Monday, June 4, 2012

LSJ Article Review

Yesterday, we posted several links to a comprehensive Lansing State Journal article about birth.  It's taken a lot of processing and conversation to reflect on this adequately, and I'm not sure I'm exactly there yet.  I thought the best bet would be to post a few of my thoughts and invite you to share yours through the comment section.  So here goes nothing! 

The overall concern I have is that too many families are being put at great risk in the greater Lansing area.  One baby who died a preventable death is too many, but it's not just one.  It's not even just two, it's several.  Not only that, the deaths don't account for those who are injured and survive, nor is it counting the near misses.  It doesn't matter how much we trust birth and how many good outcomes have occurred.  It doesn't even matter how much you love your midwife as a person.  The aforementioned concerns cannot be ignored.  I am tempted to use the word "selfish" in describing those who are more concerned with having their so-called choices taken away, than the deaths, injuries, and careless care so many are receiving.  

This comment from the LSJ articles illustrates things well:  

"I think we all share the same goals here --- safe choices for women and babies. Consider the following extended analogy:  

A friend of yours moves to a new city. She is considering moving to a fun, lively neighborhood, but one that is reputed to be dangerous at night. She talks to some of the neighborhood's residents. "I've never had any problem," they say, "I feel 100% safe here." She talks to people in other neighborhoods. "I've heard it's dangerous, but I've never actually been there, so what would I know?" She does some research online, but doesn't turn up anything conclusive. So being open minded, she visits the neighborhood by day, falls in love with the place, and decides to rent an apartment. 

Two weeks later she is violently assaulted while walking home at night. She is traumatized by the incident, but she bravely comes forward, reports the crime to the police, and decides to press charges. Do you... 

(a) ask her why she's complaining now, after the fact, telling her that she should have done more research on the neighborhood's safety before moving in, or 

(b) support her in her efforts to bring her assailant to justice? 
(Note that if you choose option (b) you are working to make the entire neighborhood safer for everyone! And that is a great thing!)

Now, suppose your friend discovers (too late, granted) that there are many fewer streetlights in this neighborhood than others places the city, making it inherently unsafer, that the neighborhood receives virtually no nighttime police patrols, that the city police do not collect crime statistics for this neighborhood, making it virtually impossible for someone to assess its safety objectively, and that the local neighborhood business association does collect crime data but refuses to release them to the public for fear of losing business. Do you...

(a) ask rhetorically why the newspaper is not reporting violent crimes in other neighborhoods, or 

(b) support your friend's efforts to get more police patrols, more streetlights, and better reporting of crime statistics, so that this neighborhood can be safer for everyone that chooses to live there?"


None of this is about taking away anyone’s choices.  What good are options for women in our area if they aren’t safe options?  We’re advocating for better options that will safely serve the women in our community by insisting that midwives are educated, licensed, insured, report their outcomes, and function within defined scope of practice.  (This doesn't mean that the hospital is perfect, but this blog and our efforts are focused on midwifery.  If others have a vested interest and insight about improving hospital care, we'd love to hear from you too as we embark upon seeking to improve options in the greater Lansing area.

Safe, responsible midwifery is not what we have now in this area.    Instead we have an uninsured, freestanding birth center with too many deaths and a ridiculous transfer rate.  We have home birth midwives here using prescription drugs illegally.  We have home birth midwives who are telling people they've never had a loss, when the reality is that two of her clients died because of seizures and hemmoraghe.  (Note, they were also considered the hospital's loss.)  We have midwives who don't know how to evaluate and appreciate risk, and certainly don't use any kind of reliable "risking out" criteria.  We have a hospital cleaning up these messes and wondering why women are seeking care elsewhere.  Something is very wrong here in our culture of birth.  I know we can do better for the women in mid-Michigan. 

In the end, it’s not only about where or how we have our babies, it’s about both mom and baby coming home alive.  The experience of birth, while important, should always be secondary to safety.  So then, the questions shift.  How can we improve safety and outcomes?  How is safety defined?  Clearly the models here are not working well enough.  The Lansing area must do better. We must get to work to build an environment that is safe, honors women and the beauty of birth, and further helps them to be a part of the process.  How can we improve maternity care for our area for both in and out of hospital birth?  What have other areas and countries done that works well?  Let's hear from you readers, we need your insight!

 I hope this series of articles can be a catalyst for change, for moving forward, and actually making a positive difference.  Whether you support home birth, hospital birth, or anything in between, there are improvements to be made and safer options to be developed.  Why should we have to pick a side, between midwifery and hospital birth?  Why can't the the two work collaboratively to improve safety and outcomes, each recognizing what the other has to offer, and for the best interest of mothers and babies?  This kind of progress can't happen until we are honest with acknowledging the losses, the injuries, the near misses, the errors in judgment and practice.  Let's get to work.  

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