So What Are We Doing Wrong?
What do you see wrong with these headlines?
“ U.S. has the Highest Maternity Care Costs in World, $98 Billion Annually ”
“ Maternal Mortality in the U.S. Doubles in 25 Years ”
“ U.S. Sinks to 50th in Maternal Mortality ”
“ U.S. ranks 34th in Infant Mortality ”
“ Maternal Deaths Worldwide Drop by Third ”
“ Worldwide Infant Mortality Rates Declined 28% in 20 Years ”
Why is it that in the rest of the world, which spends far, far less in maternity care than we do, the rate of mothers dying in childbirth is lower in 49 other countries than it is in ours? The rate of newborns dying is lower in 33 other countries? Why are their rates improving and ours are deteriorating? Don't try to pass off some garbage on me about how those countries don't keep records as well as we do - most of them keep better records. Just cowgirl up and face it - more of our mothers and babies die here, and we pay a lot more for that privilege. Doesn't that make you feel special?
So why is this? Why is our typical medical/health care in America killing women at an ever-increasing rate? Why has the decline in newborn mortality rates turned around and deaths rates for our babies have increased again? What steps are healthcare professionals taking to reverse these trends?
Unfortunately, the steps being taken by most of the mainstream medical establishment are not going to reduce the trend, which is why it is continuing to rise. In some states, like California, the death rate in hospitals doubled in only 10 years. While almost all sources of statistics and research compilation agree that interventions such as inductions, epidurals, and C-sections are largely responsible for the high rate of complications leading to morbidity and mortality, those interventions are not being used less, they are being used more.
Our mothers and babies are suffering from a standard of medical care which mistakenly perceives that more interventions equals better care. Not better outcomes, just a level of care which is called "heroic", meaning that in a court of law when a provider is being sued, they can argue that they "did everything they could" and have the chart notes to prove it. Forget the fact that the very act of performing all of those interventions is what caused the bad outcome, and what they are "saving" you from is something iatrogenic - caused by the medical treatment itself.
Time to get real, folks; doing the wrong thing more will not make it work better. Any intervention which is not medically indicated, with sound scientific evidence to back up the fact that it will improve the outcome for the patient, is in fact causing added risks and harm to mother and baby.
Can I prove this? In so many ways, yes, it is easy. An entire book could be written on the reasons why, most of which are common sense and clear to anyone who has not forgotten anatomy, physiology, and biochemistry. The average farmer understands the reasons why birth works best when it is not disrupted.
But what about outcomes? There is your definitive proof. The rate of mortality and morbidity for both mothers and babies is NOT rising among planned home births with a trained midwife. It continues to be low, along with the rate of interventions for home births.
Many arguments are thrown out about how it is "unfair" to compare low-risk home birth mothers to the average mother. Why? Can't the medical profession also counsel their mothers adequately about nutrition, supplements, diet and exercise, ways to prevent complications like pre-eclampsia or gestational diabetes, ways to improve immune function to prevent infections, reducing stress during pregnancy, strictly avoiding induction unless medically necessary, delayed cord clamping so the newborn is not anemic, gentle natural birthing techniques to avoid stressing both mother and baby, skin-to-skin contact and undisturbed bonding time for easier breastfeeding success...and so many other things that midwives are doing to promote these excellent outcomes?
Not all of our mothers come to us as low-risk; many of them work hard to achieve a low-risk status in time to be allowed to have us attend their birth; not all make it that far, but they all do become healthier and therefore safer in the process.
Maybe the medical profession should be sincerely thanking the midwives for improving our average national statistics so they don't look even worse than they are now.
August 27, 2012 - LCarr