Canadian Births: "where" is more important than ever

Canadian Births: "where" is more important than ever.  "Where" as in: where in Canada you are giving birth-
Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut. The percentage of women getting an epidural while in labour is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island. 

Isn't that strange?  That women who live on the East Coast of Canada have suddenly developed a problem giving birth vaginally?  Or that women in Quebec have strangely lost their ability to push their babies out without help of a vacuum or salad tongs?  How could this be?  Is it the water?  Maybe something in the air that they breathe?  Or could it be that doctors and hospitals in those areas are more scissor happy than in other areas of Canada? hmmmmmmm....

Personally I like the part of the article where the  SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.“We have some good guidelines but there is no money for implementation,” 
ARE they freakin' joking?!  No money to implement guidelines that will save hundreds of thousands of women from needless surgical deliveries, and save multitudes of babies from suffering respiratory distress and other life threatening problems due to the over used of medical interventions like epidurals, inductions and caesarean sections?!  No money to implement a set of guidelines that by lowering the surgical birth rate would effective cut the cost of giving birth by at least 50%?!?   HELLO!?  Is there a mathematician in the house?

*insert smiley banging head against a brick wall* 

Obstetrical interventions

Procedures for delivering babies vary markedly across Canada

New data show wide regional disparities in C-sections, epidurals and forceps deliveries

Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut, newly released data show.
Similarly, the percentage of women getting an epidural during delivery is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island.
These are just a few striking examples of how the medical procedures women are subjected to during childbirth vary markedly between regions.
“The bottom line is that there are a lot of obstetrical interventions in Canada,” said Gisela Becker, president of the Canadian Association of Midwives.
“As for the variations, there are a whole bunch of reasons,” she said.
Those reasons include everything from more women giving birth over the age of 40 through to the fragmentation of care, and from overcautious risk managers through to doctors with ingrained habits.
“It’s really hard to figure out what the correct rate of intervention should be,” said Dr. André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada.. “There are a lot of factors that come into play.”
What is certain, though, is that the variations that exist are too great and suggest some inadequacies in care, he said.
Dr. Lalonde noted that the SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.
“We have some good guidelines but there is no money for implementation,” he said.
There were about 374,000 hospital births in Canada last year, according to the Canadian Institute for Health Information.
Of those, 18.5 per cent were delivered by C-section and 81.5 per cent were vaginal births. The cesarean rate rose to 23.7 per cent among women over the age of 35.
Ms. Becker, a midwife in Fort Smith, NWT, said that while there are cases where surgery is required, the “World Health Organization says that a C-section rate over 15 per cent is not acceptable.”

HERE to read the entire article at the Globe & Mail

"Independent Women Will be Cut"

Have I mentioned that I love the Feminist Breeder Blog?!  Gina has a brilliant way to capturing your attention with her words and getting her point across with all the subtlety of a sledgehammer. Unfortunately, when you talk to people about the dangers of medical interventions during child birth and the risks involved in C/Sections, many times a sledgehammer IS needed to wake them up from their zombie like adoration of the medical machine and all the "wonders" that it has to offer to a birthing incubator... I mean, Woman.

The Feminist Breeder laments the so called feminist ideology that suffering through birth is anti-feminist, a misguided notion that has to be held accountable for at least some of the percentage of the almost 40% of surgical births that happen in North America.

"So many young women today think that drugged-up births and cesareans are the “feminist” choice, and that labor pains are oppressive or patriarchal in nature.  I understand… I really do.  I once was that girl.  I thought anything that could disconnect me from my biology meant freedom, and even joked about wanting a hysterectomy before I ever had kids.*  I didn’t necessarily want a cesarean (I’m scared of surgery) but when I became pregnant, I had blind faith that the obstetrician I hired could easily and painlessly remove the parasite I was growing in my womb with a nice epidural cocktail and some forceps.  Simple, right?
Of course I had no education whatsoever about epidurals or forceps or cesareans, and how much damage they could do to a woman’s body.  I just assumed that if the technology existed, then they must have perfected it, and if it could keep me from feeling a contraction then by golly, I had to get me some of that."

So, what if you decide to take control over your birth?  Ah, well, The Establishment doesn’t like that.  In this brilliant 2008 expose, Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First, Dr. Marsden Wagner pulls back the curtain and shows us exactly how The Establishment feels about a woman who attempts to humanize, personalize, or retain autonomy over her own birth experience.

In his book, Dr. Wagner (an obstetrician and former Director of Women and Children’s Health for the World Health Organization) explains,

“This table heaps contempt on women whose ideas and preferences for giving birth inconvenience the doctor.  Many obstetricians find the table hilariously funny.  Isn’t it frightening that the ultimate weapon obstetricians use to punish overly “independent” women is to cut into their bodies, using a surgical procedure (cesarean section) only obstetricians can perform, which completely deprives the women of control over their own bodies?”

Yes, Dr. Wagner – it IS frightening.  Even more frightening is the fact that so many young women frivolously joke about electing a procedure that you describe as nothing short of violence against women.  All the while, women and babies are dying at a higher rate in the U.S. than in most other developed countries.

HERE to read the entire article on The Feminist Breeder

 And the Maternal and Infant mortality rates in our countries (US and Canada) continue to rise, and WILL continue to rise until women take back their births and stand up- not just for themselves but for their sisters too.

The Brilliant Gloria Lemay posted this on her blog and it is ohhhhhhh so true:

When Good Women Remain Silent

“First they came for the breech birthers, and I did not speak out–because I was not a breech birther;
Then they came for the twins, and I did not speak out–because I was not carrying twins;
Then they came for the high risk women, and I did not speak out-because I was not a high risk woman;
Then they came for the VBACs, and I did not speak out– because I was not a VBAC;
Then they came for me– and there was no one left to speak out for me.”
Taken from a talk by Laureen Hudson of California at the Trust Birth Conference (March 2010).

My new favourite Quote (for this week anyways):

“’If one went to the extreme of giving the patient the full details of mortality and morbidity related to cesarean section, most of them would get
up and go out and have their baby under a tree,’ [Dr. McDonald] said.”
[Neel J. Medicolegal pressure, MDs’ lack of patience cited in cesarean
‘epidemic.’ Ob.Gyn. News Vol 22 No 10]

Don't' let the medical machine fool you into installing a zipper.  Once it's there, it's awfully hard to get rid of. Once it's there, the machine will insist on using it.

Unnecessareans {365/34}, originally uploaded by Trader Photography.

Yet another article pointing out the dangers of multiple Caesarean Section surgeries.   But what is a mother to do once she's already had a previous single Caesarean Section and now suddenly she unable to find a doctor or hospital that will allow a TOL (Trial Of Labour) to have a VBAC (Vaginal Birth After Caesarean section) birth?  Or maybe she finds a doctor that still allows VBAC's after a single previous C/S, but the OB/Hospital throws up so many rules and regulations and interferes with so many medical interventions that a VBAC become insurmountable and she ends up undergoing a second C/S.

Two Caesarean Sections, two uterine scars.

What if she wants more children?  NOW What?????  As a woman who spent 4 months searching for a midwife to support her wish to have a VBA2C I KNOW the stress.  And that was in Canada!  Imagine being in an area of the US where they have banned VBAC births altogether!  So what does a mother do when she wants to have more children only to find out that that very first Caesarean Section has now doomed her to surgical births from now on.  What does a couple do when they want and plan on having a big family, only to discover that each surgical birth will put her and her unborn baby at greater risk- risk of haemorrhage, respiratory  arrest, hysterectomy (which instantly ends her ability to ever have another child), and even death.

We know the risks that come with Caesarean Section surgeries, the studies are very clear and unquestionable.... yet still Doctors are cutting women open for 1 out of 4, and some places 1 out of 3 births!!!  IS NO ONE LISTENING?

Full disclosure.  I have a very hard time believing that every single woman who has had a C/S has been given a full disclosure of the FULL risks of a surgical birth- not just the risk for that birth, but the risks for every single birth after that surgery!! 

I spent 4 months searching for a care provider to have a VBA2C- which ended in another caesarean section.  I search for even longer to have my VBA3C.  I had to tell the hospital that I refused a C/S, sign a billion forms, and had to fight tooth and nail every step of the way, but I finally did it!!  But there are hundreds and thousands of mothers out there that are not as fortunate as I was.  The only way to get out from under the knife is to fight for your Rights, and for the Rights of your sisters, friends, cousins and neighbours.

Dangerous delivery shows peril of multiple C-sections

By Alex Friedman

For The Inquirer

The worst surgical case of my residency came when we delivered my patient's baby by cesarean - her ninth cesarean birth. The baby came out fine, but for the mother we suspected one of most feared complications in obstetrics - that her placenta had burrowed deep into the muscle of the uterus.
To get oxygen and nutrients to the fetus, the placenta needs to attach just a few millimeters deep into the uterus. We worried that hers had gone much farther and might eat through the entire thickness of the uterus, keeping it from shrinking back to its normal size after delivery and causing a massive hemorrhage.
We gave a gentle tug on the umbilical cord. Usually the placenta peels off with such gentle pulling, but hers remained stuck - an ominous sign.
The case points out a fundamental truth about surgical delivery: a first cesarean for most women leads to a cesarean with every pregnancy. And while a first section is quick, easy to perform, and rarely complicated, each repeat surgery carries greater risk.
More and more women are finding themselves on the C-section path. Almost one in three babies was delivered by cesarean in 2007, the most recent year for which data are available, an increase of more than 50 percent from a decade earlier.
At the same time, it's becoming harder for mothers to avoid repeat surgery. The number of vaginal births after a C-section fell by two-thirds, to fewer than 10 percent, over the same time period. This year, the National Institutes of Health estimated that since 1996, one-third of hospitals and one-half of doctors who offered vaginal births after a C-section no longer do so.
"There can be tremendous morbidity after three or four or five prior cesarean deliveries," said Gary Cunningham, an OB-GYN professor and former department chair at Southwestern Medical School in Dallas, who chaired the NIH panel.
"Women need to be counseled appropriately and accurately so that they can make an informed decision," Cunningham said. "But this doesn't do much good if she cannot find an obstetrician or hospital that will allow a trial of labor."
Repeat C-sections pose more risk than a first section for many reasons. One factor concerns anatomy. When a doctor performs a first cesarean, the layers of tissue look and feel very different from each other. These visual cues and textures guide the surgeon, indicating exactly where to cut.
The surgery is simple: the surgeon cuts, spreads, and pokes, layer by layer, until reaching the baby. The surgeon first opens the skin a few centimeters above the pubic bone. The fat underneath easily gives way until the connecting fascia is reached. The tough, fibrous fascia, which holds the intestines in the abdomen, is cut at the midline and opened in either direction. The beefy abdominal muscles beneath are spread.
Finally, the glossy peritoneum, the last layer of the abdomen, is entered, and only the uterus lies between the doctor and the baby. In a term patient, the maroon, swollen uterus, flanked by finger-size veins, fills almost the whole abdomen, pushing the intestines up. The surgeon moves the bladder out of the way, cuts the lower uterus open, and is met by a baby's foot, face, elbow, or behind, depending on how the baby is positioned.
The surgeon loses the advantage of good anatomy after the first section. The tissue undergoes scarring, toughens, and blends together as it heals. The variations in color and texture disappear. The intestines and bowel sometimes stick to the healing wound, putting them in harm's way the next time surgery is performed.
These changes increase the chances of an unexpected injury. "Her belly was cement," we'd say to one another during residency after a tough section.
A study from 2006 published in the journal Obstetrics and Gynecology compared C-section complications in more than 30,000 patients. Risks of requiring a large blood transfusion, incurring a bladder injury, needing to be on a ventilator, and ending up in intensive care all increased significantly with the number of sections after the first.
The study also showed greater risk for my patient's complication. Scarring on the inside of the uterus after a cesarean causes the placenta to attach abnormally in future pregnancies. During a first section, the risk of this complication was less than 1 in 400. After a sixth section, the risk ballooned to more than 1 in 15.
So we knew the risks my patient faced from her ninth cesarean and prepared the best we could. We matched extra blood, placed additional IV lines, and arranged for expert surgeons to back us up.
But with my patient's placenta stuck and bleeding, only one option remained: removing the entire uterus with the placenta still attached. Because the pregnant uterus is large, swollen, and filled with blood, a hysterectomy after a delivery is very dangerous and performed only as a last resort.
By the time we finished the surgery, blood covered the floor. Blood filled suction buckets, and saturated our sterile gowns and drapes. Blood-soaked sponges piled up in the corner.
My patient lost three times the entire blood volume of a normal person, sixteen liters in all. Only a massive transfusion kept her alive. Anesthesiologists pumped in 51 units of red blood cells and seven six-packs of platelets.
Vessels deep in her pelvis refused to stop bleeding, and instead of closing her, we packed her abdomen with surgical towels, hoping the pressure would stanch the slow, steady flow. She left the operating room and headed to the intensive-care unit with her abdomen still open.
After a reoperation the following morning and days in the ICU, she stabilized and slowly recovered.
With a first cesarean, the up-front costs - a few more days in the hospital, a longer recovery - may seem reasonable. Only in retrospect can the true costs become apparent.

HERE to read the original article

"Canada’s reputation for low infant mortality takes stunning decline"

WEll, now... can any of my wonderful readers point out some of the REAL reasons that our infant mortality rate has risen?  Shall we list them?

1- mass use of chemical induction methods to start child birth instead of waiting until baby is READY to be born
2- mass use of epidurals on labouring women which then leads to further medical interventions, which in turn leads to more medical interventions, and most often associated with "emergency" caesarean sections due to fetal distress.
3- constant electronic monitoring of the labouring mother and baby- interfering with the mothers ability to move around and follow her bodies instincts to bring baby to birth, and giving out false information on the condition of the baby, leading to diagnosis of "fetal distress" sending the mother directly to the OR for a Caesarean Section.
4- the inability of the medical machine to leave well enough alone and let mothers labour as they wish without being hammered on by medical staff "trying to help" by constantly meddling and coercing mothers to allow medical interventions that they do not want or need.
5- Hospitals  and doctors that have sky high 9-5 caesarean section rates- pushing the national average to almost 1 in 4 surgical births
6- hospital and doctors that  pretend to be VBAC friendly, yet create hurdles so high that it is virtually impossible for a labouring mother to have a Vaginal birth after previous Caesarean section.
7- hospitals, doctors and midwives that  out right REFUSE to care for a woman who wishes to have a VBAC birth after 2 or more previous C/S's- regardless of the fact that the studies show it is just as safe as a VBAC after only 1 previous C/S, and that the statistics for uterine rupture are less than .75%!!!!
8- mass scale use of Ultra Sound technologies, that give unpredictable results and have a very high margin for error, leading to premature inductions and surgical births.
9- even the most seemingly innocent interventions and policies- like limiting a labouring mothers food intake, or making her change into a hospital gown, or having student/residents/interns in the room during  discussions with medical personnel can disrupt the natural cycle of a birthing woman and lead to unnatural interventions.

Each and every one of the above listed problems with our current childbirth methods is KNOWN to increase the risk of  infant deaths. Multiple studies show that Caesarean Sections increase the incidents of infant respiratory distress and infant mortality exponentially as compared to natural vaginal birth.  And each of the medical interventions that are so carelessly used in L&D wards lead to a much high risk of having to have a C/S.

Yes, the reasons given below in the article are valid reasons, but they are not the most important nor the most common. The cause of most preterm births is still a mystery to the medical community and further studies definitely should be done to determine the cause....But instead of putting all their focus on this one "unknown", they need to focus the majority of their attention on the problems that they DO understand, the reasons that already have been studied, that the Facts that are already known.  Hospitals and Doctors need to analyse the way they approach birth and start taking responsibility for THEIR actions and how they effect the Canadian Infant Mortality Rate. A "National Birthing Plan" is great- but it needs to address the REAL statistics and the REAL reason that the infant mortality rate is climbing.  Yes, focusing on preterm and low birth weight births is important and will save the lives of thousands of babies in our country each year, but without dealing with the most common birthing occurrences that relate to and cause infant deaths they will only be putting a small bandage on an arterial bleed.

As usual, WE the birthing parents need to bring these matters to the attention of the powers that be!!  Write letters, email MPPs and MPs, phone your local city councilperson...It all starts with ONE.

(as usual, the highlighted areas are my addition)

Canada’s reputation for low infant mortality takes stunning decline

Once at No. 6 in world ranking, ‘shockingly high’ death rate now puts Canada at No. 24, prompting urgent request to Health Minister

Lisa Priest-From Saturday's Globe and Mail Published on Saturday, May. 22, 2010 3:00AM EDT Last updated on Saturday, May. 22, 2010 9:58AM EDT.

 

Once able to boast about its high world ranking for low infant mortality, Canada has now dropped from sixth to 24th place – just above Hungary and Poland.
The death rate of infants less than one year of age – 5.1 per 1,000 live births – has been called “shockingly high” and translates into 1,881 mortalities in 2007, according to the most recent data collected by the Organization for Economic Co-operation and Development.
About three-quarters of those deaths occurred in the first 27 days of life.

“ It should always be a little bit embarrassing if you are not number one. ”— Douglas McMillan, a neonatologist at the IWK Health Centre in Halifax.

The drop in ranking below countries such as Sweden, Japan, Finland, France, Ireland and Greece has prompted a prominent doctors group to request an urgent meeting with the federal Health Minister to push for a national birthing strategy.
“We’re losing our reputation,” said André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada. “We have fallen way behind.”
The main causes cited by researchers are poverty, isolation, premature births and to some degree, the way the data are collected. For example, in Canada, infant mortality includes the death of any breathing infant, even very early births and terminations due to congenital abnormalities after 20 weeks gestation, but other countries have different measures.
Still, experts say Canada could learn from other countries – Japan and Sweden among them – that have low infant death rates. Japan is successful in resuscitating premature babies, while Sweden has regulations dictating that with IVF treatments, only one embryo can be transferred into the womb at a time. (Other countries implant multiple embryos, leading to more multiple births and higher risk.) Canada’s aboriginal community has traditionally seen high infant death rates due to poverty and remote locales, but those numbers alone do not explain the country’s low ranking, says Michael Kramer, scientific director of the Institute of Human Development, Child and Youth Health, Canadian Institutes of Health Research.
“The concern is that we’re not really making any impact on reducing the incidence of these spontaneously born very pre-term infants,” Mr. Kramer said. “We don’t really know enough about what causes them, that’s the challenge – that’s where we need to make improvements.”
Premature babies are at increased risk for infant mortality. About 54,000 out of 350,000 babies were born prematurely or small for their gestational age in 2006-07, according to the latest Canadian Institute for Health Information figures.
Part of a solution, according to Dr. Lalonde, is a national birthing plan, which he estimates would cost $43.5-million over five years. It recommends federal leadership in seven key areas, including a mechanism to accurately gather data, a focus on maternity patient safety, implementing national standardized practice guidelines, and a coalition that would create a model of sustainable maternity and newborn care.
Tim Vail, spokesman for Health Minister Leona Aglukkaq, said representatives from the minister’s office will meet with the doctors group, and are currently working on a date.
Prakesh Shah, a neonatologist at Mount Sinai Hospital, belongs to an advisory group for Ontario’s strategy on late pre-term births. Socioeconomic factors – such as impoverishment – are a big part of preterm births, he says, as are delaying pregnancy and the increasing number of in-vitro fertilization pregnancies.
Dr. Shah recently sent a team to Estonia – which was tied in 2005 with Canada for its infant mortality – and found that other countries treat premature babies and their mothers much differently than in Canada.
“In Estonia, mothers stay in hospital until baby is discharged home and provide most of the care for their babies. Nurses act as consultant to mothers,” said Dr. Shah. “Here, we have medicalized the care in such a way that parents are less involved during hospitalization and suddenly, one day when baby comes home, they are expected to provide complete care. It’s an entirely different concept.”
Even the Conference Board of Canada has described this country’s rate of infant mortality as “shockingly high,” causing many to wonder: How can such a rich country do so poorly with its most vulnerable citizens?
“It should always be a little bit embarrassing if you are not number one,” said Douglas McMillan, a neonatologist at the IWK Health Centre in Halifax. “You are dealing with the most precious thing the family will have in their whole life; we need to be cognizant of that.”

 HERE to read the original article

"Emotional Inpact of Cesareans"

Another brilliant article in Midwifery Today Magazine on the topic of the Risks of Cesarean sections- not just the physical, but the emotional trauma that haunts so many mothers after being under the knife.  I have had 3 C/Sections.  Each one was very different and at different points in my life.  Each one made me feel like a failure.  Each one left me feeling like my body was imperfect- unfeminine- that it couldn't do what it was suppose to do.  Each one left me with a stronger urge to fight for the rights of birthing women everywhere, to save as many women as possible from going through what I've gone through.

Sadly though, so many women do not listen.  So many women seem to think that the medical machine knows what's best for them and they allow themselves to sacrifice up every bit of their autonomy onto the alter of modern obstetrics.   I cringe every time I hear a pregnant woman say "my doctor knows what's best for me.  I'll do whatever s/he says".  And every time I hear a woman say "Well, I'm just going to book a C/Section...."  I want to scream at them  "You have NO IDEA what you're doing to yourself!!!"

It's frustrating.  Yet I still talk about the dangers of Medical interventions every chance I get, to every pregnant woman I meet- IRL and on-line. I might be snubbed by most, but I know that my soapboxing have saved many women from the knife and many babies from the cold medical machine.  So I'll keep on preaching.  Regardless of the ridicule and back stabbing.

Emotional Impact of Cesareans

by Pam Udy

© 2009 Midwifery Today, Inc. All rights reserved.

[Editor's note: This article first appeared in Midwifery Today Issue 89, Spring 2009.]

Every 30 seconds in the US, a cesarean is performed.(1) This overuse of cesarean surgery puts moms and babies at risk—not just physically, but emotionally. My intent with this article is to show the emotional impact that cesareans can have on the family. A cesarean can reach far beneath the bogus smile on mom‘s face. It can scar her heart, as well as her uterus.
A baby girl is born. She grows and begins menstruating. She becomes sexually active and becomes pregnant. She births her baby. She breastfeeds her baby. This is life—normal and natural, yet exciting and important. In the continuum of life, pregnancy, birth and the postpartum period are milestone events. These experiences profoundly affect women, babies, fathers and families. They have important and long-lasting effects on society.
When a woman gives birth, she has to reach down inside herself and give more than she thought she had. The limits of her existence are stretched. There is a moment when every woman thinks, “I can‘t do this.” If she is lucky, she has a midwife, a doula or her mom to whisper in her ear, “You are doing it.” As she does it, she becomes someone new: a mother. If the birthing process is skipped or occurs in a hostile situation, or if the interventions become overwhelming, she becomes a different mother than she would have been if she had only had a supportive, midwifery model of care.
The Mother-Friendly Childbirth Initiative of the Coalition for Improving Maternity Services asserts that: A woman‘s confidence and ability to give birth and to care for her baby are enhanced or diminished by every person who gives her care and by the environment in which she gives birth.(2)
To control and actively manage a woman‘s labor and delivery, modern obstetrical practice relies on conformity. A woman is “subject” to rules, restrictions and protocols enforced by nameless strangers. Physicians and the hospital staff have authority—there is an unbalance of power. Doctors know this and some use their power to persuade women to “make” decisions in the interests of the physicians; and if they can‘t, there are the courts. I say: You can only consent to that which you are capable of refusing. If you can‘t refuse the test, the drug, the procedure or the surgery, then you did not consent to it. This is coercion and it leads to disempowerment of women. Disempowerment as it pertains to pregnancy and birth is the exclusion of pregnant women from the decision-making process, leaving them without means of self-protection, limiting their birth choices and leaving them few, if any, options. This is detrimental to the growth a woman should experience during labor and birth.
Many women who have cesareans suffer in silence because society expects them to “just be happy about their baby.” Well-meaning family members say, “Be grateful; a hundred years ago you both would have died.” The farce begins. We paint a smile on and pretend it doesn‘t hurt.
How do we convey the experience of traumatic birth? My heart has broken a hundred times while listening to the stories of my International Cesarean Awareness Network (ICAN) sisters. How do I tell you of the depth of the pain? We have lost the societal norm of decent and respectful care during pregnancy, labor and birth in our hospitals. Moms and babies are paying a high price for unnecessary and inferior “care.” The March of Dimes says that one in eight babies is born premature, costing $26.2 billion dollars annually.(3) Prematurity is linked to cesareans.(4) Compared to 16 other countries with at least 100,000 births, the US ranked last in maternal mortality and third to last in perinatal mortality.(5) The response to these poor infant outcomes is a 50% increase in cesareans since 1996. The belief that more medical intervention is better, regardless of cost, isn‘t supported by research.
Research has shown that when we stray from evidence-based maternity care, we have a high degree of obstetric intervention that is associated with acute trauma symptoms.(6) I caution readers to remember that how a woman perceives the event, not the event itself, plays a vitally important role in whether she has trauma symptoms.
Women report experiences that fall into the following categories:

• A sense of loss: birth didn‘t turn out like expected, loss of the experience of participating in the birth experience, not being there when the baby enters the world
• Interrupted relationship with baby: feelings of detachment from her baby
• Altered identity: sense of failure, feminine identity altered; lowered confidence in her body
• Intimations of mortality: surgery gives “rise to fears about mortality”
• Feelings of violation: from surgery where the body boundaries are violated, feeling “mutilated” or “butchered”
• Anger at caregivers: particularly regarding “what was perceived to be an unnecessary cesarean, lack of involvement in medical decisions, feeling unsupported by hospital staff before, during and after the cesarean”
• Dissociation: feeling that the surgery was taking place on someone else or from a distance
• Humiliation: being scolded
• Helplessness: not being able to take care of herself or her baby
• Posttraumatic Stress Disorder symptoms: anxiety, trouble sleeping, panic attacks(7)

Caroline said, “I felt like I was up for sacrifice…I think I was sacrificed for the sake of my own stupidity…I think I sacrificed my soul. This sounds rather extreme, but so is the pain right now…. This was supposed to be the most wonderful day of my life—better than my wedding day—and for this reason, it was a devastating loss. It‘s funny that most people seem totally accepting of weddings and marriages gone awry, and how traumatic that can be, but a birth gone wrong? To most people there is no such thing. We are just lucky we are ’healthy‘.”(8)...

HERE to Read the entire article

Who's afraid of a bum?

Breech Births. Who'd of thought that the sight of a tiny baby bum could frighten the obstetrical world so much?  But up until just this past couple of months Doctors seemed to find the thought so terrifying that they made the mass decision that they couldn't stand it any more and had to cut 4% (average statistics for breech births) of babies out of their mothers bellies for no other reason.

 Luckily last year  Andre Lalonde, head of the Society of Obstetricians and Gynecologists of Canada made the announcement that "The safest way to deliver a baby has always been the natural way,"  said last year when it began an effort to bring back breech birth. "Vaginal births are the preferred method of having a baby because a C-section in itself has complications."

"The new guidelines were announced last June, but change has been slow.
The problem is that many doctors have never delivered a breech baby and others have limited experience. It had become a lost art."

 ...A lost art.  How sad is that?  Sadder still is that it's not just breech births that are becoming a "Lost Art".  VBAC's are becoming just as rare, and trust me, through my own personal experience I've seen the fact that the medical machine is loosing it's ability to deal with VBAC births almost as quickly!!

I'ts time to take back our births!!  It's time to stand up to the faceless doctors that stand on high and make arbitrary decisions about how we are "allowed" to birth!!

Giving birth, the natural way

 

By Elizabeth Payne, The Ottawa CitizenApril 11, 2010

Every birth is a miracle, of course. But the arrival of Lily Luck-Henderson, just after midnight last Tuesday morning at the General campus of the Ottawa Hospital, was something else as well.
Lily was breech, as are about four per cent of babies, meaning she emerged from her mother's womb bottom first, rather than head first. But, unlike most breech babies born in Canada in recent years, Lily was delivered vaginally, rather than by caesarean section.
Her successful delivery is seen as a harbinger of coming change in the way babies are delivered in Canada -- or at least a step along the way.
At five days old, she has already played a starring role in something significant, according to Ottawa midwife and researcher Betty-Anne Daviss, a leading advocate for the return of breech birth deliveries in Canada, who, along with two obstetricians and a doula attended the birth. It "was a pretty momentous occasion in Ottawa," she said, and an important step toward normalizing childbirth in Canada, something the organization representing Canadian obstetricians stands behind.

 HERE to read the entire article

"Unnecessareans"

Women were not born with zippers.  We did not ask to have them installed at puberty, nor when we decided to have our babies.  Yet hospitals and most doctors seem to think that pulling a baby out of a woman's cut open abdomen is as easy and as painless and as harmless as opening a zipper.  Hell most of them would probably install zippers after every C/Section they did, just to make the next one that much easier. 

"Don't worry about going through the pain of labour and delivery... we'll just book you in on a day that's convenient for you, unzip you and  wham bam  it'll all be done!"

Gloria Lemay's Blog

Unnecessareans

Unnecessareans {365/34}, originally uploaded by Trader Photography.

I think this image is startling and perfect to remind us that a cesarean surgery is for life. One obstetrician made the following observation about the risk: of this operation:
“’If one went to the extreme of giving the patient the full details of mortality and morbidity related to cesarean section, most of them would get
up and go out and have their baby under a tree,’ [Dr. McDonald] said.”
[Neel J. Medicolegal pressure, MDs’ lack of patience cited in cesarean
‘epidemic.’ Ob.Gyn. News Vol 22 No 10]

Amnesty blows the whistle on Maternal Mortality rates in the US

Even Amnesty International sees it, yet main stream medical organizations seems to think that there is absolutely nothing wrong with Maternity care in the US (...and don't be fooled, it's almost as bad in Canada). The maternal death rate has almost doubled since 1987- 6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006. And since there is no federal reporting requirements in the US, the actual death rate may actually be much higher.

Amnesty points a finger at the lack of accessible health care as a reason for America's horrifying statistics (They are currently ranked 40th out of 40 developed nations), but also points to the high rates of Inductions and Caesarean Sections causing the maternal mortality rate to be climbing instead of falling. Currently the US spends the most amount of money on maternity care of any nations on the planet.... yet obviously they are spending too much money pushing medical and surgical interventions and not enough money on supportive health care and natural childbirth education- for parents and medical practitioners alike. Instead of encouraging and funding midwifery training and recognising the role of doulas as an essential part of supporting birthing mothers, they have instituted a dictator-like regime that bans mothers from having VBAC births and takes away their human rights to make decisions on how, where and when they will give birth.

Until ACOG , the CDC , and other major health organizations stop meddling in politics and accepting backdoor funding from companies with conflicting interests, the Maternal Mortality rate will only continue to climb. Because right now, these organizations are only interested in the bottom line instead of getting to the bottom of the reason that mothers are dying in childbirth in the 21st Century.

Too Many Women Dying in U.S. While Having Babies

By Jennifer Block

Read more: http://www.time.com/time/health/article/0,8599,1971633,00.html#ixzz0i0Lib1Ry

Amnesty International may be best known to American audiences for bringing to light horror stories abroad such as the disappearance of political activists in Argentina or the abysmal conditions inside South African prisons under apartheid. But in a new report on pregnancy and childbirth care in the U.S., Amnesty details the maternal-health care crisis in this country as part of a systemic violation of women's rights.

The report, titled "Deadly Delivery," notes that the likelihood of a woman's dying in childbirth in the U.S. is five times as great as in Greece, four times as great as in Germany and three times as great as in Spain. Every day in the U.S., more than two women die of pregnancy-related causes, with the maternal mortality ratio doubling from 6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006. (And as shocking as these figures are, Amnesty notes that the actual number of maternal deaths in the U.S. may be a lot higher, since there are no federal requirements to report these outcomes and since data collection at the state and local levels needs to be improved.) "In the U.S., we spend more than any country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries," says Nan Strauss, the report's co-author, who spent two years investigating the issue of maternal mortality worldwide. "We thought that was scandalous." (See the most common hospital mishaps.)

According to Amnesty, which gathered data from many sources, including the Centers for Disease Control and Prevention, approximately half of the pregnancy-related deaths in the U.S. are preventable, the result of systemic failures, including barriers to accessing care; inadequate, neglectful or discriminatory care; and overuse of risky interventions like inducing labor and delivering via cesarean section. "Women are not dying from complex, mysterious causes that we don't know how to treat," says Strauss. "Women are dying because it's a fragmented system, and they are not getting the comprehensive services that they need."

The report notes that black women in the U.S. are nearly four times as likely as white women to die from pregnancy-related causes, although they are no more likely to experience certain complications like hemorrhage.

The Amnesty report comes on the heels of an investigation in California that found that maternal deaths have tripled there in recent years, as well as a maternal-mortality alert issued in January by the Joint Commission, a group that accredits hospitals and other medical organizations, which noted that common preventable errors included failure to control blood pressure in hypertensive women and failure to pay attention to vital signs after C-sections. And just this week, a panel of medical experts at a conference held by the National Institutes of Health (NIH) recommended that physicians' organizations revisit policies that prevent women from having vaginal births after having had a cesarean. Such policies, designed in part to protect against litigation, have contributed to the rise of the U.S. cesarean rate to nearly 32% in 2007, the most recent year for which data are available.

The Amnesty report spotlights numerous barriers women face in accessing care, even among those who are insured or qualify for Medicaid. Poverty is a major factor, but all women are put at risk by overuse of obstetrical intervention and barriers to access to more woman-centered, physiologic care provided by family-practice physicians and midwives.

Amnesty is calling on Obama to create an Office of Maternal Health within the Department of Health and Human Services to improve outcomes and reduce disparities, among other recommendations. The report also calls on the government to address the shortage of maternal-care providers.

"Access is only one factor," cautions Maureen Corry, executive director of Childbirth Connection, a research and advocacy organization that recently convened more than 100 stakeholders, including members of the American College of Obstetricians & Gynecologists and the NIH, in a large symposium on transforming maternity care. "We need to make sure that we reduce the overuse of interventions that are not always necessary, like C-sections, and increase access to the care that we know is good for mothers and babies, like labor support."

Read more: http://www.time.com/time/health/article/0,8599,1971633,00.html#ixzz0i0LSUPmk

10 Ways to Avoid an Unnecessary C/Section

An excellent blog/article by Dr. Chukwuma Onyeije, that arose from a story on CNN regarding Joy Szabo. The story detailed the fact that Ms. Szabo had been told that she could not have a VBAC at the hospital where she planned to deliver. As a result, she ultimately moved nearly six hours away from their home in Page, Arizona, to Phoenix to give birth at a hospital that does permit women to have VBACs. And, thus, one woman's quest for a vaginal birth after a cesarean became national news.

Patient's trust physicians to make tough calls by virtue of our expertise, training and because they believe that we want what is best for them. My fear is that physicians risk losing the trust and goodwill we have with patients if we steer them away from safe vaginal deliveries toward unnecessary cesarean deliveries for questionable reasons. The current trend towards not offering VBAC may have begun due to concerns regarding safety or even medico-legal exposure; however at present, it has metaststatized to inordinant levels that I have referred to as PVH (physician-VBAC-hysteria).

The reversals in the rate of VBAC have clearly increased the Cesarean rate in the US, but have not (in any definable way) improved maternal or fetal outcomes. Therefore, presented for your review is my most recent slideset on practical ways that patients can avoid some of the pitfalls which may result in an unnecessary cesarean delivery."

HERE to read the entire article and view the presentation

1 in 3 women infertile after Caesarean Sections

One in Three Women Infertile After Caesarean

Even More are Too Traumatized to Give Birth Again

Jul 11, 2009 Joanna Karpasea-Jones

Various research shows that as many as one in three women suffer infertility after having caesarean sections that are hyped as routine.

A study in the British Journal of Obstetrics and Gynaecology has found that almost half of all women who have a caesarean section birth for their first child, don't have any more children. Of these, one in five have chosen not to have more children because they are too traumatized by the surgery and one in three are physically unable to because of caesarean-caused infertility problems.

The rate of post-traumatic stress disorder was six times higher than in first time mothers who had given birth vaginally.

Here to read the entire article

"Beyond Choice"

Sheila Kitzinger is a Natural Childbirth Advocate and a champion of birthing women world wide. She tirelessly campaigns for women to have the information they need to make choices about childbirth and is a strong believer in the benefits of home birth for women.

Sheila's books are a must read for anyone interested in childbirth!!

For more information and links to brilliant articles and books please visit Sheilas web site:
http://www.sheilakitzinger.com/


Beyond Choice

By Sheila Kitzinger

Elective Caesareans

Caesarean section is presented in the USA as a way of "keeping your vagina honeymoon fresh". In Britain, too, it is promoted by some obstetricians as a method of keeping your vagina fresh and rosebud sweet, and saving your bladder from destruction. The implication is that this is how you can keep young, hold on to love - and keep your man. A woman has only herself to blame if she lets her body sag and her insides fall out. The modern way is to have your face injected with botulism and when it comes to childbirth, keep your perineum and pelvic floor daisy fresh by opting for a Caesarean.

Women are not told about the side-effects. More than 93,000 Caesareans are performed every year in the UK. In some hospitals there is a 25% rate. Many obstetricians are no longer able to turn a breech baby in order to avoid a Caesarean. They have become deskilled. You might think that high Caesarean rates would reduce instrumental deliveries. But no. Forceps and ventouse deliveries are also on the increase...

HERE to Read the whole Article

Having posted that horrifying video this morning of an over sized barbie giving birth..... *shudder*.... I've been thinking on the topic of how medicalize birth has endangered women and babies. and thinking about the horrible truth: that it has become so mainstream, so "Normal", so Accepted, that women and their partners don't even question it any more.

Not a week, not a day goes by that I don't read comments on birthing/pregnancy forums about scheduled inductions and caesarean sections or about women planning their epidurals in advance. Birth stories of women told the most outrageous lies by the medical machine to validate the doctors opinion of why all these interventions are necessary.

I have days when I literally rant at the computer screen (these days apparently happen often enough that my kids no longer even take note, lol), and I want to scream, to tell these women that NO! They don't need to labour on their backs strapped to a plethora of monitors, with an IV and epidural in place. ...... ARGH!!!!

I tell people and try to educate people all the time- both in real life and online- I try to make people aware that THEY need to do the research and find out for themselves. And I post articles and studies to try to open the eyes of those that are blinded by faith in a medical machine that plays to a different drum.

This is one of my most favorite articles ever written on the topic of Birth and the dangers and risks of interventions. I have lost count of how many times I've posted this article on Forums, blogs, chats, web sites, Facebook...... If every pregnant woman and her partner read this article, I'm SURE that at least some of them would wake up from their stupor and see the reality of modern child birth.

Technology in Birth: First Do No Harm

By Marsden Wagner, MD

© 2000 Midwifery Today, Inc. All rights reserved.

A woman in Iowa was recently referred to a university hospital during her labor because of possible complications. There, it was decided that a cesarean section should be done. After the surgery was completed and the woman was resting post-operatively in her hospital room, she went into shock and died. An autopsy showed that during the cesarean section the surgeon had accidentally nicked the woman's aorta, the biggest artery in the body, leading to internal hemorrhage, shock and death.

Cesarean section can save the life of the mother or her baby. Cesarean section can also kill a mother or her baby. How can this be? Because every single procedure or technology used during pregnancy and birth carries risks, both for mother and baby. The decision to use technology is a judgment call—it may make things either better or worse.

We are living in the age of technology. Ever since we succeeded in going to the moon, we have believed that technology can do everything to solve all of our problems. So it should come as no surprise that doctors and hospitals are using more and more technology on pregnant and birthing women. Has it solved all the problems that can arise during birth? Hardly. Let's look at the recent track record.

Has the recent increasing use of technology during pregnancy and birth resulted in fewer damaged or dead babies? In the United States there has been no decrease in the past 30 years in the number of babies with cerebral palsy. The biggest killer of newborn babies is a birth weight that is too low, but the number of too-small babies born has not decreased the past 20 years. The number of babies who die while still in the womb has not decreased in more than a decade. While the past 10 years has seen a slight drop in the number of babies who die during their first week after birth, the scientific data suggest an increase in the number of babies who survive the first week but have permanent brain damage.

Is the increasing use of technology saving the lives of more pregnant and birthing women? In the United States the scientific data show no decrease during the past 10 years in the number of women who die around the time of birth (maternal mortality). In fact, recent data suggest a frightening increase in the number of women dying during pregnancy and birth in the United States. So it may be that the increase in the use of birth technologies is not only not saving more women's lives but it is also killing more women. This possibility has a reasonable scientific explanation: cesarean section and epidural anesthesia have both been used more and more in this country and we know that both cesarean section and epidural block can result in death....

HERE to read the complete article on Midwifery Today

Robotic birthing....When childbirth looses it's last shred of humanity

In an age of cookie cutter births, where women are processed through maternity wards like prisoners through the penal system, the final shreds of humanity are stripped away to reveal "Birth" through the eyes of the Medical Machine.

This short 3 minute video shows nursing students learning about "Birth". This is what they are taught is Normal. This is what they are taught to expect, and how to support and encourage a birthing woman.

Is it any wonder that child birth has become a intervention driven, medicalized hospital event that more closely mimics a surgical procedure, instead of the natural, empowering and intimate experience that it is meant to be? How can women expect to birth their babies the way nature intended- and has been done for a millenia- when the people who are supose to be there to support her have never even witnessed a "Natural" birth?

It is through training like this that we can blame the current medical mess that reigns in Maternity Wards across North America. It is through medical training like this that we can partially lay the blame for the soaring Caesarean section rates and mass use of medical and surgical interventions that cripple women emotionally, physically, and spiritually. Until the suposed "Child Birth Professionals" are actually trained to support women while they are experiencing a completely natural bodily function, we will never see a decline the the frightening numbers of medicalized births.

....Maybe it's about time that all child birth professionals - be they doctors or nurses- should be forced to attend a few home births with true midwives to better understand the nature of birth and to witness first hand the TRUE realities of Natural Childbirth.

"Barbie Gives Birth"

"Several states did receive stars for taking steps to reduce smoking among women of childbearing age or providing health insurance coverage for pregnant women, which may help reduce preterm birth rates, the report card noted. Multiple births and elective Caesarean sections also push up preterm birth rates, said Dr. Jennifer L. Howse, president of the March of Dimes."



No argument that reducing smoking in pregnant women is a step forward, and obviously providing health insurance is pretty much a no brainer when it comes to saving lives of mothers & babies.... But what are they doing about the Elective Caesarean section rates? Or more importantly, what are they doing to recognize that the USA has one of the highest C/Section rates in the world? The US spends more money on Maternity care, yet has a horrifyingly high infant and maternal mortality rate that hasn't dropped in 20 years. When is the American OB driven medical machine going to wake up and realize that these problems are not going to go away by driving the Caesarean section rates up, nor are they going to go away until they look at the real problem: THEMSELVES.

Childhood: U.S. Draws Low Marks on Premature Births

By RONI CARYN RABIN

Published: November 19, 2009

More than half a million babies, one out of eight, are born prematurely each year in the United States, prompting the March of Dimes to give the nation a D on its premature births report card.

The report card did not give an A to a single state. Vermont, which has a preterm birth rate of 9 percent, got a B, while 17 states got F’s, including Mississippi, with a preterm birth rate of 18.3 percent. The prematurity rate in Puerto Rico, at 19.4 percent, was the highest in the country.

The nationwide rate has barely budged in the most recent three years reported — to 12.7 percent in 2007, according to preliminary figures, from 12.8 percent in 2006 and 12.7 percent in 2005. It was 11.4 percent in 1997.

Several states did receive stars for taking steps to reduce smoking among women of childbearing age or providing health insurance coverage for pregnant women, which may help reduce preterm birth rates, the report card noted. Multiple births and elective Caesarean sections also push up preterm birth rates, said Dr. Jennifer L. Howse, president of the March of Dimes.

All babies born before 37 weeks of gestation are considered premature. They are at higher risk for death and for complications that include cerebral palsy and mental retardation.

http://www.nytimes.com/2009/11/24/health/research/24child.html?_r=1&partner=rss&emc=rss