Over this next week I have decided to write every day, each day with a totally random theme on which I will totally randomly rant.
I do this because I naively and narcissisticly believe that someone out in the universe may find it interesting.
Enjoy.
Today I begin with Maieutics & Magniloquent Monday.
Magniloquent because I chose the word Maieutics to describe Midwifery instead of just saying Midwifery. I like to use big words. It makes me feel smart.
I have some very strong feelings about childbirth and I have my sisters to thank for it. I'll be forever grateful for the education they have provided me with.
I will have a home birth. I will have an unmedicated birth. My birth will be the way I want it, because it is my body and my baby. I will not have a doctor tell me how to deliver my baby. If I want to squat and let gravity help me, get the heck out of my way. Don't put me on my back merely for your convenience.
I think midwifery is a beautiful thing. The midwives that I have met share my vision of what childbirth should be: a spiritual event.I don't want to be knocked out or on any sort of medication when my baby enters this world. They tell you not to take any medicine or drugs while you're pregnant, but they shoot drugs right into your spine at the moment of highest stress for your baby - I don't believe that has no effect on them.
I wish I had more time to rant about this because I could go on and on, but you get the idea. Open a discussion with me anytime about childbirth and I'll tell you ALL about it.
Tune in tomorrow for Telekenisis Tuesday.
Quick! I need your help!!
13 years ago
Posts
12 comments:
I commented on Tuesday first but thought I'd keep up the friendly debate.
While I believe that every woman has the right to choose how she will give birth, here are my thoughts. Infant mortality has been dramatically reduced over the years thanks to modern medicine.
The pros and cons of epidurals are widely debated. Many agree with you that they are not needed. It has been widely agreed however that they do not affect the baby. In fact, in many cases they aid the baby. There have been many cases of women who choose not to have one due to naturalist birth beliefs and it causes much unneeded stress on the baby and the mother. In most cases though, it is up to the mother to choose and is fine either way in almost all cases.
Another, huge, advantage of hospital births: if you have an emergency during birth that requires C-section or something where the baby needs to be incubated or otherwise treated quickly, a home birth becomes a danger to baby and often mother.
Hope it's ok if I comment! I enjoy your thoughts and ideas
Megan,
I will not discount your thoughts on infant mortality being improved over the years. (Although I will not go into the fact that I think it is largely attributed to all-around better hygeine and knowledge about pregnancy).
However, if you will simply type in "effect of epidural on baby" in google, multiple sites will come up (many of them very respected medical journals, not hippy mom sites) that list a scary amount of side effects for mom and baby.
I found no studies that show that an epidural can aid the birth. In most cases it slows the birth down and, because of inability to feel, the mother cannot push effectively.
Lastly, I will not deny the use of modern medicine (c-sections) when absolutely NEEDED, but I do believe (through personal family experiences) that they are far too commonly practiced by doctors, sometimes merely for the convenience of either doctor or mother.
Thank you for the opportunity of friendly debate :)
Firstly, you're welcome. :O) It's great to have a sister who is a childbirth educator/doula/aspiring midwife, isn't it?
Secondly, everyone IS entitled to their own opinion and as parents, choose what they feel is best for their child. That being said, Megan - I completely disagree with most of your comments. An epidural AIDING a baby? How many births have you attended? While my experience is nowhere near vast, I have attended 50+ births over the past 4 years. Never have I seen an epidural NOT affect a baby. Study after study shows that breastfeeding is impeded, baby is less interactive (which I have seen in my own children) and bonding is affected. Women who choose unmedicated births actually respond more quickly to their baby's needs. Many drugs can actually cause respiratory distress after birth as well.
This study (http://www.ajog.org/article/S0002-9378(09)01111-9/abstract) shows that outcomes are oftentimes MUCH better in a home or birth center setting than at the hospital. And keep in mind that this study was published in the American Journal of Obstetrics and Gynecology, THE governing body for OBs.
Having transferred from a home to hospital birth twice, I know the risks and benefits of choosing home. Both times I transferred I arrived at the hosptial BEFORE the doctor. Were you aware that DRMC, along with many other hospitals, does not have an OB on staff 24 hours a day? You would not have a c-section any faster if you were down the hall from the operating room than if you were across town, being attended by not one, but TWO professionals trained in normal birth, neither of which leaves your side during the ENTIRE labor. In the hospital you have one nurse who could have as many as 4 patients who I consider high risk because of the medications pulsing through her system, not to mention the baby's as well. How can that be considered superior care!? If you've not had a baby, you would not know that 99% of the time the doctor does not arrive in labor until the baby is crowning and often the mother is told to halt pushing the baby out to wait for the doctor's arrival. This can be detrimental to the baby - when a baby wants to come out, it needs to come out. Is that what you're paying a doctor $3,500 for? Hmm...interesting choice.
I also agree with Jaylyn that infant mortality rates dropped not because of materity care practices and birth moving to the hospital, but because people realized based on Ignaz Semmelweis' studies that MAYBE it's a bad idea to go straight from an autopsy to childbirth without washing your hands in between. WOW. Just read up on American's infant mortality rates as compared to other countries (most of which employ home birth with midwives as the primary form of maternity care) and you'll see that the US is continually in 35th place or lower for infant mortality. We must be doing something wrong.
I'd like to see your evidence to support the idea that an epidural is not harmful to a baby and that homebirth is dangerous if emergent care becomes needed. I thought it was only fair to provide studies to support my claims. My information comes from more than hearsay.
First, I never said that epidurals are always an aid to the baby. In most cases, they are not needed. However, I have a friend whose well-respected doctor told her of several cases where they had wished an epidural had been administered because the mother's health was such that the process of labor put far too much strain on her body, endangering the baby. There have been cases.
As for the mortality rate being decreased by knowledge and hygiene, I will point out that this comes from modern medicine. :-)
While I have not been present at the births, I have talked to countless recent mothers, all of whom had epidurals, and there was zero effect on the baby or the breastfeeding. My sister has done it both ways and there was no difference between her children. Which goes with my point that I think in most cases the epidural does not have an effect one way or the other. I agree that it can, but usually doesn't.
Janet, I actually did know the stuff about the presence of doctors during labor at a hospital that you mentioned. I have researched area hospitals thoroughly about these things and have long ago chosen not to deliver at Utah Valley Regional for many of these reasons. Our health care system is not perfect.
As for your information on the effects of epidurals on a mother's and child's response and interactions, in my many experiences I have never seen that to be true. Again, my sister and my friend who have done both show no difference between the children born with and the children born without. I just don't see how a temporary drug can effect a woman's response system over an extended period of time. I wonder how the women in the those studies were chosen.
I have nothing against midwifery. I also hope never to have a C-section and will fight such unless it is an emergency. But I have also known several mothers, including my own, who would have died if not for the quick action taken in a good hospital during labor that could not have happened if they had been at home.
As to the study Janet mentioned, I agree that sometimes home births can have much better results. However, as stated above I have seen it go the other way as well.
My information does not come from hearsay, it comes from personal experiences. Many personal experiences, and frankly I resent the idea that since I have not given birth I could not possibly know. As I have spent the last year attempting to get pregnant I have done much research on pregnancy, labor, and delivery and talked to everyone I can who has been through it. So please don't tell me that I couldn't possibly know, because guess what, I did.
You both have your experiences and I have mine. As I stated, it is up to each mother to choose what is best for her and her baby. For you, it will be home. For me, it will be a good hospital of my choosing.
As always, thanks for the debate. :-)
Megan - Read the studies. Then you can know where they got the 745,690 women from. Your handful of personal experiences of those around you hardly counts as a study on which decisions can be based. That is not evidence, that is personal experience. And to say that someone who was in the hospital "would have died" without the various interventions available in the hospital is asinine. Where's the crystal ball that shows how things WOULD have been in a home birth setting? And did it occur to you (and MANY others who make this claim) that simply being in the hospital in the first place introduced the circumstances that led to the emergent situation through the overuse of unnecessary interventions? Thus the hospital and/or staff "saved" the mother and/or baby. Really? How about they admit that in many cases THEY caused the problem that led to the need for such drastic measures. No one ever blames the hospital or the doctor when mothers and/or infants die, which does still happen. But when something happens at home, of course it is because of the home birth and the supposed lack of adequate care. This recent study disproves that and I wish society would see that being in a hospital does not equal a good outcome, especially emotionally for many women, even if there is a healthy baby and a healthy mom. While that is the ultimate goal, it should also include a positive experience.
Your friend's "well-respected" (that's always debatable) doctor claiming that an epidural should have been used in those situations is a personal opinion from one man (or woman) and in no way constitutes evidence-based care.
Mothers' responses to their babies has to do with the initial critical bonding period, which can be evidenced by this study. (http://books.google.com/books?hl=en&lr=&id=H392OLiJekMC&oi=fnd&pg=PA275&dq=monkey+critical+infant+bonding+study&ots=51hqQ5sVr4&sig=rwGvVoBtkH4z-m10FrlMdhmTbIc#v=onepage&q=&f=false) Also, feel free to read this article (http://alternativebirthservices.blogspot.com/2009/06/pain-medications-used-in-childbirth.html) and be sure to note the sources cited at the bottom. Babies are more likely to be separated from mom in those early critical hours after birth when bonding should be occurring.
While I do appreciate all the research you’ve done in the past year, have you talked to some of the 5-10% of women who choose unmedicated birth or some of the 1% of women who choose to birth at home or in a free-standing birth center? If not, even your personal research is not balanced. More studies on effects of epidurals: http://journals.lww.com/anesthesiology/Abstract/2005/12000/Effect_of_Labor_Epidural_Analgesia_with_and.16.aspx
http://www3.interscience.wiley.com/cgi-bin/fulltext/121511179/PDFSTART
“Direct effects of anesthesia
The use of epidural anesthesia-as the main variable differentiating groups in the comparisons and as a predictor variable in the regressions-was related to poorer behavioral outcome and recovery for the infant over the first month of life. The medicated infants showed less alertness and ability to orient over the first month, and in the motor cluster were less mature. The depressed performance of these infants on the first NBAS may have been a result of the direct action of the local anesthetic on the neonatal CNS. Belfrage et al. (1975) found bupivacaine and its metabolites in the circulation of infants for the first three days of life.”
“After eliminating potential differences due to the number of parturitional and fetal complications by the matching procedure, the epidural group was found to have longer labors, more oxytocin and more instrumental deliveries than the non-medicated group. These complications have been found to be associated with epidural anesthesia (cf. Avard and Nimrod 1985).”
“SUMMARY
The effects of maternal epidural anesthesia with bupivacaine on the infant’s performance on the Neonatal Behavioral Assessment Scale (NBAS) over the first month of life were examined. 20 nonmedicated infants were matched for biomedical and demographic variables with 20 infants delivered with bupivacaine epidural anesthesia. The NBAS was administered on days 1, 3, 7 and 28. The epidural group ;showed poorer performance on the orientation and motor clusters during the first month of life. Epidural mothers reported spending less time with their infants while in the hospital; post hoc analyses showed that they had longer labor, more forceps deliveries and a greater amount of oxytocin. Controlling for the effects of these medical variables, a dose effect was found for the mean orientation and motor cluster scores. The results are discussed in terms of possible effects of the infant’s early disorganization on the mother-infant interaction.”
Again, I’d like to see your studies cited. And if you’re going to consider all the factors, make sure you’re not ignoring the ones that will disprove your point. But, people are always entitled to their opinion, even if it’s wrong. ;-)
Good luck with your attempted pregnancy. I hope for the best for you and hope you will educate yourself on both sides of things before the birth. A closing thought: What if your beloved epidural does not take effect and/or you don’t have time in labor to have one placed? That’s why I recommend everyone prepare for an unmedicated birth. You can always change your mind later and get one, but you can’t prepare for an unmedicated birth in the moment.
Oh - and remember when thalidamide & ether were safe during childbirth? How are people going to feel about the epidural 20 years from now?
For the record, I believe that if you can handle it, no epidural is better and I plan on going that direction, but in a hospital. So again, please don't tell me that I know nothing. I simply have my beliefs about what will be best, and safest, for me and my baby.
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