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Beat the odds!
birth, UC
babyslime wrote in june2011_babies
Disclaimer: I originally wrote this years and years ago and posted it in the pregnant community. Since then it's been revised, updated and reposted by dozens of other people with the stats altered depending on the active population of the community or club it's posted in.
Some of these statistics may be outdated (they are from 2006), but depressingly enough the difference is actually worse, not better.




(For ease of reading, figures above 1 are rounded to the nearest whole number. Numbers based on statistics from research and surveyed births in the USA only.)

There are 71 people in this community.

Statistically:
23 of us will get c-sections, 12 were planned, but less than 2 of those will have been needed. Of those wanting a VBAC, 42% will be denied the option.

12 will be induced, 5-6 of those inductions will fail. Only 0.36 were necessary. 1 will request it, and 3 will have it done for a non-medical reason. Another 12 will have labour "augmented" - but the actual number could be anywhere up to 43 of us depending on your socioeconomic background, race and type of augmentation given.
"A review of the medical literature on routine induction of labor reveals that disagreement among medical researchers in different countries is rampant, and no conclusive evidence exists that routine induction of labor at any gestational age improves the outcome for either mother or baby. Caldreyo-Barcia concluded that induction is medically required in only 3 percent of pregnancies and that therefore approximately 75 percent of all inductions put both the mother and baby at risk."

7 of us will go beyond 41 weeks, 7 of those babies that went longer would have/will be born safely between 42 and 44 weeks. But, it's more likely 4 or more of those of us will be c-sectioned or induced before we hit 41.5 weeks (the average gestation period for a first time mom) - even though less than 0.035 will have had a medical need for it.

32 of us believe that "giving birth is a natural process that should not be interfered with unless absolutely medically necessary"

BUT -
66 will have electronic fetal monitoring
61 will get an IV
43 will get an epidural
39 will have our waters broken
38 will have labour augmented with pitocin
37 will have a bladder catheter
and 37 will have stitches, most likely to repair an episiotomy that 25 of us will have even though the practice was proven ineffective and dangerous many years ago.

14 of us will have no pain medication, but 1 or less will have a birth without any of these interventions.

1 of us will also have a homebirth.

2 of us will experience a postpartum hemorrhage.

55 of us will have an OB/GYN, 9 a midwife, 4 will get a doula.

50 of us will not move around once labour begins, 53 will give birth flat on our back.

50 of us will try breastfeeding, while 13 will bottle-feed from birth. The number of us exclusively breastfeeding will drop to 44 by seven days postpartum, to 10 at six months (the AAP recommends a minimum of 6 months exclusive breastmilk). Only 3 of us will breastfed 18 months or longer.
To have met the minimum goals for the 2010 Healthy Babies USA campaign, those numbers should be 53 at birth, 36 at six months, and 18 for twelve months or longer.


Interesting to note:
If that 1 of us who will have a homebirth was all 71 of us...

9 would transfer to hospital. 2 of those would be considered "urgent".
3 would have a c-section.
3 would have an epidural.
0.7 will hemorrhage.
15 more of us would report we enjoyed our births.

What are you doing to help beat the odds of interventions and lower your risk for infection, illness, injury and trauma to you and your baby?
For instance, many don't realize that by having a trained and certified doula present at your birth, your risk of these interventions drops by over 50%, and more than 2/3 more will report having enjoyed their birth experience. If you're in the market for a birth doula, check organizations like DONA or CAPPA to find one in your area. Remember above all that your rights as a mother, a woman, and a patient should be respected. You have the right to say "No", to ask "Why?" and to demand a second opinion. It's not always easy to fight a hospital system, and sometimes complications arise that may throw a wrench in your plans, but coming in with an advocate prepared to help and support you can dramatically reduce the incidence of birth trauma, and can help you not only advocate for yourself, but protect your body and your baby from unnecessary stress or harm.

"All that matters is a healthy baby" is a trope we don't need, shouldn't be hearing and isn't even true: you matter, too.

If anyone has any proactive book or article recommendations, be sure to leave them (and links, if applicable) in the comments!

(no subject)
Squee!
babyslime wrote in june2011_babies
Another FANTASTIC birth video for the inspiration tag. ;)

Home water birth. 4 minutes. What's so amazing about this? The baby is born with nuchal cord (around neck), in an in-tact caul (no waters broken) in OP position, and when her head comes out you watch her become awake and sit with head birthed... blinking and looking around before she's fully born! AmazingCollapse )

A note of clarity. :)
birth, UC
babyslime wrote in june2011_babies
Hey ladies! I just wanted to comment on the last post I made here (the, "Beat the odds" statistics post) somewhere where everyone could see it instead of it getting lost in the comments. :)

First-first, an important note:
Women matter in the birth process: we're more than merely pretty wrapping paper. Our emotional and mental health matters as much as our physical, and too many forget about that aspect when it comes to pregnancy and birth policy. With that in mind, please refrain from the trope "All that matters is a healthy baby" either in posts or as a comment on birth stories or experiences here: it is offensive and triggering for many, many women that have experienced birth trauma and the phrase takes its roots in misogynistic and oppressive ideas about women's bodies and birth. When someone is mourning a loss of experience, choice and freedom; sweeping their feelings under the rug is not an appropriate (or kind) response.

Okay, back to the point! It is awesome to see so much discussion on it: that's good! Don't ever feel awkward about disagreeing with something, or someone, and please DO step forward and talk about stuff... question, look, research, disagree, probe and understand. Some of us have never had the opportunity to learn about birth in the USA (or in our countries; I'm not American but our birth system in Canada is very similar), and without discussions like that, some of us never would. Those discussions and disagreements are GOOD to have, no matter what "side" you're on (or whether you see the issues as segregated at all). :) So please, never feel awkward of weird about adding your two cents. I feel very strongly about censorship and I think it's unhealthy to ban debate or arguments simply because they have the potential to get out of hand. The last DDC I belonged to had a strict "no disagreements under any circumstances" rule that became incredibly awkward as time went on and by the end I decided if I ever made one I would never, ever enforce such an idea! Obviously there are appropriate and inappropriate things to argue with someone about (like an opinion or preference vs. something presented as a fact), but I trust that we can all figure that part out. :)
It was never my intention to cast any judgment nor infer that someone is a "good" or "bad" mom: to be honest, I have no such judgment and am left scratching my head at the idea that any good/bad/inferior/superior was at all inferred by a list of relevant statistics to risk vs. benefits in average pregnancies and births. While I may be choosing a homebirth for myself, that does not mean I advocate the choice for all - nor do I think it's appropriate for all. I'm also a doula and an ICAN leader (ican-online.org) and part of my 'job' is to provide the facts so that women can make informed choices they're happy and comfortable with. ALL choices. And that was the purpose of that post. :) I'm also a woman who has given birth once in a center/rural hospital, once by cesarean, once unassisted, and trying this time for at home with a midwife.

Secondly, if anyone is curious about the research used to gather the statistics you're welcome to look them all up for yourself! When this information was gathered (around 2006), it took several weeks of pouring over documents and research released by hospitals, state and government agencies... as well as (at the time) current, peer-reviewed research on intervention and birth trauma in the USA. All of the language used in the post (re: "unnecessary" or "satisfied" - which is also what is being criticized as "judgmental") was the original language of the documents and no tone or idea was inferred or assumed by this poster. :) The preface, "statistically" was used to indicate that the numbers were strictly statistics based on average pregnancies and average women - we're all unique people with different experiences and preferences, but that doesn't change the reality or the risks, you know? I may know 5 people who smoked all their life and did not get cancer, but that doesn't mean that smoking doesn't cause cancer in 50% of those who do it (I pulled those last two numbers out of my butt, for the record, but I think the intent is clear). It's important to keep perspective, even if you're on the outside looking in, because otherwise we can easily become a blockade in education and access to information.
Anyway, all of this information is easy to find and readily available at your fingertips from a wide variety of health organizations. If you're planning a hospital birth, it's important to know how your local hospital ranks if you're planning a birth there, and in this lovely age of internet freedom we actually do have access to that information! Start with organizations like WHO, UNICEF and more. Many active birth blogs also correlate and archive current research by state or country to help make it easier to find. The Unnecesarean blog is a great example of this and they regularly release state-by-state reports.

I also want to clarify the tone argument (this part is inspired by the post but not specifically ABOUT it, mostly in reference to some of the discussion going on later and addressing any future discussion about it as well... so it isn't intended as a direct response). Informed choice is the #1 goal of birth advocacy - all birth advocacy - and posting the statistics in that piece was for educational purposes only. The statistics posted are all true (or were true at the time, in recent years the stats have changed and almost all have increased other than the episiotomy rate... which has gone down just slightly with the circulation of more research about how unnecessary it is) and some may find that kind of information threatening or upsetting, particularly if you're choosing a hospital birth or making an informed choice about an intervention that carries a comparably high risk (like epidurals or inductions), but please remember that in most cases there is no judgment intended either by that piece, or by the community as a whole. We're all different people with different experiences, and we all deserve the right to informed choice no matter what that choice is: natural home birth, a VBAC with an epidural, a scheduled cesarean or an elective induction; but we cannot truly have informed choice without access to all the facts, and unfortunately many of us don't have all the facts and most of us live in an environment where questioning our care provider and seeking second opinions is often the safest course of action before proceeding.
No one is (nor should they) advocating home births for all any more than anyone advocates cesareans for all; rather, the goal is that we be able to walk into hospitals and/or the offices of our care providers feeling safe and confident that our needs and body autonomy will be respected and cared for. Not only that, but that we're given access to factual, current information to help us have births that are safe and happy.

In an ideal world, your choices - ALL of your choices - would be free from manipulation and fear at the hands of care providers or employees in your birth environment, but unfortunately that isn't a reality for a lot of women. And that is the spirit in which that piece, and others like it, are posted. The realities are hard to swallow sometimes, but it's important that we know them; without all the facts, can we really say we were given the opportunity to make the healthiest and best decisions? No one is blaming women, but there is blame to be put on a system that encourages care providers and other professionals to coerce, inflate, manipulate or outright hide information for the benefit of convenience, profit or personal preference.
Sometimes in the process of finding out more we read things we don't want to hear or may not have previously known was true. For instance, many people mistakenly believe all cesareans and inductions are medically indicated, that the rise in cesareans is due to women requesting them, or that there's no such thing as an "unnecessary intervention". Some people's first introduction to the risks of homebirth were through the recent publication of the Wax study which famously quotes the death rate as "triple" for a homebirth... even though the study was deeply flawed and repeatedly debunked. If you've never been exposed to that information, or you've been fortunate enough to live in an area where the rates of interventions (and thusly, the risk of birth at your local hospital) are very low, it might be confusing or challenging to accept that these issues exist. However, that doesn't negate the fact that there is an epidemic of dangerous birth policy and practices. While you may have had a beautiful, peaceful and safe hospital birth free from unnecessary intervention; statistically most women didn't, and statistically most women won't. In order for your experience to be respected and accepted you must also understand that it was not the average outcome. Internalizing the fact that many standard birth procedures practiced in the USA, Canada, the UK, etc are unnecessary, dangerous and/or over-used may be hard, but it's something that all women need to know regardless of their birth choices. In the end you deserve to be able to walk out of the hospital (or snuggle down in your bed) feeling confident and happy with all the choices you made, knowing they were the ones best for you in your unique situation.
We can't have that without access to correct information.
And by posting that information, no judgment or offense is intended.

So let me reiterate: no one here is (nor should they be) sneering your birth choices, but rather providing additional support to those who may not have had one. Many women wish to avoid unnecessary intervention and lower their risks of birth injury and trauma, some may electively choose induction or cesarean without medical indication, both are perfectly fine choices... but please, be open to understanding that your acceptance of risk may not be the same as others.

The same goes for situations where someone may post about feeling pressured into an intervention (ie. induction) and is having trouble accepting it. Providing factual, current information to that person to help them make an informed choice is not a judgment, nor is it "unsupportive". However, if that person had said, "I'm having an elective induction, wish me luck!" - coming in and telling them, "Was it REALLY necessary to take that risk?" would definitely be an unfair judgment and unsupportive.
Along the same lines: if you're finding yourself feeling sensitive and vulnerable, particularly in the face of a difficult birth experience, please remember to sit back and take a breath before reacting to commentary on birth policy or risk. Just because it doesn't apply to you does not mean it doesn't apply to birthing women on a whole.

coendou said very eloquently in the previous post: "[If] you have made an informed choice, that is wonderful. But it does not negate the fact that the vast majority of women in developed countries, especially the US (but almost all developed countries have followed our lead, sadly) are NOT truly given the opportunity to make a fully informed choice, with full knowledge of the risks. You have weighed the options, you know the risks of an induction, but have decided that for you, not inducing would be riskier. That's a totally valid choice, but it does not mean that all or even a large minority of women who get induced have had the same opportunity. Many women are only presented with one real option by their OB and go along with it, unaware that it increases their c-section risk or that that, in turn, increases their risk of many other problems.
You are confident in your decision. That is terrific. But it also means that you should NOT find these stats threatening or unsupportive of that decision. Your personal decision does not change them at all, but you should be able to view them secure in the knowledge that you were given an opportunity that many women are denied, the opportunity to make a fully informed choice."


Be proud, be happy, and be secure in your choices - you can still advocate for the healthiest outcomes (or options) for all while making different choices for yourself. That does not make you a hypocrite, nor does it make you "inferior": it makes you the point of advocacy. :)


A really, really good example of this is one taken from my own life that I'm comfortable sharing here (and accepting questions on, for the curious):
I take medication every day that carries a risk for withdrawal and respiratory distress in my baby. I take this medication to have a survivable quality of life while living with a degenerative, autoimmune disease that causes me great pain and has left me disabled. The medications I take are stigmatized due to being high on a list of drugs frequently abused or sold on the black market. While I'm not abusing my medication, nor does my situation carry the same risk vs. benefit scale as most others would, I do have to understand that my unique perspective doesn't somehow negate that these risks exist on a whole.
When I chose to take this medication during pregnancy I carefully weighed the risks and benefits, discussed it with two doctors as well as my midwife (one of whom told me I absolutely could not take it under any circumstances due to a risk of birth defects... something which was actually completely untrue), pulled out stacks of current research and made the informed choice to continue; accepting that there is a very slim chance that my baby may have mild irritability or discomfort for her first 24 hours of life as a result. That level of risk is acceptable to me, because in my unique situation the benefits of the medication toward my ability to care for my body (and thusly, my baby) outweigh the inherent risks. However, my situation is unique, and for the vast majority of women the risk of taking it would be huge by comparison. For most women, care providers would advise them to stay far, far away from it because it can do serious harm to them or their babies.
So who is "right"? Is the medication dangerous or not?
I could cop out and say, "Both", but that's not truly correct, is it? That statement would carry my heavy bias, and my desire to not hear judgment or ignorance regarding my unique situation. The truth is that the medication is potentially very dangerous. Period. I'm an exception, and in my case the scale of risk vs. benefit is different... but that does not change the fact that the medication is inherently unsafe. To be a good advocate, and a truthful one, I need to remember to keep perspective: just because my situation is different, does not mean the facts have changed. Adding a disclaimer of, "except for me, it's safe for me" or, "well SOME people NEED it so it's offensive to say it's dangerous" every time someone discusses the medication is both unfair, and completely untrue. At best it derails a conversation about risk vs. benefit, and at worst it silences it completely or breeds myth and misinformation.

The same is true for those having a medically indicated induction, cesarean or otherwise: just because your situation is different, and unique, does not make either of those things any less dangerous on a whole for birthing women... and by no means should it lead to the censorship of conversation regarding those risks.




One last link on the subject of informed consent: I wanted to post a link to a great article titled, "An Obstetrician's Hope" written by an American OB about the medical system, with sources cited, for those who are having difficulty understanding the statistics or the ideas behind words like, "unnecessary" used in the previous post. As I said before, informed consent is the goal... but how often do we truly have it?

Here's an excerpt:
"Physicians are admonished to “first do no harm.” In practice that implies we should do nothing unless we have evidence it may improve an outcome. Yet for the vast majority of things we do in obstetrics, we do not have that evidence. In fact we often have evidence to the contrary. We routinely order continuous monitoring that has shown no benefit at all to fetal morbidity and mortality but dramatically increases the rate of unnecessary interventions thereby dramatically increasing maternal morbidity and mortality. We, without thinking, perform or order invasive cervical exams that have very poor prognostic value, have never been shown to improve any index of maternal or fetal morbidity, yet have been shown to increase the risk of fetal and maternal infection. Indeed, we routinely order or perform dozens of procedures in every labor and delivery unit in the country that have no proven benefit and in many cases fly in the face of evidence in our own literature that they worsen maternal and fetal outcomes.(8)

I cannot agree more with Dr. Fineberg’s observation that “each of these women deserves an honest discussion about the fetal and maternal risks of each option.” But she should not stop with that discussion. After that discussion is held, each of these women deserves a birth attendant that respects and supports her regardless of the option she chooses. That is where the U.S. obstetrical culture has utterly failed its clientele. We, as obstetricians, have entirely lost sight of the fact that our first obligation in ethical medical decision-making is to respect patient autonomy. We routinely order and perform procedures against our patients’ wishes, often exploiting the vulnerability of our patients, enforcing our authority through intimidation, fear mongering, and occasionally even obtaining court orders that are virtually always invalid and overturned when it is too late."


Read more here...

Thanks all. :)