Wednesday, August 20, 2008

Choosing a birth practicioner

With another baby on the way, we find ourselves looking for a birth practitioner to accompany us on our journey of welcoming our baby into the world. Susan did a lot of research on birth in America before Karen was born, and what she learned was shocking, and makes it difficult to find a doctor or midwife who shares our outlook on birth.
When comparing the maternal death rate around the world, America is ranked 26th, right above Costa Rica. That’s right. 26th. We have more medical equipment at our births than anywhere else in the world, yet our rate of maternal deaths is high. This could be related to our obesity rates, or it could be related to the unique experience that is birth in an American hospital. Consider the Netherlands, which has the lowest maternal death rate. 75% of the births there are home births attended by midwives. Obstetricians are only brought in when there is a problem. Fetal monitoring occurs intermittently rather than having to wear a strap throughout labor. Women are free to eat and move around during labor to ease their pain.
In the developed world, America has the highest rate of cesarean section deliveries. At 29%, this is far higher than necessary. Why? Because for a doctor, it is a twenty minute operation and he gets to go home? Because if they get sued, at least they “tried everything possible?” Because labor started with an epidural? Because women needed the epidural because the doctor wouldn’t let them move around to ease their pain? We don’t know, but it seems clear that questioning the rate is justified.
So, after all this research, Susan has decided on three things she’s looking for in a birth practitioner.
  1. Freedom to move around during labor – We’ve talked a lot about what went good and not so good about Karen’s birth. And the ability to move around, in and out of the waterbirth tub was a huge help. At most hospitals constant fetal monitoring and IVs are standard. Constant fetal monitoring has not been shown to be more effective than intermittent fetal monitoring, and IVs are really just a preparation for a cesarean section.
  2. Freedom to deliver the baby in whatever position is most comfortable at the time – No, she probably won’t be standing on her head and delivering a baby, But there are other positions such as squatting which many women find comfortable. Susan leaned on the edge of the waterbirth tub when Karen was born, and while she’s never delivered a baby on her back, she does feel like her position was helpful.
  3. Freedom to decide what medical treatments will be delivered to Susan and Baby. We want our birth to be as stress free as possible. We don’t want to fight with our practitioner during birth to avoid getting pitocin or an epidural, and we certainly don’t want our baby to have treatments such as eye ointment administered without cause.
It shouldn’t be that hard to find a natural minded doctor or midwife. Homefirst certainly fits the bill, but their bill is a bit steep. The midwives at West Suburban hospital are great, but it is a one hour drive each way for each prenatal appointment, and there’s a concern about getting to the hospital in time to deliver the baby.
We live within a mile of one hospital and within two miles of another. Susan has asked around on some internet groups to see if anybody knows a doctor who delivers at one of these hospitals that is more natural minded, to no avail.
Alas, we are ending up at West Suburban Hospital, with a birth attended by some really great midwives.

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