When you think about the numbers 1 out of 20 mothers… you think of a statistic like… have episiotomies, or have back labor, maybe even big babies. The last thing that I would think of would be what I learned today.
Almost 1 in 20 mothers may have a traumatic birth.
Nothing surprising to me personally since I have worked so closely over the last couple years with mothers who may not have had the ideal birth experiences, and even consider themselves traumatized by their experience. Between the first and second birth stories from The Feminist Breeder, to Sarah from One Starry Night sharing her experience while trying so desperately for a VBAC. It is something I have come to consider routine when speaking with women.
Of course there are a ton of women out there who have made it out of their childbirth experiences feeling fine, or as if their treatment was routine. I found this article, and the tale of Kerri made me sick to my stomach.
When Kerri was delivering the placenta, she started to hemorrhage. The resident on call became concerned that blood clots might be preventing her uterus from clamping down to stop the bleeding. She inserted her hand into Kerri’s uterus and without any warning or offer of anaesthetic, she began scrapping blood clots from the side of Kerri’s uterus. “She reached deep up inside and started scooping them out while pressing really hard on my uterus.. . . The resident insisted I was feeling sensation and not pain. I stated that, no, I was feeling pain.. . . She entered very roughly over and over again.”
The attending nurse and the resident, both of whom were just starting their shifts, had incorrectly assumed Kerri had received an epidural during the birth and that no additional pain medication was required. The experience was so painful that Kerri says she experienced flashbacks to an earlier sexual assault.
So powerful, so frightening, and yet all to common today. One of the biggest problems today is the way women are treated during birth, and after birth if they express any kind of dissatisfaction with their experience, especially if it yields a healthy baby. The attitude today is, if you and your baby actually survived the incident and experience, consider yourselves lucky, and quit your bitchin’ because others may not be so lucky. Kind of like saying to someone who lost a family member in a car accident, consider yourself lucky you are alive. Taboo to say the least, but wide spread in our society.
This leads to women not getting proper help, or reporting issues of depression, or Post Traumatic Stress Disorder after birth, which Gina, The Feminist Breeder has often spoken about.
This dismissive attitude ignores the debilitating fallout of a traumatic birth: flashbacks (vivid memories of the event), feelings of fear and panic, nightmares and difficulty sleeping. Women may avoid situations that remind them of their birth experience, says Christensen. They may detach emotionally to avoid re-experiencing emotions related to trauma. They may become hypervigilant in order to try to protect themselves or their loved ones from any potential future trauma. Unresolved trauma can have far-reaching consequences for a new mother and her family. It can affect her physical and emotional well-being and her relationships with other people. And if the feelings of hopelessness and helplessness that typically accompany PTSD are not addressed, the new mother remains vulnerable and more susceptible to future trauma.
Something many do not understand, or have never come face to face with.
Another story that I found alarming was Kristen of Toronto Canada.
An obstetrician consulting on her case (she had planned a home birth) ruptured her membranes without her knowledge or permission. The obstetrician had wanted to admit her to hospital to induce birth after viewing the results of her ultrasound (at 38 weeks and one day). It indicated that her baby was large (estimated at 9 lbs. 3 oz., but actually 7 lbs. 13 oz. at birth) and that her amniotic fluid levels were low (though no one has been willing to confirm for her whether that, in fact, was the case). All she had asked of the doctor was a chance to go home and get some sleep. She had repeatedly stated: “I will come back after I get some sleep and when my support people are here.” He told her he needed to check her cervix — which is when he ruptured her membranes.
“He took away all my chances to try to have the birth I wanted,” says Farewell. She then goes on to describe a birth involving cascading interventions: an epidural after 12 hours of labouring naturally (when her cervix was still at 2 cm. and the baby hadn’t dropped), then a C-section 12 hours later.
All actions that could have been prevented had this Obstetrician followed informed consent laws. In mine, and the opinion of most women, and mothers, this is nothing short of criminal. What gives a provider such a sense of entitlement that they do what they feel to a mother, especially in this kind of a case!
There truly needs to be a change in our society when it comes to childbirth. If we don’t put an end to this now, it may only get worse!
Don’t get me wrong. I think what the Baby Friendly Hospital Initiative is going is awesome. Breastfeeding education, help, and promotion is key in our society today. But my beef is regarding some of the hospitals being deemed baby friendly and their birth practices.
I am going to focus around the hospitals in my state of Connecticut that have been deemed baby friendly, and their birth practices and statistics because all of these numbers are easily accessible for me. In Connecticut we have 3 “baby friendly hospitals” which are Middlesex Hospital, St. Vincent’s Medical Center, and Hartford Hospital. My qualm? One of these hospitals has THE HIGHEST cesarean birth rate in the entire state.
Lets look at the numbers :
Hartford Hospital : 38.17% C-section rate for 2007
Middlesex Hospital : 37.50% C-section rate for 2007
St. Vincent’s Medical Center : 44.50% Cesarean rate for 2007
St. Vincent’s Medical Center also holds a VBAC Defacto Ban. Meaning there is no official ban on VBAC, but there is also no providers on staff that will allow a woman the chance to have a vaginal birth after a cesarean. Not friendly at all if you ask me.
Middlesex has a 1.26% VBAC rate, and Hartford Hospital has a 2.0% VBAC rate.
All are hospitals I recommend women stay far away from when giving birth.
These numbers are all more than DOUBLE the recommendations put in place by the World Health Organization, which is 15% at most, including high risk patients. So, here is my question…. How can a hospital be baby friendly when their cesarean birth rates are so high? Answer : The Baby Friendly Hospital Initiative does not take how a baby is born, or a hospitals L&D practices into account when it comes to the label baby friendly.
The Baby Friendly tag has to do with breastfeeding.
The 10 Steps a hospital needs to accomplish to become baby friendly are :
|1 –||Have a written breastfeeding policy that is routinely communicated to all health care staff.|
|2 –||Train all health care staff in skills necessary to implement this policy.|
|3 –||Inform all pregnant women about the benefits and management of breastfeeding.|
|4 –||Help mothers initiate breastfeeding within one hour of birth.|
|5 –||Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.|
|6 –||Give newborn infants no food or drink other than breastmilk, unless medically indicated.|
|7 –||Practice “rooming in”– allow mothers and infants to remain together 24 hours a day.|
|8 –||Encourage breastfeeding on demand.|
|9 –||Give no pacifiers or artificial nipples to breastfeeding infants.|
|10 –||Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic|
Nothing about the birth statistics, nothing about the amount of unnecessary interventions during childbirth that can and do impact breastfeeding relationships, especially c-sections. Typically babies are separated from mothers longer, have more medication in the days after, and have an unhealthy start to breastfeeding.
There is simply nothing baby friendly about subjecting our children to unnecessary medical procedures that may or may not impact their health long term.
So what is my suggestion to the Baby Friendly Hospital Initiative? Start looking at the L&D unit’s as a whole, not just breastfeeding steps. The way hospitals treat women when they are in labor, or giving birth IS going to impact their breastfeeding relationship long term. Hospitals jumping through those 10 hoops also does not give them breastfeeding success which we saw in Connecticut again with a hospital that is not on the Baby Friendly list, but has a higher breastfeeding success rate than all three of those above hospitals combined.
The three hospitals above are not baby friendly.
They are NOT mother friendly.
They do NOT practice evidence based medicine.
This seems to be a question that keeps popping up in my life. From the discussions I watch on Cafemom, to people in my own lives. Over the weekend when discussing childbirth among women at the fire house, mostly girlfriends and wives, I was shocked when most discussed wanting a natural birth. It was almost like that pleasant change I have been working so hard towards, and I haven’t even been brainwashing this crowd. LOL!
So, I wanted to share a quote from The Official Lamaze Guide, and discuss some of the things detailed in it and why they concern me. If you would like to read along in the book if you own it, the quote is located on page 5 in the box on the side.
” In spite of evidence, U.S. maternity care continues to sabotage normal birth rather than support it. In 2002, the Listening to Mothers survey learned that among nearly 1,600 new mothers across the U.S., 44% had labor induced, 71% did not move freely during labor, 93% had electronic fetal monitoring, 86% had intravenous lines, 74% gave birth on their backs, and almost 50% of their babies spent the first hours after birth with hospital staff. Only 1% of the women experienced all six care practices that promote normal birth, and none of these women gave birth in a hospital.”
Lots of alarming statistics in there. Of course the survey only included 1,600 women, but it does give us a real look into the way women are giving birth today, despite evidence showing these practices are outdated, unfounded, or harmful rather than helpful.
44% of women had their labor induced!!
That is a huge number for labor induction, especially since labor should only be induced in a medical situation. Letting labor begin on its own is key for a successful natural birth experience for so many women. It is also the way our bodies are meant to work, and the natural stages of pregnancy, and life in general. We need to stop interfering with a natural process with no indication of actually needing to step in. Inductions lead to more epidurals, more cesarean sections, pit to distress, and many more complications including premature babies.
71% of women did not move freely during labor.
Being confined to a bed while laboring is not ideal by any means, not only does it decrease the size of your pelvis, but it also can cause lowered blood pressure, and fetal distress.
93% had electronic fetal monitoring.
Even though numbers of studies have shown no improved outcome to mothers and babies with electronic fetal monitoring. Also, recently there has been a number of controversial articles about fetal monitoring and how providers, or medical professionals are reading the fetal heart tones. Many think that the over analyzable of small decelarations in fetal heart tones is leading to a higher rate of unnecessary cesarean births.
86% had IV Lines.
Meaning, the hospital providers had easier access to give mother things like pitocin with or without her consent. If I had a dime for every woman that told me she was put on pitocin without even being asked, or told it was going to be starting in her IV line, I would be a millionaire! Unfortunately until women start complaining about this practice, it is not going to change.
74% gave birth on their backs.
Which we know is probably the worst position for a woman to give birth in. I recently wrote about this in two posts, Positions You Should Be Giving Birth In Part 1 and Part 2. Decreased pelvis size, blood pressure complications, lack of gravity to help with the birth itself are all huge factors in the lithotomy position.
50% of babies spent the first hours of life with hospital staff!
Horrible! After birth, in those first few hours, it is the most critical time for mother-infant bonding. Between breastfeeding, skin-to-skin contact, and the hormones a mother releases with birth, it is so important for these babies to be with their mothers, not with a stranger.
Only 1% of these women experiences all 6 Lamaze Healthy Birth Practies
Surprising, but not all that surprising to me. Of course they were not in a hospital setting, because if they were in a hospital, they would not have experienced all 6, or even just a few. Hospitals are becoming more and more unfriendly for normal birth practices, as well as less and less Mother & Baby friendly.
Unfortunately despite the number of people who are concerned about these growing trends, the hospitals and maternity care in the U.S. is continuing to get worse, not better. It is a fight for women to have a normal birth rather than one where she is not in control of her care, or treated like a birthing mother, rather than a money making machine.
We are all fighting for change! Please, if you would like to see change, take a couple minutes and head over to Science & Sensibility, and leave a comment on Amy’s latest post.
Since the NIH VBAC Conference, and the Post Cesarean Feelings Survey posts that have been going on, I have been trying to avoid any other cesarean related posts or information for the simple overkill factor. But these numbers that came out today from the National Center for Health Statistics just could not be pushed to the side, or left for a later date post. I was just really passing them by until I sat down this evening and read the post about them over on The Unnecesarean.
Now, if you follow me, you know how I feel about the cesarean rates, and elective cesareans, but these numbers should be scary and alarming to all women of childbearing age, or who plan to have children in coming years. A couple pieces of information I found most important :
One thing I wanted to point out is that maternal request cesareans showed to make up 0.4% of cesarean sections taking place, so the excuse that women are just telling their Doctors this is what they actually want is something that does not hold much weight with me.
But why is this such a problem?
Because more and more women are opting for this procedure under the assumption that it is the least risky option or way to birth a child, when in fact it is not. Having your scheduled cesarean is nothing like going in to have your teeth cleaned. It is serious major surgery that holds serious risks including a 4 times greater risk for maternal death than a vaginal delivery. 9 out of 100,000 women who opt for an elective repeat cesarean delivery, whether it is the second c-section, or more will die.
Not to sound all gloom and doom, but I dont think our women today are being given accurate information on these risks.
Anyways, I just wanted to share that stuff before I went to bed.
I hope ya’ll have a nice night.
Yesterday the Center for Disease Control (who collects National Medical statistics) release a report that detailed information on out of hospital births from 1990 to 2006. I want to stress that the information ended in 2006, there is a good reason, but I will get back to that later in my post. What the information shows is a small, but noticeable increase in home birth, and births that take place in Free Standing Birth Centers. But surprisingly, this study also shows that the majority of women making these choices have already had at least one birth, in the hospital.
The number of midwife attended home births increase from 43% to 63% during this period of time. Which we already know that home birth, when attended by a trained medical professional is as safe as a birth in the hospital, if not safer because the lack of unnecessary intervention that takes place routinely in the hospital setting.
Unlike most people, I sat down last night, and actually read the study, news articles on it from ABC, and other various sources, and really analyzed it to write this post.
A couple interesting pieces of information that I pulled out of this study…..
Just to touch on a couple of these numbers, and pieces of information, what alarms me the most is the people choosing home birth. Mostly white, married, mid-aged women. When studies are showing more and more that the most at risk patients for unnecessary procedures, and some of the highest cesarean section rates are low income, unmarried, women of African American decent. Which is why I believe that in Health Care Reform we should be including more options for home birth insurance coverage, as well as alternative birthing coverage options for mothers who are low income on some form on medicaid.
It also shows that many of the women who are choosing home birth are very educated consumers. We need more child birth education options available to women, especially in the low income bracket. Programs that offer free classes paid by public health funds, WIC programs, etc.
33 of the home births, were to very young women, 15 years old or younger. There could be a lot of different explanations for this. But the one that stands out to me most is young women who hide their pregnancy until the baby finally comes and surprise! It doesn’t seem that in today’s culture too many young women are signing up for any birth experience that doesn’t include someone with MD after their name and an epidural.
6,582 were their second baby. What this shows not only me, but one of the authors of the Study, Eugene Declercq, is that women are opting for their second birth out of the hospital because of what could have been a negative first birth experience, or just did not care for the hospital style maternity care system. Eugene was quoted in the ABC News story as saying “The fact that it’s primarily women who had kids before and had birth in hospitals before, certainly suggests it’s a reaction to their prior birth,”
Which I completely agree with.
The numbers for other subsequent births include, third births at 4,500, fourth birth at 2,851, fifth birth at 1,808, sixth birth at 1,137, seventh birth at 827, and eight or more at 1,438.
Now that groups like ACOG and AMA are seeing these numbers, and this change, they are worrying because these births are taking money out of their own pockets. They have not been shy in recent years about their home birth policy, and how they feel about it even with a number of studies showing the safety. With these new numbers, and developments, they have gone public saying that films such as The Business of Being Born and celebrity home births are having a great influence on the choices women are making for their births, but before opening their mouth, they should do their research.
Remember that little 2006 number I pointed out earlier in my post? Well The Business of Being Born, the first mainstream film that showed home birth, as well as promotes it as a safe option was released in 2007. Oooops!
So how are they going to explain this change, and how it happened before this mainstream film? Maybe the fact that women were fed up with the maternity care system in hospitals long before Ricki Lake decided to work on a project on it? It is nothing new that women do not like the one size fits all care the hospital maternity care system provides.
But that is a whole other post in itself.
A couple other things I wanted to talk about is where home birth is most popular, and rising.
The states with the highest home birth numbers are :
States with notable increases in home births :
I found the number of home births in my own state of Connecticut to be sad, but again, a whole other post in itself.
If you would like to read the full study yourself, the link for it is
For the first time in a decade, the teen pregnancy numbers are going up, instead of going down like they have been. As an advocate for choice, and an even bigger advocate for education on preventing pregnancy, this is pretty alarming.
But not surprising considering most of these teens were the victim of the abstinence only education programs whose funding was greatly increased under the Bush Administration. Even though these programs have been proven to fail, increase teen pregnancy rates, and STD rates in the groups of teens who did not choose to abstain. It is not rocket science. If teens are not taught HOW to protect themselves through contraception, condoms, and other forms of pregnancy prevention, they will not know.
Sadly today, we cannot depend on parents to teach this. Many believe it is the school’s jobs, and some parents who think it is realistic for all teens to choose abstinence do not teach their children any other options other than, simply don’t do it.
But unfortunately for the teens today, most are not educated on parenting, pregnancy, teen parenting, and really what it takes to be a parent, and support a child. A recent study that I read published through a CNN article showed the serious lack of education teens have regarding sex. Some of the alarming numbers from this survey :
These are all alarming numbers, especially the amount of teens that THINK birth control will lead to some sort of health problem such as cancer. Yup, birth control now causes cancer, or at least that is the newest rumor on the streets. Even better rumor is that having sex while standing up will not get the girl pregnant.
Who comes up with this stuff?
But some of the reasons we really need to step back and teach our children how to prevent unplanned pregnancies is the statistics regarding teen parents, and teen pregnancy. Some of the more alarming numbers and facts are :
While being a teen parent is not a sentence of DOOM for the teen, or their child, in many cases like those above, it is. There are success stories, as there are in many cases for many things. But they are not the majority sadly.
I just hope parents actually look at these numbers, and statistics and think twice about talking to their children about really preventing pregnancy until they are older.