Home births, natural or foolish?
Posted
October 22, 2006 at
10:29 am by
Jessica
I stumbled upon a story this morning about a woman who chose to give birth in her Sydney Australia home and within minutes of giving birth, the outer body, beautiful and natural experience became seriously life threatening. The baby was also under severe duress while the mother lay bleeding to death. The midwife called in the emergency and a medevac helicopter arrived, taking 30 minutes to stabilize the pair and flew them to the nearest hospital where they are both doing fine after proactive medical intervention.
It leaves me to wonder, this small, yet growing sub-culture that engages in hating medical intervention (a sub-culture that has become so self-loathing and hateful towards progress itself or “intervention”), isn’t it selfish to denounce the medical community, only to call upon it to save one’s life when it’s needed? It’s one thing if one’s life is in danger dure to an accident, but is it wrong to secretly wish this woman gets a $25,000 bill for the medivac, as I secrety do (which I’m sure is only a fraction of the cost)? After all, valuable resources were taken away for a knowingly risky choice. In my opinion, she knowingly put her and her baby in harms way.
A Physician wrote about his thoughts on the matter in this letter to the editor of The Border Mail in Australia:
I REPLY to the letter from Janet Fraser, national convenor Joyous Birth (The Border Mail September16), which demonstrates perfectly the misinformation this minority group puts forward as “evidence-based” facts.
This group has some dangerous ideas, convincing anxious expectant mothers that a home birth is safe.
The evidence-based facts are that it is at least three times more dangerous to have a baby born at home than in a hospital, because when something does go wrong, often without warning as in about 30 per cent of all births, there is not the expertise and immediate assistance from a team of professionals, including midwives, obstetricians, paediatricians and anaesthetists.
None of the obstetricians in Albury-Wodonga support home birth, and no sensible experienced midwife would agree to deliver a woman at home when the alternative is to offer a safe delivery in hospital with immediate support available.
When a person works for 35 years doing high-risk obstetrics, seeing perfectly healthy women suddenly have a complication that is a risk to their lives as well as their baby, is it any wonder that I feel saddened by the ignorance of home birth groups which are trying to take us back to the dark ages.
The data measured by the Victorian Government proves the Wodonga obstetric team has one of the best outcomes for women and their babies.
Rural women and the dedicated team of midwives and doctors do not need to be insulted by a city based group of ideologists, telling us what is safe in our environment.
— DR PIETER MOURIK,
Wodonga
Admittedly, it is difficult to get accurate data. Those opposed to home births often cite a much higher risk than those that support it, although even in home birthing organizations, I have read that home birthing is safe in about 90% of the cases (and given they have an agenda, I take that percentage with a grain of salt).
The most common argument for homebirth is that of the feminist who believes that the male dominated medical community is trying to suppress women and rip their babies out of them to establish their dominance and to demean women. I say this is a major crock. There are plenty of female gyne’s out there and to assume that male doctors generally have a hatred of women is paranoid and delusional. Their job is keep you and your baby healthy and while some misjudgements can and do occur (nobody’s infallible), I cannot buy that it is all part of a vast conspiracy to keep women down. In fact, I think women are so self-absorbed with their own victimization, that they lack reason sometimes. I’m sure there are some male doctors that hate women, I’m sure there are a lot of female doctors that hate men, but all of them love their paychecks and common sense would dictate that they put their personal feelings aside to thwart off malpractice suits.
Generally, I think those that choose to become physicians, do so because they’re smart enough, have a “God-complex” and want to make a lot of money. The way to do that, is to be a good doctor and minimize mistakes. I actually would rather have a doctor with a “God-complex” than an indecisive ninny that based his or her decisions on political correctness or sappy emotional baggage.
Another point to consider is that many midwives are practising without licenses and the more disturbing trend, the one of “unassisted” birth where no person of expertise or birthing experience is present, except one’s family, only furthers concern. In some states, unlicensed midwives are being prosecuted, and why shouldn’t they be? The New York times reports:
Midwives see it differently. They say the ability of women to choose to give birth at home is under assault from a medical establishment dominated by men who, for reasons of money and status, resent a centuries-old tradition that long ago anticipated the concerns of modern feminism.
Chloe Hendrix-Petry’s birth has not given rise to criminal charges, but a prosecution against another midwife, Jennifer Williams, is pending in Shelbyville, Ind. It was prompted by the death of a baby named Oliver Meredith that Ms. Williams delivered in June. But she is not charged with causing or contributing to Oliver’s death.
Instead, to hear the county prosecutor tell it, the case against Ms. Williams is not unlike one against a trucker caught driving without a license. Read the rest…
Unlicensed midwives, like other unlicensed individuals acting under the guise of legitimacy, ought to be held to the same standards as anybody else. Nobody is above the law.
It is my opinion that people should be allowed to make their own choices, even foolish ones. My hope is that people are completely informed of the risks involved in home births and not just risking the lives of their babies for their own political agendas and hatred of progress that has done far more good and has extended millions of people’s lives. I feel that having a home birth is an unecessary risk that I wouldn’t want to be a part of, however, there are thousands of women who think otherwise and as empowering as they might think that makes them, I think it makes them just foolish people that got lucky.
Tags: feminists, home-birth, homebirth, midwives, natural-birth, Parenting, unassisted-birth |
118 Responses to “Home births, natural or foolish?”
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1. Rachael said:
October 22, 2006 @ 11:49 am
I’m not sure this is true:
“The most common argument for homebirth is that of the feminist who believes that the male dominated medical community is trying to suppress women and rip their babies out of them to establish their dominance and to demean women.”
While I tend to giggle when people tell me about their desire to home birth… I, who ask for an epidural 3 weeks in advance.. I am somewhat sympathetic to the idea that a woman might feel more comfortable in her own home… with loved ones around her. Most of the women I talk to here in my hippie enclave (where I am in the MINORITY enjoying as much medical intervention as possible), don’t seem to hate doctors or men, or the patriarchy. They simply want the comfort and privacy of home.
This is obviously a hot topic, but I don’t want to be part of the group that puts down women for their choices on the grounds that they’re endangering their babies, when this might not actually be the case.
Ever your fan,
Rachael
2. Jessica Carlson said:
October 22, 2006 @ 1:40 pm
I don’t deny that there are plenty of mothers who want to home birth because they want the comfort of their own home, but my guess would be that they have an OB monitoring them throughout their pregnancy and use a licensed professional for home delivery, otherwise, I’m not quite sure I buy that they aren’t doing it to “the man”. Although it’s not my choice, I can understand the lure of such a prospect.
I guess I am really talking about the ones that do it in defiance of the medical community and the patriarchy. I also see a lot of false information being spewed about, trying to influence women into thinking that medically intervention is actually more dangerous than a home birth and I think that is misguided propaganda in which one should keep to themselves instead of trying to misinform others. I think it’s fair to judge the dissemination of misinformation.
If you’ve done your homework and understand the risks, then a family has all the right to choose. My beef is with the women that decry the medical establishment and then use them when something goes wrong. It’s hypocrisy. And when everything goes right, says, “See, it’s safe.” Every pregnancy is different and you can’t just assume that a home birth is going to be safe, IMO.
Plus, there are those like myself that would die if I wasn’t able to have a c-section, which I didn’t know until I had an emergency c-section. You just never know. If one is going to do a home birth, my hope would be that they have a back-up and that a doctor is completely aware of their intentions.
Again, this is just my opinion. I am not forcing it upon anybody, just merely giving my op-ed here.
3. mad muthas said:
October 22, 2006 @ 2:44 pm
the thing is, medical emergencies can arise VERY fast during childbirth, and uncontrolled bleeding can be life threatening even in hospital. when women routinely gave birth at home, the risks were there - and they just got on with it, having no alternative. now we expect to be safe - but want to have all our choices too. sometimes you can’t have everything!
4. wordgirl said:
October 22, 2006 @ 10:43 pm
If I was determined to have my child delivered by a doula or midwife, I would probably select a hospital (or birthing center close to a hospital) that had a working relationship with such professionals. Unless my house was situatated next door to a hospital, I would not be comfortable in planning a home birth. It’s true that hospitals (and some doctors) “rape” us with their high costs and insurance is a huge racket which only exacerbates the situation. I’m also willing to allow that some choose a home birth because they can’t afford a hospital. That said, in a real emergency when it all hits the fan, everyone ends up racing to get help at a hospital, regardless whether they started giving birth in a car, a bathtub or in their bedroom. I just think home birth is too much of a gamble.
5. Cristina said:
October 23, 2006 @ 12:27 am
I am completely ignorant on this topic as I never considered a home birth. I personally didn’t feel comfortable being far away from the hospital in case of complications. However, I also don’t feel comfortable condemning women who choose home births. I agree that if a woman denounces medical intervention, then seeking medical intervention in an emergency would be a bit hypocritical, but I am skeptical that this is the position of most of the women that choose a home birth. My guess (and again, I am wholly ignorant on this) is that MOST women choose a home birth because they feel more comfortable at home and have a plan in place to get to the hospital if there are complications.
6. Kris said:
October 23, 2006 @ 9:00 am
Everybody is entitled to their opinion and view.
It occurs to me that even if you had the best doctors, OB’s (male or Female) there would STILL be the possibility of danger in the hospital. Being in a hospital does not guarantee safety.
Most women who give birth at home want the comfort of it, and have a medical back up plan in place in case something such as you described should happen. Most also don’t want the medical intervention that is so commonplace today.
Also, how many years (centuries) have women been giving birth? Granted, we have lower mortality rates these days, but we now have higher instances of deformaties, and premature babies.
7. Andrea said:
October 23, 2006 @ 10:04 am
I mean, it’s not like you go to a hospital to have birth and come out a multiple amputee…. oh wait! You do:
http://www.wftv.com/news/6253589/detail.html
This is why anecdotal evidence should be avoided. Most women who give birth in hospitals don’t end up with flesh-eating bacteria and TSS and need to have their limbs amputated–most women who give birth at home aren’t doing so with flagrant disregard for the health of their children, and most of them will be perfectly safe. This strikes me as no better than the attacks on women who choose to formula feed as somehow disregarding the safety or best intrerests of their children.
Sometimes women die when they give birth at home. Sometimes they die from c-sections. Sometimes the babies die from a birth intervention–did you see the study last week that showed that twice as many babies will die after c-sections as after vaginal deliveries? Sometimes they die from lack of intervention. Childbirth is risky, but the vast majority of women and babies will be safe regardless of the location or their choices. I would hope, on a website that is named “imperfect parent,” we would have more genuine respect for other people’s choices than to call women “foolish” when they do something we don’t agree with.
Incidentally, most feminists support any woman’s choices for her own body, including when and how and where to give birth.
8. Linda said:
October 23, 2006 @ 3:12 pm
I think people should do what they are comfortable with and make alternative plans just in case of a medical emergency if they are doing a home birth.
9. Jessica Carlson said:
October 23, 2006 @ 4:58 pm
I don’t think that being an “Imperfect Parent”, means that you always have to be politically correct in your opinions, only that you back up your opinions and don’t initiate personal attacks against an individual. That’s has always been my motto.
I have stated before, this is just my opinion. Everyone is entitled to one. I even stated more than once that even though I think this practise is foolish, that I don’t think it should be unattainable by law. I think people have the right to make decisions that I don’t agree with, so long as it’s not hurting another person.
You would be hard pressed to convince me that giving birth without medical intervention is safer than giving birth with medical intervention.
Regarding c-sections, my guess is the reason there are more complications with c-sections is because c-sections usually (not always, but usually) are done in emergency situations or situations where the mother or baby are in danger, so I can believe that more complications arise from c-sections. My bet is that without c-sections however (and I do agree there are probably more than is actually required), there would be even MORE deaths and complications.
10. Andrea said:
October 24, 2006 @ 6:53 am
actually, no–the study was looking at elective c-sections only, not c-sections for medical reasons. The c-sections are more dangerous than vaginal deliveries when undertaken for elective reasons.
To me, calling a group of people “foolish” for their decisions veers closely to personal attacks. Much as if I had said that women who fed formula to their infants were “foolish” (which I don’t believe). To anyone who had used formula, that would have come across as a personal attack whether or not my finger was pointing directly at them.
I’m a type 1 diabetic–without medical intervention, I would have died fifteen years ago. So I know how valuable modern medicine can be. I also went through two years of specialist appointments and eight very confident misdiagnoses before any of the doctors seeing Frances were willing to concede that they had no idea why she’s so small and never expect to. So I also know that doctors can be wrong. A friend of mine, a fellow blogger, has a little boy who went in for surgery to correct a spine defect when he was 3 years old and came out paralyzed. Sometimes, doctors mess up badly. Her little boy will never walk.
The only woman I personally know who chose a homebirth is, actually, a health expert; she has a master’s degree in epidemiology and studies health care statistics for a living. So when she tells me that her research shows her that homebirth is safer, I believe her; I certainly don’t consider her to be foolish. The difference, as she explained it to me, has nothing to do with believing hospitals to be ‘bad’ or the medical establishment to be ‘bad’–she simply views childbirth as a natural process, not a medical one, and wanted to treat it that way unless and until things became dangerous. Which, in her case, they didn’t. It wasn’t an act of hatred for the medical establishment (which she is part of, after all) any more than it is an act of hatred for the medical establishment to drive without a doctor in the passenger’s seat.
11. Jessica said:
October 24, 2006 @ 7:15 am
As far as the “foolish” comment, I can understand why you would think that was hypocritical of me and I probably should have said that I think their decisions are foolish and not the people themselves and unfortunately this whole discussion of semantics has clouded the real message and that is that I believe that home birth to be inferior to medical progress and intervention. My opinion. I believe that if every woman gave birth at home, we would be throwing women back to the dark ages. Again, my opinion.
12. Sarah said:
October 24, 2006 @ 4:02 pm
What I think we need to do is to acknowledge that we all have choices in this world and having a homebirth is the right choice for many people, while having a hopital birth is the right choice for others. To judge a woman because of a choice that she made, to try a homebirth, which ultimately led to a medical intervention, would be no better than judging or blaming someone who got in a car accident and needed medical intervention because they choose to take a RISK and drive their car. LIVING is risky, for gods sake, and making the perfect decision ahead of time is IMPOSSIBLE. It we all made choices that were right for us individually, we could spend less time living in fear, and blaming others for making choices that are right for them.
13. Freebirther said:
November 21, 2006 @ 9:31 pm
That is not the most common argument for homebirth and shows the obvious lack of research you have done before opening your mouth. Most homebirthers feel that the home is a much safer, more comfortable environment in which to labor and give birth. The risk of unnecessary intervention is extremely low at home. Studies have shown that women labor better when they feel safe and at ease. Laboring at home you are not restricted by the ridiculous guidelines of the hospitals, such as disallowance of food or being forced to birth in a certain position. Rather than have only an epidural to numb the pain, you can chose to use any of the devices in your home to relax, from the TV to the bath tub. It is a much more pleasant environment for the baby to be born in. Rather than being born into a cold, sterile hospital room with blinding lights, they are born into a warm, cozy, dimly-lit room and quickly given to their mother rather than weighed, scrubbed, and suctioned first. The incidence of fetal and maternal distress is much lower at home. The home is much more sanitary, being that the hospital is for sick people, yet the bacteria and germs in the home are those which the mother lives with everyday and is accustomed to (as in immune). I’d rather my child not go into a neonatal care nursery where he may lie side by side with a child who has hepatitis. The comfort factor alone makes homebirth safer, but there are statistics as well.
The risks for the majority of pregnant women are much higher in hospitals than at home, even unassisted. What you feel and what the statistics show are two completely opposite things. Most women who birth at home, attended or unassisted, are not against the medical community, just not interested in unnecessary intervention performed upon their bodies and hindering their birth. Why is that when a child dies at a home or unassisted birth, we call the mother irresponsible–but when a baby dies in the hospital for the same reason, we feel the sympathy that both mothers deserve only for this one. Do you know what the infant mortality rate of hospitals is? What about the IMR of homebirth? Here’s a newsflash: it’s lower for homebirths than for hospital births. The majority of countries with lower IMRs than America are countries where midwifery care is the standard and homebirth the norm. This is shown in several studies. Have you seen any studies on unassisted childbirth? I know hundreds of women who have done it and have seen studies that demonstrate its safety, especially when the woman has spent her entire pregnancy studying, researching, planning, preparing, learning to understand and be in tune with her body, and promoting her health however possible, paying attention to every detail. What research and statistics do you have that cause you to label it as a disturbing trend?
Tell me what risks exactly are involved in homebirth? What goes on in the hospital that could not take place at home in a normal pregnancy and delivery? Do you know the cause for most C-sections? Do you know the percentage of C-sections which are considered unnecessary? Why is it less risky to be at the hospital? Do you know anything about common birth complications and how they are handled? Do you know how such situations can be handled at home? I do, because I have done my research so that I can be prepared to birth at home unassisted. Most women who homebirth, especially unattended, know as much about pregnancy & birth as their doctors and midwives because of the preperation they undergo. I happen to believe that the hospital is an unnecessary risk and that those who had a decent birth there are the ones who got lucky, while the ones who birthed at home and were successful did so because they trusted their instincts, worked hard, took the time to understand the process, and let nature take control rather than a doctor. Your words are completely unfounded; no facts, statistics, research, studies, or surveys back them up. You label us as foolish people, willing to risk our health and our children for political agendies, which the average person giving birth at home or unassisted could care a less about feminism or rebellion. You are the one who is foolish, making assumptions and judgements with very little to back up your claims.
You say you bet that without C-sections there’d be more deaths and complications. HA! There is a reason why we are alarmed that our C-section rate is so high: because C-section increases the chance of maternal and infant death and complications. It makes the recovery time last longer, increases the risk of breathng problems in the infant, and is much more likely to cause hemorrhage than natural birth. C-section rate is directly related to infant and maternal mortality rate; as one goes up, so does the other. C-sections are performed 29% of the time, and only half of those are considered truly needed according to medical review.
No one wants every woman to give birth at home. There are some women who must birth in the hospital, such as women with transverse babies who refuse to turn. What is wrong with the dark ages? Do you think IMR has gone down solely because of prenatal care and ob/gyn assisted birth? No. The main reason is that we, as a society, are healthier, that women who become pregnant and give birth often aren’t spending hours working in the field, have a good nutritious diet, and can recognize and adequately treat complications that arise. Disease is not rampant, and our conditions are much more sanitary. Many women used to die in childbirth simply because of infection caused by unsanitary conditions, or because they were not otherwise healthy due to their lifestyle and diet. Most women who have complications during their pregnancy and birth are those who meet certain risk factors, such as age or poor diet. To go back to the dark ages, we’d have to do more than birth unassissted (which, rarely happened even back then, as women usually were attended by traditional midwives or physicians). We’d have to stop washing our hands before we eat, starve ourselves during pregnancy (and, well, everyday life, actually), work our bums off all day, stop bathing, allow men to stick their hands without washing them up inside to check up there, even labor next to women suffering from the plague. That, my friend, is what the dark ages were like, and birthing in your clean, cozy home when you’re in good health is nothing like the Dark Ages.
14. Jessica Carlson said:
November 24, 2006 @ 7:18 pm
15. Freebirther said:
November 24, 2006 @ 9:08 pm
Did you even read my post? Are you implying then that what I have said is untrue, that living conditions were not unclean in the Dark Ages, that doctors paid little attention to hygeine and sanitation in the old days, and that homebirthers feel home is safer–rather than doing it to ‘prove’ something as feminists? I certainly am not doing it to prove anything to anyone, but no, no…you’re right, you know way more about a homebirther’s reasons for doing it than the homebirther herself… I would like to see this evidence that you feel is so much more accurate than mine and that proves it was medicine and technology that created the more favorable outcome we have in birthing today, rather than other factors, and that proves homebirth is a dangerous & unnecessary risk.
What seems common sense to you is actually common myth. It is not technology and medicine, but sanitation and better overall health that have contributed the most to our lower infant and maternal mortality rates. Women who spend all day performing manual labor and do not have a balanced diet are much more likely to have pregnancy complications, one cause of high maternal and infant mortality rate in the past. Centuries ago, sanitation was terrible, practically nonexistant. People ate without washing their hands, shared food even with sick people, and did not bathe. The unclean living conditions and lack of hygenie were the main cause of infection, which was a leading cause of infant and maternal mortality. When women began birthing in hospitals, we had discovered germs; however, for some reason, it did not dawn on doctors that if you have six women all laboring in the same room, they are going to share bacteria, germs, etc. with one another and their babies–or that if a woman labors next to a woman with smallpox, she and her child may become sick and die. It was common practice for doctors to stick their hand up one woman, to check her dialation, then waltz over and perform this check on another without washing his hands first. Many women who died in hospitals years ago died of an infection that could have been prevented if sanitation, hygiene, & privacy were taken into consideration. Healthier diets and lifestyles and cleaner environments are a huge factor in today’s favorable outcomes.
Infant mortality rate was falling even before the invention of ultrasound and routine amniotomies. If you do the research, you’ll find that infant mortality rate rose when women began birthing in the hospitals, then dropped when homebirth became more popular several decades ago, when many people realized the dangers of birthing in the hospital due to risk of infection. Now we respect a woman’s privacy, keep hospitals sterile, and practice good personal hygiene in our hospitals, and that risk is no longer anywhere near as high. We have replaced these dangers with new threats: routine interventions. A simple Google search for the list of countries and their respective infant mortality rates will show that the countries with better rates than ours are those in which women give birth at home or with limited medical intervention, countries in which routine interventions of America are not as often used. You could go one step furthur and actually research hospital vs home birth, doctor vis midwife IMR, and you will find that hospital/doctor birth has a higher IMR than homebirth/midwife even in high-risk cases.
Routine IVs can lead to the administering of too much fluid. They are given in case of an emergency, which is unlikely to occur in a low-risk pregnancy. Moreover, IVs are so quickly done that having to give one in the case of an emergency would not hinder the progression of treatment at all. Routine amniotomy, done to speed up the labor, increases risk of infection and causes more painful, violent contractions that are hard on the mother and even moreso on the baby, especially considering busting the bag of waters eliminates the cushion that was protecting the child from the force of the contractions. Pitocin has the same result: more painful, stronger contractions, that often are not required, as usually the contractions naturally produced by the body will be enough to deliver the child and dialate the mother’s cervix–if only doctor and patient can have a little patience. A long labor with contractions that take time to build up in intensity is not dangerous to mother or child, only annoying and undesired. Epidural or narcotics, which relieves pain, does reach the child and increases the probability that a child will have breathing problems, can inhibit the bonding process because both mother and child are doped up, and often slows labor–which results in amniotomy or pitocin. These labor-speeding procedures increases the chances of C-section, as those intense contractions are very likely to cause fetal distress and maternal exhaustion. C-sections, again, are likely to cuase breathing problems in mother and child, inhibit the bonding process, take much longer for the mother to recover. There are a multitude of other dangers involved with these routine interventions, performed often though rarely truly needed.
Healthcare is better today, and yes, medicine and technology have contributed to the lower infant mortality rate across the globe. However, we must remember that only 5-10% of all pregnancies are high risk, and it is very unlikely that complications will occur in the remanding 90-95% of low-risk patients, who usually will deliver just fine without medicine or technology. It is in the small percentage of high risk births that medicine and technology makes the most difference–when a mother has severe preeclampsia, gestational diabetes, or twins with twin-to-twin transfusion syndrome. There are times when medical intervention is necessary and life-saving, and that usually occurs during a high risk pregnancy. Are you creditting the enormous drop in IMR and MMR simply to the fact that we can now detect and treat conditions that make pregnancy dangerous, which occur in only 5-10% of all pregnancies? There are women, even low-risk patients, who will need medical intervention during labor. The number of women who receive medical intervention is not equivelent to the number who actually need it, considering half of all C-sections are considered unnecessary by medical review. Most low-risk women will not need medical intervention.
Moreover, most pregnancy complications can be detected without routine testing. Infections, problems with the placenta, fetal distress all present themselves in symptoms such as itching, bleeding, or change in fetal activity. Palpitation of the stomach can diagnose multiple births, placenta location, and position of the baby. If a woman who is planning to birth at home with a midwife or unassisted does have any of these tell-tale signs, she does not ignore it; she informs her midwife or heads to the doctor’s office for treatment. Birthing at home isn’t equivelent to refusing necessary medical treatment. It is acknowledging that, unless a woman is already high-risk OR experiences the symptoms which should not be ignored, medical treantment is unnecessary. In cases, such as placenta previa, nothing can even be done, except hope the placenta moves before labor starts–or perform a C-section, which can usually be avoided if we wait for labor to start, being that most cases of placenta previa correct themselves by then. Do you believe that midwives do not perform testing for complications? They do. Do you believe women who birth unassisted do not perform tests? They do. Many tests, such as urinalysis or gestational diabetes, can be performed by the pregnant women herself in the privacy of her very own home!
There are alternative methods of treating labor complications, such as hemorrhage, that are just as effective, and the way a labor is managed at home by a mother laboring alone or with a midwife is adept at preventing many labor complications. It is very common for complications of labor to occur as a result of the way labor is managed; for example, yanking on the umbilical cord can cause maternal hemorrhage. An epidural can lead to breathing problems in the infant and make complications for the mother more probable. There are alternative methods of treating pregnancy complications, which are also quite effective, methods of managing pain and inducing lbor, etc. Many of these methods do not even have to be performed or administered by a midwife. Any woman with a brain can look into herbology and discover what herbs will help for hemorrhaging or even how to handle a birthing emergency. Many emergencies can be handled by a birthing mother. Is the cord around the baby’s neck, baby not breathing? Unwrap it, then stimulate the baby, administer CPR, or give him oxygen from a rented tank. Nothing more would be done at the hospital. Many solutions to common problems do not have to be performed by doctors or professional birthing attendants; they can be done by anyone with common sense and a little knowledge.
You are assuming that doctor care is superior than the care of anyone else, that hospitals are safer than any other place, etc., and the truth is that this is only true in high-risk situations…which occur 5-10% of the time. For low-risk patients, doctor care, hospital birth, and routine interventions do much more harm than good, and there is no reason to subject everyone to that unnecessary risk just in case they are part of that small 5-10%. The patients who have true high risk complications, true emergencies, are those who benefit from those things; the vast majority, the rest of us, do not–and in fact, often suffer negative consequences even if we do not realize it.
If again you’re unwilling to drink my kool aid and want to all but call my words a load of bull, I would be happy to provide sources proving the dangers of routine intervention, the % of high risk pregnancies, the fact that homebirth IMR is lower and that our IMR is higher than countries in which less intervention is used, etc. I would also appreciate some actual proof to your claims, rather than just a “Well, it’s just common sense!” response that proves nothing, while implying I do not have common sense.
16. Freebirther said:
November 24, 2006 @ 9:14 pm
Excuse me, I meant to say while implying that I do not have common sense, there in the last line
17. Freebirther said:
November 24, 2006 @ 9:26 pm
Well, I’ll be damned. I guess the page loaded wrong the first time. I had correctly worded that line after all. Geez, what a night
18. earthshoes said:
November 24, 2006 @ 9:30 pm
Greetings Jessica,
I’m the oldest of five children and of the five children, I’m one of only two who were born in the hospital. The rest of us were born with midwives at home. My mother, an old hippie, chose this method after two unpleasant experiences in the hospital with doctors and nurses who would not get out of the way of a normal birth process and insisted on stirrups, etc.
When it became my turn sixteen years ago (I’m 41 now) I examined all my options and chose the hospital for my first two children. Both times I had to fight the medical establishment to keep them from interfering in the process. I was two weeks from my due date when the doctor announced that he was planning to induce my labor if I did not go into labor on my due date. I should have seen it coming when he began mentioning it early on in my pregnancy. He made it plain he was busy and he frequently talked up induced labors and how he went about them. In short, we had an argument where he threatened to get court order if I fought him on it (he often postured like this during exams). His argument was that my blood pressure was high. My blood pressure was only high when he was in the room (documented fact, even noted by his own nurse). He had performed numerous and (I now know) unncessary medical tests and procedures, some of which were painful for both me and the baby. He did constant cervical exams, and attached me to nearly ever piece of equipment he had in his well-endowed office (and he had a a lot of it). I thought I’d won the argument concerning the induced labor (I did not back down, despite the threats), but he stimulated my cervix without my consent the day before my due date, and counted on my ignorance to keep me from knowing what he was doing during the horribly uncomfortable exam. I didn’t determine until I chatted with another doctor after the birth exactly what had happened. She said that he’d listed it in my chart. I’d been told I could walk, but they changed their minds when I got there and kept me strapped to a fetal monitor the entire labor. And–oh yeah–after being assured that I could give birth in any position I wanted, guess what came out of hiding right about the time I was ready to push? Stirrups–to make it more convenient for the doctor–who wasn’t even my OB who was off duty ( she wasn’t even in the same practice and I’d never met her before). Don’t even get me started on the epistiotomy she gave above my objections. And then there was the shot of oxycotin afterwards that made sure my uterus would contract as painfully as possible. As a final, parting blow, I had watch the nurses to keep them from introducing a bottle to my son (My husband caught them sneaking one into him, knocked on the nursery window and shook his finger at the very embarrassed nurse).
During my second birth, at a different hospital, my ob (also different than the ones above) was out of town. A nurse administered Promethazine and Demerol less than an hour before my son was born. I had requested something (not knowing I was so close to birth and was panicking some–my bad–but if they’d told me I was at 8 and nearly ready to go, it would have helped). It did me no good at all but my son was born with a snoot full of it–with repressed respirations, blue and barely crying. It took the hospital staff over an hour to acknowledge that there was a problem, leaving him with me to watch and worry over until my husband called them in and requested that they pay attention. When they did, they rushed him off to the nursery to perform a spinal tap and other emergency tests. They would not let me near him again (would not even let me see him) for a terrifying eight hours. They also put him on injected antibiotics immediately. I didn’t know a great deal at the time about the affects of demerol and promethezine, but I asked them if this might be his problem (I now know that this should never, ever be given within an hour of birth). They insisted that it wasn’t the issue and that something terrible was clearly wrong. By evening he was more or less fine–nursing like a barracuda, colored up and ready to resume normal life with his mother. A nurse had the nerve to tell me that they felt it was best that I did not bond with the baby until they were sure that he was okay (I will never forget that statement). The doctor insisted on keeping him in the hospital for a week, giving him injected antibiotics in both legs three or four times a day (you should have felt the scar tissue in his legs). I allowed to stay with him as “guest of the hospital” (wasn’t that nice of them?) and again had to challenge the nurses to not give him bottles between nursings–not because he wasn’t gaining or thriving, but “just in case” (whatever the heck that meant).
My son, who is now fourteen, has Aspergers. If I’d been sue happy, you can bet that I would have taken this inept hospital and its staff to the bank. As it was, it took me years to determine all the causes of his problems. He is going to be fine, but it’s been a rocky fourteen years.
It is no wonder that I rejected the medical establishment after that and turned to a midwife with over 30 years experience and 6 children of her own. The pregnancies were smoother than both the first two. Why? Because the midwife, who was licensed and had emergency back up through a local hospital, stayed out of the way and let me be pregnant. She saw me monthly, performed blood and urine tests, checked my (normal) blood pressure and listened to the baby’s heart beat; she was gentle and careful at all times–let me look at my own chart, and discussed everything she wanted to do before she did it. When my youngest decided to turn around during late pregnancy (even I could feel that his head was against my rib cage), she manipulated him back into position. This, I’m told, is normally a painful procedure. She was trained by a specialist in Boston in this method, known as “tickling” the baby back into position. It was truly no big deal and once she turned him, he stayed where he belonged. I gave birth to one of the boys on the bed and the other, squatting. I walked through both labors until minutes before delivery. There was no “transition”, there was no awful moments where I did not think I could make it. I had access to fluids and food throughout and could even sit in the jacuzzi if I’d wanted to. She lit candles and dimmed the lights and talked and teased me throughout the delivery. And both boys were delivered easily with no trauma and no tearing (she was trained in how to avoid that too).
They nursed within seconds of birth, comforted very easily and were easy babies, both were very social from far earlier than either of their brothers–the third borne listening and talking in words between seven and eight months, the third seeking out faces and smiling on purpose at a much earlier age than average. (We can blame that one whatever you want–I’m not a big believer in birth trauma affecting development, but I’ve wondered).
I could list statistics for you, if you want, quote medical people both pro and con (I am my mother’s daughter in many respects), but I won’t. Everyone who is giving these stats has something to gain–even the homebirthers, I suppose. The truth is somewhere in the middle, but I believe it leans in favor of home births.
I have paid (possibly too dearly) for the medical establishment’s unwillingness to consider birth a normal experience. I suspect that they are too anxious to use their tools to control the outcome, too often have selfish agendas and do not know how to truly listen to what women and babies need–being only interested in standardizing labor and delivery. I have observed friends pregnancies noting that the doctor’s solutions often caused as many problems as they solved, when unnecessary inductions and c-sections required yet more medical interventions and complications. A few years ago, while at a baby shower,I found I was in a circle of ten women who had opted for mainstream hospital births. It turned out to be an unusual accidental study; six of them had C-sections–three of those were due to induced labors gone wrong. I was stunned and they were matter of fact about it. Two confessed privately to me that they had always believed that the doctors were too quick to choose C-sections, but didn’t feel like they had any choice. To them–it was the norm. To me, it was a testimony to foolishness.
You can preach what you will (it’s your blog, after all), but you should know that there is another side to this story. Those of us who’ve done it both ways and have the proof living under our roofs, will nearly always tell you that home birth is better.
19. Freebirther said:
November 25, 2006 @ 1:23 am
Earthshoes, I think your story is a lot more pertinent than any statistics and facts anyone could give and sheds a lot of light on the argument for homebirth as well. I have only one child, born in a hospital. I, too, was objected to many tests, most of which I now know were unnecessary. I did not want a pap smear but was told it was crucial–even though I am a monogamous woman who has never slept with anyone other than my husband, who before me had only had sex one time in his entire life with one person, who according to the US military is free of STDs. I did not enjoy it and felt it cheapened the entire experience of being pregnant. When I had my bloodwork done, I went into convulsions, threw up, and nearly passed out because of the amount of blood they took–to run unnecessary tests for things like anemia, which I’d have known if I’d had because of the symptoms. I had to demand that they stop drawing blood, and they ignored me until my body began to convulse at which point I made one final plea for them to stop. At my birth I was kept in a waiting room during my contractions for about two hours; they had to be told off before they finally put me in an exam room. I was given an IV, which I did not want or need, by a nurse who after struggling with my arm and getting me very bloody for 15 minutes announced proudly that she has just given her first IV. I was confined to the bed on fetal monitors, my movement restricted by the IV. No one was interested in helping me manage my pain so I asked for medicine. I was given Nubain, which put me to sleep, and then an epidural, which numbed my pain but slowed my labor resulting in amniotomy and pitocin, which caused my contractions to become so violently painful that I began questioning my decision to have a child in the first place. No one told me about the possible negative effects of any of these interventions. My son was held up for a quick second for me to glance at, then taken away to be suctioned, scrubbed, etc. before finally handed back to me. They put ointment on his eyes in case of an infection, but didn’t explain to me that it was in case of chlamydia or gonorrhea–which I didn’t have–or that it could irritate the eyes and cause blindness. They gave him a Vitamin K shot without telling me of the link between that and leukemia. They gave him other shots, only just telling me it was necessary without explaining anything. They made me leave him in an incubator and wouldn’t let me hold him. I was unallowed to walk about unless I had him in the ‘crib on wheels.’ I was thankful that my hospital had a room-in policy and didn’t try to sneak my kid formula, but they did come in to check our blood pressure all the time whcih was a great hinderance to the bonding process–as well as encourage me to have him circumcised, which I now know was again unnecessary, potentially dangerous, and a traumatic experience overall for him. I was given very little information and treated rudely, as if I were an ignorant child who needed to be told everything from how to burp the child to how to hold him, when I did not. I had to keep track of his bowel movements and his feedings, also unnecessary. I also had to listen to the cries of the babies in the neighboring rooms as I tried to sleep. Overall, it is not an experience I want to repeat. It did not feel healthy, right, or natural. Most of the intervention was completely unnecessary and potentially more hazardous than helpful. Had he been born at home, he would have been just fine, and his birth would have been much more comfortable and pleasant. After realizing all of this, I thought of birthing in a hospital again…but I knew how much I would have to fight for simple things such as the right to chose my birth position, eat during labor, and not have an IV put in my arms. I therefore began to plan a homebirth, and from there, after even more research and contemplated, began thinking of unassisted pregnancy & birth–the goal for my next round, as long as nothing causes concern for alarm. (Contrary to popular belief we freebirthers aren’t oblivious to reality; we do know when something is wrong and seek medical attention when necessary.) This is the story of many women who chose to homebirth, and it has very little to do with feminism.
20. Freebirther said:
November 25, 2006 @ 9:14 pm
http://www.umanitoba.ca/outreach/manitoba_womens_health/hist1.htm
Medical intervention was common in the dark ages as well, though what seemed common sense to them was actually very foolish. Children often died of simple things like not being kept warm after the birth, the result of ignorance–not a lack of technoogy.
http://historymedren.about.com/library/weekly/aa100500c.htm
That infant mortality rate was sky-high is a false assumption, completely unfounded. The IMR was not nearly as high as most chose to believe, though there was still a possibility of complications such as birth defects & breech birth and maternal or infant death. Male physicians usually only attended births in emergencies, and midwives — generally with more experience — would attend the women with their assistance. The rooms were warmed, rather than made cold; mothers birthed sitting or squatting, rather than lying down, which opens the pelvis much wider. (Now, we intervene when birth stalls and the head is obstructed–when squatting would probably do the trick). The child was kept in dim light and kept very warm, handled as gently as possible back in medieval times. Most infants and mothers died simply of infection or disease because of the lack of sanitation and nutrition and rampant illnesses, as there was ‘no understanding of germs sa the cause’ and ‘no antibiotics or vaccines.’ Most babies died not because of the lack of intervention in their birth, but because of the lack of treatment for diseases they contracted. Still more died from accidents due to mobility and lack of supervision; it was near impossible to babyproof the medieval household, and mothers were quite busy with chores and couldn’t constantly watch their children. As the article points out, they weren’t charged with negligence back then. A lack of statistics and records prevent us from calculating IMR as anything but an estimate. The highest estimated precentage is 50%, though 30% is more common. Our IMR is half of that–not a great deal better, though an improvement–which is probably best attributed to factors other than our 29% C-section rate. Infanticide contributed to the higher IMR, though not as greatly as some estimate.
http://www.thehistoryof.net/history-of-childbirth.html
Keep in mind that the comforts and luxiries we have were not available in the Dark Ages, from childcare during labor to adequate heating during the winter to washing machines. Much has changed, not just our medical technology. Here’s an interesting fact: “the practice of midwifery started to decline with the opening of an obstetric ward in Britain in 1739. During these times women were banned from university medical training which made midwives look ‘uneducated’ and they were looked upon as the “less” desirable birth attendants.” Caesarian section is nothing new, as crude attempts were made as far back as 715-673 BC. The difference now is that we have sterile utentils and more educated, experience doctors performing the procedures. Many women who had C-sections in the Dark Ages died due to causes that could have been prevented either by not having had the C-section OR by having had one by today’s standards, which were not available then. There was a 50/50 chance of survival for mother & child in C-section back then; today, the odds are much more favorable but still not so much as for vaginal birth in most cases. According to this site, doctors didn’t realize until the 1840s that they needed to wash their hands between patients; amazingly, when they began to do that, IMR and maternal mortality rate improved because…less people contracted dangerous illnesses! Yes, the hospital is much safer now but interventions are still dangerous. Homebirth was never dangerous; lack of prenatal care, nutrition, healthy lifestyles, and sanitation, as well as ignorant care during labor and after child birth, inadequate supervision, etc. were the threats, not birth out of the hospital. It is the same today.
I also have to venture a question. Why is it that, though your submission guidelines suggest, after explaining why a choice was made, not passing judgement on those who chose differently, here you judge homebirthers as ‘foolish people who got lucky?’ Shouldn’t you practice what you preach?
How is it selfish to refuse unnecessary medical care but to accept it when it is necessary?
How can you have an ‘opinion’ on whether she ‘knowingly put herself and her child in harm’s way’ when you don’t know what it is she does and does not know?
What risks are there in homebirth? What does the extending of millions of lives have to do with intervention and the birthing process? Do you think our lives are longer because birth is more medicalized? Why do you think it must be feminism and hatred of progress that is the reason? Could it not be simply the desire to birth where they feel most comfortable?
21. Amy Tuteur said:
November 30, 2006 @ 5:07 pm
In order to make an informed decision, all women deserve to know the truth about the choices available to them. The problem with the homebirth advocacy establishment is that so much of what they pass on as “information” is just an amalgamation of myths, half truths and lies. For example, though homebirth advocates often claim that “studies show homebirth to be as safe as hospital birth”, virtually every study done to date shows an excess neonatal death rate at homebirth in the range of 1-2/1000 births. Yes, there are some studies the CLAIM to show that homebirth is as safe as hospital birth, but if know about statistical analysis, you will see that they suffer from serious flaws that render the conclusions invalid. Some studies “conclude” that homebirth is safe even though the data of the very same study shows an excess of preventable neonatal deaths at homebirth.
Homebirth advocates tend to suffer from a tremendous lack of knowledge about the science of birth, and a tremendous lack of knowledge about the history of birth. They repeatedly claim that “birth is natural” and imply that this means it is inherently safe. The problem is that death during birth is natural, too. Childbirth is and has always been, in every time, culture and place one of the leading causes of death of young women and babies. Even in industrialized countries, where both the maternal and neonatal death rates are quite low, childbirth is still a leading cause of death of young women and babies.
Homebirth advocates tend to be woefully misinformed about the history of obstetrics as well. During the past 100 years, the neonatal mortality rate has dropped 90% and the maternal mortality rate has dropped 99% because of modern medicine of which obstetrics is a part. It is not because of sanitation, clean water or improved public health. Why not? Look at the leading causes of death before the advent of modern obstetrics and neonatology. Among the top causes of death for babies were prematurity, birth defects, and suffocation during birth. Infection was never a leading cause of deaths for babies, so the neonatal mortality rate has been relatively unaffected by improvements in public health. Among the leading causes of death of mothers before modern obstetrics were pre-eclampsia/eclampsia, hemorrhage, and obstructed labor. The improvements in maternal mortality are directly attributable to anti-seizure medications for eclampsia, blood transfusions, antibiotics, and improved anesthesia for C-sections.
The lack of knowledge about the history of childbirth leads homebirth advocates to make additional misleading statements. Birth in nature is not inherently safe, and it is not less painful. Grantly Dick-Read, the father of the natural childbirth movement, claimed that “primitive” women did not feel pain in childbirth and only the fear inculcated by modern obstetrics produced the pain of labor. Grantly Dick-Read saw very few if any deliveries. He just made it up. Why? He believed that the world was being overrun by “primitive” peoples and that white women needed to be encouraged to produce more children. He thought that fear of the pain of childbirth was keeping women from expanding their families and that the solution was to tell them that the pain was not real. His attitude was summed up by his own words: “the mother is the factory, and by education and care she can be made more efficient in the art of motherhood”. It is quite ironic that most homebirth advocates do not realize that Grantly Dick-Read invented “natural” childbirth because he was a racist and feared that “inferior” people were having more children than “their betters”.
If homebirth advocates want to have homebirths that is their right. However, they have no right to claim that homebirth is as safe as hospital birth because the scientific evidence shows that this is not so. They have no right to claim that complications in childbirth are rare because death is a NORMAL part of childbirth, and they have no right and no basis to take credit for the spectacular drops in neonatal and maternal mortality away from modern obstetrics and try to award it to public health measure because public health measures did not lower either the neonatal or maternal mortality rates.
22. Kris said:
November 30, 2006 @ 7:09 pm
‘The spectacular drop in neonatal and maternal mortality’? Check this out:
http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/
Hospital neonatal deaths outweigh homebirth deaths nearly twice as much. See the above article.
The claim that ‘Homebirthers’ are grossly misinformed in the history and science of the birth process as well as obstetrics strikes me as absurd and misinformation on your part.
23. Kris said:
November 30, 2006 @ 7:12 pm
In continuation:
There are PLENTY of doctors, nurses, etc. in the schooling of America’s hospitals that are just as grossly misinformed, as you claim homebirthers are, if not more.
24. Amy Tuteur said:
November 30, 2006 @ 7:31 pm
Kris:
Attempting to draw conclusions from comparisons of country to country neonatal mortality rates just shows a lack of understanding about the causes of neonatal mortality and what inter-country comparisons can and cannot tell us.
It is an unfortunate fact that race is a risk factor for neonatal mortality, independent of economic status. For reasons we do not understand, the neonatal mortality rate of babies born to women of women of African descent is considerably higher than that of babies born to women who are white, Asian or Hispanic. The neonatal mortality rates of industrialized countries are very closely associated with the proportion of women of African descent within their populations. It is not a coincidence that all the countries that have lower neonatal mortality rates have a lower proportion of women of African descent in their population. Japan, which leads the list, has virtually no women of African descent among the population. The fact is that neonatal mortality for low risk white women in the US is the same as neonatal mortality for low risk white women in Europe. So comparing country to country tells us nothing about the quality of care in those countries.
It is wrong to draw conclusions about the quality of care in various industrialized countries without taking into account the risk level of the population. That’s why you will never see statistical experts draw those comparisons. Only homebirth advocates do so because they do not have adequate knowledge of statistical analysis.
Furthermore, homebirth advocates like to attribute the low neonatal mortality rates of the whitest countries in Europe to the presence of midwives and the percentage of homebirths. That has very little to do with it. Japan, which has the best neonatal mortality rates in the world, has virtually no independent midwives and virtually no homebirth. Moreover, we all know that the countries with astronomically high neonatal death rates have obstetric care provided almost entirely by midwives and almost every one has a homebirth.
Finally, to the extent that midwives offer safe care, it is because they copy virtually everything that obstetricians do. They measure blood pressure, listen to the fetal heart rate, measure uterine growth, order blood tests, give Rhogam, test for gestational diabetes, monitor the fetal heart rate in labor, use pitocin for postpartum bleeding and carry neonatal resuscitation equipment. They discovered none of it, invented none of it and learned it only from obstetricians. If they didn’t copy obstetricians, the death rates of their patients, both babies and mothers, would be appallingly high.
25. Jessica Carlson said:
November 30, 2006 @ 7:38 pm
Amy - rock on!
You are obviously very well informed. Thank you for bringing your knowledge here.
26. Kris said:
November 30, 2006 @ 8:45 pm
http://www.unitedhealthfoundation.org/shr2004/commentary/infant.htm
On the state of infant health in America, IMR’s and prematurity stats
27. Jessica Carlson said:
November 30, 2006 @ 9:11 pm
28. earthshoes said:
November 30, 2006 @ 9:22 pm
[quote comment="10673"]http://www.unitedhealthfoundation.org/shr2004/commentary/infant.html
On the state of infant health in America, IMR’s and prematurity stats[/quote]
It just needs an “l” at the end.
29. Amy Tuteur said:
November 30, 2006 @ 9:43 pm
Kris:
I’m not sure why you offered the link, but I will point out that infant mortality is not what we are talking about. Infant mortality and neonatal mortality are two different things. In general, infant mortality is defined as death up until 1 year, and neonatal mortality is usually defined as death during birth through the first week of life.
30. Freebirther said:
December 2, 2006 @ 12:10 pm
Much of what hospital birth advocates pass on is an ‘amalgamation of myths, half truths, and lies’ as well. The truth is somewhere in the middle. I have seen many studies in which hospital birth was shown to have a much higher mortality rate. That you haven’t seen them does not mean they do not exist.
I don’t know any homebirther who claims that birth is inherently safe beause it is natural. Life is natural, but it is not inherently safe. Do you have any statistics proving that childbirth is one of the leading causes of death in young women and babies? The truth is that in cultures where sanitation, health, and nutrition are valued and respected, maternal and infant mortality is quite low. Take a look at the list of countries and their respective IMRs if you want proof of that–or open a history book about birth, written by an impartial party.
The neonatal mortality rate hasn’t dropped 90%. It is estimated that, in the dark ages, infant mortality was between 30 and 50%. Those statistics come from sites that are not advocating either birth choice. Today our mortality rate is 15%. That is not a 90% drop. It is a 50% drop. There is no proof that medical intervention caused it, as medical interventions were common even in the dark ages–as you can learn from reading about the dark ages, not home birth advocacy sources. Medical intervention is not new; sanitation, nutrition, and the comforts of today are. They are much more likely to be the cause of the drop.
I am not saying that some homebirthers are all perfect, have the same arguments, or do not tell half truths. I am sure many are uninformed. That is not, however, true for most of them. MOst of them have done an intense amount of research and preparing, rather than just putting their trust in their doctor, reading only ‘What to Expect’ and then letting him take control in the delivery room without educating themselves on the pros and cons of the interventions.
Death has never been a normal part of childbirth. The neonatal mortality rate of 30-50% that existed in the dark ages wasn’t solely due to death at childbirth, but also due to cold, lack of food, rampant disease, unsanitary conditions, accidents around the home, etc. Do you think every child that dies in the first year of life does so because of the birth? You’re mistaken.
When we know about standard care in various countries, we can compare country to country. However, we have to take into consideration factors that match countries to other countries. It would be silly to compare ourselves to, say, Zimbabwe, but it would make every bit of sense to compareourselves to England…and then look at the difference in infant mortality and in the kind of care pregnant women receive, and try to draw conclusions. Most civilized countries with lower IMRs than us, not just ones where most citizens are of another races, are countries where medical intervention is not so hevily relied upon and people birth at home. While homebirth and midwifery care is responsible for the low neonatal mortality rate in countries where MOST people birth at home and receive that care (if that’s the care they are getting and the choices they are making, obviously any consequences are the result of it; therefore, if things work out, it is because of the homebirth & midwives), perhaps obstetrics in Japan are very good–unlike here in America. That obstetrics in Japan are wonderful does not, however, make homebirth here in America any less safe or hospital birth any more safe.
Midwives existed BEFORE obstetricians. They did not invent fetal monitoring, but they did measure uterine growth by palpitating the stomach, recording fundal height, etc. Instead of using pitocin, they used herbs which are MUCH safer and less likely to cause violent contractions. Who do you think resuscitated infants before doctors? Midwives did. You can resuscitate most infants without equipment. Midwives do not copy obstetricians. Obstetricians didn’t invent all of those tests. They have always simply used the resources that are available. That they use that testing now doesn’t mean that they are copying obstetricians, just that they are using what resources they now have. Many midwives, by the way, do not routinely do those tests; they do them in high case scenarios or when the mother seems to be experiencing something unusual. (Here, again, you’ve demonstrated your lack of knowledge about midwifery care.)
Can we have a little proof that neonatal mortality has always been SOOO unusuaully high? With infant mortality rate being 30-50% in the dark ages, and now being 15%, wouldn’t a HUGE instance of neonatal mortality have made the total infant mortality rate a lot higher? I don’t see how you can claim we’ve had a 90% or so drop in neonatal mortality when infant mortality has only fallen 50%.