General Question

Simone_De_Beauvoir's avatar

What are your views on how childbirth is handled in this country?

Asked by Simone_De_Beauvoir (38935points) May 27th, 2009

As someone who was always familiar with medicine and the history of public health in this country, I knew when I was pregnant each time that I had to take matters into my own hands and create a birth plan that would be followed by the doctors and such instead of becoming a statistic of induction, c-section, bye…I took childbirth classes both times and learned so much about the relationship between natural medicine and a medical world that has to ‘do something’ to the woman when that’s not necessary…I believe new mothers have no idea why certain things will happen to them but to hospitals they’re just numbers…too often all the interventions aren’t necessary, a lot the hospitals do are for liability issues and not for the mother…more people should have access to midwives and the such…

http://www.healthcareshopper.com/blog/2009/05/childbirth_medicine_-_going_in.html

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23 Answers

casheroo's avatar

I think it’s disgusting what childbirth has become in the US.

I decided to “wing it” and wasn’t opposed to pain meds, and I chose a hopsital birth because of my history of anxiety. I had no clue I’d be bombarded with all sorts of interventions.

The doctor, whom I had never met (he was on call) came in every half hour to offer me a c-section and tell me that at 3 hours of pushing, they would perform a c-section.
They were annoyed that I kept refusing a c-section, so insisted I use a vacuum to get my son out. I refused. I had done my research. There was no medical emergency need for a vacuum OR c-section. I refused, so they left me alone with my husband to push..figuring I was a sucky pusher and would end of with a c-section (I guess)
I ended up pushing my son out, but I did have an epidural (which I researched and trusted.) It took 3 hours, which was not ideal, but it was my first labor and delivery so I didn’t expect it to be a piece of cake.
I refused to let the doctor do an episiotomy, because having done research, I felt it was completely unnecessary. I remember yelling “Don’t cut me! Don’t cut me“when I saw those dreaded scissors. lol
Unless there is an emergency, a lot of interventions are unwarranted. Pitocin given after giving birth is not necessary, and I know I received it but was so worn out I had no energy to refuse or even ask why. They just told me it was routine :(

Likeradar's avatar

@casheroo Disgusting. Good for you for sticking up for yourself!

ubersiren's avatar

We are just numbers. That’s how I felt. I felt like my doctor just wanted my baby out of me already so she could go home and not have to deal with me anymore. After 14 hours of induced labor, I was told my baby wasn’t going to come and I needed a c-section. The baby was in no distress. I feel very jipped. Jipped of control, of my choices, and of a quick postpartum recovery. I am trying to get pregnant again, and am switching to another doctor and midwife. It pisses me off to even think about it. My sister-in-law had an identical birth to mine, and I know we aren’t the only ones. It is my opinion that doctors get more pay for surgical deliveries and it’s quicker. It is my philosophy that any time nature is not allowed to carry out its order, wrong has been done. That’s not to say some emergencies don’t call for a cesarean, but the numbers of them being pumped out are atrocious. Women need to be better informed about just how likely it is these days to receive a c-section if they don’t take control. Women need to know their options and speak out when they don’t feel like something is being done the right way.

As far as education goes, I can say that my childbirthing classes were very informative… for vaginal birthing mothers. I wasn’t in any way prepared for the pain that followed the surgery, barely able to walk to my baby and hold him properly, and the anguish of not being able to properly breastfeed because of delay in milk production. All normal new-mother stresses were twice as hard as they had to be.

I know I sound bitter, and I am. I wish nobody to go through what I did, as so many other moms have. All I can do is learn from my previous experiences and take control. I hope to tell as many people about my experience as possible so the message gets out.

MissAusten's avatar

I can only speak for my own experiences, which were wonderful in that I had three healthy babies with no complications.

That said, there were things I wasn’t particularly happy about when I had my first baby. My husband and I went to birthing classes and I read “What to Expect.” I learned as much as I could about childbirth, but still—until it happens to you, you have no way of knowing what to expect. I had talked to my doctor about having an epidural because I was very nervous about the pain. What I didn’t know was that my labor would progress so quickly that there would be no time for an epidural. I kept asking the nurses to get my doctor, but they said “He’ll check in on you soon.” When I said I felt like I had to push, the nurse actually rolled her eyes. I’d only been in labor for an hour and a half. My doctor (whom I adored), showed right up, said I was fully dialated, and to start pushing. Then he left again. After one push, the nurses brought him back because the baby was crowning. Five minutes later we had our baby. I guess my problem was that the nurses didn’t seem to take my requests seriously, that because I wasn’t screaming in pain or swearing at my husband I was still in the early stages of labor.

Second time around, I thought I could get through it without the epidural. My water broke, but the next day I still wasn’t having contractions. My doctor started me on pitocin, but no one told me how much more horrible the contractions would be. I didn’t want an epidural, but I was incoherant from the pain. Imagine someone taking a chainsaw to your guts—fun times. They gave me staidol, which I didn’t react well to. Just as much pain, but I was completely loopy. At least the labor was short once it got started, but my usual doctor wasn’t on call and the other doctor was an asshole. He was literally yelling at me to push, and I didn’t find out till later it was because my son’s arm was stuck and the doctor thought he might have to dislodge the baby’s shoulder to get him out. It didn’t help that the baby weighed over nine pounds. In that case, I felt like there was no communication about what to expect. If my regular doctor had been on call, I know that would have been different. He was excellent at always explaining what he was going to do, what I could expect, and what my options were.

Finally, with my third baby, I felt I was prepared for anything. Meaning, I knew to have no expectations about what might happen. I went into it all with an open mind and no firm plans. Ironically, it was the easiest birth of the three. We’d moved and I had a new doctor’s office. My doctor gave me the option of scheduling an induced labor since my first two babies were born so quickly. I jumped at that chance. I also made sure I got an epidural when I wanted it, and I have to say the nurses at this hospital were awesome about listening to me and taking me seriously. The whole experience was so much better than the first one, where I didn’t know what was happening at all, and the second one where I was in horrible pain and stoned out of my mind. Also helped that the induction was done a bit early, so this boy came out at 8 pounds even.

Sorry this is such a long answer, but to sum up, I think it’s really important for a woman to find a doctor she can absolutely trust and communicate with. Or a midwife, if that’s the case. Too often the hospital staff seem to have a “we know best” attitude and don’t take the time to remember that the woman having the baby is new to the experience and probably scared. I will always be grateful to my first doctor for talking me so calmly through the birth of my daughter. Women need to educate themselves as much as possible about their choices, read read read and talk to other women who will share stories that can help. I knew enough to insist on not having an episiotomy, and thank God they don’t routinely shave you anymore. I did take out of it a need to question everything I hear from doctors, for myself and for my children. I ask a lot of questions to make sure I understand everything.

Simone_De_Beauvoir's avatar

@MissAusten thanks for writing all that, it was good to read
doctors are important and mine (the one that delivered my first) randomly dropped me when I was on my 2nd trimester with my 2nd saying my insurance (different from the private insurance I had the first time) was no longer something he took for the duration of pregnancy, just the beginning – then he gave me over to this other doctor that he knew was ‘not as bad as the others’ (never a good sign) and that doctor treated me like a child and I had to monitor his every move telling him tests he missed or plain out refusing at the end of the pregnancy when he wanted me to go on blood thinners (as I broke my leg and was gaining a lot of weight and he thought I was going to get a blood clot)...sigh…I’m so done with him now and would have to switch him the next time…

westy81585's avatar

Talk to your husband or S/O who is going to be with you in the room if you go the hospital route. There is nothing wrong with delivery in a hospital, but you need someone who will stand up for what you want even when the doctors want to rush you through. You and or the father or whomever is with you needs to know that you don’t mind being there for 2 days or whatever, and that you’re NOT going to do the c-section when it takes 10 hours, and you don’t want to be cut and what not.

If there’s someone there to lay down the law, there’s NOTHING the doctors can do against that, they’ll just have to put up with it.

Get a mid wife to help you if you can. Even if she’s in the hospital with you. (For all their trouble, it may not be a bad idea to be in a hospital just in case something DOES go wrong).

MissAusten's avatar

@Simone_De_Beauvoir Thank you. I do tend to run on and on.

After describing just my own childbirth experiences, I started thinking in more general terms about OBGYNs and hospitals. One of the big problems is malpractice insurance. The cost is so high that my first doctor’s office lost two doctors. They couldn’t handle the insurance cost and gave up the OB part of the practice. My current doctor’s office has several doctors, and to defray the insurance costs they rotate OB schedules. Two of them at a time take a year off from OB services and only handle the gyn appointments. So, not only do you have doctors and nurses who might not be fully competent, you also have doctors who are maybe overly paranoid about malpractice and probably push women to have these interventions so no one can later say they stood by and let a tragedy happen.

I think it would be interesting to have someone in the medical field comment on this as well.

westy81585's avatar

@MissAusten Malpractice does have a lot to do with it. Even though the odds of something bad happening are slim, if it does happen, they’re liable in many cases.

It doesn’t help that our surgeons/doctors aren’t really taught a “different” method with childbirth. They’re basically taught to deal with it like it’s a sickness or injury, and as quickly as possible “fix” the problem. It’s not really “their” fault, it’s just how they’re trained. That’s why having a mid wife handy can help, they’re trained specifically on childbirth.

casheroo's avatar

@westy81585 Very true about the birthing partner. My husband knew my wishes, and upheld them when the doctors were being too pushy. They seemed to brush off my refusal of the vacuum and brought one out. My husband stepped up and said “No, we aren’t doing the vacuum” and that was that. The fact that they needed someone who wasn’t the person actually going to be pushing and having a vacuum stuck in them answer showed me that they didn’t care what I wanted at all. That’s when I realized the hospital I was in was not supportive at all :(

knitfroggy's avatar

I just watched a show last night called The Business of Being Born. It was really interesting to me. It was very pro home birth and also against so much intervention.

I was in labor for 8 hours with my daughter before her heart rate dropped out of no where. I had an emergency c-section. The cord was wrapped around her neck and her chest and was choking her. With my son I had to have a scheduled c-section because the doctors wouldn’t let me try to have a VBAC at the small hospital I was going to deliver in. I would have to go about an hour away and that wasn’t something I was interested in.

I think if people have the option to have a home birth with a midwife they should if that’s what they want to do. I for one never considered it and am thankful I was in a hospital hooked up to monitors or I’d be with out my daughter.

shilolo's avatar

Yeah, what knitfroggy said. A home birth disaster would leave an emotional scar to last a lifetime.

Simone_De_Beauvoir's avatar

@knitfroggy well I wasn’t saying that medical intervention isn’t necessary at all
in your case it was

shilolo's avatar

@Simone_De_Beauvoir That’s the point. A midwife would be i) less likely to identify a problem, ii) unable to do much save call 911, iii) stand and wait as EMS arrived to rush the person to the hospital. Even worse, without a midwife (say your husband delivered the baby), there would be no one around with any medical training if the baby or you had an unplanned emergency.

westy81585's avatar

@Everyone Midwifes know a lot more than you’d think. And they can handle a lot of emergencies. Also, it is an option to have a midwife handy AT the hospital. That would give you the benefits of the midwife with the safety of the hospital.

Complications are very rare, but they do happen, and it’s not a terrible idea to take advantage of the amazing facilities we have in this country. BUT, there definitely is a problem with the “rush rush” method most doctors have… which can be remedied by having a midwife, a good doctor, or a good partner who knows your wishes.

shilolo's avatar

@westy81585 As an actual doctor I can tell you that midwives aren’t trained to handle a wide range of emergencies. They certainly aren’t pediatricians, and will not be able to appropriately and adequately resuscitate a struggling infant. More importantly, hospitals in general don’t have you deliver with both a midwife and doctor. It typically is one or the other during the delivery, though they frequently employ both. For example, where my wife and I had both of our kids, there were both midwives and obstetricians. The first birth we had a slew of people, as it took 2–3 days for the delivery to actually happen. A midwife delivered our son, but she struggled with the placenta, and called the senior doctor in to help. The second birth we only had obstetricians, and it was a wild ride.

westy81585's avatar

@shilolo My point is that in the large percentage of births you don’t encounter a problem that isn’t controllable outside of a hospital (hence midwives tend to be capable… and in fact most regular people would be capable). And you seem to contradict yourself in the second part, they don’t have you deliver with both a midwife and doctor, yet your example stated that they employed/used both midwives and obstetricians?

But your first case seems to be what I’m suggesting. Go to a hospital, and deliver with a midwife. That way you go about it in the more “calm” /natural method… But if something goes wrong, you’ve got doctors there to save the day.

shilolo's avatar

@westy81585 Many hospitals have both, and allow you to choose which you would prefer. If you don’t indicate a specific preference (which we didn’t), they’ll just give you whomever is “up” for the delivery. You are correct that most pregnancies could occur naturally and be uncomplicated, but even if the percentage of complications is low, why take the chance? As far as midwives are concerned, they don’t do procedures (except maybe episiotomies) and can’t do epidurals. Having participated in lots of deliveries, and having had two of my own, I can say i) there is nothing calm about it and ii) I don’t really think it matters one bit if a midwife or OB delivers the baby. In the end, the goal is to have a healthy baby. Period.

dynamicduo's avatar

Just look at the infant mortality rate over the past two hundred years. Modern science, medical treatment, and understanding bacteria has effectively neutralized infant mortality in many first world countries. Back in 1900, more than 1 in 10 babies born would die (in fact, 165/1000, and it was much much higher in previous centuries). More than 10 years ago in 1997 that number was down to 7 in 1000. Thus I would say that childbirth has been handled much better in America and Canada compared to places like Afghanistan (their current rate is only a few points lower than what ours was 110 years ago, 151.95/1000).

As for how it has been made into a fast food outlet ala @casheroo‘s example, I would say this is much more a result of the American health system than it is a result of anything else.

Simone_De_Beauvoir's avatar

@shilolo
well as an actual mother of 2 I can see why, god forbid, questioning a doctor would get you all riled up but that’s the very point I’m making – there are some amazing doctors out there and there are amazing midwives out there and childbirth, to me, isn’t anything that has to be treated as an emergency every time as it certainly isn’t – of course emergencies do occur but the ridiculous rate of c-sections that the article I posted points to are not all emergency c-sections – they’re all scheduled or ‘encouraged’ by doctors c-sections…I come from a background of pre-medicine, volunteering at hospitals, public health and EMT training…I understand the history that went into the taking over of childbirth from women and midwives into the hands of the AMA…there was money to be made, yes, and doctors (at that time, men,) took over the field of silly midwives (at that time, women) and have now brought the field to a formula that every woman should be aware of – quick induction, leading to slower labor (no matter what they tell you), leading to epidurals which also leads to slower labor, leading to c-sections and lack of any advice on how to survive after all of this…I know doctors and doctors pop that baby out and are GONE, in seconds, the woman isn’t their business, but the baby is, and it’s a great paying business…

Again, I am not saying women shouldn’t deliver in hospitals, but I am saying everyone should be a lot more educated as to why things are the way they are, why the stats and rates in hospitals and everyone should have access to midwives…and as @westy81585 mentioned, there are nurse-midwives and midwives in general who are WAY more capable than some random doctor right out of residency who’s ‘up’ in the rotation, because they deliver hundreds of babies, without complications and with, all the time…

Simone_De_Beauvoir's avatar

Also, for anyone that wanted to take a cursory look over what the ‘debate’ is about, here’s a decent, though not terribly enlightening article

http://www.time.com/time/health/article/0,8599,1898316,00.html

Since010501's avatar

I have had issues with doctors in the past. Even my current OBGYN I didn’t like a lot of the time because she had way too many patients. I wouldn’t switch though because she was an amazing doctors. All 3 of my pregnancies were high risk and I had to have a horrible amount of tests run. It was a very frustrating experience—but they were doing what they could to protect my children and my own life. Unfortuneately I only have one child living from three pregnancies. My first child was premature and passed away when she was 5 days old. My son is now 17 months old, small but healthy…and I miscarried my third child.

Simone_De_Beauvoir's avatar

@Since010501 I’m sorry about your other 2 children

bea2345's avatar

If I had known in 1986 what I know now nothing would have got me to agree to a c-section. But back then, I did not know what questions to ask, or even who to ask. Recovering from the operation was horrible. I am fairly certain that I might have had a second child were it not for the cesarean. But more to the point: mothers who had vaginal births recovered a lot faster than I did.

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