Did you know that it is statistically more difficult to break up with your OB than it is your first high school sweetheart? It is. More and more women are being faced with that choice, though. In our area, we have three major hospitals whose cesarean rates are nearing 50%. Yup. Really. Is there something wrong with our bodies, all of a sudden, that we “need” to have our babies surgically removed from our bodies?! No way, Ladies. We happen to live in Michigan, which has the fifth highest cost for medical malpractice insurance. This means that if a doctor even gets a LETTER that indicates that they might be sued, their insurance will go from a burden to making it so that they just can no longer afford to practice. And it means that they will therefore “practice defensive driving” or in this case, defensive medicine.
Are you, a normal healthy woman, suffering from an illness when you are pregnant? Unfortunately, when going to a surgeon, Ladies, that is the kind of treatment we will get. It’s not their fault, entirely. Royal Oak Beaumont, which is a teaching hospital, had 492 births this past January. Guess how many of those women labored without an epidural? Just a wild guess?
One. One woman in the month of January labored without an epidural. What does that mean for the interns and residents on rotation that month? And the student nurses? It means that they will have abso-freaking-lutely NO idea what a normal, physiological birth sounds like, looks like, SMELLS like. They will not have a chance to experience birth that does not include a woman on her back or tailbone, purple pushing…after watching CNN until she is checked, told she is complete (or worse yet, told that her “body just doesn’t know how to have this baby,” and that she “NEEDS a cesarean.”), and that it’s time to push, and then after pushing for two hours, told that she’s just not moving the baby properly, and then they’ll “have” to pull the baby out with a vaccuum.
This is the experience of the doctors and nurses who are “learning” about “birth.” It is now ALSO the experience of women, who are in the most psychologically suggestible points in their lives because of the hormonal state their minds are in. They are now SURE that their bodies are broken. And they are spreading that news…if our FRIENDS are getting cesareans nearly 50% of the time…why should OUR bodies be any less broken?
But in the end, it’s not our bodies which are broken. It is the medical system in the United States, and the lack of understanding of the mechanisms of birth in the culture we live in. Our sisters don’t typically see our babies born. We don’t see our cousins or siblings born. Birth is something that many of our mothers and even grandmothers were afraid of, and have spread that fear to us.
So, what is the fix? Education, of course. Primarily, moving the system from mostly Obstetricians (surgeons, taught to look for pathology, and then cut it out) caring for normal healthy women during pregnancy, to mostly midwives (trained to know what normal healthy pregnancy includes, and, UNLIKE OBs, trained to COUNSEL women to keep them healthy--did you know that Obs aren’t required to have even one class in nutrition?) caring for the women who need only somebody who is willing to walk with them through pregnancy and birth, not test them and use technology on them where it is not warranted.
Speaking of technology. Did you know that we spend four times as much as any other country on the cost of each birth that takes place here? And to what end, you might ask? You might, as do MOST Americans, assume that that technology makes us safer. You might assume that it improves the outcomes for pregnancy, labor, and childbirth. You might assume that we get more healthy, ALIVE babies, more healthy MOTHERS. Um. Well, that would be an incorrect assumption.
In actuality, we are 128th in the WORLD for the safety of mothers and babies in childbirth. There are only two or three countries with worst records than we have. Croatia is one of them.
WHY?! In the end, the very technology we have come to depend on in the birth culture of America actually CAUSES more cesareans. We know with no uncertainty that cesareans make sicker babies and babies who die more often. We KNOW that it makes mothers more susceptible to infection, to hemorrhage, to injuries like perforated bowels and bladders…
So…how do WE keep ourselves from being part of that statistic, that 50% of women who end up with a cesarean in our town’s major hospitals?!
Be well. Eat well, exercise to your body’s capacity. FIND A PRACTITIONER WHO TRUSTS BIRTH. Make sure that that practitioner has every confidence in your body and your baby and their ability to work together to end in a healthy birth. Not many of them exist any more, in the hospital setting. There are a few…but the protocols they have to follow in order to keep their jobs often tie their hands in many cases where they would otherwise prefer to just let a woman labor. If you are financially able, find an out of hospital practitioner. Yes, study after study shows that birthing out of the hospital is not only as safe, but because of the very technology that you WON’T have there, it is actually in many cases SAFER than hospital birth. That’s a blog for another time, though.
If you DON’T think that you are financially able, ask around. I bet you that you’ll be able to find an option, a SAFE option, that you are able to afford. Most midwives believe so strongly in allowing women a safe birthing environment that they are willing to work with them on cost.
Be well. Don’t be a statistic! Don’t be like that 16 year old who refuses to break up with her first boyfriend. You only get to birth this child one time. Practitioners attend LOTS of births every year. Ask questions. How many cesareans does your doctor do? How about your hospital. And, and this is a big one, how many VBACS do they do? What are their protocols about fetal monitoring? GBS testing? Glucose testing? What percentage of the pregnant women in their practice are induced? Do they like doulas in the birthing room? Why or why not? Do they sit down and ask you what you want to talk about, and talk till you are done, or do they stand, look mostly at the chart, measure your belly if they have time or feel like it, and then rush out? Are they WITH you in the pregnancy, or are they directing you in this pregnancy…or letting you drift on until--BAM! You’re 40 weeks, and don’t you know that there is a timer in that baby and you HAVE to be induced to keep that baby from certain death?! Not that they mention the method of induction and it’s safety to the baby, or frankly, to you…
Again. Be well, that’s the best way to avoid a cesarean. But equally as important, know and TRUST your practitioner--and know and trust your body’s ability to give birth. And, if you get a red flag, if you at any point feel uncomfortable with your practitioner...find a new one. There are so many from whom you can choose!! And you are the consumer. You won't be penalized for doing so. I had a client hire me because she had literally fired her OB while she was pushing. It's never too late to feel comfortable, or to be safe while giving birth.