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Old 05-27-2008, 12:12 PM - Thread Starter
 
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hi everyone,

i am not a UPer/UCer, but i do have a question for those of you who are:

is there any kind of pregnancy or condition that would cause you to feel that having a UP/UC was unsafe for you or for your baby? do you believe in "high risk," "moderate risk," and "low risk" pregnancies? how do you even know if you have a complication of pregnancy if you UP?

in the interest of full disclosure: i prefer unmedicated, CNM-attended births when possible, and i believe that pregnancy and birth have some inherent risk to them. i get prenatal care including ultrasounds because i want to be getting what i consider to be appropriate, evidence-based care: low-risk care for low risk, and high-risk care if i become high-risk.

the reason i ask this question is that i recently read elsewhere the autobiographical account of a woman who attempted an hba2c. her uterus ruptured catastrophically, the baby died, and she had a hysterectomy. to me a vba2c is a HIGH-risk attempt and much deserving of a hospital and a doctor. certainly i don't want to give birth in a hospital with an OB, but all of life is a cost-benefit analysis. the costs frankly outweigh FOR ME the risks in a hba2c scenario. i'd love to hear your thoughts and understand a different perspective.
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Old 05-27-2008, 12:41 PM
 
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Yes, I do believe there are certain conditions that would constitute "high," "moderate," and "low-risk" pregnancies. I think each individual woman will have to weigh those things for herself during her pregnancies.

Some women here on the UC board have "moderate" or "high" risk conditions that perhaps should not be considered "high" or "moderate" by the medical community. VBAC absolutely is one of those. All the statistical evidence shows that VBACs have a relatively high degree of safety--certainly enough to warrant home birth as an option for some women. There are poor outcomes with any kind of birth sometimes; even in the hospital. It is a fact of life, but does not necessarily mean birth is inherently risky---check the stats! It's amazing that as much as people get into an uproar about the dangerous nature of birth, it is uneventful most of the time when just left to unfold on its own.

As for me personally, I would consider a HBA2C. I would have to spend time really reading and thinking about it, then ultimately, trusting what my body and spirit were telling me about having that kind of birth. I do believe in God and have extensively prayed about both of my UCs before having them. As kooky as that may sound to some, I think that being informed, thinking carefully, then trusting and acknowledging my faith and spirituality are the best way to prepare for any birth.

As for knowing you have complications when you have a UP/UC---how do you know when you have a headache or diarrhea or are just feeling run down without a doctor telling you? I think most UPing women are pretty in touch with their bodies and many of them do some sort of prenatal monitoring of themselves. Checking in with yourself daily (to whatever extent) is much more effective as a means of prenatal "care" than going once a month to a doctor who can't even remember your name! I personally do most of the basic prenatal tests in my home--fundal height, weight gain, blood pressure, urinalysis, listening to fetal heart tones. It does NOT take an obstetrician to do all of those things.....

I hope that helps.
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Old 05-27-2008, 01:03 PM - Thread Starter
 
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thanks for the quick response. i do appreciate it. i hope you don't mind if i ask some questions about it.

1. do you mean to say that the woman whose hba2c went bad didn't believe in god enough, or that she didn't pray correctly? does praying to god fervently and with correct form ensure a good outcome?

2. do you mean to say that midwifery school and/or medical school provide no education about diagnosing potential complications that you don't have?

3. my odds of dying while typing here are, let's guess, 1 in 10 million. but my odds of dying without intervention in birth are 1 in, let's say, 10,000. so even though 9,999 births (99.99%) will not result in my death (and i think i'm being generous here), the odds of dying in birth are (according to these randomly selected numbers) 1,000 times higher than dying any other day. do you see what i'm saying? do you disagree?

i want so much to believe that people who UP/UC do so with legitimate information and hopes. hearing arguments about prayer and intuition me sad precisely because i believe in evidence-based (as opposed to faith-based) care.

thanks for being my guinea pig response person here.
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Old 05-27-2008, 01:23 PM
 
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you seem to know what YOU prefer, which is important. every woman must do what makes her most comfortable, because a sense of comfort and safety is critical to safe birth.

i dont have time to reply to the entire topic, but i have to respond to your question of "odds".

lets pretend that your odds of dying on any given day (which you guess are one in 10 million) could be completely erased, making you immortal, if only you took a drug that caused you horrible pain every moment of your (very long) life. would you do that, to avoid the off chance of dying? i would not.

what about in birth? your odds may be higher to die, and taking this pain-causing pill could erase them.

each woman must choose for herself, and her child, how she is willing to live. not just birth, LIVE every choice we make is colored by our perception or risk/ benefit, and some of us choose not to make birth choices out of fear. it doesnt have to be about faith or god or science. obviously this made up scenario is just that, made up. but the choice is the same. when will we live in fear? what is risk? how much good will we give up to eliminate risk?

i also have to ask my own question of you, honestly- why do you "want so much to believe that people who UP/UC do so with legitimate information and hopes"??

Hi, I'm Tabitha. I'm a homeschooling mother of four: ds (11) dd (9) ds (7) ds (5) And I'm expecting a fifth in 2014! Find me at http://www.omelay.blogspot.com
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Old 05-27-2008, 01:37 PM
 
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I hope you are not here simply to start arguments. If you are, you came to the wrong place. The women here on this board generally have a great understanding of pregnancy, birth, and even complications. Each woman chooses to UC/UP for different reasons.

To answer your questions:

1. Absolutely not. I do not think faith is the only consideration in birth. My point is that FOR ME, my faith plays a role in why I choose UC. But conversely, if I believed God/intuition or whatever you want to call it was telling me there was a problem, I would seek out adequate medical advice/care for my given problem. I do not believe that simply "having faith" just automatically guarantees a good birth outcome, but neither does "having faith" in the medical community---women have bad outcomes in hospitals where they put their "faith."

2. No, I don't believe that, either.

3. I see what you're saying, but one of the most dangerous things we do as human beings is drive a car. My odds of being killed driving my car today are much higher than me giving birth naturally. My point is this: odds of dying in birth or near childbirth=very, very, very slim.

4. You said," i want so much to believe that people who UP/UC do so with legitimate information and hopes. hearing arguments about prayer and intuition me sad precisely because i believe in evidence-based (as opposed to faith-based) care."

To that I say that you misread and twisted what I was saying about the role faith and intuition play in my birthing choices. You totally left out the part where I said that it is important to be well-informed and that I critically read and think about my births before I decide how I will conduct them. ALL of my choices about home birth ARE evidence based.

Sadly, much of obstetrical care is NOT evidence based or is in complete opposition to the current medical evidence. I suggest you read the current medical literature for yourself. It would surprise you (and probably dismay you).

If you spent any time at all listening to the women on this board, you would see how well-informed and prepared most UP/UC mamas are.
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Old 05-27-2008, 01:58 PM
 
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Quote:
Originally Posted by tabitha View Post
how much good will we give up to eliminate risk?
Wow i think i love you!



I love when everything i am trying to articulate is so simply put by an awesome MDC mama! (ps - can i steal that and put it on my facebook page?)
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Old 05-27-2008, 02:04 PM
 
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Not a UCer, more a student of UC, but this was extremely insightful.

Quote:
Originally Posted by augustacherri View Post
1. I do not believe that simply "having faith" just automatically guarantees a good birth outcome, but neither does "having faith" in the medical community---women have bad outcomes in hospitals where they put their "faith."

Midwifery Student and Mama to 2 daughters and 3 sons.     
ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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Old 05-27-2008, 02:16 PM - Thread Starter
 
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wow, lots of questions.

1. i am ABSOLUTELY NOT here to start a fight. but i am here to try to get a response *that i understand*. if you want to help me on this journey, i really appreciate it. if not, i understand that, but please don't accuse me of starting arguments. i will be respectful and decent.

2. i have read a great deal of medical literature on the topic of pregnancy and childbirth. i consider myself as well read on the topic as any other non-medical/lay person is. if you have specific references you think i might benefit from, i would be open to hearing about those. i have read unassisted childbirth as well.

3. i have read a lot of the UP/UC threads on this board! i felt the need to ask these questions because i did not get a sense from those threads that anyone had chosen not to UC as the result of increased risk. i haven't seen a thread saying, "i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.

> how much good will we give up to eliminate risk?

i guess i believe that there are shades of good. just because i believe birth has risk doesn't mean i signed up for my epidural, pitocin, cytotec, continuous fetal monitoring, and believing in my ob/gyn-deity. i still had an unmedicated birth with intermittent monitoring by doppler. i got to listen to my hypnobabies in the tub through transition. but i did so with a provider who had a great deal more education and experience than i did. after all, it was my first birth and her whateverth. does that answer your question?

> i also have to ask my own question of you, honestly- why do you
> "want so much to believe that people who UP/UC do so with legitimate
> information and hopes"??

i want to believe that people who choose non-traditional birth do so because mainstream birth is not evidence-based, which by its essence necessitates choosing an evidence-based alternative. i consider myself part of a movement to drag U.S. maternity care back into the evidence pool kicking and screaming. i want to believe we're all on the same page about that. it's sort of like how if you really like one candidate for president you want to believe you'd agree with his or her other supporters as well. that way you're all working as efficiently as possible to to same ends rather than pulling each other apart. not sure if i'm being clear.

the evidence basis suggests even now that giving birth with some medical care is safer for mother and baby. if you don't believe or buy into that evidence basis (for example, "active management of the third stage of labor only looks better than expectant management because of how pitted up all the women are") then it's fine to say that, too. but then we aren't looking at the same ends - you are perhaps looking at changing the way research itself is done while i am accepting the research as "good enough" the way it is.
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Old 05-27-2008, 03:21 PM
 
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Originally Posted by ima-06 View Post

the evidence basis suggests even now that giving birth with some medical care is safer for mother and baby. if you don't believe or buy into that evidence basis (for example, "active management of the third stage of labor only looks better than expectant management because of how pitted up all the women are") then it's fine to say that, too. but then we aren't looking at the same ends - you are perhaps looking at changing the way research itself is done while i am accepting the research as "good enough" the way it is.
The problem with this evidence is that, typically, all UC's are clumped together--including accidental UCs, forced UCs (incest, young teens, what have you), and drug-addicted moms having babies in dumpsters UCs. About six months ago I took the stats of our UC story sticky and, mathematically speaking, our transfer/c-section/stillbirth rates were pretty much the same has those for midwife attended homebirth. Sure, those stats weren't perfect, but there really isn't a good, accurate place to get UC stats from well-informed moms choosing that option, versus the other variables, KWIM?

I'm on the fence that says most research isn't good enough, and that all sides of a given topic have to be carefully considered (ie, there is research that says co-sleeping is safer than crib sleeping, and then there's research that says the opposite... not to debate that here, just using it as an example). And in the end, it's up to the mother's comfort level and where her intuition is leading her... at the end of the day, if you really want something, you can make the statistics and research say whatever you need them to.

Sunny coolshine.gif: gun toting, retired breastfeeding, car seat loving, guitar playing, home birthing and schooling mama to Jakob (10.06), Mikah (07.08) and Korah (07.11). uc.jpg 

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Old 05-27-2008, 03:30 PM
 
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Originally Posted by ima-06 View Post
wow, lots of questions.

3. i have read a lot of the UP/UC threads on this board! i felt the need to ask these questions because i did not get a sense from those threads that anyone had chosen not to UC as the result of increased risk. i haven't seen a thread saying, "i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.
I don't have much to say for most of your questions, as a fellow lurker, I will leave this to the knowledgeable women on this board, but I must address this one.

I find it hard to believe that you have read a lot of the threads on this board and not found someone who sought medical care when they found it to be necessary. There are 2 such threads right on the 1st page of this UC board right now:
http://www.mothering.com/discussions...d.php?t=903648
http://www.mothering.com/discussions...d.php?t=902103
The second one is actually titled "They weren't unassisted". There are plenty of women seeking medical care or assistance when needed and they're not hard to find.

dog2.gifcrochetsmilie.gif Lovin' my sweetheart, pregnant with #1 (EDD Feb.2013) stork-suprise.gif

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Old 05-27-2008, 03:31 PM - Thread Starter
 
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i know what you mean, to a certain extent.

i don't happen to believe that forced-UC makes up a great deal of the statistical sample, because they must be relatively hard to document. can you imagine the conversation? "excuse me, sixteen-year-old girl impregnated by your father in the basement dungeon prison, did you have any complications of labor?"

there seem to be enough perinatal death in these threads that it's hard to believe the stats are any good, but i'm glad to hear you found good results.
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Old 05-27-2008, 04:21 PM
 
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There are two things to keep in mind when you start/get involved with these type threads.

1. Mothering.com is a LARGE and CONCENTRATED group of women. Statistically we are going to run across all variations of stats. We are going to be able to see all the "saving" the dr.'s did. We are going to see "proof" that UC/homebirth is bad and dangerous. There is just a larger sampling of specific genres (homebirth, VBAC, UC etc.). Just like dr.'s cannot make the broad assumption that ALL birth is dangerous because they happen to only work in "high risk" pregnancies a person cannot come on here and say that the stats they come up with from reading past threads is completely true. Statistics are crap. You are never going to get an unbiased set so coming to a forum such as Mothering with preferences already in place and trying to find the wrong (essentially) in other choices is not going to do anything. All you are going to find is information you were looking for to "prove" your mindset.

2. Just because someone chooses UP/UC does NOT mean they completely forgo any type of care. Part of UP/UC is knowing your body and taking charge of it's care. When you (general you) aren't pregnant you are able to wake up one morning and say I don't feel well and then take the appropriate measures to mke yourself well. Being pregnant doesn't change that ability. Read through the threads here and you will see there is a wide range of care on here. Some do nothing (me for instance...I don't do anything...I don't do blood pressure or pee in a cup etc. I act the same..I just happen to be gaining weight), some who do nothing but still get the "frivolities" like a gender scan (me again) and some who do everything they would do with an OB. Just because a woman chooses to go the UP/UC route DOES NOT maen they are not aware of the goings on in their body. If something feels wrong they are still just as likely to get checked out and re-evaluate their decisions as someone who is getting a super technical hospital birth. You'll be hard pressed to find any of the serious UP/UC women here (and by serious I mean those who don't think of this as the next milestone for proving their "naturalness", those who aren't here because they see it as a fad...yes there are people who think that every now and then) who haven't researched everything. There is one member here who was considering a UC after multiple c-sections. She came and posted and reasearched and talked with her dr.'s etc. to figure out what would be the safest, smartest way to go about her next birth. Just because a thread title starts off with "I'm going to UC!" or something of the like doesn't mean that the actual post doesn't address any possible issues and concerns. This forum is the perfect example of don't judge a book by it's cover (or in this case the title).

Technology does not equal saefty. Nor does ignorant faith. There is no way to look at a story online (or anywhere really) and infer YOUR beliefs on it and come away with what really happened.

That is all.

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Old 05-27-2008, 04:58 PM
 
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: and amen!
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Old 05-27-2008, 08:21 PM
 
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I'm on the fence that says most research isn't good enough, and that all sides of a given topic have to be carefully considered (ie, there is research that says co-sleeping is safer than crib sleeping, and then there's research that says the opposite... not to debate that here, just using it as an example). And in the end, it's up to the mother's comfort level and where her intuition is leading her... at the end of the day, if you really want something, you can make the statistics and research say whatever you need them to.
: Anyone can find research to "back-up" their ideas. Research that says OB/GYN care is best, to midwifery care is best. I don't think birth choices should just be based on research, as it can be quite falliable
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Old 05-27-2008, 10:11 PM
 
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First - I have to say that for me personally, my childbearing/birthing opinions have operated on a continuum. I started out birthing in a bc w/a mw (believing only lunatics hb, can't imagine what I'd thought of ucers had I known they existed) and am now planning a uc for the first time. Every woman is different, has a differnt journey, different reasonings behind their choices. I "get" most of what women choose and their reasonings because I feel like I can relate b/c of my own personal journey. However, I have to admit, I do have a hard time understanding "mainstream" choices of birthing in hospitals and unnecessary interventions - I try, but it's hard. I haven't been there.

For the most part, I UP. Do I believe in low, mod, high risk pregnancies - yes. I also believe that they are mislabeled or used as scare tactics by some hcp. How do I know if I'm have a complication? If I chose, which I don't, I can do exactly the same routine check up in my own home. I don't need a hcp to help me pee on a stick to see if I'm spilling sugar. I have never, out of all my pregnancies, done any testing - gest. diab., AFP, etc. b/c I found them unnecessary or I didn't have the risk factors to lead me to feel I needed to test. I am confindent in the knowledge I have gained through educating myself on cb and preg. that I believe I would recognize the signs of anything out of the norm. Then I could consult a hcp if need be.

I can't speak to vbacs b/c I've never had a ces. It's something I've never had to research. However, I know there are ucers here that have had vbacs. Since I don't know much about it, I don't judge (not that that's what you are doing). It's their choice.

I really would like to answer (or have someone answer) your questions but parts of your posts feel like baiting. Your second post about God/praying and the education of hcp gave me the impression you somehow believe ucers are making irrational choices. Maybe that's just me.

I can only speak for myself and my personal reasons for wanting a uc. In the end, I based my choice on taking responsibility for my health, educating myself, intuition and faith.

This is such a complicated topic. The fact is the book or research to say uc is safe/safer/safest doesn't exist. If only 1% of the pop is hbing, there's a lot fewer ucing and who is keeping track? Who is taking down the info? I didn't know anyone was. We can refer to stats, books, research etc. but it's not going to tell the whole story. You have to interpret the info for yourself and decide who/what to believe. I also think it's a mistake to ignore one's intuition/faith in this issue. You should never seperate. It doesn't mean your not making an "evidence based" decision if you include your intution into the equation. I think its dumb not to. And there are threads on this board when women, who were seemingly low risk, decided not to uc b/c their intuition told them it was not wise.

I get the feeling you are curious about the ucing but do not believe at this point that it is a safe option for women. Why do you feel the need to be convinced? You don't want to uc do you? So why do you want ucers to justify their choice? I think we're happy just the way we are

Just wanted to add that 2 books I have really enjoyed are Unassisted Homebirth and The Power of Pleasurable Childbirth.
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Old 05-27-2008, 11:01 PM - Thread Starter
 
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> Just wanted to add that 2 books I have really enjoyed are Unassisted
> Homebirth and The Power of Pleasurable Childbirth.

have read them, thank you.

i think my question about god is very fair given that it was mentioned as a "thing" by the first poster.
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Old 05-27-2008, 11:25 PM
 
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I think god is sometimes a big "thing." We all put our trust into something. Some women put their trust in people they hardly know - trusting that those people are making the right decisions for them and their baby. They trust that everything is done for the good of the baby. They trust that the doctor is putting the patient first and is not thinking about going home to bed, or a holiday they dont want to work, or the long night ahead when a mom is progessing very slowly.

Personally for me, after trusting this system once and being very abused by it i dont trust it anymore.

Some people put their trust in god, that he has a plan an a purpose and that everything will happen as it is meant to happen.

Very slowly i have began to build trust within myself. I trust that if i feel something is wrong that i will get the help that i need. I trust myself to surround myself with people who will respect me and who are competent enough to give help if i need it. I am learning to trust my body - i was made to give birth and i dont need a calander or a time clock or a machine to tell me when my baby has expired or when i am having a contraction.

We all have our things that we put our faith and trust in.
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Old 05-27-2008, 11:25 PM
 
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I found your comment about God to sound like zealotry.

And here were my questions:

Why do you feel the need to be convinced? You don't want to uc do you? So why do you want ucers to justify their choice? I think we're happy just the way we are
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Old 05-28-2008, 12:29 AM - Thread Starter
 
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zealotry in what regard?

i don't want UCers to justify their choice to me or anyone else. i want to be educated about why UPers/UCers choose what they choose. if you want to be involved in educating me, great. if not, great. i don't see why you'd mind my wanting to be educated.
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Old 05-28-2008, 12:46 AM
 
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hmmm

Ok, so, what research exactly are you referring to that says that the kind of UC and UP practiced in this forum is not as safe or safer than birth with a midwife or OB? I cannot think of an experiment design that would satisfy me as being without major flaws or biases or that would be doable in an academic format.

Most studies that I am aware of talk about the need for access to health care services for at-risk, impoverished populations who are UCing out of pure necessity and unable to get help when they need it.

I am all for evidence-based practices but routine check-ups with an OB or compulsory assisted childbirth are not evidence based for well educated, confident, self-aware women with a backup plan.

It is easy to accuse a woman whose HBA2C went bad unassisted, but would you re-evaluate the practive of birthing in hospitals if the same woman died from another c-section? or if she died in a homebirth with a midwife?

As for all being part of the same fight to correct the awful state of the childbirth industry, I can see where you are coming from. However, that is the problem with most movements or activism-based causes. We initially are fighting for greater choices, but in order to achieve anything, we need to come up with a pretty narrow definition of an alternative. It is kind of like feminism. We want to get rid of the gender binary, but then we end up just coming up with a new compulsory definition of what a woman should be like. We don't have to all be the same or agree on everything in order to be on the same side. And, actually, I think that most Ucers will agree with your stance on many things. I think that the consensus here is that Ucing is not for everyone and that the health care system should be fixed for the other 99% of women who use it and for real options to be available to everyone. Can a woman who has medically necessary c-sections still be in favor of homebirths? Of course. Can a UCer still see the need for more midwives and a less interventionist approach in hospitals? Obviously.

As for the God thing. I am completely respectful of anyone's faith and understand what they mean when they talk about the role of God in their experiences. I am an atheist and I still very strongly believe in UC. My trust is in my body, my intelligence and my ability to handle whatever may come. I am very rational and I know that stress, fear and other emotional and spiritual dispositions have a huge impact on how a birth can go so there is nothing silly or non-evidence based with someone praying for and visualizing a healthy birth.

It really sounds like you are honestly trying to understand and educate yourself, so I won't get too bitchy, but I could not help but giggle when you said you felt you knew as much as a non-medical person can know about childbirth. Medicine is not some closed, inaccessible select club with secret information. There is absolutely nothing stopping you from wandering into your local med school library and reading the same textbooks doctors read. The average medical student really does not spend that much time learning about the new, more accurate research or the fine details of the second stage of labour. They learn pretty much the same way a mechanic learns how to change your oil ie the same way their boss does it. It does not require a finer understanding of the physics of engines to become a mechanic and it does not require a deep understanding of anything beyond their daily tasks to become an OB.

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Old 05-28-2008, 01:03 AM
 
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i haven't seen a thread saying, "i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.
Those type of threads certainly exist, and can be found with key words such as "UC transfer". Threads by women who were not able to seriously consider uc due to complications would be more likely to be found in ddcs.

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Old 05-28-2008, 01:08 AM
 
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Well, the poster that mentioned prayer as part of her decision making process made no mention of praying fervently or correctly enough as a factor in getting a good/bad outcome. If someone has figured out a "correct" way to pray to get a desired outcome I'd like to know. There's not a "correct" way to insure you get what you ask for and, to insinuate there might be or that someone might believe there might be, seems so ridiculous that I equate it with zealotry.

I don't mind you being educated at all. It seems to me that you've likely read all the same books I have and I consider myself very well educated on the topic. I think part of the answer as to why women choose to up/uc cannot be found solely in a book - although there are some very thorough books that you've mentioned you've read that explain so so much. What's missing? When I read the uc books I think "Ain't it the truth." I have to guess (only guessing) that when you read them, you are unconvinced which leaves me confused. To be honest, I can't say it better than the two books I recommended.

Is it as simple as the risk factor? Why would ucers "risk it?" If so, and I can only speak for myself, I'm not a risk taker. I wouldn't uc if I thought I would be better off w/someone attending. That's the bottom line for me. My level of education/preparedness/personal birth history/faith are enough to insure a safe uc - or that, in the event of a complication, I will make the appropriate decision to transfer.

I'm really not trying to be snarky, I'm not that way. I want you to have your questions answered. I'm just not sure they can be answered to your satisfaction. For instance - even if I had had an open mind in the beginning about hb, all the research, stats, etc. I still would have continued to believe that hbers were taking a chance which is so silly. I gave birth w/a lay mw in her bc - which was basically like giving birth at your grandmother's house. I wasn't even doing anything different than a hber except they had the added luxury of climbing into their own bed after birthing.

There are some very well spoken women on the boards. Perhaps one of them can do a better job than I have.
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Old 05-28-2008, 01:11 AM - Thread Starter
 
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thanks soso-lynn.

the studies i'm referring to pertain not to UC/UP versus attended birth but rather to specific interventions that are feasible only with an attendant. if you read about specific interventions, some (which require the power to prescribe medications or to cut into things) are shown to be more effective at savings lives than doing nothing.

trust me that i'm not saying there is anything magical about medical school. i'm related to too many doctors to believe there is. but i do believe in the nearly magical powers of attending many births, and medical school is good for attending many births. of course 99-100% of them are intervened-with births, which sucks. but it's better than my experience, with is to say only my one birth so far - and one laborious miscarriage. it's somewhat like surgery - the outcomes for surgeries are shown to be dramatically correlated with the number of that specific surgery the doctor has done. no, i don't think birth is as medical an event as a surgery, but i do believe in that intuition is more the product of experience than luck and feeling.

your point about feminism is well taken since i share your views (i think) on feminism.

i would not re-evaluate birthing in a hospital if she'd died. because i know death is a risk of hospital vba2c: a remote risk, but a risk nonetheless. to me everything is a cost-benefit analysis. i pick the moderate solution in general because i believe in shades of gray (as i said above) and i think having a vba2c is a happy medium that i hope to avoid but would do if i had to.

i don't want to debate the choice to UP/UC. i really don't. i just wanted to understand the underlying choice. and i think i am starting to get it now. thank you.
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Old 05-28-2008, 01:30 AM
 
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the studies i'm referring to pertain not to UC/UP versus attended birth but rather to specific interventions that are feasibly only with an attendant. if you read about specific interventions, some (which require the power to prescribe medications or to cut into things) are shown to be more effective at savings lives than doing nothing.
UCing is not about avoiding potentially life-saving interventions. The fact is that most of those interventions can be obtained in a reasonable amount of time by transferring to a hospital if needed. There are cases when that does not work, but I would be willing to bet that there is a much greater risk of bad or less than ideal outcomes if you start off in a hospital instead of only going if you need to. There is also the assumption that the woman would accept certain life-saving interventions. I really don't feel comfortable with that. I would personally do anything to save mine and my baby's lives, but I don't think it's up to anyone else but me to make that decision.

but i do believe in the nearly magical powers of attending many births, and medical school is good for attending many births. of course 99-100% of them are intervened-with births, which sucks.
Attending many natural births can be very helpful in becoming a skilled attendant but most graduating OBs have NEVER seen one. I can't find the link to that article right now, though.


i would not re-evaluate birthing in a hospital if she'd died. because i know death is a risk of hospital vba2c: a remote risk, but a risk nonetheless. to me everything is a cost-benefit analysis. i pick the moderate solution in general because i believe in shades of gray (as i said above) and i think having a vba2c is a happy medium that i hope to avoid but would do if i had to.
I don't have all the details of this particular case, but what you are getting at is that one should evaluate the risks and benefits of anything they do. That is exactly what UC is about, taking charge of your own health and making up your own mind.

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Old 05-28-2008, 02:07 AM
 
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to me everything is a cost-benefit analysis.
I don't have a lot to add to the conversation except this. ITA with the above. After my two hospital births to me a UC is less risk than an attended birth.

that is all.

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Old 05-28-2008, 02:10 AM
 
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While I do feel like you will never be given enough "evidence" to really be satisfied I am coming out of my comfy lurking hiding place to address your questions.
is there any kind of pregnancy or condition that would cause you to feel that having a UP/UC was unsafe for you or for your baby? do you believe in "high risk," "moderate risk," and "low risk" pregnancies? how do you even know if you have a complication of pregnancy if you UP?
ofcourse there are conditions and situations that a loving mother would consider unsafe in which to choose a UP/UC

in the interest of full disclosure: i prefer unmedicated, CNM-attended births when possible, and i believe that pregnancy and birth have some inherent risk to them. i get prenatal care including ultrasounds because i want to be getting what i consider to be appropriate, evidence-based care: low-risk care for low risk, and high-risk care if i become high-risk.
I feel like for the most part every woman I have encountered who has chosen the UP/UC path is a woman who is intimately in-tune with her body both physically and mentally. If she is not her UC will probably not get off the ground. This is not said to sound superior, it is really just a vital ingredient in the ability to UP/UC. While all womens bodies are made to make and expel babies not all women in this day and age are mentally intune enough to take the leap required to just quietly trust their body to do a most basic function of its own human-ness.
I personally believe in GOD and to answer your question about that at the same time I feel like I put my trust in GOD and accepted that I ultimately have no control over when I die or when my baby dies. I pray for health and life and strength and clarity but I don't fool myself into believing that I can orchestrate control over the outcome of any day.

the reason i ask this question is that i recently read elsewhere the autobiographical account of a woman who attempted an hba2c. her uterus ruptured catastrophically, the baby died, and she had a hysterectomy. to me a vba2c is a HIGH-risk attempt and much deserving of a hospital and a doctor. certainly i don't want to give birth in a hospital with an OB, but all of life is a cost-benefit analysis. the costs frankly outweigh FOR ME the risks in a hba2c scenario. i'd love to hear your thoughts and understand a different perspective.
I would seriously consider a vba2c because like I said before I dont feel like its up to me to control my own fate or anyone else who comes into this world through me. All I can do is prepare myself and then I have to take that leap.
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Old 05-28-2008, 05:02 PM
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is there any kind of pregnancy or condition that would cause you to feel that having a UP/UC was unsafe for you or for your baby?

There are probably many conditions that cause me to feel having a UP/UC was unsafe for me or for my baby.

But, i do not have any conditions, and so it's not an immediate concern.

do you believe in "high risk," "moderate risk," and "low risk" pregnancies?

I believe that life carries a lot of risk, that pregnancy carries risk, that birth carries risk. but, what constitutes what level of risk is really individual. what is high risk for me is not high risk for someone else which is based on a number of factors which can be weighed in various ways.

if i felt that i was at risk for anything that medical attention would prevent or help with, then i would certainly seek that care.

how do you even know if you have a complication of pregnancy if you UP?

there are two aspects to this in my mind.

the first is that many or most things have symptoms or signs that we can look to and then decide if it's at issue or not. So even if UPing, if something seems unusual, or feels bad, or what have you--we can take that and say "ok, i need some help." and then go and seek that help.

the second thing that occurs to me are those occassions during which even with extensive PNC, there is a surprise occurance.

in these occurances, the medical model didn't prevent or prepare for it, and if it occurs during birth, it may be something that the medical model can help or hinder. it really depends upon what shows up.

i believe that pregnancy and birth have some inherent risk to them.

i agree with this statement. for me, weighing the risks is what creates birth choices.

some people consider very normal, healthy pregnancies to be "high risk" scenarios just on how they view birth itself. they feel most comfortable in hospitals, with medication and technology. Others look at very normal, healthy pregnancies as very "low risk" scenarios, and therefore consider things such as UC or HB as a safer option than a hospital.

i'm of this latter category, and with it, i'm of the mind that attendants can hinder one's process in both pregnancy and birth. that hinderance at the emotional level can create something to be emotionally "high risk" when it is in fact actually "low risk."

i find that PNC appointments often do this to women--scaring them and often n ot reassuring.

the costs frankly outweigh FOR ME the risks in a hba2c scenario.

i think that this is also really individual, and i would also assert that it isn't always a cost-benefit analysis.

while i think the cost-benefit analysis (CBA) is a very beneficial process and often a good one, it is really rather "left brained" and not in an intuitive space.

i know that i can do that CBA, but it's not the end of the process for me. i then look at it from a completely intuitive or 'feeling' space--because what might be right "logically" or "on paper" isn't at all right for me in reality.

i've been in that sort of situation before--i'm sure that we all have.

so for me, it would depend entirely upon how i truly felt and believed about the situation. sure, the CBA might say one thing, while my spirit or total person is telling me something else. And of course, sometimes the CBA is right on.

but again, this is also an individuated process. i don't know about that woman's uterus, her process in regards to determining what was a risk and what wasn't, and what risks she was and was not willing to take. i can only support her decision based on the fact that she knows her circumstances best and is capable of making good decisions for herself.

and i take the same process with my own birth. i know my circumstances best, i know what i do and do not consider risks or problems or what have you, and from there, i make a choice that i think, believe, and feel is right for me.
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Old 05-28-2008, 05:30 PM
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hearing arguments about prayer and intuition me sad precisely because i believe in evidence-based (as opposed to faith-based) care.

i really can't ask you to believe differently than you do.

even though you speak of 'evidence based,' you actually start with a premise that is basically a belief--philosophical if you will--and not necessarily "evidence based." it's how you interpret that evidence, emotionally, that starts the process for you.

like you, i agree that pregnancy and birth carries inherent risk of injury or death to mother or child. emotionally, though, i do not consider that a very "great" or "high" or "scary" risk.

because our fundamental approach to this premise is different, what evidence we seek and how it convinces us is going to be different.

for me, one of the greatest risks to normal, healthy pregnancies and births is intervention. intervention begins at the level of "idea" in my mind.

for example, because i'm going through a trying bit and am emotionally susecptable, when a client said to me (she's an u/s tech) "wow, you're looking small! your baby could be dead or not growing!" i was really emotional about it. i started to fear and doubt.

she'd intervened; she'd planted a "bug-a-boo" in my mind.

but then i took a step back. what's the real evidnece that she's talking about vs what other evidence exists?

first, there is my internal 'evidence'--my experience. i am growing a lot, eating plenty, and i feel great. my baby moves nearly constantly (it's a blast). i can baby map easily. and intuitively, i feel that the baby and i are very healthy!

second, all women carry differently, some larger and some smaller. women who are first-time mothers, like myself, tend to carry smaller. women who are very fit and have strong abdominals also tend to carry smaller. women who are of my body type tend to carry smaller.

third, my mother carried small too. she and i look a lot alike in our pictures of when she carried me at this date and where i am at this date. it's amazing! and, my MIL was similar (and she was no where near as fit as my mother).

then, we look at my client who is an u/s tech. she's saturated with scientific evidence; she's trained to look for anomolies; and she works with women of all body types and sizes, but most of those carrying small whom she sees are considered "high risk" even though the u/s indicate that very few of these infants are even problematic.

so, ultimately, i went back to my own evidence--what i think and feel and experience as well as what i know.

i look for both external 'evidence' and internal 'evidence.' while the internal is largely subjective rather than objective, i usually make decisions utilizing both aspects of my person.

i know that not everyone does, and i'm ok with that. i think that's fine, but it's not fine for me. i need to utilize both.

and trust me, even if all of the external evidnece in the world said that i was "just fine" and i didn't feel that way, you can darn well better believe i'd keep knocking on doors until i got an answer that i felt was satisfactory.
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Old 05-28-2008, 09:29 PM - Thread Starter
 
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> I feel like I put my trust in GOD and accepted that I ultimately have
> no control over when I die or when my baby dies.

i'm so confused about this statement. it seems to suggest that you would not accept any medical care.
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Old 05-29-2008, 12:10 AM
 
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"i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.
You must have missed my threads from last fall! I decided not to UC based on a very strong gut urge to hire a midwife. At my 20 week prenatal we found twins. I chose a much more medical route than I would have preferred and in fact my birth was rife with necessary interventions. I would not have chosen this route for myself but I felt it was necessary to ensure the safety of my daughter, who presented footling at the last minute.
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