Home Birth Among Catholic Women?

[Xantippe]

babochka said:

“Midwives are medical professionals these days, just as doctors are. They also benefit from the advances in medical technology. They are able to provide the same prenatal care given by doctors. In many states, midwives,even those who are not also nurses, are able to carry and use pitocin and oxygen, as well as insert an IV if necessary. Today’s midwives are not the same as midwives of yesteryear, any more than today’s surgeons are the same as the barbers who used to do surgery.”

1. Once again, there is a huge variety in qualifications among US practitioners who call themselves midwives. CNMs are graduate educated nurses who are welcome to work in hospitals. CPMs on the other hand–well who knows? In their case, it’s not accurate to say that they are “medical professionals” “just as doctors are.” One big problem is that CPMs are often moonlighting as midwives and simply do not have a high enough volume of clients to know what they are doing, even if their initial training were adequate, which it is not (there seem to be a lot of homebirth midwives who attend only one birth a month). It’s my understanding that CPMs only need to be present at 40 births (along with some fairly trivial paper credentials) to qualify. 40 is nothing if we consider that many common complications occur at 1 in 100 or 1 in 200 births. The CPM is the equivalent of the barber doing surgery. And some midwives aren’t even CPMs.
2. As we can see even from this thread, there is a lot of pushback against standard medical care within the homebirth and midwifery communities (upthread there was a poster who thought it was a good idea to turn down the vitamin K shot that protects against fatal hemorrhages and the eye goo that protects newborns against blindness caused by gonorrhea). It is not possible to assert that homebirth midwives will have the same outcomes as standard medical care if at the same time, homebirth midwives are flouting the standard medical protocols for pregnant mothers and newborns–urging pregnant women to skip the gestational diabetes tests, not doing ultrasounds, skipping rhogam shots, telling pregnant women to use garlic suppositories and Hibiclens instead of doing the standard protocol for Group B Strep, encouraging home deliveries of twins and breech babies, telling women that their bodies won’t grow babies too big for them to birth, etc. All of these practices are both common within that community and extremely dangerous. It is not possible to engage in these non-standard practices and to expect the same outcomes as a more orthodox medical approach.

 

[KellyPalmer]

KellyPalmer;10992837:

All women were forced into hospital for birth starting in the early 1900s.
QUOTE]

This can’t be what you meant to say. It doesn’t hold up to reality. Everyone has at least one great grandma who was born at home. My grandmother was born at home because they couldn’t afford the hospital. They couldn’t afford a doctor. She was born in 1910. My grandmother born her first two children at home because there was no hospital. She lived on a dirt road that was hours from any town. She did get a doctor though. Are you trying to say that some women were forced into hospitals or that women who could go to hospitals were aggresively encouraged to? I’m honestly trying to understand what you mean, but in the long run, it doesn’t matter for me. As I’ve said, I have a really good hospital and lots of pretty good hospitals to choose from. I’m not being forced.

Yes, that is what I meant to say. It is clear that you have not studied this at all. Please pick up a history book. I listed several up-thread. I’ll give a brief overview – In the early 1900’s, doctors banded together, and went to legislators to gains support for a bill to make midwifery illegal. This was several years before women’s suffrage, when all doctors were male, as well as legislators. Women, themselves, had no representation or voice in the matter. Until that point, 90%+ of births occured at home, because no one who had a choice would step inside such a dirty, infectious place as a hospital. Certainly not with doctors in attendence, who had yet to have any kind of standardized practice or educational standards to regulate them. This situation vexed physicians to no end. How could they gain the knowledge and experience they required, in order to shore up their privileged and powerful position as “holders of the fate of childbirth,” if women never came in, submitted to their experimental treatments, and gave them that necessary foothold? The answer was to make the alternative illegal. Drive the midwives out of business, and you will drive the women into the hospitals. It was a two-pronged attack; they succeeded in banning midwifery, and they also began advertising “hospital childbirth,” where women (the rich ones) would get to stay in hotel-like accomadations, and where they could have access to something called “pain-free birth” through twighlight sleep, which involved a combination of barbituates and/or narcotics, along with an amnesiac, scopolamine. These women submitted to being drugged, then tied down to keep them from falling out of bed or wandering the halls, in a drug-induced, drooling state, and then delivered, usually via mid-forceps assisted vaginal birth, in a totally passive state. After they came around, they had no memory of their screaming, half-mad/half-zombie, pain-filled labors–thanks to the scopolamine. No, they didn’t remember their labors, and so they didn’t remember pain, and the physicians’ purpose was served. Women spoke of a “pain-free birth” where they didn’t remember anything. What they also didn’t remember was their babies’ entrance into the world. Usually, they would wake up, and about 48 hours or so later, they would be presented an infant, and told “congratulations, you had a boy/girl.” 100% received episiotomies. Poor and immigrant women were the worst off, because they were, literally, the experimental subjects for a foundling discipline. Deaths related to infections soared until the practice of washing hands was finally instituted. In all of this, the one message pounded into the skulls of women, and society at large was, “You would have died outside of a hospital.” Twilight sleep was common in hospitals up until the 1970’s in the U.S. Many of the instructors in medical school practiced accordingly. Many of the texts used in the 1970’s and before are still referenced today. Joseph DeLee was the mastermind behind this type of delivery. To this day, he is considered the “father of modern obstetrics.” Your OB learns in med school that DeLee’s theories formed the basis of “scientific obstetrics.” It was only in 2005, nearly 100 years later, and hundreds of studies later than ACOG finally–finally–recommened that episiotomies be reserved for only truly drastic cases.

 

[KellyPalmer]

“All women were forced into hospital for birth starting in the early 1900s.”

Really? Rounded up by the police? Seriously? And so early?

I don’t know whether this is a good source, but here’s a more plausible number from what looks like a pro-midwifery site:

“In the United States, 1939 was the turning point when more babies were born in hospitals than at home. Since then, the percentage has risen steadily to about 98%. During the same period, the percentage of births attended by midwives had plummeted to 10% by 1935.”

birthpsychology.com/free-article/introduction-birth-scene

This is from the CDC:

“At the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications, and approximately 100 infants died before age 1 year (1,2). From 1915 through 1997, the infant mortality rate declined greater than 90% to 7.2 per 1000 live births, and from 1900 through 1997, the maternal mortality rate declined almost 99% to less than 0.1 reported death per 1000 live births (7.7 deaths per 100,000 live births in 1997) (3) (Figure 1 and Figure 2).”

So, during the period of transition from home births to hospital births during the 20th century, there was a 99% decrease in maternal deaths and a 90% decrease in infant mortality. That is quite a tribute to the efforts of US medicine.

If we take the early 20th century numbers as our “natural” baseline, nearly 1 in 100 births led to the death of the mother and 1 in 10 babies died before their first birthday.

Maybe, just maybe, US women were tired of seeing their sisters and mothers and friends and babies die, and were happy to switch over to the relative safety of hospital childbirth.

I know google is great but you really need to read a history book if you want to gain a clear picture of what happened. What you describe above happened over a very long period of time. During such times huge advancements were made such as the institution of hand-washing and the creation of antibiotics. Of course these things saved many lives! Modern advancements are good! No one is disputing that. However if you look at the period immediately after midwifery was outlawed and women were forced into hospitals (yes – that is what happened), both maternal and fetal deaths rose sharply. Your “maybe” is wrong. You are looking at this through 21st century eyes. Just close your eyes and try to imagine what a hospital was like in 1910. Seriously. Does that sound like a place you would want to go, as a healthy pregnant woman about to give birth? No way! They were disgusting! They didn’t even wash their hands in between patients! Clean water, sanitation – not the same as today by a long shot! They didn’t even have antibiotics! None of the medical technology that we see in labor and delivery wards today. They didn’t know what they were doing and literally needed guinea pigs to hone their skills. This is specifically spelled out in historical documents. You can see it with your own eyes – maybe not after a 5 minute google search but certainly in history books.

 

[KellyPalmer]

Until the 1940s, the women in my family gave birth at home with either doctors or midwives. My grandmother was apparently born right in the kitchen. She was the 7th and last child as her size (10 lbs) ripped up my great-grandmother so badly she needed padding and such to keep parts of her from falling out, so-to-speak, later in life and finally, after pushing by her children, got surgery. My three aunts and their babies who died were also doing it at home. The babies were extra large. Please note, I’m not relaying these stories as fear-mongering as this was a different time, different ideas and understanding of the practice of medicine and birthing traditions and mortality rates for children and mothers were higher back then. It wasn’t too unusual to know women or infants who died during childbirth or even from common diseases we take for granted today (ie. My grandmother lost a brother when he was a toddler after having the flu or something like it, and another brother later on to TB) but still awful and tragic all the same.

My mother, who is now in her 60s, was basically born in the jungle during WWII while her family was hiding from the Japanese soldiers. There was no real medical help, but my grandmother came through well and went on to bear 4 more children (she had 10 in all although one boy died of pneumonia during the war because they couldn’t get him to medical care). As I mentioned in a previous post, in that country at the time, the doctors did not deliver babies. The nurses were trained in midwifery because they would be expected to deliver the children.

I am just thankful that today we do have better advances in medicine and science, as well as have the information at our fingertips to make the best choices for us and our families, no matter what it is. It would be great if more hospitals and midwives could work together and we weren’t ruled by the insurance companies. I honestly think that they hurt the art of practicing medicine.

Yes, it was much more common for women and babies to die in childbirth at that time but that remained the case (actually it escalated for a time) when birth was moved to the hospital. And yes, mortality rates are much lower today. Correlation does not imply causation. Many medical advancements have been made between then and now. I don’t know a single homebirthing mother who begrudges medical advancement. However, many realize that things may have gone too far in the opposite direction. For example, c-sections have been a significant tool in reducing mortality rates however once the c-section rates goes over a certain percentage, it ends up harming women and babies. Today, more than 30% of babies in the US are born by c-section. This number is too high and there is much evidence that many of these are done unnecessarily. Those who support homebirth as a safe option, are looking through 21st century eyes, not wanting to go back in time when poverty was much higher, sanitation/clean water much worse, when antibiotics were not around and other basic medical care was non-existent.

It’s interesting that in other countries, midwives were the first to practice in hospitals. Things went down differently in the US. In Vienna, it was Ignaz Semmelweiss who discovered that the mothers under midwifery care in the hospital had better outcomes. Women under the care of a physician had three-times higher maternal and fetal mortality rates! This lead to the gradual acceptance of hand-washing there as midwives were already doing it but the physicians had previously rejected the practice. It would be many more decades before the practice would become common in US hospitals. Dr. Oliver Wendell Holmes tried to get the practice into use here in the US but was dismissed by the other physicians.

I agree with you about wishing hospitals and midwives could work together. I don’t think insurance companies are so much to blame as our slow moving legislative system and a culture of greed. Ever since midwifery was outlawed in the early 1900s, it has been a slow road to restoring those rights. Many states still have hostile laws in place against midwifery. It would have been illegal for me to have hired my midwives for the births of my first two children. They only became legal in my state in 2005 shortly after my second son was born. They are legally prohibited from practicing in many other states. This is the reason my insurance company will not cover them.

 

[KellyPalmer]

Since we’ve talked about how much things have improved with mortality rates since long ago, I think it would help to offer some perspective. Here are more current stats:



We are failing. Many will say it is because we have so many premature births and while that is a huge part of it, we compare poorly even when we only look at full-term births:

cdc.gov/nchs/data/databriefs/db23.htm

*"The United States compares favorably with Europe in the survival of infants born preterm. Infant mortality rates for preterm infants are lower in the United States than in most European countries. However, infant mortality rates for infants born at 37 weeks of gestation or more are generally higher in the United States than in European countries.

For infants born at 32-36 weeks of gestation, the U.S. infant mortality rate was lower than for all countries shown except Austria and Norway. However, for infants born at 37 weeks of gestation or more, the United States’ infant mortality rate was highest among the countries studied."*

 

[EasterJoy]

Since we’ve talked about how much things have improved with mortality rates since long ago, I think it would help to offer some perspective. Here are more current stats:

http://www.cdc.gov/nchs/data/databriefs/db23_fig1.gif

We are failing. Many will say it is because we have so many premature births and while that is a huge part of it, we compare poorly even when we only look at full-term births:

cdc.gov/nchs/data/databriefs/db23.htm

*"The United States compares favorably with Europe in the survival of infants born preterm. Infant mortality rates for preterm infants are lower in the United States than in most European countries. However, infant mortality rates for infants born at 37 weeks of gestation or more are generally higher in the United States than in European countries.

For infants born at 32-36 weeks of gestation, the U.S. infant mortality rate was lower than for all countries shown except Austria and Norway. However, for infants born at 37 weeks of gestation or more, the United States’ infant mortality rate was highest among the countries studied*."

If the US is actually performing the best compared to other countries under the most difficult circumstances, this sounds as if US emergency and intensive care is the best, while its preventative care is not so great…no big surprise there. If I am not mistaken, the same is true is some other areas. I’d expect, for instance, that trauma patients have much better outcomes here, while diabetics and others with common chronic conditions do not have so many good outcomes as in other countries. (This may also have to do with the attitudes of the patients, rather than just the attitudes of the doctors, by the way. How many of us know people with chronic conditions who follow their doctors’ orders OK with regards to taking their pills, but who cheat when it comes to diet or lifestyle changes?)

As for selecting a midwife, many of the same caveats apply as when selecting a physician. If you are in a state that has lax oversight of practitioners, it puts you in a much more difficult spot.

 

[KellyPalmer]

If the US is actually performing the best compared to other countries under the most difficult circumstances, this sounds as if US emergency and intensive care is the best, while its preventative care is not so great…no big surprise there. If I am not mistaken, the same is true is some other areas. I’d expect, for instance, that trauma patients have much better outcomes here, while diabetics and others with common chronic conditions do not have so many good outcomes as in other countries. (This may also have to do with the attitudes of the patients, rather than just the attitudes of the doctors, by the way. How many of us know people with chronic conditions who follow their doctors’ orders OK with regards to taking their pills, but who cheat when it comes to diet or lifestyle changes?)

As for selecting a midwife, many of the same caveats apply as when selecting a physician. If you are in a state that has lax oversight of practitioners, it puts you in a much more difficult spot.

Kind of. We do best with our preterm births. But there are many women who reach 37+ weeks with very high risk births. There are other studies that look at high risk births specifically. It’s not as if all births 37+ weeks are subject purely to preventative care. Also, is it possible that many who end up in preterm labor have “cheated” (as you say) in their own preventative care? I do NOT want that to come off as blaming women who have preterm birth as I do realize that it is not the woman’s fault. I’m pointing out that these stats don’t say who is high risk and who is low risk in regards to the implications being made here.

That said, if I were having preterm labor, you better believe I’d be in a hospital. Someone mentioned upthread that the filmmaker from The Business of Being Born transferred to the hospital for breach birth but that wasn’t actually true. She transferred because she was in preterm labor and her baby was born before 37 weeks. The baby was also breach but that wasn’t why she transferred.

 

[Allegra]

If the US is actually performing the best compared to other countries under the most difficult circumstances, this sounds as if US emergency and intensive care is the best, while its preventative care is not so great…no big surprise there. If I am not mistaken, the same is true is some other areas. I’d expect, for instance, that trauma patients have much better outcomes here, while diabetics and others with common chronic conditions do not have so many good outcomes as in other countries. (This may also have to do with the attitudes of the patients, rather than just the attitudes of the doctors, by the way. How many of us know people with chronic conditions who follow their doctors’ orders OK with regards to taking their pills, but who cheat when it comes to diet or lifestyle changes?)

As for selecting a midwife, many of the same caveats apply as when selecting a physician. If you are in a state that has lax oversight of practitioners, it puts you in a much more difficult spot.

That’s pretty much what I thought. Besides that, I still don’t see the point of refusing medical care in a good hospital that has an excellent record because the combined records of all the hospitals nationwide aren’t as good as in other countries.

 

[Allegra]

This is actually a big problem, as I see it, for catholic women giving birth in a hospital. Mothers of large families are sometimes treated like incompetent psychos. I have more than one friend who had a c-section consent form show up with an added tubal legation that was not requested or even discussed. I have one friend who had a nurse push sterilization during a dangerous placental abruption. Regardless of your opinion on the morality of sterilization, it is unethical to the nth degree to pressure a mother to make that decision when she is in pain or distress, but apparently this happens. I am not sure if tubal legation with a c-section is normal now or if mothers with several children are being singled out, but either way it is an alarming testament to the anti-child mentality of the medical establishment.

My own mother was never able to get pregnant again after her second c-section, which she was pressured into despite it not being medically necessary. Weather this was because of the scar tissue or some action of the doctor, we will never know, but she was young, in good health, and conceiving at regular intervals before the surgery. She always wanted more children.

This might be a problem in some hospitals, but certainly not in all hospitals. I think it is normal to ask if a tubal ligation is wanted during a c-section. The idea would be that it would save the patient a further surgical procedure. If it is possible for them to get an order to do that procedure without a signature from the patient, then I think there is a legal issue there! It seems like they make you sign a paper if you want them to bring you an extra cake of soap, so I don’t see how they can do “surgical add ons” without written consent. I don’t expect to have pressure or problems in that area. My doctor’s practice doesn’t even prescribe brith control except for patients with endometriosis or some other medical need, so I don’t think he’s pushing for tubal ligations for anyone! Do you think your mother was given a tubal ligation accidentally or against her will?

 

[Allegra]

But if the situation were different for you, and you could not get such excellent care in a hospital, would you consider the situation differently? If only every woman had such a choice! Maybe some wouldn’t be driven to look into alternatives to a hospital birth. What if your only choice was a practice that had an 85% induction rate and a 60% c-section rate? Those practices do exist. There is even one local practice that only does. Maybe an elective induction and/or c-section isn’t a problem for you, but given that both come with risks, can you see how they might be a problem for some women?

If that was the situation, it would be another story. I think my first solution would be to move some place better, however, if that wasn’t a choice, I’m not sure what the other options even would be. I guess if I was trapped in a subway car, I’d have to have a baby in a subway car. You gotta do what you gotta do. I certainly wouldn’t consider it an ideal situation though.

“Elective” seems to be somewhat of a subjective term. There are some “elective” inductions that are done for good reasons. (Hyperclampsia for example.) I would think that most women would have a huge problem with having an induction and certainly a c-section for no real health reason at all! Of course, the fact does stand that some women are just ditzy. I also know a few ditzy women (and men) who have insisted on not having proper medical care and later lived to regret it so I guess anything is possible. I don’t really consider myself to be ditzy and I’m pretty sure that unless I’m in an unconscious state, my doctor need my permission to perform a c-section on me. If I AM unconscious, he probably NEEDS to perform one anyway. If I’m not, well, he’d better have a better reason than wanting to go away for Christmas or the resulting tightness of my anatomy!

 

[TeresaMarie24]

It’s been really fascinating reading the different perspectives back and forth on here. When I first posted, I wasn’t sure this thread would get much attention; just thought I’d get a few answers about where people have given birth. I stand corrected! A lot of passionate views on both sides of the fence.

I think the bottom line is, both options, depending on your risk level and the competency of your baby catcher, are safe for women in this country. You have to be educated and informed about both choices, and even about what to do should your baby decide where you’re giving birth. Plenty of women plan for a home or hospital birth, only to have an extremely fast labor and then end up with a baby being born (insert whatever odd place you can think of). Sometimes our best laid plans are to no avail when baby decides she’s coming, ready or not!

Anyway, respect should be shown to all women and the decisions they make for their children. Whether you have a home birth, hospital birth, birth center birth, water birth, Cesarean birth, or some combination of the above, or you give birth on your own on the fly, I think it’s an amazing gift God has blessed us with to help in bringing forth new life! God bless you all and your children! Thanks again for the replies!

 

[Johanna_C]

This might be a problem in some hospitals, but certainly not in all hospitals. I think it is normal to ask if a tubal ligation is wanted during a c-section. The idea would be that it would save the patient a further surgical procedure. If it is possible for them to get an order to do that procedure without a signature from the patient, then I think there is a legal issue there! It seems like they make you sign a paper if you want them to bring you an extra cake of soap, so I don’t see how they can do “surgical add ons” without written consent. I don’t expect to have pressure or problems in that area. My doctor’s practice doesn’t even prescribe brith control except for patients with endometriosis or some other medical need, so I don’t think he’s pushing for tubal ligations for anyone! Do you think your mother was given a tubal ligation accidentally or against her will?

I don’t know if my mother was sterilized, but I am inclined to believe that the c-section caused her infertility in one way or another. She was never able to conceive again, despite being healthy and normal in every other way. Even if her infertility was caused purely by the scar tissue the fact remains that the c-section was not medically necessary, my mother did not want it, and the doctors pushed for it very hard.

As for my friend’s experiences, I’m not talking about a situation where women agree to a c-section and are offered a tubal as well - that I could understand, sort of. I’m talking about a situation where a woman verbally agrees to a c-section and is then presented with a consent form for c-section and tubal legation when tubal legation was never discussed. What if she signs the form without reading it, assuming that it is only what she discussed with the doctor? I certainly hope this is an uncommon situation, but three different women I know personally have experienced exactly that, and one was in an emergency situation where she was much less likely to read the form before signing, and the nurse wanted her to “just sign the form anyway so she didn’t have to go back and change it”. The kicker is that all of these women had 8 or more children, those fringe-radical Catholic nutjobs.

As a fringe-radical Catholic nutjob myself these experiences make me wary and distrustful of hospitals and their “standard procedures” that are predicated on an anti-child culture. C-sections are a bigger deal when you plan to have more than two kids. For all their talk about “choice” they can be quite close-minded about someone choosing to have a large family.

And to be clear, I don’t fault people who have babies in a hospital. I did go to the hospital for stitches after the birth of my first child and I wouldn’t hesitate even to have a c-section, if it was truly necessary. I’m grateful for modern medicine in those situations, but I think that the one-size-fits-all system and “standard procedures” are far from perfect in many cases. I feel more comfortable at home and that in itself makes a difference in the outcome of labor, and science shows that my odds of having a healthy baby are at least as good as in a hospital.

 

[babochka]

This might be a problem in some hospitals, but certainly not in all hospitals. I think it is normal to ask if a tubal ligation is wanted during a c-section. The idea would be that it would save the patient a further surgical procedure. If it is possible for them to get an order to do that procedure without a signature from the patient, then I think there is a legal issue there! It seems like they make you sign a paper if you want them to bring you an extra cake of soap, so I don’t see how they can do “surgical add ons” without written consent.

In my state, a woman must consent to a tubal ligation well in advance of childbirth, in order to prevent her from being pressured into the procedure in a moment in which free consent might not be possible. I’ve had my last 2 c-sections in Catholic hospitals anyway, so that hasn’t been an issue for me.

 

[Johanna_C]

In my state, a woman must consent to a tubal ligation well in advance of childbirth, in order to prevent her from being pressured into the procedure in a moment in which free consent might not be possible. I’ve had my last 2 c-sections in Catholic hospitals anyway, so that hasn’t been an issue for me.

Good! I wish that were the case everywhere.

 

[mommamaree]

Also, it’s more tolerable to have a slightly longer painless labor than a slightly shorter excruciating labor.

Just wanted to hone in on this wise point you have made. I have had 6 pregnancies, with 2 miscarriages and 4 healthy full-term babies. My childbirth experiences have gotten progressively more difficult. Delivering my fourth child was very traumatic for me. Psychologically, at almost 35, I don’t think I would be capable of handling the pain again, were I to find myself pregnant. My husband and I have discerned that we might have to stop having babies now, since the last delivery left us both so shaken. He never wants to see me that helpless and scared ever again. I never want to feel that way again, either. But if we end up with a thunderclap baby, I think that despite never having had any pain relief of any kind ever during childbirth, I will be begging for the drugs. I thought I would want a huge family and only midwife-attended births in a birthing center, but now I am forever changed and would want to be surrounded by doctors and nurses.

 

[Jimmygill]

I’m a man. But hey!! My mum had us at home I’m the 1960s they wouldn’t ALLOW her into hospital because she was healthy (she begged they said no…oh how things change). But I was old enough to remember my brother being born at home. Itighr be an Irish thing but the house was full. My dad fried breakfast for Nurse Knight the midwife (who lived nearby and who knew everyone). The nurse then went drag car racing. Ha ha. And the nuns from my school came over and lit the coal fires and made us lunch. Great day. A really abiding childhood memory

 

[EasterJoy]

Kind of. We do best with our preterm births. But there are many women who reach 37+ weeks with very high risk births. There are other studies that look at high risk births specifically. It’s not as if all births 37+ weeks are subject purely to preventative care. Also, is it possible that many who end up in preterm labor have “cheated” (as you say) in their own preventative care? I do NOT want that to come off as blaming women who have preterm birth as I do realize that it is not the woman’s fault. I’m pointing out that these stats don’t say who is high risk and who is low risk in regards to the implications being made here.

That said, if I were having preterm labor, you better believe I’d be in a hospital. Someone mentioned upthread that the filmmaker from The Business of Being Born transferred to the hospital for breach birth but that wasn’t actually true. She transferred because she was in preterm labor and her baby was born before 37 weeks. The baby was also breach but that wasn’t why she transferred.

No, I don’t want to imply at all that women “cheated” on their preventative care. I meant to imply that more of them can’t afford it, so thank you for clarifying that (as it could be inferred from my mention of diabetics who take their pills but don’t change their diets!)

When you have a system where everyone gets care, you automatically lower the intervention mentality, too–for better and for worse, because the system has an incentive to avoid interventions. When you have a system that anyone might sue even if the doctor (or midwife) is not at fault, you almost enforce an intervention mentality, because nobody can afford to go into court and face the accusation that they “did nothing” when there is some intervention that could have been tried.

It could be that an “intervention” mentality increases good outcomes in preemies, but actually works against the highest number of good outcomes in full term babies. For instance, it was found that avoiding surgery was a good strategy for a lot of carpal tunnel cases because the health care system in some countries enforced a wait-and-see “treatment plan” because of the waiting list for OKd surgeries was so long! They could compare the outcomes of those who got treatment promptly and those who had to wait around, and the ones forced to wait around did better. Getting better by doing nothing and only getting surgery when doing nothing failed to work was the best strategy. When there is the money to do something, though, people want that, especially when waiting around is painful and the condition is debilitating. When the system says, “sorry, it is the best we can do”, though, then it isn’t malpractice to do nothing.

 

[Mary_Gail_36]

I haven’t read all the posts.

I just wanted to touch on something. I was able to research my maternal great grandparents. They were Italian immigrants in Chicago. They lived in Chicago from their marriage in 1910 unit they went back to Italy in 1921 circa.

During that time my grandmother gave birth to 5 children. I was able to pull their birth certificates. For place of birth all 5 gave their home address. For birth attendant 4 out of the five had the name of a woman, and the title "midwife ". Only one was delivered by a doctor, but at home.

I do not know why the reason at this birth a doctor was called, but it might have to do with the fact that the same month that baby was born, two of my great grandmother’s other children passed away from pneumonia. Perhaps my great grandmother had also contracted the same illness as her children, that is a guess on my part.

 

[Xantippe]

Here’s one more practical issue–very few homebirth midwives carry malpractice insurance. If, due to negligence, the mother dies or is seriously injured or if the baby dies or is born with serious birth injuries, there will be little possibility of seeking compensation from an uninsured homebirth midwife. Bear in mind that the care of a child with brain damage due to oxygen deprivation is very difficult and expensive, so that even a non-litigious family would need the money, if only to provide adequately for the care of their injured child.

Whatever the practitioner’s qualifications, it is always wiser to go with one who carries appropriate insurance.

 

[Allegra]

In my state, a woman must consent to a tubal ligation well in advance of childbirth, in order to prevent her from being pressured into the procedure in a moment in which free consent might not be possible. I’ve had my last 2 c-sections in Catholic hospitals anyway, so that hasn’t been an issue for me.

I would think such a policy would also be a good “check point” against error.