baby to the hospital?  they don't say whether it is CNMs or CPMs in their study in teh abstract, but i will bet that it is CNMs.  and i imagine that if there were terrible stats the OBs and Gynos of AJOG would have found it.  

 

i think that many mamas get into this whole train of thought that a hands off MW is best, that a naturally minded, non-intervention mw is best.  and probably for most births they are fine, but we really need to understand that responsible well trained MW is literally a life saver.  A bad OB is just as dangerous.  Yes, hbs and mws can be safer.  Just as hospitals and OBs can be safer.  there needs to be a place for women to be able to find out stats on the midwives they are considering.  but, i just don't believe that a hb with a well trained responsible intelligent MW is more dangerous than a hospital birth.  after reading that AJOG article, i really do not believe that.  

Liz's MW should not be practicing at all.  to miss all the signs of distress, to refuse to transfer, to not understand that Liz was having a placental abruption.  that is just criminal.  she is a danger to women in that region.  

i don't hb because i want to be able to brag about my birth or how much of an earth mama i am, i don't do it for natural parenting points.  

i don't know anyone who does that.  i hb because i know that with a well trained responsible mw, i am safer at home than at a hospital.  i am very lucky that i have a well trained responsible mw who has been practicing in hospitals, birth centers, and homes for over 30 years.  she is a CNM with hospital privileges.  we are lucky in Md because we have some really great mws.

this thread is really interesting, because it brings up a lot of issues that i hadn't thought about - how to improve hb.  and i probably wouldn't have really thought about how horrific Liz's birth was without reading it again and thought about my own births and mw from that perspective.  

 

raelize is offline  
#142 of 301 Old 03-01-2011, 11:27 PM
 
Marissamom's Avatar
 
Join Date: Dec 2009
Posts: 1,543
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


 

Quote:
Originally Posted by firewoman View Post


 I would not say that it completely accounts for the discrepancy in mortality and morbidity rates in the U.S. compared to other industrialized nations but it may have some bearing.  Just out of my own curiousity I looked at the total population of Ireland in 2000.  It had roughly 3.8 million inhabitants compared to the U.S. having 281,422,000.  The same year only 1200 of Ireland's nearly 4 million inhabitants identified themselves as black while in the U.S 36.4 million (or 12.9%) identified themselves as black.  If the demographics were similar Ireland would have around 490,000 of it's population identify themselves as a black person.  1200 is only a small fraction of 1%.  So you can see how such a large discrepancy may affect the neonatal, infant and maternal morbidity and mortality rates.  And that is just Ireland.

 

 


I wasn't meaning that the higher complication rates among african american women isn't a factor, or implying that there isn't a larger black population in the US than in other countries. you said that the complication rates for black women is also higher in other countries, I'm wondering if the amount of discrepancy between races with regards to complication rates is the same or similar. 

 

 

IdentityCrisisMama, thank you for the links. It's good to know that controlling for education, income level, age, etc, doesn't account for the difference, and good to see a couple of possible contributing factors. 


Marissa, Partner to J geek.gif, SAHM to A (05/09)fly-by-nursing1.gif and I (03/11)stork-boy.gif. we cd.gif
selectivevax.gifdelayedvax.gifnocirc.giffemalesling.GIFecbaby2.gif part-time and familybed1.gif through infancy. planning ahomebirth.jpg
Marissamom is offline  
#143 of 301 Old 03-02-2011, 02:55 AM
 
mwherbs's Avatar
 
Join Date: Oct 2004
Location: Tucson, AZ
Posts: 5,575
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
Quote:
Originally Posted by IdentityCrisisMama View Post

Interesting articles about the African American infant mortality question: 

 

http://www.arc.org/racewire/030210z_kashef.html

 

http://journeytowellness.com/childhood-health-article/infant-mortality-and-african-americans.html



The article in Racewire is pretty much what the midwives at the midwives of color conference were saying . Now wiht newer studies that look at psyneuroimmuniology , cumulative stressors equal higher levels of inflammatory markers = higer chances of PTL, depression,metabolc disorders, heart disease, high bp, sleep disturbance....

At Kathleen's site she has several references and talks a bit about pni not specifically on race but the info applies...
http://www.uppitysciencechick.com/


And here is a review that discusses acute and chronic stress pathways and shows how they lead to CHD... The thing is the info we have on PTL is related too.

http://www.annals.edu.sg/pdf/39VolNo3Mar2010/V39N3p191.pdf

IdentityCrisisMama likes this.
mwherbs is offline  
#144 of 301 Old 03-02-2011, 08:28 AM
 
firewoman's Avatar
 
Join Date: Feb 2008
Location: Sandy Eggo
Posts: 1,607
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

 

Quote:
 Their neonatal and perinatal rates as reported by the WHO are lower or equal to ours.  yes, maybe they count them differently, but according to the WHO, they are lower or equal to ours.

Raelize-I'm really not trying to give you a hard time, but you seem to have missed my point on this.  IF Cuba (or any other country for that matter) compiles their data differently than the U.S. does, and I believe they do, comparing the rates of both countries is apples and oranges.  It is because we include data about the births of babies with a very youg gestational age that our neonatal death rates are as high as they are.  Babies born alive at 21 weeks don't live.  This group of very young babies generally die.  It is because we count these babies that our rates seem worse.  If Cuba starts counting their neonatal death rates at say 30 weeks, they have dodged the earlier ten weeks of premature babies who have much less chance of living, regardless of how much excellent medical treatment they receive.  Does that make sense?  It is difficult to determine which premature births all other countries include and which ones they don't.  It doesn't make sense, logically, that Cuba has a "lower or equal to" neonatal mortality rate than us but has a maternal mortality rate 4 times higher than ours.  Maternal mortality is harder to fudge than neonatal mortality for the reason I have stated above.  Obviously there are other factors, too, but that is a big discrepancy.  If I had to choose to give birth in Cuba or here in a hospital, I would choose here without any hesitation.

 

Again-My argument wasn't that homebirth is evil.  Check out my avatar.  That is my baby being born in a tub in my bedroom.  I have had three homebirths and the same CPM attended all three.  What I don't like to see are statistics being used to vilify a particular region when the numbers being compared aren't using the same parameters.  I'm also so tired of hearing homebirth advocates (of which I am one) using data that is half true to "teach" others about what is safe and what isn't.  I like facts and comparing apples and oranges is not a good way to get at the facts.  I'm aware that some against homebirth do the same thing but I try not to stoop to that level. 

 

Marissamom-I missed your point and I understand now exactly what you mean.  It would be interesting to check that out.  It was an OB that told me that black mothers in other countires had similar complication rates in other countries.  I could ask her if she can cite any studies that illustrate her claim.    


Stephanie-33 lucky mama of 5 precious ones: DD-12, DS-9 , DS-6 , and DD-3 and Bridget Alannah  SHE'S ONE NOW! loving wife to DH-38
firewoman is offline  
#145 of 301 Old 03-02-2011, 09:23 AM
 
klemomma's Avatar
 
Join Date: Jan 2009
Posts: 172
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by firewoman View Post
Wow.  I just finished reading this whole thread.  This is an interesting topic but unfortunately I don't even know where to begin.  There is some terminology being thrown around incorrectly, IMO.  Several times I have read about a "CPM" practicing in a state that doesn't certify non-nurse midwives and getting into trouble for it.  Does this mean the midwife is certified in another state and crossing state lines to practice or is she not certified at all?  If she is not certified, she is not a CPM.  CPM's in my state have a standardized education and are required to pass the NARM exam.  They are then licensed through our state medical board.  There are midwifery schools that are MEAC accredited and some that are not.  If the school is not MEAC accredited there are more hoops to jump through to sit for the NARM and to earn a CPM.

 

Being a CPM and being licensed by your state are two completely separate issues. The CPM credential comes from NARM, which is a national organization. Some states license non-nurse midwives, and a CPM credential is required or one option to obtain state licensure. In other states that do not license non-nurse midwives, a person can still have the CPM credential - there is just no licensure available to them from the state. That state does not recognize the CPM credential. CPMs all have to meet the same requirements to get a CPM - it doesn't matter what state they are in. But, what does change from state to state is how the state treats those who hold a CPM. There is no inherent part of obtaining a CPM that means you will or can be licensed through the state medical board.

 

So, a CPM in my state has met the same standards as a CPM in California. But, because no licensure is available to her, she cannot obtain malpractice insurance. She may be targeted for prosecution for various things, such as "practicing medicine without a license", etc. The only places to report negligence / misconduct / malpractice are to NARM or possibly to legal authorities (i.e. the police) - no medical or otherwise overseeing board. The laws regarding the licensure and practice of midwifery are what vary so greatly from state to state.
 

Personally, I see the point that we have to be the instigators of change. But at the same time, I don't think any one "small" change will do the job. I think the real reason that other countries have much safer, more successful systems with midwifery / homebirth is because they are CENTERED around midwifery. Midwifery is the focal point of care. OBs are specialists who are used when necessary, not as a general rule. Because of this, there is a much greater coordination of care efforts. And even still, it isn't perfect. It could be improved.

 

In the US, we have to change our culture of birth and our culture of medical care. As long as we have an adversarial system, meaning the medical community is staunchly opposed to home birth and non "medical" midwives (which of course is almost exclusively about money), midwifery will continue to be at least to some extent "underground" or unregulated or what have you. I personally believe that as long as our billion (trillion?) dollar medical industry continues to make ginormous profits on birth, they will be opposed to anything else, and it is high-near impossible for any grassroots effort to successfully combat this monster of our medical system. Of course that doesn't mean we can't or shouldn't try. I just don't think we will see real, substantial progress until there is a revolution in our medical system away from profits and towards healthy people.

 

And as to the issue of negligent providers, someone else pointed out that this happens in the hospital too. And then someone said that that isn't relevant to the discussion. But I think it is. I think it is important to take note of the fact that there are plenty of negligent, incompetent OBs out there too. What happened to Liz could have happened in a hospital with an OB if the OB was incompetent. And I think this is relevant because there often doesn't seem to be substantial enough consequences for incompetent care providers in either setting - that is a danger to all women, whatever route of care they choose. Personally, I think we need changes in the system that make it easier for women to choose a competent provider *for any setting*.

 

So maybe I've gone off the ranch a little and need to focus on what we can do to at least make HB midwifery safer as it currently stands. To that point, I think step 1 is to start collecting data in a very organized and thorough way. We need much more data about HB in general and about specific MWs. That would be the best step 1, IMO.

 

Liz, I am so, so very sorry about Aquila. I know my words are only words and can't change anything, but still, I wish they could. I have seen many in the NCB community "turn" on  you to speak, and I do think it isn't right. I have never had the impression that you felt home birth in general was absolutely unsafe after your loss. I have always taken it that you felt it isn't safe enough and that you wanted to make people aware that it can be unsafe in certain situations. I wish you continued strength, hope, and perseverance on your journey.


fly-by-nursing2.gif~Amy, Wife to E, Happy Momma to K 4/04, L 11/05, E 8/07, V 1/10, and J 10/11

klemomma is offline  
#146 of 301 Old 03-02-2011, 09:31 AM
 
OvenSeeksBun's Avatar
 
Join Date: Sep 2008
Location: Manitoba, Canada
Posts: 448
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

NAK

 

I haven't read this whole thread yet, but I wanted to chime in and share my experience of midwifery in Canada. I live in Manitoba, where midwifery care is fully covered by our provincial health care system (just as an OB/GYN or any other provider would be), so nobody has to pay out of pocket.. You can have your baby at home or in the hospital, and our city's first birth centre is currently being built and is due to open in June 

 

At my 36th week of pregnancy, a copy of my midwives' records was sent to the hospital in case of transfer, and my midwives informed the hospital when I went into labour and after my baby was born. They seem to have a good relationship with the medical system. They consult with an doctor when needed, for example if I had tested positive for GBS and needed abx during labour.

 

Sounds great right?  Well it is, IF you can get yourself into the system. This is very true:

Quote:
Originally Posted by carriebft View Post

 

On the other hand, choice would be decreased. In Canada, many women would not be able to have a homebirth who could have a homebirth here. How important is that choice? that's the sticking point for me.

 

I waited almost a week after I found out I was pregnant, because we had been TTC for a year and a half and I wanted to make sure it was for real. BIG MISTAKE! I knew that midwives were hard to come by, and I knew you had to call early... but since I was charting, I figured I knew sooner than most right? There are 5-6 clinics in the city  out of which midwives practise. I called one and gave them my info, they faxed my info to the rest of the clinics and then I had to wait. One by one the rejection letters came in, all were already at capacity. I was devastated. My friend's midwife recommended a "birth plan friendly" OB, who I saw for my 13 week appt. She had a terrible bedside manner, and for the first time I was worried/nervous about labour and child birth.

 

Then when I was 29 weeks pregnant, a miracle happened - I received an email that a midwife was returning from maternity leave, and was looking for clients due Nov-Feb that were interested in home birth. I called immediately and I got in!

 

The clinic I got in with has 6 midwives divided into two groups of 3, so you don't just see one midwife for visits, you alternate between 3.  I liked this because each midwife was different, had different strengths and advice. Every day, one midwife was scheduled to be at the clinic, and the other 2 were on call. This was nice because you didn't have to worry about your appointments being cancelled because of someone going into labour. There are always 2 midwives at a birth, one from your "group" and one from the other group. This way if something should happen, one midwife can tend to the baby and the other is there for the mother.

 

As long as mother and baby are healthy, you remain in the care of the midwives until 6 weeks post-partum. For the first 4 weeks you have in-home visits, you go in to the clinic at the 4th and 6th week, then they send your records off to your doctor.

 

I think it's a great system, and I sincerely wish more women had access to it. My friend recently told me that there are 8 new midwives being trained in my city, which is great news. The problem with midwives being paid for by the government is that the government gets to decide how many midwives they will provide funding for.
 

 


Wendy (26), married to my sweetheart since 2007. Mommy to Caroline, born Boxing Day 2010 by beautiful home water birth h20homebirth.gif  intactlact.gif
 
 
OvenSeeksBun is offline  
#147 of 301 Old 03-02-2011, 12:50 PM
 
AustinMom's Avatar
 
Join Date: Jul 2008
Posts: 896
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by klemomma View Post



Personally, I see the point that we have to be the instigators of change. But at the same time, I don't think any one "small" change will do the job. I think the real reason that other countries have much safer, more successful systems with midwifery / homebirth is because they are CENTERED around midwifery. Midwifery is the focal point of care. OBs are specialists who are used when necessary, not as a general rule. Because of this, there is a much greater coordination of care efforts. And even still, it isn't perfect. It could be improved.

 

In the US, we have to change our culture of birth and our culture of medical care. As long as we have an adversarial system, meaning the medical community is staunchly opposed to home birth and non "medical" midwives (which of course is almost exclusively about money), midwifery will continue to be at least to some extent "underground" or unregulated or what have you. I personally believe that as long as our billion (trillion?) dollar medical industry continues to make ginormous profits on birth, they will be opposed to anything else, and it is high-near impossible for any grassroots effort to successfully combat this monster of our medical system. Of course that doesn't mean we can't or shouldn't try. I just don't think we will see real, substantial progress until there is a revolution in our medical system away from profits and towards healthy people.

 

And as to the issue of negligent providers, someone else pointed out that this happens in the hospital too. And then someone said that that isn't relevant to the discussion. But I think it is. I think it is important to take note of the fact that there are plenty of negligent, incompetent OBs out there too. What happened to Liz could have happened in a hospital with an OB if the OB was incompetent. And I think this is relevant because there often doesn't seem to be substantial enough consequences for incompetent care providers in either setting - that is a danger to all women, whatever route of care they choose. Personally, I think we need changes in the system that make it easier for women to choose a competent provider *for any setting*.

 


I couldn't agree more.  I think your point in paragraph two would be solved if the US was more like your point in paragraph one.  This NEEDS to happen to make ALL birth safer in the ENTIRE US, with every race.  I'm not sure the Midwifery model can really change much more (besides the points like requiring more than one MW at birth, catching antepartum risks, etc) in order to gain that respect, I think the OB world is going to have to take a tiny tiny step forward first.  I'd be nice if ACOG would come around and stop bashing OOH birth and start supporting it.  It'd also be nice if the media didn't portray pregnancy and birth as a disease or something a body can't do, even under normal healthy situations.  It'd be nice if the OB on The Doctors TV would not be such an idiot!  That's harsh, but I do think she could use a little more education and at least come across like a professional and a believer in birth. 

 

On negligent providers, I completely see this, and I think this is the point a lot of people are trying to make when they bring up the 'death happens in hospitals too' card.  They aren't saying "Liz you better get over it."  Some are saying, yeah it sucks way way bad, and it happens in hospitals too and those CPs are rarely reprimanded and I don't think every put out of practice.  That sucks for every mom who has had a death and every future mom going through that practice, OB and MW alike. 

 

I think we as mom's can start by really asking more questions.  I'm not blaming anyone, but if every mom asks a MW about her mortality rates and then finds out something happened as Liz described, then I doubt any mom would stay with her.  Then that MW WOULD be put out of practice.  I think it's important to be involved in your local birth networks and draft/publish interview questions for moms to ask their CPs.  I think it's important for moms not to get caught up in 'everything will just happen the way it's supposed to and I'll just let it be.' stuff and start saying, 'no, I'm going to make sure I do everything in my power to NOT have trauma happen to me or my baby.  I think it's important to know facts and not just information that has been skewed or twisted (unintentionally and intentionally) to support OOH birth.  We have to be real because having a baby is very real, and you are the choice maker for two lives, and I think it needs to be taken seriously by all.

AustinMom is offline  
#148 of 301 Old 03-02-2011, 01:51 PM - Thread Starter
 
liz-hippymom's Avatar
 
Join Date: Jul 2003
Location: deep in the heart of texas!
Posts: 1,262
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)

and what makes you think midwives are going to voluntarily be honest when asked? i can guarantee she was not honest with clients after me about my daughters death- i know this for a fact

 

 


 

Quote:
Originally Posted by AustinMom View Post




I couldn't agree more.  I think your point in paragraph two would be solved if the US was more like your point in paragraph one.  This NEEDS to happen to make ALL birth safer in the ENTIRE US, with every race.  I'm not sure the Midwifery model can really change much more (besides the points like requiring more than one MW at birth, catching antepartum risks, etc) in order to gain that respect, I think the OB world is going to have to take a tiny tiny step forward first.  I'd be nice if ACOG would come around and stop bashing OOH birth and start supporting it.  It'd also be nice if the media didn't portray pregnancy and birth as a disease or something a body can't do, even under normal healthy situations.  It'd be nice if the OB on The Doctors TV would not be such an idiot!  That's harsh, but I do think she could use a little more education and at least come across like a professional and a believer in birth. 

 

On negligent providers, I completely see this, and I think this is the point a lot of people are trying to make when they bring up the 'death happens in hospitals too' card.  They aren't saying "Liz you better get over it."  Some are saying, yeah it sucks way way bad, and it happens in hospitals too and those CPs are rarely reprimanded and I don't think every put out of practice.  That sucks for every mom who has had a death and every future mom going through that practice, OB and MW alike. 

 

I think we as mom's can start by really asking more questions.  I'm not blaming anyone, but if every mom asks a MW about her mortality rates and then finds out something happened as Liz described, then I doubt any mom would stay with her.  Then that MW WOULD be put out of practice.  I think it's important to be involved in your local birth networks and draft/publish interview questions for moms to ask their CPs.  I think it's important for moms not to get caught up in 'everything will just happen the way it's supposed to and I'll just let it be.' stuff and start saying, 'no, I'm going to make sure I do everything in my power to NOT have trauma happen to me or my baby.  I think it's important to know facts and not just information that has been skewed or twisted (unintentionally and intentionally) to support OOH birth.  We have to be real because having a baby is very real, and you are the choice maker for two lives, and I think it needs to be taken seriously by all.


 

 


mdcblog5.gif   Liz mama to DS 10, DSS 9, DD 6, DS 3, DD 2 , Aquila- dec 19th 2009 died at my homebirth, and....welcome Willow born 9-16-10 (9 weeks early)  nut.gif
liz-hippymom is offline  
#149 of 301 Old 03-02-2011, 03:33 PM
 
AustinMom's Avatar
 
Join Date: Jul 2008
Posts: 896
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I'm not trying to be rude at all, yet I sense you taking offense to this.  I'm sorry if I have offended you, I really am.  I don't think it's wrong to encourage mamas to ask their CP questions.  I don't at all.  If you take offense to me saying 'a mom has a right and should use that right in asking her MW/OB if a baby has ever died under their care.' then I'm sorry.  I can't help what any OB or MW does.  I can't.  I think the moms should ask, and if she think she isn't honest, or if she want to make sure, check out the boards and such and see if there has every been a complaint filed against him/her. 
 

Quote:
Originally Posted by liz-hippymom View Post

and what makes you think midwives are going to voluntarily be honest when asked? i can guarantee she was not honest with clients after me about my daughters death- i know this for a fact

 

 


 


 

 



 

AustinMom is offline  
#150 of 301 Old 03-02-2011, 03:57 PM
 
lunarlady's Avatar
 
Join Date: Jan 2010
Posts: 1,330
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I think asking the MW is not enough. You have to talk to your community. My last MW was not very good. But she interviewed well, and as a busy mom that is what I based my decision on. After my birth, I talked to some doulas and HB mamas and discovered my MW was not well regard in those circles. So we need to encourage our community to provide honest information about MW to all pregnant mamas to help them make informed decisions, and help connect expectant moms to the community so that they can access that information.
liz-hippymom likes this.

CD'ing, homebirthing, milk making school teacher. Supporting my family on my income and trying to get out of debt in 2013!
lunarlady is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off