Wednesday, August 29, 2012

"Labor" Day - A Rally for Improving Birth

The upcoming weekend signifies to most Americans, a day of recognition for their hard work.  Labor Day for some marks the end of summer.  For Natural Childbirth Advocates, Labor Day seems like a good day to hold a rally at our State Capitol to proclaim to the world the desperate need to reduce cesareans and induction rates.  (No, not infant mortality rates or birth injuries.  You read it right, cesareans and inductions.)     
     "We need women, men and children to come stand in support of evidence-based   
      maternity care for everyone on September 3, 2012. The Rally will be held in locations 
      all over the country as the launch to Empowered Birth Awareness Week."

Hmmm.  Where to start on this one.  Whomever made the decision to use an existing national holiday to promote their natural childbirth agenda, may want to reconsider.  Some find it blatantly disrespectful and outright appalling.  I'm not sure if it was intended to be a cute play on words, ("labor" meaning your body preparing to give birth) but newsflash, that's not the definition of the word we recognize as "Labor Day".    

     "The Purpose – The National Rally for Change is to encourage and insist that all 
      maternal healthcare providers practice evidence-based care. On average it 
      takes 20 years for proven research to become practice. For the sake of mothers and
      babies everywhere, we can’t wait 20 years."

Really?  Evidence-based care for ALL maternal healthcare providers?  What about out of hospital midwives?  (Note that out of hospital birth saw a 29% increase over the last five years.)  Last time I checked there isn't much evidence supporting putting garlic in your vagina to prevent gestational diabetes.  Nor is there much evidence for taking on the delivery of a breech baby outside a hospital with next to no experience.   There isn't much research that supports a midwife or a Naturopath doing vacuum extractions outside the hospital either.  Research supporting a midwife using expired drugs that she doesn't know how to dose?  Nope.  I don't know what research has to say, but I'm pretty sure there's an ethical conflict with midwives who are caught practicing negligently, costing lives, and then just decide to change the name of their birth center, and continue to practice.  These are real stories and real people, not just wild accusations.  The things that are happening to babies in the care of renegade midwives is horrifying...yet some find cesarean and induction rates to be the center for concern.

      "The long-term effects of unnecessary inductions and cesareans are just starting to be 
      realized. This matters for all people.  This is not a protest, but a public outreach event 
      located where the vast majority of the population gives birth." 

I'd venture to say the "long term effects" of the death of a child has a far greater impact on any given family than having a cesarean.  The death of child impacts the parents, siblings, grandparents, aunts, uncles, friends in a ripple effect that never fully dissipates.  The "long term effects" of raising a child with Cerebral Palsy are far greater than having your labor induced.  A lifetime of intensive care and worry that follows like a dark shadow.  That doesn't even account for the mothers who seek a natural childbirth only to find their bodies are so badly damaged that they are left dealing with incontinence, multiple surgeries, and an incredibly long (years) recovery. 

It's ironic then, and more than a little hypocritical, that the people who have agreed to go to this rally (all 14 of them according to their Facebook Invitation) are staunch natural childbirth advocates, and out of hospital birthing families.  How does this group have any right or knowledge base to determine whether or not a cesarean or induction is "necessary"?  Well, they don't, plain and simple.  A more appropriate cause would be addressing the deeply rooted issues in midwifery, those care givers they support themselves instead of the doctors they would never choose for the birth of their babies.  Those of us that choose to birth in the hospital don't need you, or anyone else to rally on our behalf.  Many of us "Wonderbread" moms are grateful for the cesarean that saved our baby's life.   

Truth be told, this group even considered holding their Lansing area rally at Sparrow Hospital, the area's only hospital with a level 3 RNICU.  These are the very doctors and nurses that jump in and try to save lives when things go wrong during out of hospital birth.  The "evidence-based" practices this group is advocating for are things like supporting physiological birth, reducing cesarean rates, reducing induction rates, reducing interventions, and so on.  This is all great and wonderful, but sometimes interventions save lives.  Doesn't it make sense that a hospital that handles the highest of high risk patients, premature labor, mothers who are drug addicts, and everything in between would have births that end in cesarean?  Not to mention this is the same hospital taking great strides to implement collaborative care, bring nurse midwives into their maternity services, and build a doula program to support natural childbirth.  

If you want to really "Improve Birth", lets start with the people causing the greatest amount of harm, the midwives that don't give a damn about risk.  That may not be all midwives, but it is certainly too many midwives in the greater Lansing area offering out of hospital birth.  Improving birth to me means doing everything possible to make sure the mother and baby make it through the experience alive.  If a physiological, "empowering" experience has taken place and your baby dies as a result, what good is that experience?  It's worthless, it's devastating, it becomes your worst nightmare.  I can attest to the fact that there is nothing "empowering" about watching your baby die in your arms.  Why on earth would we rally about cesarean rates that are very much on par with the national average, when we have babies dying preventable deaths because of somebody's refusal to appreciate that sometimes our bodies need help?  Sometimes our babies don't just know how to be born, and they certainly are, "meant to live".  I don't know many mothers who would choose a dead baby over a cesarean, or an induction for that matter.  It does matter how are babies are born.  Alive and undamaged would be preferable.    

I have to believe that people are far more concerned with the practices stated above that are happening in MI and across the country in the out of hospital birth sector, than they are with cesarean and induction rates.  If there is room for improvement on cesarean rates and inductions, that's great.  Rallying at the capitol on a national holiday is not the way to do it.  Nor do I think it's appropriate for home birthing women who would  never have their babies in a hospital anyway, to be leading the way.  

I absolutely support natural childbirth.  I do think the journey is an important one, and certainly the experience spiritual.  That does not mean that those aspirations come at the sacrifice of safety.  Aim for natural child birth, support it, but do not be so arrogant as to think that it works that way for every woman every time.  Nor should you assume it will happen for you.  Birth is complicated, and someone once said, "It's the most dangerous day of your baby's life."  Let's get our priorities straight here, making safety the priority, and improving birth by holding our midwives to higher standards.   

P.S.  No one will be at the capitol on Labor Day, politicians take federal holidays off. 

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