State of Childbirthing

How many of you have heard this story?

“Why would anyone give birth at home or even with a midwife? My doctor saved my babies LIFE. If I were not at the hospital with him, my baby would have DIED.

I began having contractions about 2pm. We called our OB who said we should come right in to be monitored. So, I got in and they confirmed that I was having contractions every 10 minutes apart. They said I was about 2cm. I asked for some lunch but they said no, but I could have ice chips. Sure am glad that I ate a big breakfast.

Well, they hooked me up to my IV to keep me hydrated (just in case) and I stayed on the monitor for an hour before the IV filled me enough that I needed the restroom. So, I got up for the restroom and found out, after sitting on the bed for that time, my contractions picked up while I was on my feet. I mentioned this to the nurse and she said that that was why they like to keep ladies in the bed – to make it easier on them. Fine with me, back to bed.

Well, after 2 hours of no progress (they checked me a few times and surmised I was stuck at 2cm), they started pitocin. My back hurt a lot and I asked if I could move around, but the nurses said I shouldn’t, because it would move the monitor belts and to remember what they said earlier. About this time, I started to get tired, so I had a shot of Stadol and got in a good nap.

Around noon, my doctor came in to check on me. He said that I wasn’t contracting enough and I was only at 4 centimeters and they would have to turn up the Pitocin. They turned it up a bunch and it hurt so much that I got an epidural. The epidural was just wonderful! I couldn’t feel anything! I recommend to get it as soon as possible ladies!

A little later I began to run a fever and I was told that some laboring women did that. So, they gave me antibiotics in my IV. My doc also wanted baby out because of the infection that was most likely giving me the fever, so he broke my water so I would go faster. By now, I had not eaten since 6am and was REALLY hungry. They said it was dangerous to eat in case I had to have a C-section, so I had some more ice chip. I had to pee again, but, since I couldn’t feel my legs, I was catheterized. But they only put it in and took it right back out. And no problem, because I couldn’t feel it anyways. I took a nap until my doc’s back-up came in at 6pm.Since my doc was off at 5, I had a new person.

She checked me and said I was only at 6cm. She said it was dangerous for my water to be broken for too long and that she was going to turn up the pitocin the rest of the way. I was so glad that I had the epidural. As I had been having the monitors on this whole time while lying in bed, I could see the contractions were off the sheet and I didn’t want to feel that!

Within the hour, I was at 9cm. I was going to have a baby! So, they started to prep the room for pushing. I was put in stirrups and the mirror was put in place – I was so excited! Once my dilation was done (in another 30 minutes), I was given the ok to push. I couldn’t really feel the urge to push, so they instructed me with one nurse on either side holding up my legs. So – I pushed for 20 minutes with only a tiny bit of progress. About this time, my fever started to spike again and my babies heart rate began to go down during contractions. My doctor said that either the baby was too big or he wasn’t tolerating my long labor well. So, they said it was a c-section or my baby’s life. So I signed the papers and half an hour later, my husband was holding little Dana; weighing in at 6lbs 2oz.

Dana went off to the NICU to be checked out and I went to recovery. The doctor came and checked on me in the recovery room. She said we had a problem called cephalopelvic disproportion, where Dana’s head was just too big to fit through my pelvis, and that it’s a very common problem now because people are healthier and they grow bigger babies than they used to. She said that, because of this, all my babies would have to be C-sections no later than 38 weeks, because if I go into labor, my uterus could rupture and both my baby and I would die….. "

I, for one, am tired of idly listening to this ‘story of heroism’ when the hero caused the catastrophe in the first place. What type of hero is one who will set up a disaster to place him/herself in the place of savior, whether intentionally or unintentionally?

American Obstetrical practice.

I have nothing against doctors. I am thankful, thankful, thankful for medicine and its advancements when it is necessary to use the technology. I, myself, chose an Obstetrician for 4 of my births.

In the event of normalcy, though, it is proven that childbirth is much safer for mother and baby in the hands of a midwife. Why is this? That is what I am going to get to the bottom of.

Many states in the U.S. do not recognize DEMs (Direct-Entry Midwives) and CPMs (Certified Professional Midwives) as legal caregivers during birth. Their reasoning is that midwifery outside of the RN training that many state bars provide is not adequate knowledge to ensure the safety and health of laboring women. Direct-entry midwives and CPMs, on the other hand, argue that the practice of midwifery is very different from both the practice of nursing and medicine. Contrary to the medical model of care in Obstetrics, they uphold the Midwives Model of Care, a standard of practice drawn up by four midwifery-advocate groups in 1996. Based on the belief that giving birth is natural physiological process, not a medical condition, it approaches pregnancy and birthing with the mother's wishes being respected, use of technology is minimized, and emotional health is monitored as closely as physical well-being.

Many medical professionals see CPMs and DEMs as outright dangerous. One cannot blame them when 99% have not attended a homebirth nor seen any midwife that they are not ‘over’ in action. One also cannot blame them when the science of their business is, in and of itself, risk. They are conditioned, for 4-8 years or more, to view childbirth as risky until proven otherwise; whereas the midwifery model of care views childbirth as natural and safe until proven otherwise.

Case in point, Dr. John Schneider, president of the Illinois State Medical Society, the most powerful opponent of legalizing home-birth midwives, argues that DEMs are dangerous because they are not ‘properly trained’ to deal with the life- threatening complications that may arise at birth. "I have no objection to a physician working with an advanced-practice nurse midwife," he says, but he vows that ISMS will never recognize the legitimacy of DEMs: "This is not a third-world country."

Interestingly, the APHA (American Public Health Association) and the WHO (World Health Organization), on the other hand, two much more knowledgeable and larger-scaled organizations, have both endorsed births attended by midwives in out-of-hospital settings as a safe- and, in the case of the WHO, the preferred-alternative.

The WHO believes that the OB-Gyns model of care, in fact, is dangerous on some levels. Why is it dangerous you ask? As stated before, for OB-Gyns to treat every birth as if it's a disaster waiting to happen is to see risk and disaster at every turn, instead of seeing natural process and small (often) inconsequential variance. In "Care in Normal Birth," a 1997 working paper, it warns that such an attitude toward birth "interferes with the freedom of women to experience the birth of their children in their own way, in the place of their own choice," and "leads to unnecessary interventions."

The WHO maintains that often, medical doctors are so preoccupied with emergency situations that they don't have time to give normally laboring women the attention or the safety that they deserve. They identify midwives as the most appropriate and cost-effective birth practitioners for healthy women and recognize both the direct-entry and nursing models as valid routes of training. "More important than the type of preparation for practice offered by any government is the midwife's competence and ability to act decisively and independently," states "Care in Normal Birth."

Many medical personnel and organizations do not recognize CPMs and DEMs as valid or respectable attendants for births as they believe they are unqualified and even dangerous. Many will point out examples of midwife attended fetal deaths, as in the case of Yvonne Cryns. Mrs. Cryns was indicted on two counts of involuntary manslaughter in 2000 by the state of Illinois after she attended a home birth at which the baby was stillborn.

It makes one wonder, though, if the death of a child were all that was required to discredit ones qualifications and safety of practice, Obstetricians in the U.S., with their comparatively high infant mortality rates, are just has incompetent and unqualified for assisting in childbirth. By their own merit, they should not be practicing.

In 2000, according to the Maternal and Child Health Bureau of the Department of Health and Human Services, the United States ranked 30th in maternal mortality and 27th in infant mortality in comparison to the WORLD. In comparison to other developed countries, we are the second worse. In developed countries where' midwives act as primary birth attendants, mortality and cesarean rates are much lower.

The midwifery model of care is not just a benefit, it is a health issue. What a world, or at least a nation, this would be if midwives and Obstetricians worked hand in hand, as equals and peers, not as competitors and corporations. Other countries have caught onto this basic truth; are we, as Americans, to proud to admit err and learn from other countries? I am afraid that may be the truth. Some people wonder why I urge, so heavily, for friends and family, peers and strangers, to research the difference in the midwifery model of care.

It is not a bias without fact. It is a bias rooted in research, tempered with knowledge, and a healthy dose of fear of the ‘risky business’ (pun intended) of Obstetrical practices in the United States.

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