Monday, January 17

More Birth Talk

Apparently I'm not the only one blogging about homebirth in South Dakota. There is a new post up today at South Dakota War College with links to the original letter sent by the medical lobby and a response crafted by South Dakota Safe Childbirth Options. Go check them out for yourself!

Saturday, January 15

Spoon ... er ... ism

This post is written especially for my friend Gabi, who I know will be amused by it.

For everybody else, you're welcome to stay, but be aware, this is one of those bodily-fluid, baby-feeding, earthy natural posts. If that sort of thing bothers you, get out now. You can come back in a day or two and read a nice post about baking cookies.

As you may recall, I had some problems with breastfeeding each of my children and had to supplement with formula for both of them. With Rosi, an undiagnosed case of postpartum depression made it extremely difficult for me to keep up nursing once we added formula. She was weaned by six months. Ian, on the other hand, is still not weaned. He started solid foods almost eight months ago and hasn't had any formula in several weeks, but he's still breastfeeding a few times a day.

Lately, he's been getting really interested in utensils and how to eat with them. For the last month or so, he'll grab a spoon and just tote it around as he goes about his business. We've started calling it his "security spoon."

The other morning Ian was holding on to his security spoon and he asked to nurse. I pulled him up into my lap. Rather than immediately latching on, he looked speculatively at me for a moment, then raised his spoon.

Catching on, I gently pushed his hand away, telling him, "No, you cannot breastfeed with a spoon."

Friday, January 14

And Speaking of Birth ...

The new South Dakota State Legislative session opened this week. I've been getting a lot more involved lately with a group of local families lobbying for legal recognition of Certified Professional Midwives. Currently, licensure is available only to Certified Nurse Midwives and the state actively prosecutes non-nurse midwives for practicing without a license.

Lobbyists from the state medical association and three regional hospital groups sent a letter to state legislators last week warning them against our efforts. Of course, the medical organizations told them homebirth isn't safe, basing their claims on the controversial "Wax Paper" published last summer. Using only 5% of their sample data, this strongly and repeatedly crticized meta-analysis of previous studies suggests that homebirth triples the risk of neonatal death (babies dying in the first 28 days of life). The study is so deeply flawed that fellow researchers have called for it to be retracted in both the British Medical Journal and the Lancet.

All of this hoopla brings me to a question I read recently. One I found startlingly, deceptively simple:

Why are US doctors so opposed to homebirth?

Doctors say it's for safety, as though they are saving women from themselves. Yet clearly the research demonstrates not only that homebirth with a Certified Professional Midwife is as safe as hospital birth for most women, but women and their midwives are quite capable of appropriately transferring care when the risk of homebirth outweighs its benefits.

Most homebirth activists will suggest it's really a money issue: Doctors don't want to give up the additional income they get for overmanaged hospital births. But I'm not so sure this is the case either. Homebirth represents less than 1% of all births in the US. Even if that number doubled overnight, that would be less than a 2% decrease in the average OB's caseload--and that 2% would be the moms who most want to avoid the monitors, medications, and surgical procedures that make childbirth most profitable.

So, if it's not about safety, and it's not about money, what is the real cause?

I've begun to wonder whether the real issue is that, despite the vast number of studies showing homebirth is just as safe as hospital birth for low-risk women (and the flaws of the few studies that found otherwise), most doctors have simply been trained to view pregnancy and birth as inherently a high-risk enterprise. No matter what evidence they may read in their journals, they just can't accept that natural, physiologically normal birth requires only rare interventions.

In other words, I think doctors may be having trouble accepting the fact that, most of the time, they are not needed.

What do you think?

Thursday, January 6

Amy, Birth; Birth, Amy

Adam and I were talking about a coworker of his whose baby was born this week. He mentioned that she'd had a c-section. I wondered aloud whether that may have been a consequence of her labor being induced. He confirmed that she had been induced the day before surgery.

Rosi was sitting beside me, listening to our exchange. After a moment, she turned and asked, "Mom, were you introduced when you borned Ian?"