Wednesday, November 28, 2007

Is Homebirth Safe?

Another great article I've received through Google Alerts.

Is Homebirth Safe?
by Lauri Smit


Many people ask if homebirth is safe. Our society views labor and birth as pathological, an illness that needs to be fixed or cured. Since the beginning of time, humans have given birth without medical help or intervention.

Is the Hospital Really the Safest Place to Deliver?

The National Perinatal Epidemiology Unit concluded in Where To Be Born in 1994 that "no evidence exists to support the claim that a hospital is the safest place for women to have normal births." The World HealthOrganization (WHO) reports that "it has never been scientifically proven that the hospital is a safer place than home for a woman who has had an uncomplicated pregnancy to have her baby. Studies of planned home births in developed countries with women who have had uncomplicated pregnancies have shown sickness and death rates for mother and baby equal to or better than hospital birth statistics for women with uncomplicated pregnancies."

David Stewart states that "since the founding of NAPSAC in 1975, we have searched for the data, if it exists, that supports 100% hospitalization for birth. We have not found it. We have formally requested all of the major medical associations (ACOG, AMA, AAP, AAFP) and any other professional organization who supports 100% hospitalization to share their data. To date, they have not. We have asked them to write chapters for the NAPSAC books. We have offered to publish their documentation. We have given them the opportunities to speak before large audiences at NAPSAC conferences in order that their valid statistics, if they have any, can be made known. To date, they have failed to produce even one study in support of their contention." If your doctor tells you that home birth isn't safe and you should birth in the hospital, ask for his/her statistics. Chances are, s/he doesn't have any.

Unnecessary Medical Interventions

The research shows that lower intervention rates are achieved at home, making for a more natural, gentle birth experience for mother and baby. Overuse of interventions in low-risk deliveries have iatrogenic results, meaning the intervention caused more problems than it was supposed to remedy. A.M. Duran stated in The Farm Study, published in the American Journal of Public Health in March 1992, that "home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries." Dr. Lewis Mehl compared matched populations of 2,092 home births and 2,092 hospital births. Midwives and family doctors attended the home births, while OB/GYNs and family doctors attended the hospital births. Within the hospital group, the fetal distress rate was 6 times higher, maternal hemorrhage was 3 times higher, limp unresponsive newborns arrived 3 times more often and there were 30 permanent birth injuries caused by doctors. In another study, Dr. Mehl compared matched groups of 1,046 home births with 1,046 hospital births. There was no difference in infant mortality. In the hospital births, there was greater incidence of fetal distress, lacerations to the mother, neonatal infections, forceps delivery, cesarean section, and nine times as many episiotomies.

Perinatal/Infant Mortality

The United States is in 22nd place among developed nations of the world. David Stewart reported in the NAPSAC News that the national infant mortality rate in 1991 was 8.9 deaths per 1000 live births. Washington D.C. had the highest mortality 21 deaths per 1000 births. The state with the lowest death rate was Vermont, with only 5.8. "Vermont also has one of the highest rates of home birth in the country as well as a larger portion of midwife-attended births than most states." Stewart adds that "the international standing of the U.S. did not really begin to fall until the mid-1950s. This correlates perfectly with the founding of the American College of Obstetricians and Gynecologists (ACOG) in 1951."

British childbirth expert Sheila Kitzinger states that planned homebirth with an experienced lay midwife has a perinatal mortality rate of 3-4 neonatal deaths per 1000 births, as opposed to 9-10 deaths per 1000 births in the hospital. In a study of births in the Netherlands in 1986, 41,861 women having their first babies in the hospital had a perinatal mortality rate of 20.2. 15,031 having their first at home with a trained midwife had a perinatal mortality rate of 1.5.

Marsden Wagner states that the countries with the lowest perinatal mortality rates in the world have cesarean section rates below 10%. The United States' cesarean rate is 25%. Obviously medical interventions, including cesarean section, are not doing for women what doctors claim.

What About "Emergencies"?

Birth isn't without risk. There is a slight risk that a major catastrophe could happen which could possibly be better handled in the hospital, such as umbilical cord prolapse, uterine rupture, abrupted placenta, postpartum hemorrhage. Birth is generally a slow process and there is usually ample time to transport even in the case of a true emergency. A skilled midwife provides one-on-one care and monitors the laboring woman carefully for potential problems.

Shoulder dystocia is handled better at home because of the freedom of birthing positions. If there are signs of trouble, a midwife can easily and quickly help the birthing woman get onto her hands and knees (the Gaskin maneuver, named for Farm midwife Ina Mae Gaskin). In the hospital, the beds aren't as adequate for allowing this type of position change.

The baby's oxygen supply is preserved at home by delaying umbilical cord cutting. In the hospital, the cord is cut immediately, increasing the need for resuscitation efforts.

Postpartum hemorrhage can be remedied at home by putting the baby to the breast immediately to stimulate oxytocin production and uterine contractions. Compression of the uterus can also be done at home. Some midwives carry IVs or an injection of Pitocin for these circumstances.

For true emergencies that require transport to the hospital, women laboring at home 20 minutes from the hospital have the same access to emergency surgery as women laboring at that same hospital. Many hospitals cannot prepare for an emergency surgical delivery in less than 20 minutes. The ACOG standard is currently "30 minutes decision to incision" for all non-scheduled cesarean sections.

Postpartum Depression

Women who give birth in the hospital are much more likely to experience postpartum depression or even post-traumatic stress disorder. Sheila Kitzinger states that the more interventions a woman experiences, the more likely she is to be depressed, with cesarean sections carrying the greatest risk. British physician Aiden McFarlane notes that while 68% of mothers that delivered in the hospital experience postpartum depression, only 16% of mothers that delivered at home do. This could be because of how birth is handled in the hospitals in this country, including numbing medications and routine separation of mother and baby.

Hospital Risks and Errors

There is a chance that your doctor won't be there for your birth and you may end up with an inexperienced student or someone you don't like. At home, your midwife remains with you throughout labor and delivery.

There is a chance that your or your baby could contract a disease or illness (hospitals are for sick people). Your own germs are in your own home.

Your baby could be switched with another baby or snatched by a stranger. In 1983, 101 newborns were stolen from healthcare facilities; 94 of those were recovered, seven are still missing. No fear of this at home.

You have a one in four chance of having a cesarean section in the hospital, compared to 1-5% at home. Cesarean section carries a greater risk of death than do vaginal deliveries. A study in Georgia, cited by Nancy Wainer Cohen and Lois J. Estner, showed a maternal death rate of 59.3 per 100,000 women who had a cesarean section compared to 9.7 per 100,000 for women who delivered vaginally. Other complications of cesarean include infection, infertility problems, organ damage, postpartum depression, pain, and paralysis from anesthesia.

Conclusion

So are you perfectly safe delivering at home? Carl Jones states, "There is always going to be some risk when giving birth, as in all of life, and women should be carefully screened for any health problems that could be dangerous during labor and delivery. For certain women in rare circumstances, obstetric care is essential. However, for most women, better, healthier results are seen when mothers choose to birth at home." If you are a woman with no health problems or contraindications to safe labor and delivery, consider birthing at home. The risks to you and your baby are lower at home.

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References

Bloyd-Peshkin, Sharon, "Midwifery: Off to a Good Start," Vegetarian Times, December 1992, p. 69.

Duran, A.M. "The Safety of Home Birth," American Journal of Public Health. 82(3):450-3, March 1992

Goer, Henci. Obstetric Myths vs. Research Realities, Bergin and Garvey, January 1995.

Institute of Medicine. Research Issues in the Assessment of Birth Settings, National Academy Press, Washington, 1982, p. 175.

Jones, Carl. Alternative Birth, Los Angeles: Dorling Kindersley, 1991.

Kitzinger, Sheila. Home Birth, London: Dorling Kindersley, 1991.

Stewart, David, PhD., "Five Standards for Safe Childbearing."

Stewart, David, PhD. "International Infant Mortality Rates--U.S. in 22nd Place," NAPSAC News, Fall-Winter 1993, p. 36-38.

"Where to Be Born", National Perinatal Epidemiology Unit, 1994.

Tuesday, November 20, 2007

Hospitals' Maternity Ward Waste

I have recently signed up for Google Alerts. It sends you an email with a list of all of the news articles, or blogs that have been posted on the web with any words of your choosing. You can choose how often you get an email updating you with all of the articles. It has sure cut down on my research time and allows me to skim through the few lines they give to see if I want to read the article. I got this article below today in an email. I couldn't have said it better! You can read it below or you can click here to go to the articles page.

"Let me count the ways. The ways that hospitals waste money.

First we'll take a look see at the No. 1 diagnosis using up the most hospital beds nationwide. It's not scary, it's rarely life-threatening, it's not even an illness. It's childbirth and, for the most part, the beds are filled with healthy women giving birth to healthy babies.

But due to a phenomenon called the "fear of imminent trouble," doctors anticipate complications because they have seen birthing tragedies in the past. Often, they jump in too early and cause the very complications they are bent on avoiding, making them more susceptible to imminent trouble the next go-round.

They induce labor with medications that increase pain, leading to the need for an epidural, which delays labor. Once the fetus fails to progress, C-section is likely. The World Health Organization says C-sections should occur in about 10 percent of all births but the United States boasts a 29 percent rate, causing us to spend $2.5 billion a year more than necessary. We utilize epidurals for 85 percent of all births, with a 23 percent rate of complication and run an IV drip on 86 percent of the women when an evidence-based approach would suggest IVs in 0 percent of the cases. Zero.

Ultrasound imaging is the second most reliable method for measuring the length of the pregnancy. The most reliable way is to ask the mother the date of her last period. That's free. Ultrasound certainly isn't. But back to the birthing miracle.

Fetal monitoring is used on all births when studies of 58,000 women showed a simple stethoscope to be as reliable. There are no studies showing that routine fetal monitoring improves birth outcomes. That's money down the drain. A lot of money.

Birthing beds, which cost thousands of dollars, serve to mechanize normal human functions. Squatting is free and safer but it doesn't allow for an obstetrician's comfort (the word obstetrician means to stand in front of).

Midwives, who allow squatting, are used in 75 percent of births in Australia, the Netherlands, Great Britain and the Scandinavian countries. The rate is even higher in Canada. In fact the 28 countries with the lowest maternal mortality rate all use midwives. The United States is 37th, with 90 percent of our births attended by highly trained surgeons.

Then we have mandatory bilirubin testing on all babies when a transcutaneous bilirubin meter could identify borderline levels and trigger a venous test if necessary. Although all Monterey County hospitals use the less expensive testing, many hospitals do not.

This wastes tens of millions a year. We do mandatory hearing testing to find the 33 infants born each day with hearing loss in the United States. With 11,000 babies born every day, that's a lot of testing for a rare condition we can do little for in the first place.

So that's childbirth. If we do that with a non-disease, just think how mucked up we get with the "real" stuff. I'd love to tell you about it, but I'm out of room. You'll have to ask your doctors. They know. They also know that if they don't waste the money, we'll sue them if something goes wrong. Just ask them, they'll tell you all about it."

Monday, November 19, 2007

A Water Birth Story

We have heard rave reviews about birthing in water, especially from our midwife. She says that it really helps with pain and also with tearing as you deliver. I've definitely heard of it as a great experience, but never thought it was 'for me' but then again, I NEVER thought a homebirth was 'for me' 3 months ago either! We are now planning on having a birthing pool during our delivery. If I like it, great, if not, then it was worth a shot.

Here's a wonderful article on a couple who decided on a water birth and their experiences.

Wednesday, November 14, 2007

Grow Your Own Garden

We had a meeting with our midwife last night. Things are going very well. I am measuring right on target and Joseph's heart beat sounds wonderful. My blood sugar was pretty high so I'm going to have to take another test soon. I'm not too excited about that. I've never had a problem with it before so hopefully it was just a fluke.

Penny pressed on the issue of proper dieting last night. She showed us a great way to add some protein to our diet, which is a major staple during pregnancy. The key was, it was totally organic and very very cheap.

Growing your own bean sprouts.

I found this video on YouTube. It's exactly what they showed us last night. We used hose to cover the lid because our seeds were so small. You'll have fresh sprouts in just 3-4 days and the nutritional benefits are great.

It was great to be reminded of how easy it is to eat healthy with just a little work. I'm having a much harder time making sure I get all of my necessary servings each day with this pregnancy than I did with Samuel, for obvious reasons. I needed a boost to get me back on track.

There were two other couples there who are birthing with Penny the same month as I am and both women have had a cesarean as well. It was great to have that in common. There are so many other VBAC stories out there. It's quite encouraging to hear them all and learn from their experiences.

Monday, November 12, 2007

A Doula At Your Birth

Numerous clinical studies have found that a doula's presence at birth tends to result in shorter labors with fewer complications, reduces negative feelings about one's childbirth experience, reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans and reduces the mother's request for pain medication and/or epidurals - DONA International

Click here to learn more about doulas.

Friday, November 9, 2007

It All Started With The Circumcision Issue

When we were expecting Samuel the talk of circumcision didn't come up until the last days. Both of us just assumed that he would get this 'routine' procedure done. We wanted to do some research though into why exactly this is routine and if this normal procedure in America was necessary. We quickly discovered that it was not. There has always been talk that having the foreskin of a male intact would cause health issues. That's why we thought it was worth it. But once we started doing more research we realized it was not as worth it as we had thought. It's simply a tradition. There are health concerns associated with keeping the foreskin intact, but they don't outweigh the concerns of circumcision itself.

My good friend, who was my labor coach, hooked me up with another woman who she knew that decided not to circumcise her boys. She was extremely natural in her birthing plan and I wanted to know more about her perspective on it all. (It was literally days before Samuel was born that this whole process was going on). While talking to this woman I asked her what was her ultimate reason for not circumcising. Her answer was: "if the world does it, we do not." Wow, that hit me like a ton of bricks. Why was her answer so shocking to me? It does say in the Scriptures:

"Therefore, I urge you, brothers, in view of God's mercy, to offer your bodies as living sacrifices, holy and pleasing to God - this is your spiritual act of worship. Do not conform any longer to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God's will is - his good, pleasing and perfect will." (Rom 12:1-2).
She sure wasn't conforming on that issue. She was putting all her energy and resources at God's disposal and trusting him to guide her. If it was a decision that was just foolish that would be one thing, but it was clearly a decision that could go either way. She allowed God to move in her heart whatever way he saw fit. She wasn't implying that absolutely everything that goes on around her is wrong, she was merely saying that she tries to have God lead her in her decisions and does not just do something because everyone else is. But, most likely if the world is doing it, it doesn't align with God's will, because our world is sinful and does not want to do the will of God. The insight I received from her really started to make me wonder. What else was I just naturally conforming to the pattern of this world without even realizing it?

It clearly says in the Bible:

In ALL your ways acknowledge him, and he will make your paths straight. (Prov. 3:6).
I clearly had a ways to go to being able to know God's good, pleasing and perfect will because I was not acknowledging him in all my ways. If I was not acknowledging him in an area, I could guarantee that there was no way I could possibly know his will in that area.

This was a break-through for me as I learned to follow God's lead in my life. I don't know if or how he would choose to convict others of this same issue, all I know is what he's done in my life. There are many things I know he has yet to convict me of that he has already convicted others of. But, for me, that whole issue has truly started to transformed my heart and mind over the past year and a half. I did not have the time to dive into all that the issue would entail, but I knew I was on the brink of something different in my life. A different perspective. Looking at each and every option as one where I could just make the decision myself, or where I could seek God's guidance and have him lead me where he saw fit.

I regret not being as spiritually along in my journey as I am now. I regret allowing the birthing process with Samuel to go the way it did. But, now that I am truly starting to understand this concept of acknowledging God in ALL my ways I am beginning to see his good, pleasing and perfect will for childbirth. It is far from what the world sees as the best way to give birth, but that's okay. God said we would stand out if we followed him.

Here is a link to the American Academy of Pediatrics' Circumcision Policy if you care to know more about this issue.

Tuesday, November 6, 2007

Trusting The Great Physician

One of the main reasons why this decision seems right to us is that we have lost trust in the medical field when it comes to treating women and newborns how they should be treated. I was so disappointed to hear the doctor tell me that I would most likely never be able to give birth to a child vaginally because my pelvic bones were just too narrow. I trusted her, after all, she has a degree in this! Well, going through the dozens and dozens of pages of records from the birth I came to realize that after she would talk to me in the room she would then go back and type into my records something that contradicted what she had just told me. Samuel's head had gotten below the narrowest part of my pelvic bones. She never told me that. She told me he hadn't moved down in quite some time. That was wrong. He was making progress.

Aside from the disappointment in the doctors, finding that particular fact out was so empowering. My body could do what it was designed to do. There was hope and a great possibility that another child could do the same thing! I had come so close to the home stretch. That fact alone gave me no reason to need to automatically have another c-section.

Thus began my search for my next step. Would I again allow myself to be at the mercy of someone who their only concern as of late was malpractice suits and getting the most bang for their buck (doctors get paid more for c-sections than vaginal births), or would I take all the knowledge I have learned and put my trust into women who believe that women are being treated very poorly in hospitals and being lied to on an hourly basis. I choose the latter! I choose to put my trust into women who have gone against the grain to step out and support those women who want their births to be treated like a miracle, not a disease. These women have once worked in hospitals and some still do doing. They see the error, and they want to make a difference. They want to step out and give women a choice of having a safe and natural birth outside of the confines of unjustified rules. I am so thankful that homebirths are now 'coming back' into popularity. They are coming back because so many women out there have been so disappointed in the medical field in regards to childbirth.

Why is it somehow okay for doctors to lie to their patients? I am so fortunate to have gone through the experience where both Samuel and I did not suffer much physical damage (aside from the 7 inch scar across my abdomen and a matching one through my uterus). But, what I still feel is the emotional pain. Their is lingering grief to not having the guts to stand up for exactly what I felt like was the right thing to do. Samuel was posterior, and I knew that. I knew posterior babies take much much longer to be born. I knew that both him and I were doing very well. My water had not broken so I was in no danger of needing to worry about the time. Even if my water had broken, I still had many hours until I had to worry about fear of infection. But, I was tired. I did not have the motivation to argue with the doctors when they were telling me that I really needed to start pushing this labor along. That my time was running out. So, I got some pitocin to speed things up.

What I was convinced of was that my labor was abnormal. That my labor was unusually long and that it needed to be ended shortly. Because why? What were the medical reasons I was given that I needed to hurry things along? None. I was not given facts. I was just told that if it did not hurry up they were going to have to take the baby c-section. But, I was doing fine, and so was Samuel! Why couldn't we just sit it out and let nature take it's course. I will never know what the outcome would have been if just a few details were different. But, what I do know is that if I can at all have a say in what my birthing experience will be like with Joseph, it will be nothing like it was with Samuel. Praise the Lord, I have a say!

It was quite a long journey to get to where I am today. I went from accepting the fact that I was just going to have another c-section with Joseph to realizing that I should probably get more than one doctor's opinion, to realizing that there is absolutely no medical reason why I cannot attempt a VBAC, to finding a doctor and midwife team who would support my VBAC decision, to realizing how limited I still will be giving birth in a hospital, to wanting to try to give birth in a hospital with a doula for guidance through the labor so I have the best possible chance. All that lead me to come across the idea of a homebirth and how it would allow me to have the absolute best possible chance of a natural birth. This was a very unfamiliar topic to me as I began researching into this topic. It seemed Hippie. It seemed unwise. But, it also seemed like a wonderful way to bring a child into this world, if the circumstances were right.

There are lists and lists of reasons you should not consider a homebirth. I do not fall into a single category on one of those lists. I am healthy, active, have good nutrition, have no medical issues whatsoever, am not pregnant with multiples, and have had a very easy pregnancy with both of my children. I am a perfect candidate for attempting a homebirth. But, I've already had a c-section. Not a huge problem! The reason why I 'had to have' the c-section was for an isolated innocent that puts no hindrance on subsequent pregnancies. My uterine scar is favorable to labor again. Yes, my chances of a uterine rupture go up, but they only increase an insignificant amount. Considering a woman who has never given birth has a chance of her uterus rupturing as well. This gives me no real reason to shy away from it.

It has been a long and windy road to where we are today and the journey is by no means finished. We have a few more months to continue to build our knowledge on this issue. We feel very blessed that the Lord has put this opportunity in our path. We want to make sure we are making our decisions as the Lord would have us, not what others are trying to convince us is the right decision. We have decided to trust the Great Physician!

Relative Risks of Uterine Rupture

The greatest concern for women who have had a previous cesarean is the risk of a uterine rupture during a vaginal birth. According to the American College of Obstetricians and Gynecologists (ACOG), if you had a previous cesarean with a low transverse incision, the risk of uterine rupture in a vaginal delivery is .2 to 1.5%, which is approximately 1 in 500 (1).

Here are some probability statistics for you:

Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.

You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.

The annual risk of having a heart attack is 1 in 160, 2 times more likely than rupture. Your risk of dying from heart disease is roughly 1 in 6, or 55 times greater than your risk of rupture.

If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom rupturing during her labor.

You're about 17 times more likely to contract an STD this year than you are to have a uterine rupture; more likely to contract gonorrhea than to rupture, as well.

You're 13 times more likely to get food poisoning than to rupture.

You're more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.

If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience a uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die in an accident (annual risk) than you are to suffer a rupture.

Having a serious fire in your home during the next year is twice as likely as experiencing a rupture.

You're ten times as likely to win at roulette as you are to have a uterine rupture.

If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.

The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more likely than that of rupture (2).

Sources: 1. ACOG Practice Bulletin, No. 5, July 1999,
2. http://www.gentlebirth.org/archives/vbacrisk.html

Sunday, November 4, 2007

Should You Have Your Baby at Home?

A great article sheading some light on why homebirths are so popular.

Should You Have Your Baby at Home?

Today in the United States, at the end of the twentieth century, advances in science and technology account for many positive changes in our quality of life. Yet more and more women from all walks of life are choosing to give birth the old-fashioned way — in their own homes. Why?

The fact is, in spite of all the good that has come from scientific discoveries and experiments, medical science has not been able to improve the human body and the way it was designed to work. Yet when our bodies are not functioning the way they were created to function, we are more fortunate than our ancestors in that modern medical science can sometimes help.

So why are families having homebirths? Though each couple may have individual reasons, most plan homebirths because they believe that most of the time pregnancy and childbirth are normal functions of a healthy body — not a potential life-and-death crisis that requires the supervision of a surgeon.

There are risks involved in childbearing. In a small percentage of cases the skills of an obstetrician/gynecologist and high-tech equipment like ultrasound and fetal monitors are necessary in order for the mother or the baby to survive childbirth without long-term ill effects.

The neonatal mortality rate for the U.S. in 1989 was slightly more than 10 per 1,000 live births.[1] We have the most highly sophisticated and expensive system of maternity care in the world, yet in the same year twenty other countries — countries with less technology than we have in our hospitals and laboratories — had more babies survive their first months of life than our babies in the United States.

What do they do in those 20 countries to have better outcomes?

With fewer high-tech hospitals and obstetricians available, many of those countries — like Holland, Sweden and Denmark — use midwives as the primary care-givers for healthy women during their pregnancies and births.[2]

The World Health Organization urges the U.S. to return to a midwife-based system of maternity care.

Understanding the potential danger in the overuse of childbirth technology, the World Health Organization has repeatedly implored the U.S. medical authorities to return to a midwife-based system of maternity care as one way to help reduce our scandalously high mortality rates.[3]

Midwives, in fact, still attend most of the births around the globe. Physicians, in spite of their advanced training and surgical specialties, have never been proven to be better childbirth attendants than midwives. And no research has been done that proves hospitals to be the safest places in which to give birth.

In fact, study after study has demonstrated that for the majority of child-bearing women in the U.S., the homebirth/midwifery model should be the standard for maternity care.

1. National Committee to Prevent Infant Mortality, HOMEBIRTH No. 8, Sept/Oct 1990, p. 5.
2. The Five Standards of Safe Childbearing, 1981, Stewart, p. 114.
3. Mothering, Jan/Feb, 1990.
To read more about this topic and 6 myths about childbirth, click here.

Friday, November 2, 2007

Reducing the Cesarean Rate

After talking with my previous doctors and my current midwife they affirmed my suspicion that my C-Section could have been avoided entirely. Why would anyone opt for having major abdominal surgery when it could possibly be avoided? I have no idea. Talking with a few of them assured me that the reasoning for my surgery should in no way hinder me from having a vaginal birth. My files say that I needed a C-section for FTP, which in medical terms means, 'Failure To Progress,' but as I've recently discovered the underground name for that is 'Failure To Be Patient.' They were sick of my labor taking so long so they tried to speed up the process. My water had not even broken yet, so I was fine continuing to labor, but they have rules and regulations and they wanted to hurry it along. I was one of many who need a room, remember! Once they tried to speed it along, I needed an epidural 'just in case' I needed to end up having a c-section. The reason for my c-section was 100% because I received an epidural. There are many side effects of epidurals that I will go into later. But for now, here is a great article for ways to reduce your chance of having a c-section.

If you would like to go to the site where I found this story, click here.

Reducing the Cesarean Rate
A look at the increase in the cesarean rate and ways you can reduce it!
© Brenda Lane

Oct 4, 2006
Vaginal birth in hospital, Jyn Meyer

The cesarean rate in this country is at an all-time high. What are ways that you can help to reduce your own chances of having a cesarean?

Looking back nearly 40 years, the cesarean rate in the United States in 1970 was only 6%. This meant that about 94% of women were giving birth vaginally in this country. However in 1987, it reached a whopping 24.4%. Many wondered if the trend would continue.

Although there was a slight decrease in the cesarean birth rate between 1990 and 1996, there has been a steady rise since then. In response, both the CDC and US Department of Health and Human Services in 2000 recommended that the national cesarean rate be reduced to what was considered to be a reasonable target of 15%. Was there reason to think that we could reach that target?

Unfortunately, in 2003, the cesarean rate grew again to 27.1%. Again the target set by the Department of Health and Human Services for cesarean births for the year 2010 at no more than 15% for a first time mother and 63% for repeat cesareans.

The reality is that our latest statistics do not show that we are anywhere near that goal. In fact we are moving in the wrong direction. In 2004, the statistics showed a 29.1% primary cesarean rate. The Listening to Mothers II survey reports a possible rate closer to 31% for 2005 or approaching nearly one third of all births in the United States. There are many possible reasons why the cesarean rate is so high right now including the high rate of inductions and the use of electronic fetal monitoring for nearly every hospital birth.

Is there anything you can do about the rising cesarean rate? If you are expecting, here are eleven ways to reduce your own chances of a cesarean:

1. Choose a provider with low cesarean rate and high VBAC rate.

2. Choose a supportive place of birth with a low cesarean rate. (Consider a birth center or homebirth.)

3. Use continuous labor support (doula) during labor and birth.

4. Delay getting an epidural until you are 5 cm dilated, the baby is at zero or lower station and the baby is rotated into the anterior position.

5. Take a good childbirth preparation class that reviews and practices a variety of pain relief techniques and positions for labor.

6. Write a birth plan.

7. Allow labor to start on its own and avoid a labor induction unless there is an indicated risk for you or your baby.

8. If you are low-risk, spend early and most of active labor at home.

9. Stay upright and mobile during labor and while pushing.

10. Realize that labor has its own timetable and pattern. Some mothers will need only hours to labor and others will need several days. Both are normal.

11. If your baby is breech, try methods to turn your baby to vertex or finding a provider skilled to deliver your baby in the breech position, instead of scheduling a cesarean.