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#1 of 54 Old 10-09-2008, 08:24 PM - Thread Starter
 
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From the roll call and birth stories sticky

485 births

4 infant deaths, 0 maternal (causes: cord wrapped too many times around neck, uterine ruputure, shoulder dystocia w/ cord compression, fetal demise - they believe baby passed away before labor began)

43 transfers (not all emergent, some were for pain relief/prolonged labor)
10 cesareans

0.8% infant death rate
8.9% transfer rate
2% cesarean rate

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#2 of 54 Old 10-09-2008, 08:40 PM
 
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Interesting!

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#3 of 54 Old 10-09-2008, 09:26 PM
 
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Very interesting. How long did it take to calculate that?

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#4 of 54 Old 10-09-2008, 09:30 PM
 
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wow, thats good to know.
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#5 of 54 Old 10-10-2008, 12:11 AM - Thread Starter
 
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It's hard to compare our statistic to U.S. statistics because of many factors.
Perinatal, neonatal, intrapartum, and fetal mortality rates all have different meanings. Perinatal is late term intrauterine death and early neonatal death (1st 7 days), neonatal period is 1-29 days of life, intrapartum is death during labor, and fetal is synonymous with stillbirth. All four infants were "stillbirths" but one was dead before labor began, one died d/t uterine rupture during a UBAC (higher risk), and two died of fetal asphyxia.

These were the best statistics I could find:

U.S. 2003 - 6.74 deaths per 1,000 fetal deaths and live births. This includes
Infant deaths of less than 7 days and fetal deaths with stated or presumed period of gestation of 28 weeks or more. This is the perinatal death rate.

This is a death rate of about 0.7%

We really need more numbers to draw any significant conclusions but I think our numbers look pretty good! I'd also encourage any lurkers who UC and don't ask to be added to the birth rolls to do so, to help those considering UC to make an informed decision. Post your birth stories so others can learn from them. We have to help each other.

Source for US perinatal mortality stats: http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_06.pdf

I know, I know, I'm such a nerd.

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#6 of 54 Old 10-10-2008, 01:45 AM
 
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wow you are on the ball with math! that made my head spin haha

that is really neat to see "on paper" like that!! thanks for sharing!

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#7 of 54 Old 10-10-2008, 02:55 AM
 
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Remember tht the UC roll call contains self-reported results- one of the least accurate methods of data collection. I know my UC is on the list, but if I had transferred I might not have returned to this space to announce the birth, or to have the statistics added to the roll call.

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#8 of 54 Old 10-10-2008, 04:07 AM
 
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That's very interesting! I was hoping at least that the infant mortality rate would be better than the national average, but then it's hardly a scientific study, plus we need a lot more births to get a more accurate picture, and one of the stillbirths was because the baby passed away before labor, not because of unassisted birth.

The results were not disheartening, however. I think they are awesome and show that not only in unassisted birth AT LEAST as safe as hospital birth, but that we mamas are intelligent and know to transfer if we need to. Too many people believe that we are trying to be martyrs and kill our babies just to have a crunchy experience. Now I can show husband's family that we are at LEAST as good as doctors. Yay!

Go mamas!

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#9 of 54 Old 10-10-2008, 10:45 AM
 
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Thanks so much for this. It really helps put things into perspective with numbers and statistics attached.
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#10 of 54 Old 10-10-2008, 02:02 PM
 
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Quote:
Originally Posted by ErinBird View Post
Remember tht the UC roll call contains self-reported results- one of the least accurate methods of data collection. I know my UC is on the list, but if I had transferred I might not have returned to this space to announce the birth, or to have the statistics added to the roll call.

:

I know some here IRL who post on MDC, one with a sad outcome and they're not on the stats page.

We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.

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#11 of 54 Old 10-10-2008, 02:28 PM - Thread Starter
 
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Quote:
Originally Posted by phatchristy View Post
:

I know some here IRL who post on MDC, one with a sad outcome and they're not on the stats page.

We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.
You're never going to get two perfectly balanced groups. It's impossible. This is a problem with any study. That is why they have limitations. Also, I know there are some people who lurk and UC with sucessful outcomes and never post. Some UCers are kind of shy about their private lives, YKWIM? Some don't care about being on the birth rolls. So I just used the information we already had. Maybe it is not perfect, but it is more information than we had before.

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#12 of 54 Old 10-10-2008, 03:09 PM
 
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Thanks for doing this! I'm excited to show my husband.

One thing that I find interesting, of the fetal deaths (oh I hate sounding this clinical knowing that there are mamas on here who lost their sweet little ones) is I think that most could not have been prevented by being in the hospital. Although that raises questions, were those 4 births hospital transfers, or did the deaths occur at home? I think that further investigation into the causes of death for those children would be a good thing to do. The UK has the maternal death reporting system and describe how mothers die in childbirth, giving a final conclusion for what happened, if it could have been prevented and if someone was responsible. I think that doing that for these births would be beneficial information for women seeking to make the UC decision.

M.Ed. Mama to Chunka (1/07), Beauty (5/09) and Elizabear 3/12): Birth Doula (working toward certification) AAMI Midwifery Student, Advocating with Solace for Mothers & The Birth Survey

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#13 of 54 Old 10-10-2008, 03:21 PM
 
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Originally Posted by amberskyfire View Post
That's very interesting! I was hoping at least that the infant mortality rate would be better than the national average,
I actually think that its a good thing to see that the UC rate here is about the same as the national average. No matter how hard we as mothers and they as doctors, specialists, experts, policymakers, etc try to prevent all fetal deaths, its not ever going to happen. There will always be a portion of risk to childbirth, its inherent to life and the process. Those 4 deaths could likely be unpreventable and were going to happen regard of the birth location, and attendants.

To me, those deaths all sound to be "organic" in nature meaning that they likely could have happened in a hospital as well as at home--no one, not even the demi-god OB could have prevented it (I'm going off of really limited information to make that speculation).

I think there's also an interesting point to be made about iatrogenic causes of death. Iatrogenic means that it was doctor caused. Is those deaths were unpreventable, then the additional variable of doctor negligence would be taken out of the equation. Or it would be transferred from doctors to families who are the ones embracing the responsibility of that birth and we could speculate that parents could be just as likely to make "mistakes" as highly educated, paid and skilled professionals are. Maybe that's where OBs are the most afraid, they realize that the stats could support the conclusion that they all their effort really is uneeded in most cases.

Another thing about making this analysis of stats comparable, is that we'd need a whole lot more UC stories. The infant mortablity rates and maternal mortality rates are measured by porportions of 100,000 to minimize variablity due to chance. Our sample is only 450. However, I still think that its very informative. Really, is anyone interested in writing up a research study on this and getting it published after asking permission for the UCers here to be included?

M.Ed. Mama to Chunka (1/07), Beauty (5/09) and Elizabear 3/12): Birth Doula (working toward certification) AAMI Midwifery Student, Advocating with Solace for Mothers & The Birth Survey

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#14 of 54 Old 10-10-2008, 03:26 PM
 
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Also did you count this one?

http://www.mothering.com/discussions...2&postcount=24

Not sure if you would because its reported by a friend and not by a member.

M.Ed. Mama to Chunka (1/07), Beauty (5/09) and Elizabear 3/12): Birth Doula (working toward certification) AAMI Midwifery Student, Advocating with Solace for Mothers & The Birth Survey

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#15 of 54 Old 10-10-2008, 03:29 PM
 
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Quote:
Originally Posted by Serenyd View Post
It's hard to compare our statistic to U.S. statistics because of many factors.

...

These were the best statistics I could find:

U.S. 2003 - 6.74 deaths per 1,000 fetal deaths and live births. This includes
Infant deaths of less than 7 days and fetal deaths with stated or presumed period of gestation of 28 weeks or more. This is the perinatal death rate.

This is a death rate of about 0.7%
I will note that a certain blogger is comparing the UC data presented here with the CNM hospital neonatal death rate and coming out saying that the UC death rate is 20 times higher...

I take issue with comparing the UC numbers with CNM numbers on the CDC wonder data set. My biggest reason for taking issue is that in the case of the CNM data, I'd bet my house that there are a good number of neonatal deaths not being attributed to CNMs in that data set that started out as intended CNM births, but at some point transferred to OB care, and are thus reflected in the OB numbers.

How many of the 4 deaths reported here as UC deaths had actually already transferred to OB care prior to the death?

Then there is the issue of that blogger only cherry picking what she considers to be "low risk" CNM births--after 37 weeks, white non-Hispanic, blah, blah, blah.

Is this REALLY reflective of the UC population birthing here? How many of the UCer's here are doing VBACs which many CNMs are not "allowed" to attend? How many are less than 37 weeks? How many have undiagnosed GD, are "too old" for CNMs...or whatever else risk factor you want to throw in there?

As others have pointed out...you are working with a "self selected" data set...so the true results could be skewed a LOT in either the direction of a higher or a lower death rate.

And finally...statistical significance. If there had been only ONE death in the UC group, that blogger would be crowing that the UC death rate is 5 times the CNM death rate...but obviously there is an issue of statistical significance going on.

Jenn
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#16 of 54 Old 10-10-2008, 03:40 PM
 
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Ok, I'm just demonstrating my obsessive birth/researcher tendency now...

I'm also interested in how many women who UC'd here would say after the fact that the experience was traumatic.

I'm considering a PhD program where I would do a dissertation on traumatic birth (PTSD, anxiety and depression after births that were scary/disappointing/abusive). It would be interesting to compare the incidence of trauma in UC and homebirths to trauma in hospitals. I have the theory that trauma in hospitals is much more likely to occur and that it should be added as a indication of morbidity (after the fact health conditions, illness, disease and wounds that are left over and do not include death).

M.Ed. Mama to Chunka (1/07), Beauty (5/09) and Elizabear 3/12): Birth Doula (working toward certification) AAMI Midwifery Student, Advocating with Solace for Mothers & The Birth Survey

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#17 of 54 Old 10-10-2008, 07:59 PM
 
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Originally Posted by jenneology View Post
One thing that I find interesting, of the fetal deaths (oh I hate sounding this clinical knowing that there are mamas on here who lost their sweet little ones) is I think that most could not have been prevented by being in the hospital. Although that raises questions, were those 4 births hospital transfers, or did the deaths occur at home? I think that further investigation into the causes of death for those children would be a good thing to do.
If you go look at the list, the mothers actually have stories posted that explained what happened. For most of them yes, I think they would have happened the same in a hospital. One happened unexpectedly AFTER the hospital transfer while the baby had been doing pretty much okay until the emergency happened, but that was after the transfer. One had died before labor began. A third died at home because the cord was wrapped too many times around the neck causing the baby to suffocate because it was stuck for I think 20 minutes while crowning. While it's possible that that one could have been helped by being in hospital, I don't think it would have been as they probably would not have continued monitoring as the baby was coming out. Baby would have had to be pushed back in for a cesarean. It was just one of those freak occurrences, you know?

It's important to know, of course, that sometimes these things just happen and whether in a hospital or at home, there really isn't anything that can be done in some cases. My heart goes out to those mamas who have lost their little ones. They are living my nightmare and to be so strong and brave after the death of your baby is a strength I don't know if I could ever aspire to.

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#18 of 54 Old 10-10-2008, 09:15 PM
 
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Originally Posted by jenneology View Post
I'm also interested in how many women who UC'd here would say after the fact that the experience was traumatic.
At least one.

The hospital part of the birth was not traumatic. The PTSD I experienced was due to the UC, at-home part.
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#19 of 54 Old 10-10-2008, 09:17 PM
 
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with my stillbirth a birth story was the last thing i wanted to write. tho i think some women need to do it, i think its pretty common not to.
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#20 of 54 Old 10-11-2008, 05:14 AM
 
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I was reading the unnamed blogger's post and found out about your UC stats. I have left a reply to the other uc stat post adding my 4 UC's. HTH!

And yes, I think it is important when comparing that many uc's are *not* low-risk. My last baby was my 7th, born at age 38, without *prenatal care.*

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#21 of 54 Old 10-11-2008, 06:06 AM
 
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Both of my UCs were also VBACs. I was 38 at the time of my last baby's birth (UC).

Just for the record
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#22 of 54 Old 10-11-2008, 06:33 AM
 
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Has anyone collected the stats on MDC midwife assisted homebirth? I'd like to see how those compare just for curiosity's sake.

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#23 of 54 Old 10-11-2008, 12:57 PM
 
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Both of my UC's were VBAC's.

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#24 of 54 Old 10-11-2008, 03:47 PM
 
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This is reallty interesting information. It would be wnderful to be able to have a real study done.

Carrie, The Birthteacher CCE and Doula, real mom to five; and womb-mom to G. born at 23w by emergency C. 12/09
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#25 of 54 Old 10-12-2008, 02:39 AM
 
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Just ducking in here quick, but I'm always glad to see threads discussing the stats. There's another big thread in the UC archives titles "Statistics" that's pretty good too.

Quote:
We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.
Also, the way UC birth is approached varies dramatically from fully spontaneous birth to managed birth, and people are affected to different degrees by cultural conditioning and notions about the way birth should be, what constitutes risk, what constitutes a complication, how you deal with it, etc. To have a really accurate picture, we'd have to know all that as well. And that's where the stories come in, how they are helpful.

Quote:
I'm considering a PhD program where I would do a dissertation on traumatic birth (PTSD, anxiety and depression after births that were scary/disappointing/abusive). It would be interesting to compare the incidence of trauma in UC and homebirths to trauma in hospitals. I have the theory that trauma in hospitals is much more likely to occur and that it should be added as a indication of morbidity (after the fact health conditions, illness, disease and wounds that are left over and do not include death).
(bolding mine) Yes, absolutely.

Quote:
with my stillbirth a birth story was the last thing i wanted to write. tho i think some women need to do it, i think its pretty common not to.
I'm sure you're right, but on the other hand, people who are part of a community tend to report back. With people who've been posting about their pregnancies for nine months, I think it's pretty uncommon for them to just disappear in the event of a poor outcome. Which is one reason why a requirement for being in the UC roll call due date section is being an established member of MDC.
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#26 of 54 Old 10-12-2008, 02:53 AM
 
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Well now you can make that 486 births since I just very belatedly added my birth story to the roll call.

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#27 of 54 Old 10-12-2008, 02:57 AM
 
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Just to add to the stats (as I'm not in the original stats) - DD was a planned UC with shadow care - after 45 hours of labor we transferred (I think DD was malpositioned and the car ride jostled her into the right position) my water broke as I stepped out of the car and I was at 8cm when they checked me 10 min later. She was born 2 hours later after 15 min of pushing. I truly believe I probably was in transition at home and hit the "I can't do it" wall - had I not been a first time mom, I probably would have stayed. I ended up with an epidural at the hospital and DD was born VERY blue and got bluer (don't know the apgars) and had to be taken away for a bit. I think that the epi contributed to it.

At any rate, #2 will be a UC.

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#28 of 54 Old 10-12-2008, 03:01 AM
 
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I don't think I ever added my birth story but I did ask to have my stats added.My last birth was the UC after 2 military and one civilian hospital birth, all in different states.I was considered high risk by the hospitals but never felt like the care I received was better than my own knowledge( I'm too high risk to be treated by a MW but any resident can come in for the birth?).I did and still have problems after my hospital births (so bad that I still get a cold feeling when I see the hospital on the hill here) but my UC was very healing for me.

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#29 of 54 Old 10-12-2008, 07:36 PM
 
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There are several reasons I don't get too wrapped up in statistics, especially when it comes to UC. Some of these things have been mentioned in previous posts.

1. Humanity is undergoing a change in consciousness. We are just beginning to discover the immense power of our own thoughts and feelings, as well as our connection with the "larger self" (or God/Goddess/All that is, etc.). Little by little we are letting go of our allegiance to and dependence on "the authorities" in many aspects of our lives, and instead learning to trust in the authority and intelligence of the Self. During this transition we are bound to make "mistakes," but in time this will change. This is not to say that we will never seek advice or assistance from medical professionals, but birth is a natural bodily function, not a disease (in spite of what most people believe).

2. When women grow up in a culture that fears birth, it can be quite a challenge to have a homebirth, let alone a UC. As Grantly Dick-Read and numerous others have pointed out, fear hormones shut off the flow of birth hormones. As a result, birth becomes painful and problematic. This is why UC, in and of itself, isn’t going to solve our problems in birth. We may eliminate one of the primary causes for the problems in birth – unnecessary medical intervention – but if we haven’t eliminated “inner intervention” (fear), we may still encounter problems. And of course not only do we have to overcome our own fears, we also have to deal with the fears of our friends, family and a society that thinks we’re nuts. The added stress of going against “the herd” can and does negatively impact labor. Once again, in time this will change.

3. Negative outcomes in hospitals are grossly under-reported. This fact was brought out in Jennifer Block’s book “Pushed” and has also been admitted by the Centers for Disease Control. We truly need to question the accuracy of hospital birth statistics.

4. As mentioned before, we cannot compare UC moms to low risk hospital birth moms, as many of us would not be considered low risk (myself included).

5. How do we define UC? In at least one of the “UC” deaths the labor had been induced (membranes stripped) by a midwife (twice). If the woman had gone on to give birth in the hospital and the baby had died, would a doctor blame the midwife who had induced the birth? Possibly. Or if a doctor had performed the procedure and the woman had gone on to have a midwife-assisted homebirth where the baby died, would the midwife blame the doctor? Also a possibility, as stripping membranes/induction is known to cause problems. I’m not necessarily saying the death was caused by the induction, but if we’re going to talk “statistics” we need to have a better definition of what constitutes a “UC.”

6. As was also mentioned, this is a self-selected study. I’ve gotten thousands of letters over the years from women who were either planning a UC or had had one. I know that many of these women don’t post on message boards. But even for those who do, there are numerous UC message boards and email lists these days. Trying to prove the inherent dangers of UC by taking one message board, where there have been 4 reported deaths in 30 years (or possibly 3 if we eliminate the midwife-induced birth), is not only unscientific it’s simply unfair.

Those who are waiting to have a UC until the statistics “prove” it’s safe may be waiting a very long time. I also question the sanity of living a life (or having a birth) based on statistics. Those who do this will never get married, as the majority of marriages end in divorce. Does this prove that the concept of marriage is inherently flawed and therefore it should never be attempted? I am not naive or misinformed. I’ve done my research and understand that the primary reasons for the problems in birth can be traced to 3 main causes: poverty, unnecessary medical intervention and fear. True physical deformities are rare. I don’t live in poverty, do not allow others to interfere with my natural bodily functions, and am not afraid of birth. Therefore I knew UC was the best choice for me.
Laura
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"I also question the sanity of living a life (or having a birth) based on statistics."


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