What Women Aren't Told About Childbirth - Mothering Forums

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Old 10-23-2007, 08:02 PM - Thread Starter
 
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http://www.alternet.org/story/65608/?page=entire

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The survey Listening to Mothers II (LM 2) was released in 2006 and reports on U.S. women's childbearing experiences. Conducted for Childbirth Connection by Harris Interactive in partnership with Lamaze International and Boston University School of Public Health, it is the first comprehensive survey of women's childbearing experiences. The survey population is representative of U.S. mothers 18 to 45 who gave birth to a single infant in a hospital, with 1,573 actual participants.

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."

The majority of women ended up attached to IVs, catheters and fetal monitors. They had their membranes artificially ruptured and were given epidurals. Most of these women had little understanding of the side effects of these interventions, including cesarean and medical inductions. The report also shows that though women understood that they had the right to refuse medical interventions, few did, and many received interventions, such as episiotomies, without their consent.

Just as troubling is what is not being done. A "very tiny minority" of women received all of the care practices that promote natural birth. "With 4 million U.S. births annually, a single percentage point represents about 40,000 mothers and babies per year," the report authors say. Despite the relative health of women in the United States, many women are not getting the uncomplicated births they might expect.
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Old 10-23-2007, 08:54 PM
 
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I would like to see women, at their very first prenatal visit with their provider, receive a detailed handout on what to expect and what to prepare for. Like "Here's what we do at week X, and week Y, etc.," and "Here's what tests we normally do and why," and "Here are the things you should start thinking about so you can decide what kind of birth to have..." Kwim? At least get people thinking, and realizing that they DO have options. But I guess it's easier to have a compliant patient when they aren't educated and don't know what to expect.
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Old 10-23-2007, 09:19 PM
 
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I'd also like to see doctors quit scheduling inductions because "you are just about 40 weeks anyway, and I will be out of town the week you are due, so that way I can be there instead of my backup".:

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Old 10-23-2007, 09:34 PM
 
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I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.
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Old 10-23-2007, 09:37 PM
 
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thank you for posting that Pam! I will definately be sharing it with all the women I know.

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Old 10-23-2007, 09:49 PM
 
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The Food and Drug Administration (FDA) has never approved Pitocin for the use of augmenting labor and it has been suggested now that mismanagement of Pitocin is the leading cause of liability suits and damage awards.

Continuous electronic fetal heart monitoring is another seemingly innocuous medical intervention that is linked to adverse outcomes. Even though it requires women to be strapped to a machine and therefore limits their mobility -- movement in labor is listed as one of the recommended comfort measures by Lamaze International -- it may seem that constant feedback on a baby's heart rate would reduce unnecessary interventions and surgical procedures. Yet, some studies have shown CEFM to be an ineffective indicator of fetal distress and one of the causes of the increase in cesareans.

"There is no scientific reason do to any of this stuff," says Eisenstein.

EXCELLENT ARTICLE!!! THANKS FOR SHARING!

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Old 10-23-2007, 10:01 PM
 
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The Food and Drug Administration (FDA) has never approved Pitocin for the use of augmenting labor and it has been suggested now that mismanagement of Pitocin is the leading cause of liability suits and damage awards.
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Could you post a link for me where it says this? I tried looking on the fda website but I can not seem to find it. (Its not that I dont belive you, I just would like to learn more )

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Old 10-23-2007, 10:37 PM
 
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Could you post a link for me where it says this? I tried looking on the fda website but I can not seem to find it. (Its not that I dont belive you, I just would like to learn more )
It's in the article in the link that was posted here initially by PaMidwife, it's further down the page though.

http://www.alternet.org/story/65608/?page=entire

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Old 10-24-2007, 01:32 PM
 
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It's in the article in the link that was posted here initially by PaMidwife, it's further down the page though.

http://www.alternet.org/story/65608/?page=entire
OHHHH, Ok, I feel like a dummy, lol. Im sorry!

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Old 10-24-2007, 02:01 PM
 
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"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."


Really??

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 10-24-2007, 03:34 PM
 
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"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."


Really??
Yeah...I'm shocked...really, really shocked...

*sigh*
I had the whole "I'm trying to avoid another section this time" conversation last night. The response..."Oh - so you have to be in the hospital". Naturally - the best way to avoid a section is to be really, really close to an OR...

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Old 10-25-2007, 04:31 PM
 
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I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.
:

I find myself thinking about this all the time - if I never happened to find Mothering.com at a really key point in my life, would I have known that there's a whole other side to the coin? Or am I more inclined that way anyway? I can't remember a time when I didn't want a homebirth, so I'm not sure. Some of my not-as-close friends don't even seem to know that there are decisions to be made besides "breast or formula?"...and lots of them choose the latter anyway...another post...maybe if the same mainstream baby books would stop getting passed around from one woman to another...

I'm hoping I plant some seeds with my birth in other women's minds...because I certainly am not surprised by that study when I hear all the stories about inductions gone bad, pain medications making things worse, etc, etc...

On another message board that was formed for moms in my community someone asked everyone to share their birth stories and there was NOT ONE STORY that didn't contain some sort of intervention until a doula finally gave her great home birth stories. I personally wrote her and thanked her because all of the previous stories sounded so horrible to me and the women writing them weren't fazed by what had happened to them at all.

Sorry, that was long, apparently I needed to get something off my chest...

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Old 10-25-2007, 06:31 PM
 
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I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.
:
Although DH is wondering where to put the new bookshelf we need for all my natural birth books...
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Old 10-25-2007, 10:41 PM
 
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I'm finding it hard to relate to any woman who DOESN'T try to learn all she can about pregnancy / birth etc when she finds out she's pregnant. It's just hard for me to wrap my mind around, or maybe I'm a nerd. A lot of women just think about baby registries and maternity clothes and baby showers, instead of the marvelous process actually going on in their bodies.
Maybe so. But, a lot of women also believe that when their mothers, sisters, best friends, and doctors are all saying the same thing (eg. "get the epi - no need to suffer" or "labour is hell, and that's all there is to it" or "thank God for my OB - my baby/I would have died"), they tend to believe it.If they do start looking for info, they read What to Expect when You're Expecting from cover to cover. Or, in my case, they pore over the "official" provincial pregnancy/newborn guide, which is called Baby's Best Chance.

I didn't try to learn a bunch of other stuff, because I thought I already knew it. I thought I knew what to expect. I thought the doctors really wouldn't do a c-section unless it was absolutely necessary to save me or my baby.

I loved being pregnant. I was eagerly looking forward to labour. I didn't give a crap about maternity clothes (I've never owned any, except a pair of black pants for work), baby showers (mine was after the baby arrived, anyway) or registries! I was all about pregnancy/birth - I read the guide (I practically memorized it!), and talked to everyone I knew who had a baby about what it was really like. That was mostly women of my mom's generation, as I was one of the first in my entire circle to have a child. I didn't do a lot more research, because...honestly, it doesn't seem to me to be something that needs to be "researched"...it feels like something that should be intuitive. It actually was intuitive - I paid no attention to anything I'd "learned" about labour when I was actually experiencing it.

I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things. I've done a ton of research over the last few years, but that's because I don't want to end up cut again...and that scar means that I need to be armed with info. I use it as ammo - but it doesn't really add anything to being pregnant.

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Old 10-25-2007, 11:06 PM
 
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I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things. I've done a ton of research over the last few years, but that's because I don't want to end up cut again...and that scar means that I need to be armed with info. I use it as ammo - but it doesn't really add anything to being pregnant.
Yes! And honestly, some of us prefer to think about the 'marvelous process actually going on in [our] bodies' in less detailed ways. I purposely avoid descriptions of fetal development when I'm pregnant. I like the mysteries of it.

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and Brigid Eleanor (11/20/08)
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Old 10-26-2007, 12:29 AM
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I guess what I'm trying to say is that's it's possible to be less than totally interested in researching pregnancy/labour/childbirth without it being about a lack of concern with these things.
:

Also:

1. I think it's ignorant to think that every woman has the time, ability, or know-how to do this research.

2. There is a huge range in the way people respond to information. Information empowers some people and overwhelms others.

3. Even if you do have all the right information and are a strong person, you can still get caught in the machine.

I think it's way too easy to suggest that the problem lies with individual women, when really, the issue is that we have a broken system.

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Old 10-26-2007, 01:32 AM
 
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yessss...but those individual women who put themselves into situations where they are statistically more likely to end up cut because of who is attending and where the birth will take place are PART of the broken system. It is evident in woman after woman after woman after WOMAN who is raised up believing that, as a doctor has had so many years of learning, they are infallible, that the doctor always knows what is best for an individual (over said individual, who lives in their own body) (and, when it is actually, in obstetrics, OFTEN protocol set by lawyers that "knows" how to "treat" a "patient"), and that the staff always has the patient's best interest in mind (or that they have even been educated as to the alternative treatments available to whatever treatment is being offered, so they can help a patient to CHOOSE what might be in their best interest with true informed consent...).

I, too, have a difficult time with "ignorance is bliss" attitudes. NOT that everybody has it, or that anybody should be "punished" with cesarean because they blindly trust a doctor. The doctor does, of course take an oath that includes that they will "FIRST DO NO HARM." However, when information IS readily available, and women choose to ignore it because, oh, they have a cute doctor, or even though they are young, healthy, and KNOW the stats, choose to birth at a hospital because it's the one with the good NICU...it simply helps to perpetuate the brokenness of the system. And that bugs me.

*shrug*

Lets see how long it takes doctors to glance at this report and completely disregard it, just like they do every other piece of literature that supports the midwifery model of care. Sorry ladies, I'm tired and cranky tonight. : Maybe I'll feel better about it in the morning.

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Old 10-26-2007, 02:29 AM
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yessss...but those individual women who put themselves into situations where they are statistically more likely to end up cut because of who is attending and where the birth will take place are PART of the broken system.
This statement presumes a range of choices that many women may not actually have.

Consider:

- women whose choices are limited by geography.

- women whose choices are limited by financial realities.

- women whose choices are limited by illiteracy (which is way more common than you might think.)

- women whose choices are limited by the false dichotomy of risk categories (that would be me.)

- women whose choices are limited by lack of access to health care.

- etc. etc.

Blaming these women for their choices and feeling unable to "relate to" these women for their lack of empowerment does not fix a misogynistic, paternalist system that sets women up to fail.

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I, too, have a difficult time with "ignorance is bliss" attitudes.
How do you reconcile this with the fact that for some people (not just women) health information can be truly overwhelming?

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Old 10-26-2007, 04:05 PM
 
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I know what you're saying Pi, there are some people that truly just don't have access (same goes for nutrition, finding good financial advice, etc), especially when the system is set up so strongly to point them down an unhealthy path.

I wonder more about the women I know though, who don't have any of those limitations, who are generally well-informed people. As a PP said, when your sister and your mother and your aunt are all telling you the same thing and those are people you trust, it's hard to ignore. *sigh* Not sure what the answer is...

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Old 10-26-2007, 04:31 PM
 
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I guess the whole "you have to do your research" thing strikes me on a personal level...

I had an unwanted c-section in 1993. By the standards of this board, I was very uneducated. I chose a doctor - we didn't have legal midwives and I certainly wouldn't have had a clue where to find an underground one, even if I'd known they existed.

But, you know...my baby was frank breech when I got to the hospital - 8cm dilated. He hadn't been frank breech 20 hours prior when I went into labour. I've been told by doctors, midwives, L&D nurses and other women that a baby can't turn in a first-time mother, because things are too tight...that the breech was "missed". And, I frankly don't give a crap how much education, experience, etc. these people have...because I was there - I was the only one there (laboured alone for about 8-10 hours)...and that baby turned when I went into labour. If I'd been experienced with labour, or if I'd realized that a baby could turn at that point, I'd have known it. But, he turned - the pressure in my lower pelvis disappeared, and a hard lump appeared beside my navel, where there hadn't previously been one.

The hospital where I was cut didn't do routine sections for breech in 1993.

So...I was fairly uneducated about birth by MDC standards...and looking back, I don't think it would have made a damned bit of difference if I'd been educated to the max. My education wouldn't have told me that "no - I don't want a c-section" would be ignored. My education wouldn't have told me that my baby could turn breech at the last minute. My education wouldn't have told me that a breech would mean I was cut.

Maybe this is why I hesitate to put too much importance on researching the issues. I could have researched until my hands were all paper cuts...and I'd still have ended up being doped with general anesthetic and cut open over my protests.

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Old 10-26-2007, 04:34 PM
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To GISDiva: That's true, and it's also true that demand can drive change. I.e. if more women demanded better care, change might be easier to achieve.

I just think that putting so much blame on other women (or even individual health care practitioners such as doctors, who are caught in the same machine) is way too easy, and ignores the real problem.

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I wonder more about the women I know though, who don't have any of those limitations, who are generally well-informed people.
Are you sure that they don't have any limitations? Limitations are not always visible, you know. And cognitive and emotional limitations count, too.

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Old 10-26-2007, 05:25 PM
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I could have researched until my hands were all paper cuts...and I'd still have ended up being doped with general anesthetic and cut open over my protests.

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Old 10-26-2007, 08:35 PM
 
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To GISDiva: That's true, and it's also true that demand can drive change. I.e. if more women demanded better care, change might be easier to achieve.

I just think that putting so much blame on other women (or even individual health care practitioners such as doctors, who are caught in the same machine) is way too easy, and ignores the real problem.


Are you sure that they don't have any limitations? Limitations are not always visible, you know. And cognitive and emotional limitations count, too.

Worth mentioning. Historically, women have demanded better care. They insisted that they did not want to birth alone in a "delivery room" without their husbands. They did not want shaves, enemas, legs in stirrups, betadine scrubs, episiotomies etc. They have prepared for natural childbirth by taking the appropriate classes and so on. The response has been met with pretty wall paper and a "home like" environment that is, IMO, misleading. It leads women to think that a healthy, normal attitude is prevalent in the medical setting. Well... it's not. All of these changes were forced as a result of consumer demand. Not because birth became more "normal" in the medical model. Despite these changes, the big business of medicine wins out. Birth is less normal in this country now than it has ever been. And I know it can be a hard pill to swallow, but the absolute fact is that what a woman wants for her "birth experience" is never a part of the equation when medical decisions are being made about her care. The all encompassing, holistic approach of looking at each individual WHOLE person, situation etc. does not exist in the medical model. Because (and we've heard it a million times) of the litigious society in which we live, where no one takes personal responsibility or even realizes that no one is to blame in many unperfect circumstances, the medical system has to practice defensive medicine regardless of whether the defensive choices are good or bad for a particular woman or situation. I think that single biggest thing that could drive significant change toward normalizing birth is a cultural understanding and acceptance of the tenative nature of pregnancy and birth. Until then we just have to accept that it is what it is and be grateful that MOST women do have options if they find themselves wanting a different model of care.

~Bridgett
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Old 10-26-2007, 08:44 PM
 
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To GISDiva: That's true, and it's also true that demand can drive change. I.e. if more women demanded better care, change might be easier to achieve.

I just think that putting so much blame on other women (or even individual health care practitioners such as doctors, who are caught in the same machine) is way too easy, and ignores the real problem.


Are you sure that they don't have any limitations? Limitations are not always visible, you know. And cognitive and emotional limitations count, too.

Worth mentioning. Historically, women have demanded better care. They insisted that they did not want to birth alone in a "delivery room" without their husbands. They did not want shaves, enemas, legs in stirrups, betadine scrubs, episiotomies etc. They have prepared for natural childbirth by taking the appropriate classes and so on. The response has been met with pretty wall paper and a "home like" environment that is, IMO, misleading. It leads women to think that a healthy, normal attitude is prevalent in the medical setting. Well... it's not. All of these changes were forced as a result of consumer demand. Not because birth became more "normal" in the medical model. Despite these changes, the big business of medicine wins out. Birth is less normal in this country now than it has ever been. And I know it can be a hard pill to swallow, but the absolute fact is that what a woman wants for her "birth experience" is never a part of the equation when medical decisions are being made about her care. The all encompassing, holistic approach of looking at each individual WHOLE person, situation etc. does not exist in the medical model. Because (and we've heard it a million times) of the litigious society in which we live, where no one takes personal responsibility or even realizes that no one is to blame in many unperfect circumstances, the medical system has to practice defensive medicine regardless of whether the defensive choices are good or bad for a particular woman or situation. I think that single biggest thing that could drive significant change toward normalizing birth is a cultural understanding and acceptance of the tenative nature of pregnancy and birth. Until then we just have to accept that it is what it is and be grateful that MOST women do have options if they find themselves wanting a different model of care.

~Bridgett
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Old 10-26-2007, 08:46 PM
 
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I'd also like to see doctors quit scheduling inductions because "you are just about 40 weeks anyway, and I will be out of town the week you are due, so that way I can be there instead of my backup".:
Or at 35 weeks, since its your 6th baby and apparently it'll just slip out you body after 35 weeks. :

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Old 10-27-2007, 02:24 PM
 
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I have to agree with you about the choices women make in pregnancy and childbirth being based on ignorance. This is like saying that a woman who needs food stamps could make better food choices if she just educated herself a bit more. The truth is that $84.00 per month per person doesn't go far no matter how educated you are or the choices you would like to make.

I think that the childbirth education and referral groups need to do everything they can to get the word out that some providers and facilities are better or worse than others.

There is a group near me that I hope is doing a better job of this now than they were. There was a provider that they received a lot of complaints about, but they never passed that info along to the women who inquired about her. Their response was that they provided the questions to ask and the responses to expect to indicate a mother/baby friendly provider. However, women needed to educate themselves and use their discretion. This is assuming that women had the interpersonal skills to make that happen. Providing the partial information they did (Q&A) w/o telling women the rest of what they knew is the same thing as telling her the benefits of any given intervention w/o telling the downside. It is not a truly informed and educated choice because she doesn't have all the info she needs.

If any one has been following the thread about disappointment in your midwife, there is a link to three articles from Midwifery Today describing and discussing midwives as bullies. The bullies know the answers that these women expect and tell them what they want to hear. The women think they have made an informed choice, but w/o knowing the really bad experiences some women have had with that provider, then their choice is not fully informed.

I like the NYC project where women go on-line and rate the provider and facilities. Then the information is there w/o the woman having to ferret out who knows what, so she gets the whole picture.

Wife, mother, midwife, triathlete
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Old 10-27-2007, 05:32 PM
 
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I just had my fourth baby six months ago and I had a nurse literally struggle with me trying to pin me down to insert an IV that I said multiple times I did not want. I had to ask if there was pitocin in it and there WAS despite the fact that I went from one centimeter to pushing out baby in an hour and a half. WTF did I need pitocin for? To rupture my uterus? The hour and a half was spent with them telling me that I was not in labour, it was braxton hix and they tried to sedate me with a sleeping pill. The IV came when they finally checked me and realized I was fully dilated. They thought now would be a good time for an epidural. I told them it was too late, he was coming NOW and all they wanted to do was get that IV into me. My baby literally shot out and landed on the mattress with no one to catch him. ONly my mom and dh even bothered to look when I yelled "Is that the head?" Then the nursing staff claimed that they could not have known I was truly in labor, despite the fact that dh, my mohter and myself told them how fast it goes once it truly starts and that Ive had three other kids and I know when Im in labor. They were very condescending in explaining to me that every labor is diffren and bh really hurt (despite the docs assurance that they DONT). They wouldnt call my doc so she got there twenty min after the fact. At some point after the baby was born I quit struggling because I was focused on him, since he was born in the caul and a little blue. My cries of "is he ok?" were also ignored and by the time I heard him cry and relaxed, the IV was in. And don't you know I got a bill for those IV fluids as well as for "general labor and delivery". Hm. He delievered himself. DH looked at me afterwards and said, "we could have done this at home" and I wish to hell we had because the next two days were spent with someone waking me up every hour to check on me. Where was that concern when I needed it?

What does all that have to do with informed consent? Well, I still never consented to that IV that I finally yanked out on my own.

~Me, mama to soapbox boy (1991), photo girl (1997), gadget girl (2003), jungle boy (2005), fan boy (2003) and twirly girl (2011). Twenty years of tree hugging, breastfeeding, cosleeping, unschooling, craziness
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Old 10-27-2007, 08:17 PM
 
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~pi
I have to agree with you about the choices women make in pregnancy and childbirth being based on ignorance. This is like saying that a woman who needs food stamps could make better food choices if she just educated herself a bit more. The truth is that $84.00 per month per person doesn't go far no matter how educated you are or the choices you would like to make.
I think Women should educate themselves about choices in pregnancy despite their socioeconomic status. Staying ignorant is no help to an already oppressed population.
I also think a pound of apples goes further financially and nutritionally than a pound of pop-tarts. No matter what your grocery budget is, it makes more sense to eat healthy food.
I guess the point is that even women who who don't have the luxury of considering alternative care if they wanted to, should still feel that they can have some measure of security knowing how best to work within the confines or parameters of where they are receiving their care.

~Bridgett
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Old 10-27-2007, 09:20 PM
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Staying ignorant is no help to an already oppressed population.
This is true ...

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I think Women should educate themselves about choices in pregnancy despite their socioeconomic status.
... but how do you propose actually achieving this?

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I also think a pound of apples goes further financially and nutritionally than a pound of pop-tarts. No matter what your grocery budget is, it makes more sense to eat healthy food.
I invite you to actually do a little digging into the economics of food supply. There is plenty of research to support the idea that it is significantly more difficult for many low income people to find decent (or any) produce, partly because grocery stores have moved out of low SES areas, leaving behind mainly convenience stores.

And sure, a pregnant, urban, single mom of two could make the trek out to the grocery store in the suburbs. On the bus. After her shift at her second job ends. Then she could bring home her pound of apples and feed that to her children while she educates herself about birth options. :

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I guess the point is that even women who who don't have the luxury of considering alternative care if they wanted to, should still feel that they can have some measure of security knowing how best to work within the confines or parameters of where they are receiving their care.
What good does that feeling do when it isn't actually true? Have you read some of the posts made here by women who were well-educated and had interventions applied to them against their will?

Just out of curiosity, do you have any clinical criteria that would preclude a woman from being accepted as a potential client? How about financial criteria? Do you offer free classes?

professor & maman de DS1 (6) & DS2 (1)

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Old 10-27-2007, 10:02 PM
 
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I am sick and tired of reading on these forums that homebirths are for upper class women. That is a lie. My mom had me and my sibs at home and was asked if it was because she could not afford a hospital. When I had my four at home, everyone thought it was because I was a hippie (no, I am not). Now a days, everyone blames their insurance for limiting their choices.

Please stop letting other people and organizations make important decisions for you. Vote with your feet and stay home for your birth. Hire a midwife, a doula, and educate yourself and your Partner. Stop playing the victim. People spend more time planning a vacation or dinner out than they do planning a birth, an event that will decide their obstetrical health history for a lifetime and affect the healthy beginning of life of their baby. You are going to live the rest of your life with the decisions others make for you in labor, delivery, and recovery.

Harsh, but terribly true.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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