Do you think women have a "right" to a painfree childbirth? - Page 6 - Mothering Forums

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#151 of 162 Old 03-07-2010, 06:08 PM
 
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But again, who decides necessary?

We've already covered that there is no real way to distinguish between those who "need" an epidural and those who "want" one. How do you distinguish that? A person who is terrified of giving birth with pain to the point of psychological trauma for months after the birth I'd argue needs access to safe pain relieving medication, of which an epidural seems to be the most effective. Do you say no since she has no "medical" reason? What if that same woman is a sexual assault survivor? What if she cannot disclose that because the person abusing her is her husband who comes to every appointment with her.

You can't know. Noone can know with 100% accuracy. I want homebirths, I advocate for homebirths and natural childbirth, I am a student midwife and I do labour support now. That doesn't mean I don't understand that these are not in any way shape or form the best or right choices for every situation.
Every other surgical procedures have guidelines. For example, a woman with uterine fibroids will be able to get surgery to ahve them removed if they are painful, above a certain size or if they are causing a fertility problem (deforming the cavity). Someone can get a hip replacement if they meet the criteria for it, someone can get a fake breat if they had a mastectomy, which they will get if they either have cancer or are high risk of getting breast cancer (if they carry a certain gene, have a certain family history, etc). That's the way medicine works in all other areas but as I said, the culture surrounding birth would need to change to start applying the same norms.

As far as psychological issues, they are generally acknowledged as legitimate medical issues and can be provided for in any guideline. While the case of a sexually abusive woman who cannot speak out because her husband comes to her apointments is really horrifying, giving her an epidural is not going to make it any better. Should we make epidurals the norm for routine pap smears as well, you know, just in case? Perhaps providing good psychological care as part of standard health care plans and better laws and mechanisms to help people who are being/have been abused would be a better idea. We might be able to make that happen with all the money we could save from unnecessary procedures.

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#152 of 162 Old 03-07-2010, 06:38 PM
 
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Why? I don't think every woman who lacks "training" needs an epidural, either. I've most definitely been in labour...nowhere near as much labour as I'd have preferred, but definitely labour.

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#153 of 162 Old 03-07-2010, 06:55 PM
 
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I just wanted to say, I was really enjoying what was a thought provoking and interesting topic. It's interesting to me to see the different perspectives on the issue because it's truly one of those things (like most things IMO) that just isn't as simple as black and white.

...but that is going to go downhill really quickly if we resort to snarkiness. Lets refocus on making it a productive discussion

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#154 of 162 Old 03-07-2010, 06:55 PM
 
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If she says it is. If she says it will help her get through her labour without having to feel the pain and pressure that frighten her who are you to say it won't make it any better? The abuse no, but there are ways to make abuse worse for people that happen all the time in the medical field, doesn't mean we shouldn't take people at their word and try and not let it happen.

My whole point is that if you are going to say that psychological reasons are just as valid as physical ones (which I obviously agree with) then how do you decide who has a valid psychological reason and who doesn't? You can't. That's the point.

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Why? I don't think every woman who lacks "training" needs an epidural, either. I've most definitely been in labour...nowhere near as much labour as I'd have preferred, but definitely labour.
I have to agree. I have never taken a childbirth education class of any sort, and I've never had any "training". I made it through a pitocin induced labour without needing or wanting an epidural, and it certainly wasn't pain free.

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#155 of 162 Old 03-07-2010, 07:07 PM
 
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C'mon you guys, the low blows about who knows more about this because of how much they've labored/studied etc etc are totally moot and are going to get the thread shut down

I think everyone has equally relevant information, for the sole reason that discussions like this are all about exchanges of information with the idea of challenging your ideas and making you more open to other perspectives....not to reaffirm your own biases by putting other people down. Exchanging information and even debating can be constructive...it's not a bad thing, and it doesn't mean that someone who disagrees with you isn't just as smart or deserving of respect.

*sigh*

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#156 of 162 Old 03-07-2010, 07:41 PM
 
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Very good points. I agree that if a society chooses to provide birth services to women that appropriate guidelines can be made to decide who should receive any given birth related intervention just like they do for other medical procedures. Why would that be any different?
It just doesn't make sense to me to provide unnecessary (at least in a large percentage of cases) interventions to all women on the off chance that someone might fall through the cracks. No system is fail safe and without issues.
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#157 of 162 Old 03-07-2010, 08:12 PM
 
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Very good points. I agree that if a society chooses to provide birth services to women that appropriate guidelines can be made to decide who should receive any given birth related intervention just like they do for other medical procedures. Why would that be any different?
Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?
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#158 of 162 Old 03-07-2010, 08:17 PM
 
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Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?
Yes, this

Also, I don't think it's fair to compare obstetrics to the rest of medicine. Not the way we have it set up right now. Obstetrics is the only specialty I can think of where most of the people (way over half) probably do not NEED to be in it. Having a baby is not, in and of itself, a medical thing. It's a body thing, yes, but not a medical thing.

However considering that more that 90% of people giving birth here do so in a hospital and without a midwife that's how it's being set up. It's hard to talk about rights and choices when the deck is stacked so heavily in favour of the intervention side.

I think homebirth should be the norm, I think natural childbirth should be encouraged and supported and help given for it, I think breastfeeding should be the norm as well.

I think that there is a time and place for other options from a life saving perspective. But I also think it's a terribly slippery slope when we take away the choice for things like c-sections, epidurals, formula, pick anything that goes against the "biological normal" in the name of someone's reason being "not good enough".

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#159 of 162 Old 03-07-2010, 08:19 PM
 
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Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?
Actually, I prefer a free market for health care and all other goods and services where all consumers and producers are free to buy and sell what they see fit.
I said, "if a society chooses to provide birth services to women," because the reality is that the free market is not at work in any health care system that I know of, but I think that within existing systems there is room for improvement.

ETA: The reason why I prefer a free market is because I don't think other people need to decide for me what I can and cannot have for my birth. If a system is set-up to distribute health care, I think it has to decide what is appropriate and will be covered and what is not. If I choose what is not part of the covered services, then I am paying twice for services.
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#160 of 162 Old 03-07-2010, 08:26 PM
 
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Yes, this

Also, I don't think it's fair to compare obstetrics to the rest of medicine. Not the way we have it set up right now. Obstetrics is the only specialty I can think of where most of the people (way over half) probably do not NEED to be in it. Having a baby is not, in and of itself, a medical thing. It's a body thing, yes, but not a medical thing.

However considering that more that 90% of people giving birth here do so in a hospital and without a midwife that's how it's being set up. It's hard to talk about rights and choices when the deck is stacked so heavily in favour of the intervention side.

I think homebirth should be the norm, I think natural childbirth should be encouraged and supported and help given for it, I think breastfeeding should be the norm as well.

I think that there is a time and place for other options from a life saving perspective. But I also think it's a terribly slippery slope when we take away the choice for things like c-sections, epidurals, formula, pick anything that goes against the "biological normal" in the name of someone's reason being "not good enough".
I am confused. I don't think we can play it both ways. Either birth is or is not generally a medical event. If it is or becomes a medical event in a society which provides care regardless of the ability to pay, then why can't as the PP suggested there be guidelines in place to decide who should get which services?
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#161 of 162 Old 03-07-2010, 08:48 PM
 
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I am confused. I don't think we can play it both ways. Either birth is or is not generally a medical event. If it is or becomes a medical event in a society which provides care regardless of the ability to pay, then why can't as the PP suggested there be guidelines in place to decide who should get which services?
There are guidelines. That's basically what the standard of care is - guidelines.

I really don't think guidelines on pain relief, of whatever kind, in childbirth make any sense. Nobody knows how much pain a woman is in except for her. I know that when I checked in to the hospital with ds1, I was told by the admissions nurse, the L&D nurse, and the...think it was an intern...that I was "obviously not that far along, but we'll check you out". I was 8cm, and during a contraction, I was 10cm. They called a crash section for breech on the spot. So...three medpros assumed I wasn't that far along, based on their assessment of my appearance when I approached the check-in desk. They were all wrong. I don't want them deciding whether or not I can have pain relief.

What kind of guidelines could we possibly establish for something like that? I'm inclined to think we could say "no epidural in the parking lot"...but women can't really have that, anyway.

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#162 of 162 Old 03-07-2010, 08:55 PM
 
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There are guidelines. That's basically what the standard of care is - guidelines.
If everyone can have something that she requests, that doesn't seem like much of a guideline.
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