elwoodblues

If you can find the infant mortality rates in those countries you're speaking of (and compare them to a country that uses modern medicine almost exclusively), then you might be able to finish your point. Remember, though, even the US practices some measure of 'old-school' midwifery. A hefty number of Amish, Christian Scientisis, and people who simply don't like or trust modern medicine for whatever reason.

alek0

Netherlands has lower infant mortality rate than US, and interventions there are far less common.
<a href="http://www.bartleby.com/151/a28.html" target="_blank">http://www.bartleby.com/151/a28.html</a>

Again, nobody is arguing against all medical interventions. Only unnecessary ones, which do more harm than good.

I am still waiting for proponents of medical interventions to justify high episiotomy rates in US hospitals.

I would also like to hear an explanation for selective scepticism on this board. It is OK to question anything going against conventional medical practice, but it isn't OK to question that conventional practice even when it has no sound basis?

brighid

Well, for me pregnancy is a disease at least if my 1st one is indicative of any subsequent ones. I was terribly sick from beginning to end. I vomited, often violently every day for the 1st 6 months and I had to carry a barf bucket or bag with me at all times. I suffered from dizziness, fainting spells, spots in front of my eyes, heart palpitations during the 1st 6 months and then those things increased in frequency in the last trimester but also add cluster headaches to the list. 12 weeks before the baby was born I worked half days from 2-7 as my dizziness, vomiting, etc. was worse in the morning. 6 weeks prior I was unable to work at all because I became so sick. My delivery was the stuff nightmares are made of. Forceps should not be able to fit inside THAT part of your body. I had 3rd and 4th degree perennial tearing in 5 directions, severe enough to extend 2 or 3 inches into each thigh in multiple directions. I almost hemorraghed to death and my mother who has been and ICU an Critical Care Nurse from about 10 years at that point commented that she has never seen anyone loose that much blood and live. Shark attack victims have less stitches then I had and the recovery time … well let’s just say I was VERY glad I didn’t have a husband. I was unable to have a bowel movement for 10 days because any pressure on the part of my body would have caused the stitches to rip. Walking was oh so fun, especially up stairs. It took me a VERY long time to heal and I won’t go any further into the gruesome details. The experience I had with that group of doctors was not good and as I gain more knowledge about labor and delivery the more I realize that I am lucky I am alive.

My sister in-law was given an episiotomy because her doctor was late for his golf game – words from his own mouth. It resulted in rectovaginal fistulas.

That being said I have looked into using a doula and a midwife in conjunction with my regular OBGYN. I know many women who have gone this route because there is a significant part of the whole pregnancy and birthing process that the medical community doesn’t always address well. I think doctors are often too busy to give patients the kind of time and attention a family needs during the 9 months of pregnancy. They do so because they do feel like pregnancy is treated more like a disease. Pregnancy is natural, but it’s not safe by any means. Any establishment that says it isn’t inherently dangerous is bald-faced lieing. I think there needs to be a more happy medium between the current treatment and how midwifes, doulas, etc. address pregnancy. I want to feel more in control of the situation, understand more about what is going on with my body, be advised about proper nutrition, exercise, etc. and hopefully have some of the fear removed from the process. I like the idea of a doula who is there to help the parents throughout the pregnancy, but especially during the delivery and I cannot tell you appealing the thought of giving birth in a whirlpool is.

Here is some info on the Bradley Method:
<a href="http://www.bradleybirth.com/tbm2.htm" target="_blank">http://www.bradleybirth.com/tbm2.htm</a>

Some information (including two studies) on the benefits of a doula:
<a href="http://www.eddesign.com/jjsite/clinical.htm" target="_blank">http://www.eddesign.com/jjsite/clinical.htm</a>

My best friend recently returned from 9 months of study in Rotterdam and while on holiday she and her husband became pregnant. She spent the 1st trimester in Europe and part of the second. She commented on how different her experience was there and that most European women had their children at home and not at the hospital. This caused her to look into similar options while back in the states. She and her husband interviewed many doctors, midwives and doulas and settled on having the baby at a Birthing Center, with the use of a midwife (who is affiliated with a hospital and works closely with OBGYN’s) and a doula. The Birthing Center is 5 minutes from the hospital and if there are complications they are prepared to have the baby at the hospital. She has the option of choosing the Whirlpool for delivery.

According to the sight Alex provided Europe has a MUCH lower morbidity rate then the US – almost twice as low and even though our morbidity rate is significantly lower then most nations it lags behind our European counterparts and yet they use the more “unconventional” services. Why does Sweden have a 3.47 p/1000 births rate and the US a 6.76?

"Today, only 7 percent of births in the United States are attended by midwives. This statistic is striking, considering that midwives attend approximately 70 percent of births in Western Europe. Midwives have long played a pivotal role in the European health care system. As modern medicine developed in Europe, the practice of midwifery evolved as a parallel specialization to obstetric care provided by doctors.

In countries such as the Netherlands, midwives practice independently as part of the greater health care system. In fact, the Dutch system of care is deemed by the World Health Organization as the ideal system of its kind. Whereas American midwives are viewed as alternative providers of care for pregnant women, in the Netherlands they are viewed as the primary health care providers for pregnant women."

<a href="http://epregnancy.com/features/lifestyle/midwives2.htm" target="_blank">http://epregnancy.com/features/lifestyle/midwives2.htm</a>


I think there is more to be investigated. I hope because of experience, education and more options my next pregnancy will go much better. There are no guarantees, but I do believe the medical community has room for improvement on the front of pregnancy, delivery and post-partum care.

Brighid

[ September 03, 2002: Message edited by: brighid ]</p>

DMB

Brighid: It sounds as though you had a nightmare experience. I am so sorry for you.

I think that the Netherlands and Scandinavia do better than the UK. Here it seems to be the luck of the draw what kind of care you get. When my stepdaughter was having a first baby 14 years ago, she was initially under the supervision of her general practitioner (roughly first trimestre) and then, while under the overall supervision of an obstetrician, was monitored for the rest of the pregnancy by the midwives from the small team who were to deliver the baby. When she went into labour, she was admitted to a unit that was attached to the local hospital, so that higher-tech intervention was possible if necessary, and she was helped throughout the birth by one of the midwives she knew already, in a home-like setting.

This seemed to me to be a good compromise between the risks of a home birth and the different risks of an interventionist hospital.

Jamie_L

Others have jumped in and said what I want to say. But I'm going to say it anyway.

I do agree that some procedures may be too routine (c-sections for one). I think sometimes things become easy and routine, and doctors stop questioning their need as carefully.

HOWEVER (and imagine this "however" is a lot bigger than I can print here), medical involvement is invaluable.

The media presents childbirth as routine and not lifethreatening. People who have smooth childbirths (and there are many) perpetuate this. It's easy to believe. I believed it. Then my first child was born stillborn at full term. Close medical monitoring and induced labor allowed my other two children to survive, although they otherwise would not have. In fact, my first child could also have been saved with better monitoring.

Maybe that makes my view skewed, but my view is that childbirth IS dangerous. I'm amazed that the human race has survived. Our good friend would have died along with her child without a c-section (the child's head was literally to big to pass through her birth canal). The c-section was actually done for different reasons. Only later did they figure out it was a doubly good idea.

My wife did give birth without an epidural in her last two pregnancies. This was a choice she made, and I applaud her. Anyone who wants that experience and control should have that choice. But choosing to abandon medical care is just reckless, in my opinion.

In short, it is good to be informed about medical monitoring and procedures being done to you. My wife and I became students of obstetric procedures during her second and third pregnancies. It's important to understand and question where appropriate (especially in a hospital situation where nurses and doctors may be new to your case), but that doesn't mean you should throw out medical practices altogether.

Our bodies just aren't perfect. Ask anyone who has cancer.

Jamie

brighid

Jamie,

I don’t think anyone is stating that medical science should be abandoned, but rather it shouldn’t go unquestioned and it needs to be tempered a bit. Medical intervention is necessary in some cases, but I think that conventional medical wisdom in the US is a bit reactionary and I understand why it is but I don’t agree that it is always the best course of action.

The Netherlands example is a good case and point. The midwives there are highly educated, and skilled and they work hand in hand with the obstetricians or “conventional” medicine. They have a much lower morbidity rate, fewer c-sections (which do pose a higher rate of complications then vaginal delivery), fewer episiotomies (and those complications have been delineated here) and a higher rate of breastfeeding postpartum. All of these things are beneficial for the baby and the mother. I certainly don’t abdicate throwing medical science and doctors out the window. I personally think the best-case scenario is a certified nurse midwife-OBGYN team that works closely together, especially for those women who are at low risk for complications. I also think many women (myself and every women in my circle) are dissatisfied with the overall (not just the medical treatment) care they receive with conventional medicine. I don’t like being treated like a disease and I want to understand what’s going on with my body. Some doctors do a very poor job at explaining those things, or are too busy with many patients to take the time a woman (and her husband) feel they need to make the pregnancy and birthing process less stressful and more healthy. There are many doctors who provide that superior care and my comments are not to indict the whole medical community.

I was terribly mismanaged and it nearly cost me my life. My recovery was long and painful, and unfortunately my experience is not uncommon. The psychological damage runs a bit deeper. Now that I am married I want a child with my husband, but the thought of enduring that again is horrifying. So, I am researching my options, educating myself, interviewing doctors, midwives, doulas, hospitals and birthing centers in my area. Pregnancy is dangerous and that is why the utmost care needs to be given to the woman, not just on a medical level but also on a physical, mental and emotional level. The emotional well being of the mother plays a pivotal role in her experience, as well as the health and delivery of the baby and that is missing from western medicine.

At the end of my very horrible ordeal one of my nurses told me that it was because I remained calm that my baby and I were alive and too often in my situation they loose both the mother and baby. I don’t know about any one else, but I feel confident that my experience would have been much different if I had been more educated about what to expect, if I wasn’t treated like an inconvenience by my doctor when I had “silly” questions, and if I had someone there to be my advocate. I also believe there is a point where a mid-wife can no nothing more and must turn the care of the woman and child over to the doctors and hospital. This scenario should be provided for in the beginning and everything should be set up in advance. The example of European countries provides enough credible and scientific evidence that things CAN be done better in the US and perhaps that needs to be investigated further.

Brighid

Mark_Chid

Pregnancy is of course NOT a 'disease'. It is, however a medical condition, and should be treated as such.

alek0

Mark Chid,
do you think that every medical condition should be treated with unnecessary intervention? Women in labour are unfortunate victims of many questionable medical practices. Since every medical intervention has risks and potential complications, what is the benefit of unnecessary interventions? I am still waiting for your explanation of high episiotomy rates? Do you have anything better than being told by health care provider and didn't see any reason to doubt?

Mark_Chid

Obviously not, 'unnecessary' is by defintion something undesirable - but the implication of the original post that started this thread was that a layman is capable of defining 'necessary' intervention and that we shouldn't trust our health professionals. The claim was made that since childbirth was natural, medical intervention should not be needed except in extreme circumstances. this, unfortunately, is crap - human births have a very high mortality rate in the absence of medical assistance.

alek0

So you don't think that laymen can decide that certain interventions, such as episiotomy for which there is plenty of proof (published in peer reviewed journals) that it does more harm than good, are not necessary?

I would really like to see some explanation of selective skepticism on this board, i.e. "it is OK to question anything except information obtained from a health care professional" even when that information comes from insane ramblings from 1925 which have been disproven over and over again in modern medical literature. Why is that?

Original poster never suggested that he wanted his wife to go give birth unassisted in the woods. He was complaining that many of interventions are unnecessary. I have given you an example of a common medical procedure which is harmful and rarely needed. I can give you lot more examples. What do you have to say to that?