AMA: Ricki Don't Know 'Bout Birthin' No Babies

181. I think the server ate my post.

For Kaeth: http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/
http://www.bmj.com/cgi/content/abstract/330/7505/1416

Posted at 12:37PM on Jun 18th 2008 by Lisa

182. But Doc, why the need for induction at all? I'm astounded at the number of inductions that take place these days. I'm still angry I allowed my first to be induced. If a woman is laboring fine on her own, why mess with it? Whether you believe in God or nature surely you can appreciate the engineering marvel that is the human body. A woman's body was designed to give birth, and does it well enough on it's own, generally speaking of course. It's rather arrogant to think that we can improve on nature or that nature needs your help doing what it designed us to do and what we have been doing for thousands of years.

I just don't understand why hospitals, and many doctors, can't practice evidence based care. Leave mothers alone until there is credible evidence to show you should intervene in her labor. I'm not downplaying the need for hospitals and cesareans, they can and do save lives. But there is absolutely no reason to rupture the membranes when a woman is dilated to maybe a 2 and laboring fine on her own. Why "speed things up"? Drugs are dangerous and have consequences to their use. They should only be used in cases of emergency. I agree that epidurals should be a woman's choice, but they should be told that it will make it harder for them to push and increase their risk of getting a cesarean. They should know that it lowers their blood pressure which results in the baby getting less oxygen and possibly getting distressed. Women are not told this. I was not told this.

For kaeth : I read an article in Mothering magazine recently that talked about our nation's rising maternal mortality rate. Also, any book on homebirth will have credible studies and statistics. Ina May Gaskin, Sheila Kitzinger and Barbara Harper are a few authors worth reading. There was one study published in the lancet awhile back, I'll see if I can find it.

Posted at 1:59PM on Jun 18th 2008 by FRS

183. I am a nurse,too with experience in labor and delivery. I am also the mom of three. Things can go to s**t in seconds. Trust me, it happened with my third child, after two normal, perfect deliveries. He coded at birth. If not for the obstetrician, pediatrician and NICU nurses that were immediately available at his birth, he would have either died or had irreversible brain damage. Although I applaud Ricki for showing the other side with home deliveries, let's remember that it wasn't too long ago that the mother and baby often died in childbirth at home due to poor health care at during and at birth.

Posted at 3:02PM on Jun 18th 2008 by hotmomma

184. hotmomma, yet you leave out ALL the mothers and babies that die in hospital delivery.
Why not address those issues?
Or the rate of interventions in hospitals that lead to cesareans?
The 40% of women who end up with a cesarean after failed induction?

Posted at 2:44PM on Jun 18th 2008 by Danielle

185. My first delivery was in a hospital and was a nighmare. I ended up with an e-c section BECAUSE of the doctors and hospital. I was told because I was 41 weeks that I needed to be induced with pitocin, total bs. But I trusted my doctor and went along. After 19 hours of labor (both on my back and birthing ball) I was dialated to only a 3. They would have had me go forever if it hadn't been for the fetal distress that it caused my daughter.

If I would have been more educated, I would have resisted the induction and allowed my daughter to be born when SHE WAS READY. I will never allow another induction again. 40 weeks is a bell curve average, not an emergency or reason to get baby out. Home births are outlawed in my state unfortunately.

AMA needs to butt out. It is ludicris that it is legal to abort a baby, yet now they are concerned for baby and mom's health with being born naturally at home? Bulls**t!

Posted at 3:27PM on Jun 18th 2008 by it's a woman's choice

186. I also forgot to add that I also had breastfeeding issues because of the labor/ c-section/ and my daughter ending up in the NICU because of the whole ordeal. Despite my best efforts for an entire year, I never had a full supply to give her.

Posted at 3:36PM on Jun 18th 2008 by it's a woman's choice

187. But Jan, being in a hospital does not guarantee a baby's safety, thus the poor statistics in our country. Many hospitals, with their endless need to interfere with the natural process of birth in an attempt to control it and hasten it, create the very problems they supposedly "save" us from.

After much research, I could not, in good conscious, and for the safety of my daughter give birth in a hospital again. As long as I'm low risk and healthy, why risk hospital birthing and open yourself up to all sorts of nasty, antibiotic resistant forms of bacteria? You look at home birth as being risky, while many of us who've not only experienced both but have spent endless hours researching it feel that it's the hospital births that put mom and baby at unnecessary risk.

Posted at 5:20PM on Jun 18th 2008 by homebirth momma

188. I'm pregnant with our second child. We're self-employed, and have no insurance ( a VERY common thing for entrepreneurs). When I called around to all the area hospitals to see what we could arrange for prenatal care and my delivery, I was told I needed to come to my first appointment with $5,000.00 in hand, which would cover the doctors fees for a normal delivery, but which would not include any ultrasounds or the hospital fee. We're doing alright, but we certainly don't have that kind of money just laying around. The only place I could find that would even speak with me about a payment plan was a birthing center, and thank God for them. I wanted to do a home birth, but we live so far from the nearest hospital, that the midwife recommended the BC. These women are taught well how to spot dangers before they become life-threatening, and I have never met a midwife so concerned with herself that she'd allow a woman and baby to be in danger. My mother had a home birth with my sister, and it was a wonderful experience. For those who meet the strict criteria midwives have for delivering at home or in a BC, it is definitely something to consider. Having a baby does not mean something is wrong with you. It's nice to have a healthcare provider who thinks of pregnancy, labor and delivery as a natural, beautiful thing.

Posted at 8:39PM on Jun 18th 2008 by amyk

189. I too am a labor and delivery nurse. After seeing what I have seen in the hospital, I would choose a home birth in most cases. Many of the "emergency" c-sections are caused by interference with the body's normal labor pattern. Many women are being induced, have epidurals, and other interventions that greatly affect birth. In the good studies I have seen comparing planned hospital birth with planned home birth or planned freestanding birth center births, the same number of babies die or have damage, but fewer women have c-sections. In fact 1 in 4 women will have a c-section in the hospital. 1 in 20 women will have a c-section in the birth center or home setting. This is a HUGE difference for women and for their future babies.

If you haven't seen Business of Being Born, you should see it. Not only is it entertaining but it has tons of good, accurate informatiion and some history about maternity care that I think it is important for women to learn.

Posted at 10:21PM on Jun 18th 2008 by Mary B

190. before you go spouting off how dangerous home births are please educate yourself. home births are just as safe as hospital births for low risk women. studies and research have proven it time and time again.

in fact todays maternity health care system is horribly corrupt! read Born in the Usa or Pushed. how many of you have actually watched The Business of Being Born? yet some how all of you have an opinion about it. please.

you know what happens when you assume. you make an ass out of yourself.

banning home birth is a violation of human rights - period!

Posted at 10:25PM on Jun 18th 2008 by cali4niachef

191. I can't stand the medical profession, they are so affraid of losing money....that's what this all comes down to. Home birth and birthing centers are where babies should be born with hospitals as a back-up if something should go wrong. I have a four month old that was delivered by a midwife but I was required to be in the hospital. I will never do that again, it is so clinical and impersonal. I will be having my next baby at home. The responsibility of Doctors and nurses these days seems to be to push drugs and surgery and it isn't any different when it comes to delivering a baby. We really need to get back to basics and be real women and step up to the plate when it comes to delivering our children! The biggest crock is that doctors try to convince you that you shouldn't have a vbac (vaginal birth after c-section)!! If you can avoid a C-section, I urge you to do so....don't rob yourself of the experience.

Posted at 8:39AM on Jun 19th 2008 by Jessica in NY

192. The AMA, ACOG and any other organization have no right to dictate how a woman personally decides to give birth. The U.S. morbidity and mortality rate, for infants and mothers, is much too high since medical interventions have risen. We need more homebirths with skilled midwives present, if the mother so chooses. Cleanliness and sanitatary practices are most to credit with the lower rates of death since the turn of the last century, not the fact that a doctor was present.

Posted at 8:02AM on Jun 20th 2008 by Cherie, CLC, CLE

193. I am so saddened to read some of these comments. I have has 3 beautiful home births in a state where "lay" midwiffery is still illigal. And 6 of my sibilings were also born at home. . I have attended countless home births. I would never tell another woman that she should have a home birth but it was the perfect choice for me and my family! It is and should be a personal choice and no matter what the law says I will still attend and support home birth, although I surely hope it never comes to that! I am genuinly disturbed by some of the comments posted earlier about home birth horror stories because if you actually did your research you will find that in a normal pregnancey, women do amazingly better handeling labor, delivering, coping with post-partum and dealing with complications durring and after birthing, when they are in the comfort of their own homes! One of my brothers passed away after complications durring his birth and we nearly lost my mother, but she went on to have 2 more wonderful home births and I, even after living thru the saddness of losing my brother, I still chose that home birth was the best and safest way to welcome my children into this world. What we all have to remember is that birthing is a billion dollar business for docors, so the more stuff they give you and do to you, the more the money they are getting from your insurance and it has been proven that intervention leads to more intervention and more $$$. I understand that there are risks in birthing but that is true whether or not you are in a hospital. I would like to say however that I am glad that hospitals have the technology to help when it is absolutly nessasary, however I believe women would not have to use this technology so often if they were given more support and information on safe,natural and alternative birthing.

Posted at 8:08AM on Jun 20th 2008 by Tina

194. There are so many comments now that I might repeat someone else has said. First of all, it's good that this is creating such debate. It's about time we brought attention to the fact that our state governments are limiting our choices about how and where to give birth. Little by little the medical profession is limiting our choices about how we give birth have been restricted. The AMA- the main lobbying and advocacy group for our nation's physicians- has made this painfully clear in their position statement. Think about what they're saying: they are advocating for laws to restrict how families choose to give birth. We know that the choice to give birth cuts across religious, political, and cultural spectrums.

The state of the birth industry in our country is poor: our c-section rate is up in the 30% range, inductions are up, we have more low birth weight babies, our infant mortality rate ranks high among industrialized nations. This cuts across race, class, religious and socioeconomic groups. We as citizens, as parents, of this nation need to question why this is happening.

It's time that we engaged in a debate about our state government's attempt to restrict trade-- for midwvies that is. Those who are specifically trained to attend homebirths (CPMs) are restricted in many states. CNMs (like the one at the core of Ricki's film "The Business of Being Born") are restricted in many states unless they have physician permits (as in my state, NC.)

For low risk women homebirth is a safe option as it was for Ricki Lake. Look at the British Medical Journal's study on the safety of homebirths attended by CPMs. Midwives know how to screen for risk factors. They also need to have a collaborative relationship with MDs and with hospitals so that they can transfer care appropriately when necessary. Independent practice for CNMs and licensure for CPMs should be the norm.

Posted at 10:31PM on Jun 19th 2008 by sylvia

195. A huge percentage of people claim that their babies lives have been "saved" in the hospital, but it is the hospital that has created these situations so the babies need to be saved. Pitocin and laboring on your back cause so many "emergency" c-sections.... then it gets blamed on the cord or the contractions. Natural birth is not always perfectly safe, but it has better statistical outcomes than ospital birth. Doctors are threatened on one end by law suits and on the other end by the natural birthing community. Ricki Lake is an easier target than the legal system. Too bad she's one of the good guys.

Posted at 8:21AM on Jun 20th 2008 by AChristine