“Bias in the Media” Moments: Doctors made assumptions but lest we forget…

I connected over to an article at Today, and of course, the article begins with this:
“Doctors have long assumed that Cesarean sections might be the best choice for babies that will be born preterm.”

Which almost looks like doctors are taking responsibility for making these choices.

But read through the article and you will notice the tone changes until you get to this:
“When you start to look at 37 maybe 38 weeks, there’s an increased belief now that the longer a baby stays in the womb, up to 40 weeks, the better the outcome is for the baby,” she said.There are women who want a C-section to avoid labor pain, Snyderman said.

”They say ‘I don’t want the pain, please let me just do a C-section,’” she added. “You have to remember the ultimate outcome should be a healthy baby.”

So. Which is it? Mothers are causing this wanting to get out of labor? Or physicians were doing cesareans to prevent babies from getting to full-term to “protect them from vaginal birth”?

Yet another fine example of the media really doing a bad job of reporting because they are trying so hard to look “balanced” rather than authentic or accurate.

Interview with Dr Michael Klein

Brio Birth talks to a leading researcher here:

http://www.briobirth.com/articles/exclusive-interview-childbirth-researcher-dr-michael-c-klein-says-birth-technology-overused?page=0,1

I have heard him speak and was highly impressed with a lot of what he said. You can check him out on Lamaze previous conference sessions as well

Living “At Risk”

Living “at risk”

• An OB could lose their practice, their livelihood, their home or their car.
• VBAC mothers could lose their life or their baby’s life on that table.

Reposted from my personal blog, original date 10/22/2007

Burning the Midnight Oil

Recently, BirthAction’s been a little quiet. We’ve been regrouping a bit with changes in staff and I’ve personally been doing a lot of soul-searching, changing and self-education. We’re looking for more volunteers to help create resources that moms need to have and information going beyond what normal birth is about and getting into those other realms of how we can do something about it. Even if it’s just that one starfish at a time.
We’ll get back to the Starfish on the 15th. I have a particularly one in mind, you see.
Now, that sounds like a lot of jumble, I know.

The point is, there are things brewing in the distance. This is your wake-up call. Get in and be a part of the action. Pay attention and do what you can. You are not just a mom. You are a force of nature.

Oh and for those of you who like to sit on the fence and play devil’s advocate about medical care, maternity issues, etc., that’s fine. You play the fence. I have no problems with you deciding after informed consent that you want your inductions, your epidurals, your cesareans. But someone out there is holding the line for you, protecting your rights, making sure that there is safety in your procedures.

Don’t all those women deserve that from you, too?

Control Matters.

I am reading a book called The Decision Tree and on page 12, after several pages discussing the evolution of studying heart disease, the author comes to one defining point:

Control matters.

All of the do this, dont do that we have going on in health care leaves us with feeling like we are supposed to be told what to do and how to do it, rather like errant children who have been busted for stealing cookies.

In the world of pregnancy and birth, being weighed highlights just how bad this can get for a mom-to-be. A nurse prompts you to take off your shoes and step on to the scale. She then plays with the scale and comes up with a number and writes it down. A completely passive process that leaves one feeling like she has no control over such a simple function. It is training for handing over all the functions of pregnancy, even the simplest, yo someone else.

So how would moms feel if they took back this role? “thanks, I can weigh myself.” or ” what was my weight”? Or even more interestingly, I don’t feel like being weighed today?”

One mom was so pleased to see the weight gain, her pregnancy with triplets was an example of control over her long journey of trying to have a baby

Another mom was weekly tsk tsk’d over her weight gain because she was obviously fat and obviously judged for it. She felt she had no way to control the unprofessional attitudes of her providers or their increasingly weight-based interventions that had no basis in what was actually occurring in her pregnancy or with her baby.

Who is in control of your pregnancy? What decisions are you making? The answer could affect your overall health picture for life.

Dealing with deaths at birth.

I’m putting this out here because there are and have always been deaths at birth.
If you are a mama who isn’t wanting to discuss this because you are expecting, skip it, please! You deserve peace.

So, how do we process these things? How do we tell others?

I wrote a blog post a while back:

http://birthaction.org/2011/08/28/capitalizing-on-loss-and-risk/

about how anti-homebirth people used death at birth to put forward an agenda
and how sometimes, natural birth advocates do it as well.

So how do we talk about these losses reasonably? Explain them? Explain that it’s not a competition between hospital or homebirth but instead, a journey of independence and the right to take on risks for ourselves??

Where’s the Data? Proof ACOG can’t get its act together over cesareans.

There is no data registry for uterine rupture in the United States or for any other adverse obstetrical event such as cesarean. We treat each cesarean as if it’s the first one since the scalpel was invented. What if there was a randomized data pool that each cesarean HAD to register in if you were a member of ACOG. Let’s see..the obvious questions:

• Provider (you could assign providers numbers and make it anonymous, there is a way to provide accountability and still track those providers who are doing shoddy work)
• Hospital
• Scar Type
• Scar Length
• Scar Location
• Closure Materials
• Infection Present, Infection within 24 hours, Type of Infection (cultured),
• Patient demographics
• Number of Prior cesarean(s)

This would offer so much information:

• If some obs have every single patient over 200 lbs getting a cesarean for “big babies” and others have a true bell curve, there is evidence of fat bias.
• If a certain closure material is used, repeatedly, with bad outcomes, there will be trends.

Most importantly:

There would be data to work with to start talking about uterine rupture outside of the realm of “we’re terrified because it can happen to anyone” because after thirty years of cesarean “research” it’s time to stop pretending that studies don’t change outcomes, it’s time to stop pretending that physicians determine more of why a cesarean happens than mothers do, it’s time to start tracking information so that if a mother has a uterine rupture, we can look back and ask these questions about what happened in her previous pregnancies and draw the lines to providers, materials, procedures, interventions that are drawing lines to a future where every woman has a cesarean, is at more risk to lose more babies and have more complications.