Sunday, June 22, 2008

Yeah mothers rights

Sunday, May 13, 2007
Medical: Dangers Of Hospital Births

Happy Mother's Day!!!

This article is also posted on Calla's blog.

As most of my friends know, I birthed my daughter naturally for 33 hours and 33 minutes. By naturally, I mean without an epidural or drugs. I was just as afraid as every other new mom about the pain of labor, but I made a purposeful decision. Despite what anyone may tell you, it isn't a time to let others induce you, let others drug you, let others cut you, unless of course that is your educated choice. But, most women want whatever is best for their child and that, for 90% of us, is labor without interventions.

For the child, inducing labor is dangerous. For the child, it is best to allow labor to happen on it's own course (except where the child is 2 weeks overdue or the water has already broken). Inductions increase c-section rates, increase risk for the baby including oxygen definiciency, increase infection, and increase the mortality rate for the mom and the child.

For the child, epidurals are dangerous. For the child, it is best to have a drug-free labor (except where fatigue has set in and the mother needs to rest), since epidurals can lead to complications for the mother and child (infection, overdose, allergies, fever), longer labor, and an increased c-section rate and use of forseps. Epidurals are the number one cause of fevers during labor unrelated to infections. Fevers lead to increased complications (often c-sections), infant death, and low Apgar scores. Maternal fever is now also linked to newborn seizure.

For the child, c-sections are dangerous. For the child, it is best to have a natural delivery (except where the child is breach, the mom has a fever, or either one's heart rate has gone too low or high). C-sections are a serious surgery and are physically damaging. The risk of the need for a hysterectomy, maternal & infant death (3-4 times compared to natural birth), organ damage, respiratory problems, and many other complications all increase after a c-section. After a c-section, moms are more likely to be re-admitted to a hospital and are more likely to become infertile. Future babies are more at risk for preterm birth and have an increased risk of stillbirth. The consequences of elective c-sections are indisputable.

With doctors in the United States encouraging use of all these interventions, how can you protect yourself and your baby? Low risk pregnancies in this country still have over a 30% chance of a c-section; most of those c-sections are unnecessary, unwanted, and unsafe. But physicians earn an extra $3000 or more per c-section as compared to a natural birth, and with approximately 150 deliveries per year on average, doctors are doing 50 c-sections a year making an extra $150,000 per year. The number one reason for an unplanned c-section: "failure to progress". Or is that "failure to wait"? First-time moms normally have long labors, with the average labor lasting 19 hours. Failure to progress is defined as 2 hours of active labor without progress. First, doctors should not be putting plastic gloves, instruments, or anything else unsterilized in the canal every two hours, because that leads to infection. Moms should only be checked very rarely or when they feel an urge to push (to make certain they are fully dialated). Second, your body knows what to do, and sometimes it may take longer than others but with most c-sections given for "failure to progress," please consider whether your doctor has a "failure to be patient".

I did research on the web and found a Midwife-run birth center nearby, called Birth Care. There, the c-section rate is less than 4% (national average is 33%), the episitomy rate is less than 6% (national average is 25%), and the average Apgar score 5-minutes after birth is a 9 (out of 10). At Birth Care, the baby is brought to the mom's belly or breast right after birth, when she is still attached to the umbilical cord. The mom gets a chance to bond and breastfeed her child immediately. All these photos are from the Birth Care Center in Alexandria and show you the comfort of a Midwife-led birth.

These statistics and supporting studies clearer show that it is safer to birth your child outside the hospital for a normal birth despite what the medical model or some well-meaning old lady may tell you. In developed countries, the Netherlands has one of the lowest infant mortality rates in the world (approximately 3rd) and one of the highest rates of homebirth (two-thirds of all births with less than 3% c-sections). The U.S. has the one of the highest infant mortality rates (24th in the world) and one of the highest rates of hospital births (about 96% with 33% c-sections).

If you have a high-risk pregnancy and need to birth at a hospital, make sure to have a doula or birth assistant by your side, working for you and with you. Your doula can help you make educated choices when you are in labor and unable to rebuff the pressure from well-meaning nurses and doctors to have a c-section or induce labor. Your doula can be as an advocate for you when you are busy birthing your child and your husband is busy comforting you. Your doula can also act as a second pair of much needed hands, running to get you ice and giving your husband a chance to take a break after the first 24 hours. Not surprising, births with doulas are shorter, easier, and have less interventions (including less c-sections!).

So for all those moms out there who feel lost in getting the birth you want, don't give up.

A hospital is no place to be sick. -- Samuel Goldwyn

Another great article

ICPA Family Wellness First - 025
Dangers with Elective C-Sections
A recent study titled: Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with "No Indicated Risk," found that the risk of death to newborns delivered by voluntary Caesarean section is much higher than previously believed.

In this study of almost six million infants, researchers found the neonatal mortality rate for Caesarean delivery among low-risk women is 1.77 deaths per 1,000 live births, while the rate for vaginal delivery is 0.62 deaths per 1,000.

Their findings were published in this month’s issue of Birth: Issues in Perinatal Care.

The study included 5,762,037 live births and 11,897 infant deaths in the United States from 1998 through 2001, a statistically significant sample even though neonatal death is a rare event. There were 311,927 Caesarean deliveries among low-risk women in the analysis.

“Neonatal deaths are rare for low-risk women — on the order of about one death per 1,000 live births — but even after we adjusted for socioeconomic and medical risk factors, the difference persisted,” said Marian F. MacDorman, a statistician with the CDC and the lead author of the study. “This is nothing to get people really alarmed, but it is of concern given that we’re seeing a rapid increase in Caesarean births to women with no risks,” Dr. MacDorman said.

The researchers noted that vaginal birth is beneficial to the baby. During this process, hormones are released promoting healthy lung function. The physical compression of the baby moving through the vaginal canal also helps remove fluid from the lungs and helps infants in breathing. Other risks of c-section mentioned by the researchers, like cuts to the baby during the operation or delayed onset of breast-feeding, were also considered as reasons for the increased death rate.

Although there was no mention of the importance of cranial molding that happens in a vaginal delivery and not in a c-section, we do know that vaginal births allow for this process necessary for central nerve system function.

Dr. Michael H. Malloy, a co-author of the article and a professor of pediatrics at the University of Texas Medical Branch at Galveston, said “Despite attempts to control for a number of factors that might have accounted for a greater risk in mortality associated with C-sections, we continued to observe enough risk to prompt concern.” He remarked that doctors might want to consider these findings in advising their patients giving them the option of informed choice.

I think some women have been seriously misled into believing that c-sections are better and safer than normal, natural deliveries. What is not emphasized when they are being given the option for elective c-sections is that a c-section is a majory abdominal surgery! Just because the c-section rate is increasing, it does not make it safer for either the mother or baby.

In a previous FWF E-Newsletter: We discussed a study that sited the many risks of c-section to both the mother and baby.

Also, our web site has many studies listed on the dangers of c-sections: and the importance of natural birthing:

One interesting study on our site discusses whether OBs should even be seeing women with normal pregnancies, let alone offering elective c-section to low risk mothers!

Our advice remains -- for all of your family decisions -- make sure you are informed before you choose what seems to be safe and accepted practices.

Dangers of Elective C-sections

Cesarean Birth in a Culture of Fear By Wendy Ponte
Issue 144, September/October 2007

When I tell someone I am working on a story about the escalating rate of cesarean sections in the US, it often leads to a conversation that goes something like this:

"C-section rates are up to 50 percent or higher in some hospitals," I say. "Doctors often feel they must do a C-section to protect themselves from a malpractice suit. And many of them seem to feel that a C-section is actually better than vaginal birth. A lot of women are being given unnecessary surgery."

"I had a C-section," my acquaintance will say. "But in my case, it was necessary."

"Tell me about it."

"Well, the baby's heart rate started to drop on the fetal monitor, and the doctor was worried that she wasn't handling labor very well. So he said a C-section was the safe thing to do."

It's an awkward conversation, to say the least. I would never want to make any woman feel bad about the birth of her child. Women need to be honored for their birth stories, no matter how those stories go. And having been told by both a doctor and a reliable-looking and expensive piece of machinery that her baby could be in trouble, my acquaintance probably made the best decision she could make in that moment. By the time she reached the point when that decision was made, it could, in fact—after hours of beeping noises on the fetal monitor, the suspense of the hospital atmosphere, and loads of chemicals pumping into her body—have been the only choice available.

And yet I also know what hundreds of other birth activists know. Some percentage of women who think their C-sections were necessary—because of fluctuating heart rates, large babies, failure to progress, previous C-sections, difficult birth positions, and on and on—have actually had unnecessary C-sections.

I know this because the World Health Organization (WHO) says that any time a country's cesarean-section rate rises above 15 percent, the dangers of C-section surgery outweigh the lifesaving benefits it is supposed to provide. 1In the US, the overall C-section rate has now reached 30.2 percent.2

That conversation, which I have had all too many times with various women, boils down to this: There are too many C-sections being done—unless it is your C-section. Then, it just isn't so clear. That conversation parallels the one that seems to be happening on a national scale. Although the arguments against the use of C-sections, except when there is no other choice, are clear, and although these arguments are supported by plenty of evidence and statistics, doctors and patients do not seem to be using that information to change birth practices. It doesn't seem to matter that, in the US:

A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.
A woman having a repeat C-section is twice as likely to die during delivery.
Twice as many women require rehospitalization after a C-section than after a vaginal birth.
Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.
Babies born after an elective cesarean delivery (i.e., when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.
Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.3
The US is tied for second-to-last place with Hungary, Malta, Poland, and Slovakia for neonatal mortality in the industrialized world.4
Babies born via C-section are at high risk for not receiving the benefits of breastfeeding.5
The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births. The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.6

Despite these statistics—which are just drops in the bucket of information available about the dangers of cesarean surgery—the procedure keeps being done. Women are not well enough informed, say birth activists. Medical schools are not teaching doctors how to create optimal scenarios in which successful vaginal birth can happen. Doctors are making decisions based on fear of malpractice suits rather than medical necessity. But even though we know all of this, and even though the statistics are compelling, high-tech birth practices continue, and the C-section rate keeps climbing, with every indication that it will climb higher. Why? "In another century, these birth plans will be perfect time capsules of postmodern maternity," says Tina Cassidy in her recently published book, Birth: The Surprising History of How We Are Born, "for if there is one thing that writing this book has taught me, it is that birth always reflects the culture in which it happens."7 Which made me wonder: In examining the way we give birth today, what would an anthropologist a hundred years from now learn about our culture?

The Mantra of Fear
If an imaginary future anthropologist took a look at our current birth practices, she or he might conclude that we were a very frightened people indeed. In her book, Cassidy reports that many women have a deep feeling that birth is inherently dangerous. "Deliveries at home and in birth centers have been statistically proven to be as safe as those in hospitals, where, not incidentally, one's chances of having a cesarean soar just because you walk through the door. . . . There are, and always have been, trade-offs in decisions about where a child should be born. . . . Weighing those options, women still want to give birth where they feel most safe. And for all but a fraction of those pregnant today, that place is on a bed that can—if necessary—be wheeled into the operating room, surrounded by machines, and attached to electrodes and a catheter that drips anesthetic directly to the spine."8

Just look at the statistics in the 2006 survey "Listening to Mothers II." Only one in four women surveyed had attended a class in childbirth education—however, 68 percent of these women had watched one or more television "reality" shows that depict childbirth.9 With few exceptions, these shows portray births that follow a strictly medical model, usually problem pregnancies in which women and their babies are rescued by heroic medical procedures. Machines beep wildly in the background, and the atmosphere is fraught with tension.

Maureen P. Corry, executive director of Childbirth Connection, which sponsored the "Listening to Mothers" surveys, feels that such shows make women believe that this type of birth is completely normal for all women.10 In the 2006 survey, 72 percent of first-time mothers felt that watching these shows "helped me understand what it would be like to give birth." In other words, being rescued from a dangerous situation by medical technology now seems to them to be a normal part of the birth experience. Even more striking is that 32 percent of first-time mothers felt, on the other hand, that the shows "caused me to worry about my upcoming birth."

Neither position seems likely to prepare a woman for the idea of birth as a normal life process that might actually go well on its own, with little or no intervention—a process that is, in fact, biologically more likely to go well. "Our culture has an 'accident waiting to happen' mentality," says Corry of the survey's findings. "It makes birth go from a normal physiological process to something that resembles intensive care. I think it is indicative of the larger culture in general."

Indeed, we seem to be a people who are just waiting for something to go wrong. You have only to turn on the evening news to get a good dose of what there is to be fearful about. On any given day, you can hear that the supplement you were told last month would add years to your life has now been proven to be toxic. Your chances of developing such-and-such disease have been increased by your living in the town or neighborhood you moved to last year. If you don't send your children to get extra tutoring right now, they will never succeed in their chosen careers.

Certainly, the events of September 11, 2001, and fears of terrorism have increased this tendency—or perhaps it is our fear-filled response to these threats that has caused our lives to become even more anxiety-ridden. For many, it has become impossible to sort out the difference between sensationalism and valuable information. And this very uncertainty itself provokes more anxiety, adding yet another layer of fear.

Our fear-based culture shows up in another birth-related way: the overriding fear of most doctors—even many midwives—of being sued for malpractice. This fear is based on grim reality. Being sued for malpractice can be life-changing and devastating: Doctors can lose their practices, their homes, their life savings. And so, as the normal ebb and flow of labor unfolds, physicians all too quickly resort to responding as if to a worst-case scenario. If a woman is not progressing quickly enough, or if the fetal monitor she is attached to indicates a change in the baby's heart rate, the physician feels the safest route is to use every medical tool available, to show that all the bases have been covered. To protect themselves from the expense of a major, career-destroying lawsuit, doctors pay for malpractice insurance at increasingly outrageous rates—some as much as $200,000 per year.

But why is it that the very things that cause birth-related morbidity rates to rise are seen as the "safe" way to go? Why aren't women and their doctors terrified of the chemicals that are dripped into their spines and veins—the same substances that have been shown to lead to more C-sections? Why aren't they worried about the harm those drugs might be doing to the future health of their children, as some studies are indicating might be the case?11 Why aren't they afraid of picking up drug-resistant Staphylococcus infections in the hospital? And why, of all things, aren't women terrified of being cut open? Again, the response seems totally irrational.

Our future anthropologist might soon conclude that the answer lies in our culture's biggest fear of all—of letting go and allowing natural processes to carry on—and our fascination with and blind faith in science and technology as the ultimate antidotes.

Read the rest of the Article Here: