Sunday, January 16, 2011

Where are the mothers?

I live in a city with a hospital that has roughly 3,500 births every year.

Their cesarean rate is very hard to find (as are most hospitals'), but based upon information from some of the doctors and nurses that work there, it is estimated to be around 50% (some say closer to 60%). The rate is, in part, this high because the hospital doesn't "allow" VBACs. So, the many first-time mothers whose labor inductions fail (induction rate is very high in my area) or whose labor is taking too long that end up having a cesarean...with future babies, they are told that they must have a repeat cesarean. I have met many mothers in my city that have had 4 and 5 cesareans. It is criminal.

There is a hospital about 20 minutes away that allows providers to attend VBAC, though not every provider does.

Where are the mothers? I am a little surprised to see how very, very few women seek out the services of a midwife for an out of hospital VBAC. I would expect there would be such a demand that we would be needing more and more midwives to accommodate the demand. But, there isn't.

Of course, not every mother will decide that an HBAC is the right choice for her. But, it makes me wonder...where are the mothers? Ar they signing up for repeat cesareans? Are their doctors telling them that, although their hospital doesn't 'allow' VBACs, even the National Institute of Health came to the conclusion that a VBAC is a perfectly safe option and that perhaps they should look into different birth options? I seriously doubt that.

There are approximately 50-60 homebirths each year in my county. It would make me so happy to see that number sky-rocket in the coming years.

8 comments :

Lori said...

As a doula and CBE who just moved to the area I couldn't agree more! I work HARD to make sure every one of my students and clients understands the current birth culture and choices they can make to help them stay on the natural birth/vaginal birth path. But I have asked myself the same question in even finding students and clients: What are women being told by their caregivers?

Nicole said...

I had my first son as a c-section because he was occiput posterior and would NOT move despite TONS of re-positioning and attempts by my doctor to physically manipulate him from both inside and outside... I also had not used any drugs and had been walking around at home until two hours prior to pushing. I hope to have my second baby as a VBAC and will do whatever i can to make this happen... But the concept of home birth makes me shutter. I am sure there are wonderful home birth experiences for some women, but i remember the last hour of my labor and by the time they sent me in for a c-section my son's heart rate was dropping and i felt like i was being tortured/murdered internally. The thought of having to stay like that for 40 minutes while waiting for an ambulance to come to my home and get back to the hospital.. and me and my pain aside.. my son wouldn't have made it. I feel like home birth is placing a huge gamble on the health of you and baby... why would ANYONE want to risk this?? There is a reason for medical technology. Sometimes it is abused and overused... but overall it is a good thing and has helped a lot of people. Like me! Maybe the reason most mothers don't want home births is because of reasons like this...

AJ said...

This is a great point... we can't just blame the hospitals for high-C/s rate. After all, who is giving them that business? and WHY?

A Babe in the Woods said...

I'm very new to the area and am in the process of planning my next pregnancy. I hope to be pregnant by the end of 2011. During my first and only pregnancy in 2007, my midwife diagnosed me with pre-e at 32 weeks and I had an emergency c-section (like a bonafide, all hands on deck emergency). I know that my VBAC wishes will be an uphill battle. If I can stay healthy during my next pregnancy, I hope to have an HBAC so I won't have to worry about fighting the stupid hospital system here. At the same time, I really worry about my options. Since my experience, I've studied pre-e like crazy and some of recommendations I've heard from midwives truly scare me. For example, if one more midwife tells me that the Brewer Diet is a good idea, I'll scream. So for me, it sometimes feels like I'm either stuck with a scheduled c-section at some awful hospital or stuck with taking my chances with a potentially undereducated midwife.

Something I've noticed here in the Salem area is that there aren't a whole lot of support groups for mothers who are interested in homebirth, VBAC or HBAC. For example, where I used to live, a local doula started a cloth diapering and babywearing meetup on Meetup.com. Those topics attracted moms who *might* be interested in homebirth or at least homebirth-curious. By hosting the group, the doula was able to increase her business and spread accurate information to the group and the members were able to connect with like-minded moms. It was a really wonderful group. The focus was cloth diapering, but birth options were always discussed openly and honestly. I'm sure more than a few hospital-birthing moms jumped on the homebirth wagon becuase of the group. Another midwife hosted a "Gentle Birth" group on Meetup and was able to connect with homebirth-curious families that way. Again, it was a great resource for both the members and the midwife.

When I moved here, I was a bit bummed by the comparative lack of similar groups. I can only locate one mom's group and it doesn't seem very active. So this might not be a question of "where are the mothers" but more a problem of getting us organized, engaged, and educated. Instead of worrying about what caregivers are telling their patients, why not start more groups that encourage mothers to educate each other and share experiences? That kind of dialogue can lead to real change, especially if midwives are involved.

A Babe in the Woods said...

I'm very new to the area and am in the process of planning my next pregnancy. I hope to be pregnant by the end of 2011. During my first and only pregnancy in 2007, my midwife diagnosed me with pre-e at 32 weeks and I had an emergency c-section (like a bonafide, all hands on deck emergency). I know my VBAC wishes will be an uphill battle and sometimes I wonder whether I should even bother hoping for one, considering my history. If I can stay healthy during my next pregnancy, I hope to have an HBAC so I won't have to worry about fighting the stupid hospital system here. At the same time, I really worry about my options. Since my experience, I've studied pre-e like crazy and some of recommendations I've heard from midwives truly scare me. For example, if one more midwife tells me that the Brewer Diet is a good idea for someone like me, I'll scream. So for me, it sometimes feels like I'm either stuck with a scheduled c-section at some awful hospital or stuck with taking my chances with a potentially undereducated midwife.

Something I've noticed here in the Salem area is that there aren't a whole lot of support groups for mothers who are interested in homebirth, VBAC or HBAC. For example, where I used to live, a local doula started a cloth diapering and babywearing meetup on Meetup.com. Those topics attracted moms who *might* be interested in homebirth or at least homebirth-curious. By hosting the group, the doula was able to increase her business and spread accurate information to the group and the members were able to connect with like-minded moms. It was a really wonderful group. The focus was cloth diapering, but birth options were always discussed openly and honestly. I'm sure more than a few hospital-birthing moms jumped on the homebirth wagon becuase of the group. Another midwife hosted a "Gentle Birth" group on Meetup and was able to connect with homebirth-curious families that way. Again, it was a great resource for both the members and the midwife.

When I moved here, I was a bit bummed by the comparative lack of similar groups. I can only locate one mom's group and it doesn't seem very active. So this might not be a question of "where are the mothers" but more a problem of getting us organized, engaged, and educated. Instead of worrying about what caregivers are telling their patients, why not start more groups that encourage mothers to educate each other and share experiences? That kind of dialogue can lead to real change, especially if midwives are involved.

Radical Midwife said...

A Babe in the Woods,

There is a new VBAC support group forming, I believe. If you email me, I can give you the email of the gal who is starting it up. lennon @ motherbabymidwifery . com (without the spaces)

I'm sure it is frustrating to hear midwives say 'just do the brewer diet'. I am not a believer that the brewer diet is the cure-all. In fact, to the contrary, I think that true pre-e is pretty rare (thankfully!), and THAT is why so many midwives don't see it (while they believe it is due to the brewer diet). I think it is important, of course, for all pregnant mothers to have enough calories, and yes, protein, but I don't push the brewer diet.

Good for you for researching and figuring out how to give yourself the best chance at a healthy pregnancy next time. I hope your next pregnancy is smooth and easy, along with your birth!

Karinda said...

I talk to so many moms prenatally and they are not being told the truth. Most of the time if they ask about VBAC or Dr mentions VBAC at all they are told something similar to, "You could do that and it is an option but you will be risking abruption and it is possible that your baby and/or you could die so you need to think about it." So typically all of the information they are offered is fear-based. The same happens with inductions and post-dates. I have had clients tell me that they would never wait as long as I did for Petra to be born because they wouldn't risk their babies health like that. It is fear-based information and not enough parents do their own research. They want to trust and believe their physicians.

Giliane said...

dear we don't even have midwifery care in my country, childbearing is regulated by obstetricians.

No antenatal care is provided by midwives because they are not allowed.

Almost all births are induced and if not augmented, we are always so ecstatic when we have a natural childbirth. Our c-section rate is 30%, induction and augmentation rate much higher.

We are not allowed to practice independently and home births do not exist except by accident.

Midwifery led care is non existent.

Birth centres do not exist.

I wish I can do something, but I am 24, what can I do. I am currently planning to bring about change and introduce midwifery led care, I know it is going to take a lot of time an effort but I am determined. If you have any tips I would love to hear them.

Giliane

http://thesimplethingsinlife2012.blogspot.com/