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#1 of 215 Old 04-21-2006, 10:18 PM - Thread Starter
 
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I'm involving myself in a debate elsewhere and nearly everyone is against UC. I had a very much attended childbirth with my first, and while I wouldn't do UC, I very much want a homebirth for my next (if there is one lol). Anyways, that said, I DO believe in the right to do as a woman so pleases for her birth. So, can anyone help me beyond the stickied posts on statistics regarding injuries and such for hospital births vs UC?

THanks!

edited per mod request ;-)
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#2 of 215 Old 04-22-2006, 09:55 AM
 
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I had this bookmarked, but it's hardly a 'scientific' study

http://www.unhinderedliving.com/stats.html

I have just re-discovered unassistedchildbirth.com and I don't know if this article would help with your 'case' but I'm enjoying it. I had read her site, but it was still when I was trying to figure out how I wanted to birth. Now that I know I want to UC and am pg, I'm really enjoying it again

http://unassistedchildbirth.com/uc/whynotmidwives.html


Cara
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#3 of 215 Old 04-22-2006, 01:20 PM
 
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this is not statistics for UC, but for homebirth with Lay Midwives versus out of hospital & hospital CNM, versus OB, versus D.O.

http://www.texasmidwives.com/SafetyStats.htm

The last year figures are reported on this infant mortality chart, 2000, Lay Midwives had 0.3/1000, CNM 1.9/1000, OB 5.5/1000 and DO 4.7/1000.
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#4 of 215 Old 04-22-2006, 04:29 PM
 
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I'm sorry, published statistical studies for planned UCs just don't exist. Judy from unhinderedloving.com did an informal survey of something like 100 births, and I think there is a separate survey that was done on the CBirth list at yahoogroups (you might post there to ask of anyone has it,) and then there is of course our list of around 100 UC births here at MDC (on the UC support thread.) Those are of course such small groups as to be considered statistically insignificant, so probably wouldn't be of much help in trying to convince someone that planned UC for healthy women with access to medical care when needed is generally as safe or safer than medically assisted/monitored birth. I think if you're going to talk to someone about UC you pretty much have to look at the philosophy of it, and explain how medical intervention and monitoring interferes with normal physiological functioning of the body.
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#5 of 215 Old 04-23-2006, 09:12 PM
 
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There have been few studies on the safety of UC compared with homebirth, below are three, "older" studies. The World Health Organization has info. on women birthing alone but this is globally, and may indeed slant the percentages.

Home delivery and neonatal mortality in North Carolina.

Burnett CA 3rd, Jones JA, Rooks J, Chen CH, Tyler CW Jr, ****** CA.

Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home
delivery.
**Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; **planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; **and unplanned home deliveries, 120 neonatal deaths per 1,000
live births.
***3 vs 30!
The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality.
Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. *Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.



Am J Public Health. 1987 Aug;77(8):930-5.
Neonatal mortality in Missouri home births, 1978-84.

Schramm WF, Barnes DE, Bakewell JM.

A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 percent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. ***Nearly all of the mortality excess for planned home births occurred in
**association with lesser trained attendants (12 observed vs 4.42
expected), while for unplanned home births the excess was entirely among infants weighing 1500 grams or more (19 observed vs 3.50 expected).

For planned home births attended by physicians, certified nurse-midwives, or Missouri Midwife Association recognized midwives, there was little difference between observed and expected deaths (5 observed vs 3.92 expected). There also was little
difference in deaths for unplanned home births weighing less than 1500 grams (26 observed vs 29.69 expected) compared with hospital births. **The study provides evidence of the importance of having skilled attendants present at planned home births.


Am J Obstet Gynecol. 1984 Dec 1;150(7):826-31.

Perinatal and maternal mortality in a religious group avoiding obstetric care.

Kaunitz AM, Spence C, Danielson TS, Rochat RW, Grimes DA.

We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a ***perinatal mortality rate three times higher and a ***maternal mortality rate about 100 times higher than the statewide rates. These findings suggest
that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death.

PIP: All reported perinatal and maternal deaths from 1975 to 1982 among Faith Assembly members living in the state of Indiana were verified. Fetal death and the neonatal mortality rate were defined per 1000 live births; perinatal mortality was the combination of fetal deaths and neonatal deaths per 1000 births plus fetal deaths; and maternal mortality was calculated per 100.000 live
births.

344 live births were identified in Elkhart and Kosciusko
Counties among religious members during this period. 291 of these mothers (85%) did not have prenatal care, the prenatal care for the remaining 53 (15%) was unspecified.
The mothers tended to be aged 20-34, white, married, and have minimum of high school education. 21 perinatal deaths were established among this population sample with 12 fetal deaths and 9 neonatal deaths. 11 fetal and 6 neonatal deaths occurred to members residing in the above 2 counties. Trauma or asphyxia at birth (often as a result of umbilical cord problems) and respiratory problems
were responsible for most of the mortality.

6 maternal deaths occurred: 4 due to hemorrhage and 2 caused by infection. During this period there was a total of 61 maternal deaths in Indiana, and thus about 9% of maternal mortality
occurred among Faith Assembly members (100% vs. 36% deaths caused by hemorrhage and infection). 3 of the 6 church members who died were 35 or older, and 2% of the births occurred to women 35 or older in these countries.

The estimated perinatal mortality rate for this group was 45/1000 live births vs. 18/1000 for the whole state, almost 3 time higher. The fetal mortality rate was 32 vs. 9 for Indiana (significantly higher); and the neonatal mortality rate was 17 vs. 9, respectively.
***The maternal mortality rate was 872/100.000 live births for church members residing in the 2 counties vs. 9/100.000 for Indiana: an astounding ninety-twofold higher rate. The risk of perinatal and
maternal death is greatly augmented even in the US when women do not utilize obstetric care

Seems MW attended homebirths might be the safest overall!
Mary
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#6 of 215 Old 04-23-2006, 10:50 PM
 
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Ah, I'm sorry, I was under the impression that these studies did not differentiate between planned and unplanned homebirths without midwives. I'll have to see if I can get a closer look at these studies. (Doesn't look like they're available on the internet, unfortunately.)

Quote:
Seems MW attended homebirths might be the safest overall!
Not so fast.

The Missouri study compares homebirths with highly-trained attendants and lesser trained attendants. It does not appear to differentiate between unassisted births and assisted births. A poorly trained attendant is worse than no attendant at all.

Questions about the North Carolina and/or Indiana studies: How many total unassisted births are we talking about? Did these include premature births? How long did a baby have to live on life-support to be counted as a "live" birth? What exactly did the low-risk and high-risk demographics consist of? Did religion or other factors prohibit mothers in the planned UC group from seeking medical care if they needed it? It's extremely important to know these things in order to make a judgement about planned unassisted births in general, because maybe these births do not represent planned unassisted birth in general, and specifically those in which the mothers are healthy, have ready access to medical care and willingness to seek it if they need it, and have no one acting as a quasi-midwife/doctor.

How these statistics were gathered is important to know as well. If they were gleaned from birth certificates, that really tells us very little. For instance, a teenager wishing to hide her pregnancy, perhaps trying to abort but failing and taking very poor care of herself during the pregnancy, could give birth by herself in her bedroom to a stillborn or very ill baby, and that would count as a "planned unassisted birth." Or, say my baby had a congenital defect and my spiritual and philosophical beliefs led me to allow the baby to die peacefully at home rather than spend painful months in an NICU with no guarantee of survival. That also would count as a "planned unassisted birth" at which a death occurred. There are countless other variations and situations that are not reflected in a purely statistical count.

The relevant statistics -- those that would actually tell us something about what most of us are wanting to do here -- would have to be solely of healthy informed women planning spontaneous instinctive UC births, with no one trying to act as midwife, with access to medical care and willingness to receive it if necessary. They would also have to rule out those who declined life-prolonging medical care, because that has no bearing on whether unassisted birth is safe or not.
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#7 of 215 Old 04-24-2006, 10:18 AM
 
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These indeed included planned homebirths without a MW, please read the studies closer. The questions form the OP was whether anybody had statistics, there are not many studies out there but what I shared was some of what I could find. Again the WHO has some info on birthing alone but it includes third world countries so I think it would slant the info quite dramatically because many of these women do birth alone with tragic outcomes.

I don't think it is far to question how the studies were done. Do you use the same quality control techniques when you look at studies that show hospital births carry risks?

I would love for more studies on the safety of UC. We just know are doing studies on homebirth vs. hospital and found homebirth with a MW is SAFER than a hospital birth for low risk women.

From the first study I posted, it was 3 infant deaths per 30, that's a BIG difference!

Mary
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#8 of 215 Old 04-24-2006, 10:18 AM
 
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Yup, I'm guessing it would be really hard to get accurate statistics on UC as well as UP. I'm not going to a professional for prenatal care, but I take care of myself and would if the need arised, so it's hardly accurate to dump me into the same group of women who don't care about their babies, so they fail to get prenatal care for that reason. I'm pretty sure there was a big propaganda, er, educational push for prenatal care a while back, much like the current propaganda, er, educational push for preschool, showing less infant mortality for women who got prenatal care, showing kids did better in school and life if they went to preschool. We'll not do preschool either, but we're not opting out of it because we don't care about our kids, we're opting out of it because I'd rather keep them home with me in an environment where we know they'll be loved and not harmed and teach them colors, shapes, etc. You can't really lump people who 'homeschool' pre-school into the same group who just doesn't take their kids to preschool because they don't feel like making the effort.

Same with UC, as 4littlebirds said, it's hardly accurate to lump the UCers on this board with the mothers who do not want their child, do drugs, and then birth a stillborn or very sick baby that they were trying to deny or hide.

There also is a liability issue. If I was filling out a survey for the state about my birthing choices, even if it was anonymous, I would mark that I am having a lay midwife out of fear of prosecution for UCing, so I would be skewing the data out of looking out for my family. I wonder how common that was in those studies?



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#9 of 215 Old 04-24-2006, 10:37 AM
 
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I totally think it is fair to question how the information was gathered. I also think there is a big difference between someone who is scared and alone and who births a baby unassisted and someone who educates herself on the process of natural birth and gives birth unassisted listening to the cues her body has given her in the context of the wisdom she has received from other women who have given birth unassisted. So to me, the scientific theory and comparisons of birth to sex (natural hormones shut down when a mother is uncomfortable due to observation or lack of control over her surroundings) give me more peace of mind than any statistics might be able to. Just my two cents...

Tana, wife to Steve (5/02), mom to Ben (7/03), Joey (10/06) and Caroline (9/09)
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#10 of 215 Old 04-24-2006, 10:50 AM
 
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Quote:
Originally Posted by doula mary
These indeed included planned homebirths without a MW, please read the studies closer.
That's what I was saying, Mary, I was apologizing that I had apparently given wrong information that there were no studies that existed that differentiated between planned and unplanned homebirths without a midwife. Sorry for not being clearer about what I meant.

Quote:
I don't think it is far to question how the studies were done.
Of course it is. How else can we have any hope of determining whether the results are relevant? Do you just accept that every study ever done is valid?

Quote:
Do you use the same quality control techniques when you look at studies that show hospital births carry risks?
I haven't looked at hospital birth studies in detail, but I would certainly hope that anyone looking at any such study would, yes.
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#11 of 215 Old 04-24-2006, 12:22 PM
 
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Okay, let me explain my problems with these studies in a little more detail.

Quote:
A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 percent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. Nearly all of the mortality excess for planned home births occurred in association with lesser trained attendants (12 observed vs 4.42
expected)
First, how was infant mortality defined for physician-attended hospital births? This has to be known for any study comparing hospital birth and homebirth. Babies who will eventually die can be kept alive far longer in the hospital than at home, allowing them to be marked as "live births".

Second, how many of these planned homebirths had "lesser trained attendants"? Say 2000 of them were; that would show a mortality rate of .6%. Say 12 of them were; that would show a mortality rate of 100%. It is really not enough to know total deaths; you have to know what numbers were actually started with in order to make value judgements.

Finally, what does any of this have to do with unassisted birth?

Quote:
We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a perinatal mortality rate three times higher and a maternal mortality rate about 100 times higher than the statewide rates. These findings suggest that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death.
I agree with this -- when it's needed. In our roll call group here at MDC, you'll notice that about 10% of those hoping to UC transferred to the hospital, and another 10% or so sought trained help at home. There were others that transferred to the hospital after the birth for various concerns. Our surveyed group has had no deaths from infection, hemorrhage, or respiratory issues, and this is at least partly because the women in our group will seek medical care when it is needed.

That this group singled out was religious and had no prenatal care and apparently did not seek medical care for hemorrhage, infection, and respiratory issues, indicates to me that perhaps there was a religious prohibition against seeking medical care. Obviously in such a situation (especially if the birth attendants are trying to act as "doctor" or "midwife" which is common among those choosing UC for religious reasons) death rates are going to soar.

Quote:
Seems MW attended homebirths might be the safest overall!
As far as these studies go, the most we can say is that this is conditionally so.
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#12 of 215 Old 04-24-2006, 01:19 PM
 
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Quote:
Originally Posted by doula mary
There have been few studies on the safety of UC compared with homebirth, below are three, "older" studies.
FWIW, these aren't studies per se. They're ABSTRACTS of studies. They give a quick and dirty bottom line and none of the information that's necessary to evaluate their true significance.

I have access to JAMA online, but they archive only abstracts prior to 1992. And my access to Am J Obstet Gynecol only goes back to 2004. But I do seem to have the Am J Public Health article.

It states that 474 of 3,645 home births (3,067 planned) were attended by "father or other attendant" which is defined as "Primarily fathers, but also paramedics, chiropractors, friends of family or anyone else not identified above". A further 725 births were attended by "Non-Missouri Midwives Association" midwives: "Religious midwives, those who identified themselves as midwives on birth certificates or who were identified by other sources in the study as midwives but were not recognized by MMA". These two groups comprised the "lesser-trained attendants".

Interestingly, they had to make some "assumptions" about some of the births in the survey for which no one reported any information. These included:

"If the certifier on the birth certificate was one of the parents, the mother was married and an Apgar score was reported, it was assumed to be planned with an unknown attendant.

If the certifier was a physician, the mother was unmarried, but no Apgar score was reported, the home birth was assumed to be unplanned.

If the baby weighed less than 1500 grams, it was assumed to be unplanned."

Of the "unplanned" births, 54.5% of the mothers smoked during pregnancy.

Quote:
Am J Public Health. 1987 Aug;77(8):930-5.
Neonatal mortality in Missouri home births, 1978-84.

Schramm WF, Barnes DE, Bakewell JM.

A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 percent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. ***Nearly all of the mortality excess for planned home births occurred in
**association with lesser trained attendants (12 observed vs 4.42
expected), while for unplanned home births the excess was entirely among infants weighing 1500 grams or more (19 observed vs 3.50 expected).

For planned home births attended by physicians, certified nurse-midwives, or Missouri Midwife Association recognized midwives, there was little difference between observed and expected deaths (5 observed vs 3.92 expected). There also was little
difference in deaths for unplanned home births weighing less than 1500 grams (26 observed vs 29.69 expected) compared with hospital births. **The study provides evidence of the importance of having skilled attendants present at planned home births.
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#13 of 215 Old 04-24-2006, 02:24 PM
 
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In a scientific study, you should ALWAYS question how the study is done. ALWAYS! And, anyone who has ever worked with statistics will tell you that you should scrutinize statistics very closely. It is so easy to slant statistics - as a pp showed by actually posting some of the information. The study cited is so flawed it is ridiculous. I'm not sure who was responsible for going through this study before it was published, but I can take a guess that it was someone who makes money from the management of births. Anyone interested in pure scientific information would have thrown this out immediately.

Mom to Eoin (11/02), Eilis (09/04), Eamon (07/07), and Ellery (04/10)
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#14 of 215 Old 04-24-2006, 03:38 PM
 
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Thanks, Alison. Reminds me of the Washington homebirth study that was touted by ACOG (the one supposedly showing death to be twice as likely to occur with homebirth midwives than with hospital births.)

I want to point out that statistics can only do much for us. If a baby dies or is damaged due to iatrogenic causes that would have not occurred in an unassisted birth, the mother isn't going to be much comforted by a study that says that hospital birth is safer than unassisted birth. As well, if a mother's baby dies in an unassisted birth, she isn't going to be much comforted by the fact that birth generally happens most normally when not managed or observed. Every individual case has unique factors that have to be taken into account. And no matter what choice one makes there is no guarantee of a good outcome; no choice is going to be best all of the time.
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#15 of 215 Old 04-24-2006, 05:56 PM
 
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I'm sorry I did not explain myself very well I do indeed believe that how the study is done is very important as well as WHO sponors the study....good to know. I have met some who UC that tear apart any info...but yield to a "hospital" study in a minute.

Here at MDC, out of approximately 100 attempted UCs (not counting hoped-for UCs that resulted in hospital transfers or calling in for midwife care), there was one death. One baby died out of 100!!!! That is high!

I encourage the UC community to try to continue to keep records of their births. I'm very interested in knowing accurate numbers
Mary
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#16 of 215 Old 04-24-2006, 06:30 PM
 
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As we all know, 100 is not at all a good sample size. Unhindered living has a sample size of 150 or about that and she doesn't have any deaths in her data. I'll be the first to admit that both of these samples are way too small to draw anything from them. (editing already!) In stats you determine the percent of accuracy of your statistic. You can be XX% sure dending on the sample size among other things that I can't remember. So, a sample of 10,000 might give you 99 percent acuracy, but a sample of 100 is going to give you like 5% acturacy, or really, it's useless. Man, I wish I hadn't sold my stats book now!

Even if MDC had 2000 UCers to submit information, the information would still be skewed because it's not randomized. People who post on MDC do not make up a nice randomized sample demographic Say, if there were 4 deaths in the hypothetical 2000 people from MDC UCers, you could not say that on average there were 2 deaths per 1000 for people who UC. You could say that 'of the 2000 people who submitted responses to a survey on MDC regarding UC and infant death, it was shown that in this group of people 2 deaths occurred out of 1000.' Or something like that. Been a couple years since I've taken statistics, but you have to be very accurate in how you explain your statistic and not jump to conclusions.

What I did learn in statistics is that it's hard to get accurate data. In a hospital it would be easier, because you can be fairly certain that deaths per # of live births are going to be recorded, as they record everything there and it is easier to pull statistics because they have been recorded. Even easier would be to gather specific data from each specific hospital; in Rochester General Hospital they had 4 deaths per 1000 live births in the year 2000.

Getting a good randomized sample from homebirthers would be very very difficult because it's not in a controlled environment with mandated reporting, as hospitals probably are.

I'm not sure if I'm making sense. It makes sense in my head I might have to go back and edit...


Cara
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#17 of 215 Old 04-24-2006, 10:15 PM
 
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In stats you determine the percent of accuracy of your statistic. You can be XX% sure dending on the sample size among other things that I can't remember. So, a sample of 10,000 might give you 99 percent acuracy, but a sample of 100 is going to give you like 5% acturacy, or really, it's useless.
Thanks, myhoneyswife, you made the point much better than I did.

Quote:
Originally Posted by doula mary
I'm sorry I did not explain myself very well I do indeed believe that how the study is done is very important as well as WHO sponors the study....
Then you must have meant something different when you said you didn't think it was fair to question how the studies were done?

Quote:
I have met some who UC that tear apart any info...but yield to a "hospital" study in a minute.
What does this mean?

Quote:
I encourage the UC community to try to continue to keep records of their births.
Um, okay. Well, that's what we've been doing.

Quote:
I'm very interested in knowing accurate numbers
Our numbers are accurate.
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#18 of 215 Old 04-26-2006, 02:06 PM
 
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While I don't have any statistics or hard facts at my fingertips right now...I do know that I have had the same problem with people that I know. This is my solution: Don't tell anyone what you are planning except friends that you know will be supportive and of course your husband/partner. I found it much easier not to have to debate with people while I was pregnant-after the birth people will just tell you that you are crazy or lucky that everything worked out. Also, giving people a due date that is a little later than when you actually think the baby will be born helps too because no one is expecting it so soon so usually they won't be calling yet with the "have you had the baby yet?" type questions. Good Luck!!
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#19 of 215 Old 04-26-2006, 02:47 PM
 
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Originally Posted by doula mary
I'm sorry I did not explain myself very well I do indeed believe that how the study is done is very important as well as WHO sponors the study....


Then you must have meant something different when you said you didn't think it was fair to question how the studies were done?


Quote:
I have met some who UC that tear apart any info...but yield to a "hospital" study in a minute.


What does this mean?


Quote:
I encourage the UC community to try to continue to keep records of their births.


Um, okay. Well, that's what we've been doing.


Quote:
I'm very interested in knowing accurate numbers


Golly....as mentioned before my first post was not written well...I was probably half asleep, I did not write what I meant to...

Sorry also, I used "abstracts" vs. studies...you ladies aren't very defensive are you?!

I did not mean to imply your numbers are not accurate, but there are indeed few studies done on UC's and I think there should be. Dont you? There is not much out there in terms of formal evidence based information supporting/not supporting UC.

Mary
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#20 of 215 Old 04-26-2006, 03:08 PM
 
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Doula Mary, this
Quote:
Seems MW attended homebirths might be the safest overall!
that you wrote put me on the defensive for sure. You are on the UNASSISTED BIRTH forum and to write that on here was asking to stir up emotions.
I don't think in our birth climate there could/would be accurate stats done on UC anyway, so no I don't really think there needs to be studies. I KNOW UC is safest for my baby and me and that's all I really need to know.

OUR DAUGHTERS ARE PROTECTED SHOULDN'T OUR SONS BE TOO! :
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#21 of 215 Old 04-26-2006, 03:11 PM
 
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Quote:
Originally Posted by doula mary

Sorry also, I used "abstracts" vs. studies...you ladies aren't very defensive are you?!

I did not mean to imply your numbers are not accurate, but there are indeed few studies done on UC's and I think there should be. Dont you? There is not much out there in terms of formal evidence based information supporting/not supporting UC.

Mary
I'm pretty sure what raised our hackles was this part at the end...
Quote:
Seems MW attended homebirths might be the safest overall!
That statement really cannot be made (and I do realize you included the word 'might') regrding the stats that you were presenting because it wasn't a good study, and thus drawing any conclusions from it would be wrong. Yup, there is a shortage of studies of UC, and realistically it would be almost impossibleto get good studies of UC because of the fear of CPS that most of us have that motivates us to lie if we feel it's best


Cara
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#22 of 215 Old 04-26-2006, 04:52 PM
 
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Not trying to stir anything up, the OP was looking at stats for UC...not much out there but wanted to share the limited stats.

Based on research and evidence....so far that is available MW attended birth does seem to have the lowest infant and maternal mortality based on the abstracts posted earlier.

Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.
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#23 of 215 Old 04-26-2006, 05:21 PM
 
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Doing ones own prenatal care also means that many of these deaths could have been the result of birth defects or missed miscarriage/stilbirth - things that these mothers likely would have terminated for in pregnancy.

I had a UP and hospital transfer for preterm labour, and my son died. He had a birth defect incompatible with life. A few weeks later and I would have had him at home.

Termination (by way of abortion or early induction) doesn't count as 'infant death' the same way. They tend to just speak of that as "failed pregnancy" or "product of conception".
So if I'd ended up doing a UC, cases like his could be included in a study for infant death.

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#24 of 215 Old 04-26-2006, 06:03 PM
 
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First, Mary, it would be very helpful if you would use the quote tags when quoting someone else -- it is confusing otherwise.

Quote:
Originally Posted by doula mary
Sorry also, I used "abstracts" vs. studies...you ladies aren't very defensive are you?!
Alison_in_oh, as far as I know, is not a UCer (this is the first time she's posted in this forum) so I don't know why she'd be defensive. In any case, accusing the poster of defensiveness doesn't make her point any less valid. I can't think why you'd have a problem with it unless you're feeling defensive yourself.
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#25 of 215 Old 04-26-2006, 06:14 PM
 
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Quote:
Originally Posted by doula mary
Based on research and evidence....so far that is available MW attended birth does seem to have the lowest infant and maternal mortality based on the abstracts posted earlier.
"Seem" would be the key word here. We've already laid out very clearly why these studies are seriously questionable and/or nonrelevant to what we're doing here.

Quote:
Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.
No, it's not, which is why I don't understand why you keep bringing it up.
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#26 of 215 Old 04-26-2006, 06:21 PM
 
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I'm pretty sure she was saying that we were all being defensive, and that's pretty much correct We believe UC is safe, and I *know* that *for me* it is safer than having a MW. I'd flip out at a midwife and would be really irritated having her here while I birth, that's just how I am

I think that we are defending UC against some questionable stats just the same way that majority of MDC defends not vaccinating against the questionable stats that we're all bombarded with on a daily basis as to why vaccination is a good thing and it's bad for our kids if we don't vax. Same deal

I'm pretty sure that if I went onto the vax board here on MDC and posted some abstracts of studies that showed that vaccinations do indeed coorolate with a lower childhood mortality then I'd get people to be defencive also. Same with if I went to the homeschool board and posted studies about how kids do better when they go to classes with peers in a school environment. We're a pro-UC board here, it would be expected that we'll defend and pick apart any study that's posted that says that UC isn't as safe as MW attended births, ya know?

I'm not picking on you, I think it's good to discuss things, but if you're posting stuff that shows that MWs are safer than UCing, then it would be logical to expect us to pick it apart.

Cara (who is saying all this with a smile, I'm not angry at all, just talking... sometimes this doesn't come across well on the net)
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#27 of 215 Old 04-26-2006, 06:37 PM
 
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Thanks Cara,
Sorry..I'm an old lady...when I push the quote bottom, it still doesn't do what I want it too.. tell me how to do the "tags" Also, usually when I'm posting I have a 4.5 year old on my lap nursing and am typing with one hand..it's a trick, sorry my posts are not clear.


"Seem" would be the key word here. We've already laid out very clearly why these studies are seriously questionable and/or nonrelevant to what we're doing here. ..

Lets not play the semantic game..evidence thus far, does show that MW attended births have better outcomes and I will maintain this position until I see evidence that suggests otherwise...not trying to be snappy but honest. However, if YOU want to UC...cool...but I'm not sure research thus far is proving it as safe as births with a experienced attendant.

Quote:
Information from the World Health Organization that tracks maternal mortality GLOBALLY...supports that MW attended births seem to have the lowest rates of problems compared to women who are not attended and OB assisted births. Granted though, since it is globally, it is not fair to compare the US rates for a UC and Africa's....many factors influences health.


"No, it's not, which is why I don't understand why you keep bringing it up."

I mention it because since there IS so little evidence or studies on UC...one must look at what is available...WHO does track infant and maternal mortality. It is not relevant to compare the US vs. a third world country...it IS relevant to compare countries such as Canada, UK, Sweden, Norway who happen to have BETTER infant and maternal outcomes and recognize that these countries have a MW model of care.
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#28 of 215 Old 04-26-2006, 06:43 PM
 
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Hi, lurking UCer here, I've been keeping up with this thread, and what kind of made me feel defensive was Doulamary bringing up how "other" UCers have reacted to research. Are you prejudging unassisted birthers as a whole, Doulamary?

Studies based on birth certificates *are* problematic, because they may not truly reflect the practice of educated unassisted birth. In areas where midwifery is regulated a woman may have a birth with a midwife who is "illegal" and will declare that birth "unassisted" to the gov't. There are alot of factors that can influence the reporting.
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#29 of 215 Old 04-26-2006, 06:46 PM
 
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I feel what the evidence indicates in that midwife attended birth is safer than the alternatives that have been looked at - what has not been looked at is educated unassisted birth as we know it in the developed world, so no statement can made about its safety - period.
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#30 of 215 Old 04-26-2006, 06:54 PM
 
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Yeah, that. Exactly
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