Friday

when it comes to the american way of childbirth...

...it's true that SOMETIMES LESS IS MORE.

Not only do we have a c-section epidemic in this country, we also have record rates of labor induction, often for reasons of convenience rather than for true medical need.

And our infant mortality rates are still higher than 40 other countries, including many you wouldn't expect, like Slovenia.

17 comments:

Katie S. said...

Having recently had a c-section and
talking to moms with the same experience...There are a couple of reason I think the rate is so high.

1. Doctors by law can only use a suction 3 times before having to stop.

My doctor though if she could have kept trying she would have been successful. I have also heard from others that using foreseps is an art and since it is not being used much the art has been lost.

2. Since mothers are having children older in life(I was 36), I think there is a correlation to c-section rates.

3. The use of epidurals. You cannot push if you cannot feel.

Anonymous said...

Its absolutely tied into the fear of lawsuits, which sucks, but its the climate right now. I would only have a baby in the hospital if I knew it had to be a c/s. Regular deliveries in hospitals are so weird with the forced pushing, counting to 10 crap, mom on her back, people asking constantly if they can cut up your baby`s penis while you`re in labor,it goes on and on.

Jenny said...

Speaking of what anon mentions: Katie, I don't recall having seen your position on circumcision. Seems like something you might have a strong opinion on.

We okayed it for our son, but I've never been happy about it. I deferred to my husband, who was on the fence but finally said we should (for reasons having to do with infection and cleanliness), but I'm not sure I would make the same decision again. Thinking about the procedure makes me extremely sad.

DJackson said...

I wrote a long blog about how I was told my baby was going to be 12+ pounds and forced into induction which led to section. When he was pulled out he was 8lbs 12 oz. I regret it. Suction isn't needed, forcepts aren't needed. Women need to know that their bodies were made to birth babies. Doctors need to quit putting their wishes and pocketbooks over the mother's health and women need to stay off their backs during labors.

Suzette said...

I disagree with the last post about forceps not being needed, nor suction. Women may know their bodies, and their bodies may be meant for birthing, but that doesn't mean all works as it should. After being in labor for more than 18 hours and pushing for more than 2, my baby became distressed. She needed to immediately be out. My body, the one you say is meant to birth, wasn't capable of moving her without the help of forceps. Sometimes medical intervention is necessary.

katie s. said...

I agree with Suzette. I was in labor for over 24 hours. The babies head could be seen but no matter how much I tried to push we could not get him out. So the suction came out and the doctor really tried. Both baby and mom were both starting to freak out, I was sad about the c-section because I wanted a natural birth...So the next best thing was to do whatever i could to become a successful breastfeeder, 18 months later and still breastfeeding. I love it. The closeness is magical but now that I want to have another child and have not had a period I need to wean. I still relaly believe the rate of c-section and older moms go hand in hand. Plus epidurals. Someone tell me how you can feel to push if you are totally numb down there!

Leslie said...

Regarding not being able to get the baby out without suction or forceps, I don't know about the situations of those of you who posted here, but sometimes those issues can be resolved through changes in laboring positions--that's the kind of thing a midwife is supposed to help with. Of course, having said that, my third section was due to a malpresentation. I was at 9 cm for five hours. This was a homebirth and it ended in transport, and my midwife never even suggested changing positions as a solution, because she was convinced it was a case of cephalopelvic disproportion. Since my VBAC baby was much bigger, I now know that wasn't true. :-)

Arlene said...

My son (7) was born at home. My 5 week old was born at Lisa Ross, almost in the water but I had to go potty and couldnt get back in the tub!

I did Hypnobirthing as much as I could. Relaxation and mind over matter is the key. IMO

Anonymous said...

um..I think these stats can be misleading. I would question whether it is the SAME women who are being induced, c sectioned etc etc that are involved in these deaths. more likely, my suspicion is two concurrent situations. I would bet in the US, at the same time we have those who can afford quality medical care and choose to avail themselves of it are getting these interventions. At the same time, you have these poor uneducated unmarried women who if they have any prenatal care at all, its probably not very quality. Who probably dont eat right, dont recognize the signs of things like preclampsia until its too late etc etc. If the interventions are at all related to the deaths I would bet the same condition that led to the death may be what triggered the intervention in the first place. For instance a woman who has ignored her health throughout her pregnancy develops toxemia and only does something about it (or indeed even recognizes something is wrong) when her she has a headache so blinding she cannot function. Then she shows up at the emergency room (since she never even went to an OB for prenatal care in the first place) and they need to get the baby out as fast as possible. Simply saying these two high rates exist in the same country says absolutely nothing if they are not dealing with the same pool of people. And I suspect they are not. Statistics are SO misleading. BTW they have just disproved the IQ points/breastfeeding thing. the correlation is with maternal intelligence. And college educated women are more likely to breastfeed and also to pass on higher IQs. They recently found NO IQ difference between breastfed and bottlefed siblings.

Naomi said...

I have also heard from others that using foreseps is an art and since it is not being used much the art has been lost.

I read a really fascinating article earlier this year that discussed forceps vs. c-sections. (I'm pretty sure Katie saw the same article and I'm pretty sure she linked to it, so other people here may remember it, too.) The author noted that when used by a skilled practitioner, forceps can resolve many of the same problems as a c-section (i.e., a baby that won't come out because it's in a funny position). However, nobody starts out skilled and a c-section is a lot easier to do right. I would rather have a forcep delivery than a c-section if it's being done by someone with decades of experience. But I'd rather have a c-section than a forceps delivery if it's being done by someone who's still in the early stages of learning. And I suspect the majority of women feel the same way. Doctor training is one of those things I really prefer not to think about, frankly, because I know that they do NOT tell you (unless you ask) whether you're the lucky person who gets to be treated by the complete neophyte on his first day of his residency. And someone has to be that patient, or there will be no experienced doctors..... anyway, forceps are a high-risk skill to obtain, if that makes sense. You can do a hell of a lot more damage by screwing up with forceps than many other routine medical tasks. And it's not a skill that can be learned through observation, because you can't see what you're doing. You just have to practice until you get it right.

Regarding women's bodies knowing how to give birth -- our bodies provide a really narrow margin of error. Most of the time, yes, women are fine without intervention. All of the time -- no, not all the time. The professions of midwifery and obstetrics developed around that measurable percentage of the time that things go horribly wrong, and trying to figure out how to save the lives of women and infants who weren't making it. I'm not saying that a 30% c-section rate is reasonable or justifiable, but saying "we should just get rid of interventions completely because women know how to birth their children" is also not a reasonable stance.

Anonymous said...

Naomi, you are one of the few people I have seen make intelligent comments on this subject. While I am not a doctor, I have held medical jobs both with humans and animals and it really irks me when people with no medical background attempt to draw conclusions based on how they "think" the world should be. The glorification of third world cultures and "the good old days" tops the list. If you spent some time in these countries or you could time travel you would see horribly horribly grim situations and you would be able to see that all this "evil western baby stuff" wasnt the product of a bunch of nasty male doctors but of a strong desire to save lives.

katie allison granju said...

Naomi makes many excellent points, and I want to iterate that I am not ever making the case that good medical care during childbirth saves lives. It does. And when an induction or C-section are truly necessary, they are lifesaving and something for which we should be very grateful.

But they are waaaay overused, and induction leads to higher c-section rates, so they are also linked.

This morning I was talking to a male acquaintance whose wife had a baby a few weeks ago. I asked him how it had gone.

Oh, she ended up with a c-section, he told me.

Oh gosh, I'm sorry, I said, what happened?

This is what he told me:

Well, the baby was so big that they decided to induce her on her due date. They were afraid the baby would just be too big otherwise. SO they started her with cytotec and then gave ger pitocin, but after 18 hours, she was still only dilated to 2. SO then they broke her water and she asked for an epidural, and after 4 more hours, she was only at 3. So then she told the doctor she knew she was going to end up with a c-section, and she was exhausted, so he agreed. He told her he would rather do it while the baby's heart rate and vitals were still excellent. So she had a c-section.

The baby weighed 8 lbs 7 ozs.

END OF STORY

This is indisputably a typical American birth these days. And I'd probably be begging for a c-section, too- after 24 hours of induced labor with no progress.

One of the things I am seeing more and more often is "we need to induce because the baby is going to get too big." That's not a good reason to induce. And when you induce a woman whose body clearly isn't ripe, you are very likely to end up with no progress and yep, a c-section.

Let me say it again: c-sections and other medical interventions are lifesavers when they are needed. But they are far too often UNnneeded and a Very Bad Idea.

-Katie

Leslie said...

"One of the things I am seeing more and more often is "we need to induce because the baby is going to get too big." That's not a good reason to induce. And when you induce a woman whose body clearly isn't ripe, you are very likely to end up with no progress and yep, a c-section."

What they ought to do is let baby go to term and if THEN it is too big they can worry about a section. Babies rarely get too big for the mother who grew them to birth them. And all they are putting on in the last few weeks is fat, which squishes. :-)

Erin said...

Katie S:

Have you tried just cutting way back on breastfeeding your toddler, and see if your cycles return? I cut back as far as I could without losing my supply, and my cycles did come back. I was then able to nurse my toddler up until the second trimester of this pregnancy.

DJackson said...

"Statistics are SO misleading. BTW they have just disproved the IQ points/breastfeeding thing."

I find it hard to believe that milk made to grow a large bodied, small brained, hooved animal is just as good at growing brains in humans. Mothers shouldn't need any statistics to know that a human baby will be more likely to thrive on human milk than a man made formula.
I have worked in a hospitalsetting while going to school for an RN and I have seen nearly all women who are birthing on their backs which doesn't let gravity help with the decent of the baby and in those instances where the mother was not up and moving around forceps and suction are very much needed. There are instances where medical intervention was not the cause and section is nessasary to save the mother's and child's life but in my opinion those are few and far between.
It doesn't matter if you wait until the baby is full term and then decide the baby is too big. As in my case I had 2 ultrasounds techs tell me my son at 38 weeks was 10 pounds 10 ounces. We waited to 40 weeks to be induced and were told he would be over 12 pounds by now. When he was born he was 8lbs 12oz. There is no way to tell when the baby is ready to come or term and how big that baby really is.

Anonymous said...

Mine was as big as they thought. Needed forceps and needed epiural.

Meagan Francis said...

To me what's just as important in the difference between a c-section or highly-interventive birth and a low-intervention birth isn't just the birth itself but what happens to the mom and baby immediately afterward and how her postpartum recovery is affected.

I agree that technology can be lifesaving when used properly, but that it is too often used unnecessarily (and yes, I believe it's due in large part to our lawsuit-happy culture). But over the years I've been having babies and being around other women having babies--and even after three wonderfully peaceful midwife-attended, out of hospital water births that I wouldn't change for the world--I've become more concerned about how the mom-baby unit are treated AFTER the baby is out. Is the birth treated as a major, once-in-a-lifetime, life-changing event? Are the mom and baby and dad respected and given space and support to help them become a family? Or are they just one more item on the caregiver's to-do list?

I've seen hospital births that go both ways. And I came to realize that though I am personally much much more inclined to give birth "my way", I've seen situations where I would have chosen the c-sec with a great provider over the vaginal birth with de-personalized and shoddy care.