Gloria Lemay on U/A Birth

Here is Canadian Midwife* Gloria Lemay's response to the DIY Deliveries: More Women Go It Alone (ABC's Good Morning America report), originally posted on ICAN.

“The baby could be born in a breach [sic] position, or with the umbilical cord wrapped around its neck. The mother could suffer from significant tearing or from a maternal hemorrhage and bleed to death in as little as five minutes.”

Dear Women,

The above quote is by a physician who was interviewed by Good Morning America for a program about Unassisted Birth on Jan 8, 2008.

I think it’s very important to address the statement that a woman can hemorrhage and bleed to death in as little as five minutes. This is a very horrifying comment for a doctor to make and, for anyone who doesn’t really know birth, it could be enough to send them running for the hospital.

First of all, yes, it’s possible to hemorrhage and bleed to death quickly in birth IF YOU HAVE A SURGICAL WOUNDING. Women die from bleeding in cesareans and with episiotomies. The closest to death that I have ever seen a woman in childbirth was in a hospital birth where the ob/gyn cut an episiotomy, pulled the baby out quickly with forceps and then left the family doctor to repair the poor woman. We were skating in the blood on the floor and desperately trying to get enough IV fluids into her to save her life while the family doctor tried to suture the episiotomy wound as fast as he could. I have never seen anything like that in a home birth setting or a hospital birth that didn’t involve cutting.

Think about it--would any midwife ever go to a homebirth if it was possible for the mother to die from bleeding in five minutes? I know I wouldn’t go if that could happen. We had a visit here in Vancouver BC from an ob/gyn from Holland back in the 1980’s. Dr. Kloosterman was the head of Dutch maternity services for many years and he was a real friend to homebirth and midwifery. He told us that you have AN HOUR after a natural birth before the woman will be in trouble from bleeding. Does this mean that you wait for an hour to take action with a bleeding woman? No, of course not. If there’s more blood than is normal, you need to call 911 and transport to the hospital within the hour, but you’re not going to have a maternal death before an hour is up. I have had 10 transports for hemorrhage in the many homebirths that I have attended (over 1,000). Two women have required transfusions. The other 8 recovered with IV fluids, rest and iron supplements. Of course, no one wants to see blood transfusions in this day and age. We also don’t like to see a woman anemic after having a baby because it makes the postpartum time very difficult. The most important action after having a baby is to keep the mother and baby skin to skin continuously for at least the first 4 hours.

What doctors won’t tell you is that the most severe cases of postpartum anemia are in women who have had cesareans. Major abdominal surgery results in anemia. I have a friend who is a pharmacist in a hospital. He spends most of his days trying to figure out individual plans to help cesarean moms get their hemoglobin counts up. He finds these cases of severe anemia in post-operative mothers very distressing.

I hope this information is helpful to you.

As far as the other nonsense this person is trying to frighten you with:

1. Significant tearing—if you look with a mirror at your vulva after birth and there seems to be skin that “flaps” away from the rest of the vulva structures, you can always go into the emergency ward and have someone suture the wound. Tears do not bleed like cuts do. This should not dissuade anyone from staying away from the place where the scalpels reside.

2. Breech position—you’ll know if your baby is breech. When the membranes release, you will see black meconium coming out the consistency of toothpaste. With a head first baby, the meconium colours the water green or brown but with a breech, the meconium is being squeezed directly out without mixing with water. The other way that you should suspect a breech presentation is if you have a feeling from about 34 weeks of pregnancy on that you have “a hard ball stuck in your ribs.” Breech presentations are about 3 percent of births.

3. Cord wrapped around the neck—the smart babies put their cords around their necks to keep them out of trouble. If you have a baby with the cord around the neck, it can be unwrapped very easily either during or right after the birth. The most important thing is to keep the cord intact.

Gloria Lemay, Vancouver BC Canada
Advisory Board Member, ICAN
Contributing Ed. Midwifery Today Magazine
Teaching midwifery on the internet at www.consciouswoman.org
Speaking at the Trust Birth Conference, Redondo Beach, CA in March 2008

* Gloria Lemay cannot officially call herself a "midwife," according to British Columbia ruling. Only midwives belonging to the BC College of Midwives may use that title. She is allowed to advertise as a "birth attendant."

Thank you, True Face, for bringing this to our attention.


Anonymous said...

Their really ought to be a screening process for what people are allowed to say on TV. Like I always say everyone is entitled to an explaination of why their opinion is wrong.

Rebecca said...

What Gloria Lemay is saying is scarily inaccurate. If you want to have an unassisted home birth, more power to you, but women need to know that it is riskier. Women can bleed to death in 5 minutes, especially if they have placenta previa and an abruption. Not common, but it can happen. Gloria Lemay is not a good source either. SHe's been found guilty of criminal negligence leading to a baby's death, and I believe has been involved in other deaths as well, but I don't know what the legal outcomes were.

Nicole D said...

Sounds like someone has been reading Dr. Amy (me sticking my finger down my throat).

Rebecca - Any woman who doesn't do their research, knows the risks, and accepts them should not be doing u/a. But women who do their research, know the risks, seek advice from professionals when the need arises - those women I will always support - whether or not I agree with their choice.

Previa, easily detectable with u/s (which many u/a women get) and many times with doppler. Abruption - not often mortal for the mommy, and can be controlled until medical attention is received - if the mother/partner has done their homework.

OTOH, she is not negating that a woman can bleed out rapidly, she is simply stating the facts: women who are more prone to this are women who have had major interventions or medications that are common in the hospital birth scene. To cite this as a plausible reason not to u/a or h/b is folly.

On Gloria's court hearing - so, if a doctor looses a baby while at a hospital, they are not a good source, nor are they educated/qualified to help women birth babies? Well then, the majority of OBs that are in practice right now should be booed off to the cornfields to deliver cows on their backs with IVs in their legs, numbed from the udder down, with a surgical incision midway.


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