On Childbirth

I finally got around to watching The Business of Being Born today (via online streaming on Netflix.com btw). I've been wanting to ever since I first heard of it, just a few months before Donovan's birth. By then I had already switched from my OB to my midwife and was planning a natural birth (with, of course, backup plans if needed). In a way I think it's good that I waited this long to actually watch it. I think enough time has passed now since giving birth that I could look back on the experience while watching the documentary, and actually start looking forward to next time-- which has not been true of any other time in these past 15 or so months.

Most of the facts and arguments brought up were not new to me-- the US has a very high rate of c-sections; mid-wives have a horrible name in our country for some reason when they are the norm in prenatal care world-wide; too often doctors make decisions in childbirth that are based more on cost, schedules, and worries over getting sued, rather than the best interests of the mother or baby. And so on. But there were a few things that I had no been aware of, or had not thought of before, that I found extremely interesting.

At one point in the film one of the doctors interviewed wondered whether some of the drugs now being routinely given to women in labor might have some connection to Autism, ADHD, or any of the other disorders and problems that have been on the rise in recent years. I forget what percentage of women one of the hospitals said they gave pitocin to, but it was well over half. There are also at least 10 other drugs mentioned that are routinely given to laboring women to help speed up labor, reduce pain and discomfort, and help deal with the side effects of previously given drugs. How well do we know the long-term effects of thse drugs on women and on their newborns? We have a pretty dreadful history of using drugs in pregnancy and childbirth that only later are found to have devastating effects: two examples include Thalidomide in the 50's and 60's, and in the film they mentioned another drug that was given to women during childbirth in the 90's, that was later linked to causing the uterus to rupture in women who had previously had c-sections. (EDIT: the drug is Cytotec (Misiprostol), given to try to induce labor.)  We've spent so much time and energy trying to find a link between vaccines and Autism, has anyone looked at any of these drugs used in childbirth and looked for a possible link?

As Zach brought up when I was telling him about this, isn't it odd that we take so much care of what we put into our bodies when pregnant, freaking out about the tiniest potential exposure to mercury or listeria, and also are so careful about what the give newborns, yet we bombard ourselves and our babies with all these drugs during childbirth?

(I also always wondered how, when we're told over and over again not to lay on our backs during those last months of preganncy b/c it restricts bloodflow to the fetus, how it makes sense to then labor and give birth in that same position)

The second interesting point was one related to medical care. Childbirth in the US costs 2-3times as much in the US as in most other developed nations, yet our mother and infant mortality rates are mong the highest among that same group. A hospital birth, even a completely normal, uncomplicated one, often costs $10,000 or more. But that same birth at home or in a birthing center will be half the cost, if not less. It reminded me of all the talk lately about our health care system in general-- how we spend so much more than other countries, yet end up less healthy. I don't know if this expands out well to other areas, but when you look at prenatal care there are clearly a lot of interventions used that cost a lot of money, and that 90% of the time are not necessary. It's pretty easy to pinpoint where these are, and it'd be pretty simple to cut these costs while still providing excellent care-- and maybe even with better results and fewer deaths. That's the ironic thing, that most doctors and our culture in general will have you believe that giving birth outside a hospital setting will put you and your baby in greater danger, but when you look at other developed countries where home/birth center births are more common their childbirth-related mortality rates are lower.

Medical advances are, clearly, a WONDERFUL thing. Amazing, awesome, super increedibly great. Lives are saved every day because of the advances we have seen in medicine. C-sections are a necessity and save lives. Epidurals can be wonderful and beneficial to mothers who are overwhelmed by labor pains. Sometimes labor can be so intense that a woman stops progessing because her body is too tense, and an epidural can help her relax and get things going again. However, just because something is good some of the time does not mean it's good all of the time. Certain practices, like the use of continuous fetal monitors, have no medical evidence behind them that they make any difference, yet hospitals use them because they're easier on staff... even if that causes the mother to be confined to bed in a position that's not only uncomfortable but may inhibit labor's progression (meaning she then needs pitocin... and then an epidural b/c of harsher contrctions, while lying down...and so it goes). Our medical advances are great for the small percentage of the time when they are truly needed. The rest of the time, they are not only not necessary, but may in fact be harmful.

One of the things I hope this documentary does is change the public opinion of midwives and hospital-free births. A midwife is not some woman who just comes in with a warm towel and hopes everything goes well. Midwives are trained professionals. They come with most of the same supplies your doctor does, and is trained and prepared to look for any signs of potential complications that may come up. The center where I gave birth was just a few minutes away from the nearest hospital, and my midwife was in touch with the midwives at the hospital so they would know that a birth was taking place and be alerted in case I needed to be trasnferred so the whole process would be as smooth as possible if it needed to happen (I can't speak for sure, but imagine most midwives here do the same). I think it is so sad that most OBs have never seen a truly natural, intervention-free birth. In so much of the rest of the world, the norm is to be treated by a midwife, and the OB comes in only when needed in the case of complications or high-risk pregnancies. This seems so much more common sense.

I could probably go on and on about this topic, but I think I'll stop here. I will mention that Ricki Lake and Abby Epstein (producer and director of The Business of Being Born) launched a new website called My Best Birth, geared to help inform women of all their choices so they can make an informed decision of what is THEIR best, preferred birth scenario. No, we can't plan our birth perfectly and anyone who doesn't realize how unpredictable birth can be is fooling themselves. But you an have a plan, and be prepared. And whether that plan is to give birth at home or in a hospital bed, it should be made with care and consideration, and with all options laid out on the table.