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June 18, 2008

ricki lake vs ten million doctors

I had to pull myself up off the floor (where I have been lolling with our new baby, Sylvia, for approximately six months) to get back to this blog and write about the latest birthing scandal. In case you haven't heard, the medical establishment is really pissed off about all the feel good home birth stuff that's been going on (thanks to Ricki Lake) and they want it to end. So they've come up with some kind of official statement about how hospitals and birth centers are the safest places for births. The long-term intent is to encourage states to make home births illegal.

Here's my opinion for what it's worth. I think home births are not the solution to what has shaped up to be a genuine crisis in maternal care in America. But the fact remains that home births are entirely appropriate for some people and there is no question that the thousands of excellent, experienced midwives who work tirelessly in support of women and babies would not be doing home births if they had women and babies dying on them! Here's the deal: home birth is really only advisable given certain factors, including a low risk pregnancy and ready access to a back-up hospital. Please believe me when I tell you that home birth midwives and women who want to live and have their babies live, know this! So it's not at all a question of what all women should be doing. And sadly, though Ricki Lake says she's all about "choice," her documentary--most of which I really loved--did go over the edge in terms of making home birth seem the only way a thinking person would go. It's a great movie, so there's no reason to alienate people who might support the idea but for so many possible reasons cannot have a home birth of their own.

Home birth isn't safest for everyone. There's no doubt. But does that mean the hospital "the safest" place for everyone to give birth?

Unfortunately, the statistics are not leaning in that direction either. One in three women are getting a c-section, increasing a variety of risks most very small, some large. One of the best points in Jennifer Block's PUSHED is that elective C-sections and unassisted home births are both "solutions" to the same crisis. Confronted with a hospital birth, some women think, "God, it all sounds so awful, just cut the baby out of me at a prescheduled time." Others say, "I'm just not going in there! I'll do it myself!" It may seem that the elective c-section mama and the unassisted homebirther have nothing in common but Block's point is that they are both just responding to a similarly lousy situation.

IDEALLY, there would be really fantastic birth centers all over the place so women really and truly have this so-called choice that everyone keeps talking about. And hospitals would have better policies (i.e. more rooming in and more labor support and fewer unnecessary interventions) and home births with experienced midwives would be legal in every state.

When I was ready to have my second baby in NYC - what's the population here 18 million??? -- everyone kept saying, "What about a birth center?" Well, I toured the birth center at St. Luke's and it was fine but there were about three rooms and the likelihood of getting into one the day I went into labor was very slim!

I think it's terrible that home birth and hospital birth are pitted against one another. I just don't want to see some poor woman die because she had a dangerous unassisted home birth and I can't stand watching the c-section rate soar. The more polarized this debate becomes the more likely we'll see that kind of thing.

I'm back! Missed you all. Hope to be here more often. Here's a baby face - Sylvia's -- to add a little sweetness to my diatribe.


by ceridwen at 10:17 PM
in birth | in a perfect world (ie: sweden) | media momming


oh look! you're back. it is difficult to get off the floor. my girls are almost two and i still spend a good deal of time looking at ceiling fans whirling as i am jumped on and tortured.

homebirth? why can't a woman make a decision to do whatever the f she wants to do? why is there always someone somewhere trying to make some kind of golden standard for our health? personally, i wanted to be as close to an epidural as possible for the twins birth, but far be it from me to deny anybody the right to pop their babies out wherever they feel comfortable doing so.

comment by Juliette G. at June 20, 2008 2:30 PM

Nice post. Beautiful baby!

I've written my own post about the "resolutions." If you get back up on the computer, you may enjoy reading it!

I have my own newborn.... just love giving him loves!

comment by Susana at June 21, 2008 1:10 PM

you should see what truly horrific parents do. they loan their kids to teenagers who think they can raise children. seriously, it on this new NBC show called Baby Borrowers. criminal

comment by Gary at June 22, 2008 4:34 PM

I loved the movie but it did pose a few questions for me. Should I absolutely say NO to induction? I want to try for natural for sure but lets say we are up to hour 30 and I'm still not where I need to be to get that baby out? Should I just say let's do the C-Section? From what I have been reading and what was in the film, it appears that induction & epidurals are just not good for the baby.

I am a first time mom and considered a high risk pregnancy due to my age of 41.


comment by Gina Stickley at August 1, 2008 6:13 AM

Hey Gina--

Medical induction is actually an incredible tool when used appropriately; as is a well-timed epidural. The main problem is that inductions are pretty much a routine procedure these days. And they do come with risks (and they can be highly unpleasant, too). As the documentary shows, women are not given the chance to spontaneously begin labor and let their bodies have a good go at alone. But after 30 hours of painful natural labor I think a push of pitocin or (preferably?) an epidural could be an great help and worth it from a risk/benefit POV. An epidural can give an utterly exhausted women who has been laboring on her own for a long time exactly the break she needs. And suddenly she'll open up and the baby is born and the epidural has actually prevented a c-section! Pitocin is less fun, because it can cause mammoth contractions but at times it is helpful, too. Also, it may make you feel better to know there's some disagreement about whether your age automatically makes you "high risk." Absent of other factors, age alone may not make that big a difference. Of course, you'll be labeled advanced maternal age, which is always fun. But try to focus on the fact that a woman's body is designed to do this. And let yourself off the hook about the epidural-- if you end up needing it, go for it! It's not a sign of failure and can actually be a really great thing and the right choice. There are things you can do to encourage a natural birth but it's important to stay open. Micromanaging birth-- even with the goal of a natural birth--is never a good idea. Every body and every labor is its own thing- see how yours unravels and trust that you'll make good choices as you go. Hope this helps! And congratulations. - Ceridwen

comment by ceridwen at August 1, 2008 11:03 AM

I had as close to an all natural birth at a mojor hospital. I hated how many times they kept asking and asking if I wanted drugs well they called it pain medication or epidural but lets be honest DRUGS!!! They did have a wonderful nurse who help tremendously for part of my labor until they made her go home for the day. When I was close to delivery I wanted an oil massage (where I was told from Lamaze they would hold a warm olive oil cloth in "that" area) Their version of said massage was to poke me with a Q-tip blotted into a fingertip sized cup of the supposed oil mixture. Anyways I tore second level and got the equivelant of 30+ stitches and I WILL STAY HOME NEXT TIME! The only reason I went to the hospital this time was my husband was paranoid and he now completely agrees with me. I will use a midwife and doula next time and do it with no doctor pressuring me into using "normal" drugs!

comment by Sarah Butcher at September 3, 2008 1:52 AM

I'm a (pseudo) first timer, and currently not that near to giving birth (today is the last day of my first trimester). I have never wanted a home birth (I want as many people around to wait on me as possible!), and this was confirmed to me very strongly when I had a difficult miscarriage at 12 weeks back in May. When I was losing consciousness due to loss of blood at home, by husband called an ambulance (he says it was the scariest phone call he's ever made). I have neve felt so taken care of - all the medical professionals who came across my path that awful day were amazing - I trusted them with my life and would do it again in a heartbeat. I realize that not all hospital experiences are as positive as mine, but they're not all nasty, either. I get really frustrated when the 'All-Natural' crowd tries to make me feel like I'm going to be putting my baby in harm's way if I trust my doctors.

comment by Jolayne at October 6, 2008 6:58 PM

I too saw the movie. I thought it was an interesting movie and I felt she had some very good points. What I didn't like is that because you chose to have your child in a hospital it is not considered to be a natural childbirth. I wanted to have a natural childbirth and luckily I was able to have one. No pitocin, no epidural, and I was free to move around (in the limited space, due to complications). I feel that as long as you are aware of all that can happen and aware of various drugs and conscious of what is going on with your body during labor then you can have a natural child birth any where.



comment by F.P.E. at November 6, 2008 3:54 PM

Oh my. What about strep B? I had a 4 hour labor, which meant only 4 hours of IV antibiotics, not enough to kill it decisively in my birth canal and subsequent (or consequent as it were) baby. An an exposed baby can have major and devastating complications including death.

I did hear of one women recently in a DC hospital whose baby died solely for this reason (the M.D., to her minimal credit, retired immediately after). And as a young widow, I know a disproportionate number of men whose wives have died in childbirth. [I will also tell you to cross the street very, very, very carefully].

So for me, with a super-fast labor and strep B, I would totally have preferred to be in a hospital.

I was "lucky" -- did everything "naturally" but of course at 4 hrs I had no choice.

Just another perspective.

Supa D. Fresh

comment by Freshwidow at November 22, 2008 9:25 PM


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working mums

comment by garcia at April 18, 2009 5:57 AM

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