Category Archives: Dangers of Hospital Birth

Denied a VBAC???

Cesarean Section

More and more we are hearing about women being “denied” a VBAC (Vaginal Birth After Cesarean) by their OBs, Midwives, or local hospitals. Here is some information that can help you get the birth you want and deserve:

#1- VBACS ARE NOT ILLEGAL! Anyone who tells you this is lying (or grossly misinformed.) Period.

#2- Any hospital that accepts Medicaid or Medicare that states they have a “VBAC BAN” is in direct violation of federal code 42CFR482.13 which states that any hospital that is federally funded can lose funding if they deny care and can lose all funding if a complaint is received. 

#3- EMTALA, Federal Emergency Medical Treatment and Labor Act, also known as COBRA or the Patient Anti-Dumping Law. EMTALA requires most hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention.

This means hospitals HAVE to take you if you show up in labor. If you have been denied a VBAC by a hospital or know of a hospital with a ban you can call EMTALA at (404)562-7500 to report them.  You can also contact http://www.medlaw.com if you have been threatened by a hospital for court ordered cesarean, told a hospital has a VBAC ban, or dropped from a providers care within 30 days of your due date or while you were in labor. 

#4-  Check out birthaction.org, specifically your state’s resource page on where you can file other complaints. Also check out  Birth After Cesarean for lots of other specific info on how to get your VBAC.

And last but most importantly!

#5- Contact a local home birth midwife! Even if you think “you could never have a home birth”, or “home birth is too scary!” it can be an eye opening moment when you sit down for a consultation with someone who protects normal, natural birth. It gives you  a chance to ask any and all questions you may have, understand how birth at home works, and provides you with an opportunity to see that not all midwives are long skirted, patchouli smelling, hand-it-to-the-man-ers(although we love those kinds too!!!) and are trained in handling low-risk birth outside of the hospital setting. 

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Filed under Dangers of Hospital Birth, Natural Birth Advocacy, Uncategorized, Vaginal Birth After Cesarean

The Birth of Mirielle by Diana

BB 3

This story comes to us from one of our beautiful clients, Diana. She wanted to share her story with other mamas so that they might be empowered to fight for the birth that they want.

My story is a tad different from many women. I knew what I wanted from my birth experience. I knew from the very beginning that my body was made to do this so I treated my pregnancy as a blessing. In month 4 I went to my OBGYN and handed over the rough draft of my birth plan to see what their thoughts were. I was a member of a practice of 6 doctors, 5 women, and 1 man. The doctor during this visit sat down with me and said “You are going to need some sort of classes to help you get through your first birth naturally. Try either Bradley Method or Lamaze classes. But you’ll need something. We get a lot of women that want to do it naturally…..until they get into the labor suite. Women who prepare have a better chance.” That afternoon I got on my computer, contacted Melissa, the local Bradley instructor, and by 6 pm I was sitting in week 3 of a 12 week session. I got all the materials I needed and my partner, Anthony, and I looked forward to how the class would prepare us for the birth of our child.
Weeks went on and on and Bradley Method graduation day came. After completing the course I started toying with the idea of switching to a birth center birth though I planned on a hospital birth. Unfortunately, due to my pregnancy history of anemia, I was risked out of that being an option. Because of this same reason I did not consider a home birth because our house was too far from a hospital should anything go wrong. I had my final birth plan approved by the obstetricians who were on call around the time of my due date, I had two wonderful doulas, bags were packed, and I was prepared to deal with a hospital staff who may scoff at my desires to do things naturally.

At 7 pm June 18th my contractions began. They were not bad by any standards and I was able to talk and move. I must have baked 6 pounds of brownies for the hospital staff to enjoy. Comfort was an elusive state for me. My labor was not painful, just very uncomfortable. No position was the “right” one. The night passed and early morning came. Megan, one of my fabulous doulas, was called at the un-Godly hour of 4:00 am. She arrived at 5-ish and sat up with us all night/morning as we talked and joked. Labor progressed and contractions started to get more rhythmic. Their interval timing decreased and I started to get shaky. When I began heaving and vomiting regularly with contractions Megan was sure I was entering transition and we should leave to the hospital where my doctors would be waiting for me. We called ahead and arrived at roughly 9:00 am. I went to the office of the OBGYN practice and had a vaginal exam. Charlie, doula number 2, met us here. At this time I was I was 4 cm dilated.

I was sent down to triage and family started arriving to await the baby’s arrival. I was hooked up to a monitor to assess my progress. In my birth plan I clearly stated I wanted AS LITTLE INTERVENTION and MONITORING as possible. Though, to be fair, they informed me an initial monitoring would be required to see “where in the labor process my body was”. While this monitoring session was taking place I started to notice it was quite lengthy so I asked if everything was okay. The nurse replied “Well, the baby’s heart rate showed a deceleration and we need to monitor it to make sure it doesn’t happen again. If we can go for a full half hour with no decells we’ll be in the clear.” Let me prepare you now…..this is where it all started. Also, keep in mind these monitors are highly uncomfortable belts that strap around the largest part of your belly and squeeze whether you are contracting or not

After further monitoring the OB on call, Dr. R, arrived and read the findings as they were being sketched out by the machine. Dr. R was not thrilled. She suggested we go ahead and move to a room and keep me on the monitors. I told her I would not like to stay strapped down in a bed and asked politely if this was a possibility. She was happy to put me on mobile monitors that were wireless and even waterproof so I could labor in the tub. When I arrived to my room the nurses were told laboring in the tub had been approved by my doctor because my bag of waters had not broken. Apparently a tub labor is very rare at this establishment. But they sanitized everything and when I was all “monitored up” I got in. When in the tub, covered with a towel, family members trickled in and out to say hello and comfort me. I was only allowed 3 people in the room at a time so many people traded off.

While the tub was a wonderful place for me, the nurses were having a hard time letting me enjoy it because every time the baby would move they could not clearly hear the fetal heartbeat and they were under the impression it was decelerating. They claimed this was happening “too often for their comfort”. So out of the tub I went. I was laid down in the bed for another vaginal exam, as it had been about 2 hours since the first one. Still 4 cm. At this point the staff was starting to get slightly annoyed with my wishes to be mobile. When they would leave the room I would get up and move to my heart’s content. I continued laboring in the best way I saw fit.

I decided the tub was where I needed to be so I got in. I also decided the monitors were a little too much for me at this point and they came right off. They were causing too much discomfort and unnecessary panic from the staff. Of course when there was no reading being emitted from the machine a nurse rushed in quite panicked until she saw me. She asked me to return to the bed, even though I was clearly in the middle of a contraction, she tried assisting me up. Anthony told her politely to please wait until I was finished with the contraction before trying to help me into bed. After the contraction ended I told her the tub was where I was going to stay and that if I absolutely had to, I would hold the monitor responsible for the fetal heart rate reading to my belly and move it as the baby moved to be sure they could hear everything properly. Straps were not an option any longer. They baby continued to kick the monitor as if to say “Get that thing out of here.”

Another hour passed and the nurses were getting quite worried about the baby. Charlie, my second doula, informed me “What they failed to inform you of is that heart decelerations are normal during contractions due to constriction and that a few are nothing to worry about.” She was reassuring me that everything was ok and to listen to my instincts about the baby. These instincts also reassured me things were perfect. My last little bit of confidence came from the fact that the baby was moving and that even when she moved you could hear a faint heartbeat coming from the machine at an obviously NOT slower rate than before.

Even so, Dr. R came in and informed me they were going to start IV fluids and oxygen. I told her no. Anthony told asked her “Why?” In my birth plan I specifically outlined IV fluids were not an option. She asked us why and my explanation was evidently not good enough for her. For the next 30 minutes Dr. R and the nurse argued with Anthony, myself, and Charlie about IV fluids stating they were needed to help keep the baby’s heart rate up. They did not relent just because a contraction came. They did not relent when Anthony and Charlie asked them to please stop talking to me during contractions. Eventually I consented to wearing an oxygen mask for a few minutes to get them off my back and they gave up about IV fluids. I then went back to mobile laboring and the machine kept pushing out readings.

After this oxygen treatment failed to work to their liking, they went off to a corner of the room. There was a decent amount of whispering as they reviewed my birth plan. Charlie informed me, after eavesdropping, they were going to start asking me to consent to things I previously told them I would like to avoid. IV fluids were once again brought up. I was asked to return to and stay in the bed. I did neither. I continued to move around. I continued to do what felt natural and right for me.

When Dr. R returned for the 5th time and completed the third vaginal exam I was still 4 cm. It had now been 5 hours. At this point the serious conversation which led to much insult towards myself began. I explained to the nurse who was “caring” for me that I disagreed with the reading coming from the monitor. I knew that movement was a good sign and told her “the heartbeat only decelerates when the baby moves into a new position and the monitor can’t get a good reading. I think it’s slightly misgiving.” She seemed to not hear a word and pressed on with the issue of heart decells. Anthony interjected with a similar statement to mine but she cut him of to say “We go to school for YEARS to learn to read these machines. I think I know when I see a decell in a fetal heart rate.” At this point we knew in what direction things were headed.

Dr. R started telling me that if there was no progression within the next few hours we would have to start considering breaking my bag of waters. In a previous office visit I asked how many hours they would wait during labor until deciding it was necessary to break the bag and this same doctor told me to my face “18 to 24 hours depending on the condition.” Again, it had been 5 hours. I didn’t object, just listened to what she had to say, knowing what I was willing to do to get my ideal birth. Contractions came and went, Dr. R and her nurse came down hard about starting interventions I was not comfortable with. Finally the exchange of words which can be called no less than a one-sided argument as I refused to let myself become flustered by their persistence came to a zenith when my own doctor, whom I hired, voiced to me verbatim “I can get an order of non-compliance to properly treat this child,” It was this statement which lead to my decision to go home.

I stopped talking. Dr. R said her peace. The nurse continued to monitor me and the baby. After a few minutes the nursing coordinator for the hospital was sent in to try and convince me to stay. She was very nice, but then again someone had to be in order to get me to stay. I knew I had to maintain with her my viewpoint that I needed to be in a caring and nurturing environment in order to properly deliver my child. I told her the hospital had been nothing but stress since the moment of my arrival and that it was my belief that this was the cause of my failure to progress. I told her there was no other option for me but to return home. I looked my doctor in the eye and told her I was sorry if she felt I was insulting her expertise, as that was not my intent, but for the health of myself and my child it was in my best interest to leave.

I can honestly say I don’t remember the ride home. According to Anthony I slept through most of it, awaking only when I had a contraction. At home our tub was sanitized and Charlie prepared me a wonderful lavender oil filled bath to labor in. I got in and slept a bit. After no more than 30 minutes my labor started getting much harder. My moaning got much deeper and new instincts came over me. I wanted to get out of the tub. I wanted to stand, I wanted to be on all fours, I wanted to sit on the toilet and try that. I could not get into a position I was okay staying in. My restlessness eventually landed me on all fours, with my head against a wall for support. Anthony helped me then sit and sat behind me to help me. After another 30 minutes of position “musical chairs” I settled on all fours again. While all this was happening my father was having a panic attack after listening to what the nurses and doctors told him while we were at the hospital. So he decided he needed to come into the bathroom where I was laboring with Anthony, Charlie, Megan, my mother, and my best friend to tell me I was being irresponsible and should get my ass back to the hospital. He neglected to recognize my calm efforts to tell him this was not the time and continued to upset me to the point of sending me into a contraction. It came on hard and, this time, with the sensation I needed to use the bathroom.

I looked at Anthony and told him to get Charlie and Megan. I told them I thought we should go. Since I had not yet experienced a feeling of “I can’t do this” and they didn’t want to leave too soon to the hospital and risk a repeat of that morning, they told me they thought we should wait a little longer. A minute later another contraction came on and I looked Anthony in the eye saying in all the seriousness I could muster, “We need to go now”. As I was contracting I reached back and felt the baby crowning along with a strong urge to push. I calmly tried to control my breathing and the head went back up into the canal. We packed into the car. Anthony drove his SUV as my mom rode shot-gun. I was in the back bent over the car seat on all fours once again. We sped off t the hospital hoping no cops would try and stop us while Anthony did 80 mph in a 40 mph zone. We ran one red light (after stopping and checking for oncoming traffic).

Halfway there the baby crowned again. I told my mom “Look.” She turned over her seat and said “Oh my God, that’s the head.” I was able to again, keep calm and let my baby go back in. As we had the hospital in view I finally felt the contraction that wasn’t going to be controlled. I told my mom to tell me how far out the baby was and she said “Ok the nose is out, you need to push.” I pushed and out came the head. One more push and I heard my baby crying. We were in the hospital parking lot. My mom proclaimed “He’s here! He’s here!” I said “It’s a boy?!?!” She replied “No! It’s a girl!!!” My daughter was finally here. Anthony flew out of the car to get nurses and doctors and after we got all situated on the stretcher with a crowd of onlookers amazed at the rare event of a “car-baby” we were wheeled inside. I kept my daughter held close with the umbilical cord still in tact as her APGAR scores were taken. Anthony cut the cord. I was given a small private room just outside of the ER to deliver the placenta. As soon as that was done Anthony carried in our daughter with the most awe-struck expression on his face. We looked down at her in pure amazement with full knowledge our lives had just been changed forever. Mirielle Airi Diez De AShe’s the love of my life.
ndino was born at 6:54 pm on June 19th 2009 weighing 5lbs 10 oz and measuring 19 ¾ inches long. The smallest angel I’ve ever seen.

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Filed under Birth Stories, Dangers of Hospital Birth, Natural Birth

Have your baby at home! Here is why:

Dangers of Hospital Birth: Why Birthing in a Hospital Causes More Problems Than It Solves for Normal Birth
by Ronnie Falcão, LM MS

There’s a saying that birth is as safe as life gets. Sometimes birth can become dangerous for the baby or, very rarely, for the mother. This is when hospital-based maternity care really shines, and we’re able to save mothers and babies who might have died a hundred years ago. Thank goodness that there are skilled surgeons who can come to the rescue when truly necessary.

There’s also a saying that when you’ve got a hammer in your hand, everything looks like a nail. So it is that for hospital-based birth attendants, it is easy to become accustomed to treating every birth as a disaster waiting to happen. Many obstetricians have lost touch with the possibility of normal birth, so much so that even a pitocin induction with an epidural, fetal scalp electrode and vacuum extraction is called a “natural birth”. Some hospital staff seem offended by the idea of minimizing interventions, as if preferring not to have a needle the size of a house nail inserted near your spine is the same as declining to have a second piece of Aunt Sally’s Fruit Cake. Sadly, some of today’s younger doctors may never even have seen a truly physiological labor and birth—a birth completely without medical intervention.

This is how the saving grace of the hospital can become the scourging disgrace of maternity care. In their rush to prevent problems that aren’t happening, hospital personnel may aggressively push procedures and drugs that can actually cause problems. Pitocin can cause uterine contractions that are so strong that they stress the baby and cause fetal distress. [1] IV narcotic drugs affect the baby so strongly that the baby may not breathe at birth [2] ; there is even a specific drug that is used to counteract the narcotics to help these drugged babies to breathe . [3] There is considerable debate as to how epidurals affect the progress of labor, but they certainly affect a woman’s ability to get into a squat, which opens the pelvic plane by 20-30%; anyone can understand that this could affect the possibility of the baby’s fitting through the pelvis. Epidurals can lower the mother’s blood pressure so that the baby isn’t getting enough oxygen through the placenta; this can cause fetal distress and the need for an emergency c-section to rescue the baby . [4]

In addition to the specific dangers of individual obstetric interventions, hospital births suffer the effects of any form of institutionalized care. Perhaps the best-known risk of hospital birth is hospital-acquired infections. Those most susceptible to hospital-acquired infections are those with compromised immune systems, such as newborns. In particular, babies are born with sterile skin and gut that are supposed to be colonized by direct contact with the mother’s skin flora. If antibiotic-resistant hospital germs colonize the baby’s skin and gut instead, the baby is at high risk of becoming very sick from infections that are very difficult to treat. The overall infection rate for babies born in the hospital is four times that of babies born at home [5], and these infections are more likely to be antibiotic-resistant.

More people die every year from hospital-acquired infections (90,000) [6] than from all accidental deaths (70,000), including motor vehicle crashes, fires, burns, falls, drownings, and poisonings. An additional 98,000 people die each year from general medical error . [7]

Another obvious risk of institutionalized care arises from the piecemeal nature of the care. Because there are so many different kinds of personnel performing so many different procedures, there is a lot of potential for miscommunication about critical matters. In an astoundingly progressive admission of institutional shortcomings, Beth Israel Hospital published a paper [8] about a tragic miscommunication that resulted in a baby’s death. To their great credit, instead of covering up this horrible mistake, they used it as a wake-up call to revise their protocols, in an attempt to reduce miscommunication and increase safety. Unfortunately, other hospitals are slow to adopt the reforms of Beth Israel Hospital.

One of the most dangerous aspects of hospital care is that those providing most of the direct care (i.e. the nurses) are hierarchically subservient to those managing the care from a distance (i.e. the doctors). This kind of a power structure can prevent knowledgeable nurses from mitigating the potentially dangerous actions of the doctors.

Many people feel that the hospital must be the safest place to birth because of all the equipment they have. Well, the equipment is only as good as the people using it. In many hospitals, there are not enough Registered Nurses to cover all the patients, so they use Medical Technicians, who are trained to perform procedures but not necessarily trained to interpret fetal heart tracings. Most labors start at night, and women birthing second or subsequent babies often birth during the night. This is the time when the senior staff are home sleeping in their beds, because their seniority allows them to opt for the more desirable daytime shifts. A recent study confirmed that outcomes at births are worse during the night, because even the most sophisticated equipment is useless in the wrong hands . [9]

(For the record, many homebirth midwives now carry equipment that is as sophisticated as that in most hospital birth rooms. This includes continuous electronic fetal monitors and equipment for performing neonatal resuscitation if necessary.)

Institutionalized care also suffers from the economic pressures of running an efficient organization, regardless of how this might interfere with the normal process of labor and birth.

Sometimes doctors recommend pitocin without true medical necessity, simply to hasten the birth. This may be due to a need to free up a birth room to make room for other patients, or because the doctor has other responsibilities elsewhere. Stimulating labor artificially overrides the baby’s ability to space out the contractions if the labor is too stressful. This increases the risk of fetal distress.

Hospital staff have a strong bias towards confining the laboring woman to the bed and requiring her to push in a reclining position. This often puts the baby’s weight on the placenta or umbilical cord, possibly restricting the baby’s supply of oxygenated blood from the placenta. In contrast, upright positions put the baby’s weight downward, towards the open cervix and away from the placenta and umbilical cord, reducing or eliminating fetal distress caused by cord compression.

A rush to clamp and cut the umbilical cord within seconds after birth is one of the most dangerous hospital practices. This premature severance of the umbilical cord cuts the flow of oxygenated blood to the baby before the baby has established the lungs as the source of oxygen. Premature cord clamping also deprives the baby of the blood that would naturally fill the pulmonary vasculature as it expands in the minutes immediately after the birth. This practice is documented to increase the risks of neonatal hypoxia, hypovolemia, and anemia, thus increasing the need for blood transfusions. [10]

There is some very new research showing that placental tissue itself may be a rich source of pluripotent stem cells, in addition to the blood stem cells in blood drawn from the umbilical cord. [11] We do not yet know whether premature cutting of the umbilical cord halts the migration of pluripotent stem cells from the placental tissue into the baby’s body to repair damage from even minor birth trauma.

Perhaps the most egregious and unnecessary interference with the normal birth sequence is the separation of mother and baby immediately after birth. Even a ten-minute separation is too long during this critical first hour after birth – it prevents the natural nipple stimulation that increases the mother’s oxytocin to contract the uterus and prevent a postpartum hemorrhage.[12] Instead of baby-provided nipple stimulation, hospitals are now routinely using synthetic oxytocin by IV or injection after the birth to control bleeding.

Similarly, early cuddling of mother and baby stimulates oxytocin production in the newborn, thus raising the baby’s body temperature to help with the adaptation to the extrauterine environment. The mother’s body is the best warmer for the newborn. [13]

Because different personnel are involved in providing piecemeal care for mothers and babies, providers do not always see how their actions in one area may cause problems in another area. For example, because obstetricians are not involved in breastfeeding issues, they may not realize that cutting an episiotomy hampers a woman’s ability to sit comfortably in order to nurse her baby. Likewise, the pediatricians also are not involved in breastfeeding, so they may not realize that separating the mother and baby right after the birth in order to do a routine newborn exam also interferes with breastfeeding. Nursery nurses often do not seem to appreciate the importance of minimizing the separation of mother and baby and thus also unwittingly interfere with breastfeeding. They tend to ignore the World Health Organization’s recommendations to delay initial bathing of the baby until at least six hours after the birth, even though bathing causes the baby’s temperature to drop so dangerously low that they do not return the baby to the mother for an hour or more. [14] [15]

I emphasize the hazards to the breastfeeding relationship because breastfeeding is so vital to a newborn’s well-being, reducing infant mortality by 20%. [16] This is a huge health benefit, and hospitals should be taking the lead in tailoring their routines to support breastfeeding. But because the functions of caring for mother and baby are separated into the roles of maternity nurses (who care for the mothers) and nursery nurses (who care for the babies), sometimes the mother and baby are also physically separated. Most of the time, there are no lactation consultants in the hospital – they are often only available during weekday business hours. But babies need to be fed around the clock, and if a Lactation Consultant isn’t available to help a struggling mother/baby pair, it might become necessary to feed the baby artificial breastmilk with a bottle, which further interferes with successful breastfeeding.

Because the entire model of hospital birth is based on the birth as a medical procedure, hospital staff seem to miss the fact that they are interfering in a delicate time in a new baby’s life. Perinatal psychologists describe the first hour after birth as the “critical period”, during which the baby will learn how to learn and whether or not it is safe to relax and to trust the outer world. This has tremendous implications for mental health and stress-related disorders. [17]

There was a time when cesareans were acknowledged to be a risky surgery reserved to save the life of the mother or baby. Now even cesarean surgery has become almost routine. Some obstetricians and hospital administrators are advocating for a 100% cesarean rate as a solution to liability and scheduling problems that are inherent in providing maternity care. [18] Unfortunately, cesarean surgeries increase risks for the mother and for this baby. They also increase the risk for subsequent pregnancies, with higher rates of placenta previa and placenta accreta, and small but non-zero risk that a pre-labor uterine rupture could result in the baby’s or even the mother’s death.

When someone needs to be in the hospital and needs to be receiving medical treatment for a life-threatening condition, the risk-benefit tradeoff comes in heavily on the side of benefit.

But for women who are hoping to have a drug-free birth, it makes no sense to expose themselves to the infection risks associated with simply being in the hospital. Most people know that it is unwise to take a newborn baby out and about in public because of the risk of exposing the baby even to ordinary germs. It is even a worse idea to expose the baby to the antibiotic-resistant strains of germs commonly found in hospitals.

When a woman planning a homebirth needs medical care and care is transferred to a hospital-based provider, the phrase “failed homebirth” is often written in her chart, even if she goes on to have an outcome that is better than if she had started out in the hospital. I would like to propose the concept of a “failed hospital birth” as any birth where hospital procedures specifically cause more problems than they solve. When you consider hospital infection rates, surgical complications, and the damage to the breastfeeding relationship caused by routine separation of mother and baby, we might find that close to 95% of planned hospital births are failed hospital births. They failed to support the mother in an empowering birth experience to better prepare her for motherhood, and they failed to satisfy the baby’s overwhelming need and desire to enter and adapt to the outside world as nature intended.

Our society has an obligation to improve maternity care services as much as possible. Consider that the countries with the safest maternity care rely on midwives as the guardians of normal birth, reserving risky medical procedures for cases of true need. “In The five European countries with the lowest infant mortality rates, midwives preside at more than 70 percent of all births. More than half of all Dutch babies are born at home with midwives in attendance, and Holland’s maternal and infant mortality rates are far lower than in the United States…” [19] The United States needs to return to a model of midwives as the default maternity care providers, reserving the surgical specialists for the highest-risk patients. We need to educate pregnant women so that they understand that the choices they make about drugs during labor affect their baby, just like the choices they make about drugs during pregnancy. We need to offer women realistic pain relief alternatives to dangerous pharmaceuticals; warm water immersion during labor provides risk-free pain relief that many women find as satisfactory as an epidural. (Mothers who are uncomfortable with the idea of waterbirth can easily leave the tub to give birth “on land”, while still deriving tremendous comfort and safety benefits of laboring in water.) Hospitals need to develop new routines that protect mother-baby bonding and the breastfeeding relationship as if they are a matter of life and death, because they are.

Obstetricians would do well to practice according to the wisdom contained in the phrase, “If it ain’t broke, don’t fix it.” This means supporting healthy women with normal pregnancies in birthing at home if they choose and encouraging women planning hospital births to work with them to minimize interventions that turn normal births into risky medical procedures.

[For references, see gentlebirth.org/original or e-mail midwife@gentlebirth.org]

_______________________________
Ronnie Falcao, LM MS, is a homebirth midwife in Mountain View, California. 650-961-9728

1) Oxytocin for labor induction.
Stubbs TM.
Clin Obstet Gynecol. 2000 Sep;43(3):489-94.
2) Neonatal Resuscitation Textbook from the American Heart Association and the American Academy of Pediatrics, p. 7-3, “Narcotics given to the mother to relieve pain associated with labor commonly inhibit respiratory drive and activity in the newborn.”
3) Neonatal Resuscitation Textbook from the American Heart Association and the American Academy of Pediatrics, p. 7-3, “In such cases, administration of naloxone (a narcotic antagonist) to the newborn will reverse the effect of narcotics on the baby.”
4) A comparison of the hemodynamic effects of paracervical block and epidural anesthesia for labor analgesia.
Manninen T, Aantaa R, Salonen M, Pirhonen J, Palo P.
Acta Anaesthesiol Scand. 2000 Apr;44(4):441-5.
5) Outcome of elective home births: A series of 1146 cases.
Mehl–Madrona, L. E., Peterson, G., et al.
J. Reproductive Med., 1977 (5), 281–290.
6) http://www.cdc.gov/ncidod/dhqp/healthDis.html
7) http://www.cdc.gov/washington/overview/patntsaf.htm
8 ) A 38-year-old woman with fetal loss and hysterectomy.
Sachs BP.
JAMA. 2005 Aug 17;294(7):833-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=16106009&query_hl=112&itool=pubmed_docsum
Articles at:
http://www.boston.com/business/healthcare/articles/2005/08/17/a_babys_death_prompts_reforms_in_care/
http://www.medpagetoday.com/OBGYN/Pregnancy/tb/1559
http://www.rmf.harvard.edu/risklibrary/cases/r_dec2001news-C-TeamworkFlaws-incP.asp
9) Time of birth and the risk of neonatal death.
Gould JB, Qin C, Chavez G.
Obstet Gynecol. 2005 Aug;106(2):352-8.
10) Neonatal transitional physiology: a new paradigm.
Mercer JS, Skovgaard RL.
J Perinat Neonatal Nurs 2002 Mar;15(4):56-7
11) Stem Cell Characteristics of Amniotic Epithelial Cells.
Miki T, Lehmann T, Cai H, Stolz DB, Strom SC.
Stem Cells. 2005 Aug 9
12) MISSING
13) Randomised study of skin-to-skin versus incubator care for rewarming low-risk hypothermic neonates.
Christensson K, Bhat GJ, Amadi BC, Eriksson B, Hojer B.
Lancet. 1998 Oct 3;352(9134):1115.
14) THERMAL PROTECTION OF THE NEWBORN: A SUMMARY GUIDE from the WHO
15) The effect of bather and location of first bath on maintaining thermal stability in newborns.
Medves JM, O’Brien B.
J Obstet Gynecol Neonatal Nurs. 2004 Mar-Apr;33(2):175-82.
16) Breastfeeding and the risk of postneonatal death in the United States.
Chen A, Rogan WJ.
Pediatrics. 2004 May;113(5):e435-9.
There’s a newish book, “Impact of Birthing Practices on Breastfeeding” by Mary Kroeger
17) This statement is a summary of a number of different books, papers, etc. The two key books for someone interested in this topic are:
“The Magical Child” by Joseph Chilton Pierce
“The Scientification of Love” by Michel Odent, MD
There’s a group of psychiatrists dedicated to the topic:
Association for Pre- & Perinatal Psychology and Health
http://www.birthpsychology.com/
Summary of key points:
http://www.birthpsychology.com/violence/odent1.html
http://www.birthpsychology.com/primalhealth/primal6.html
This last article contains numerous additional research references.
18) Who is responsible for the rising caesarean section rate?
Usha Kiran TS, Jayawickrama NS.
J Obstet Gynaecol. 2002 Jul;22(4):363-5.
http://forums.obgyn.net/forums/ob-gyn-l/OBGYNL.0006/0219.html
Phelan, J. P. (1996, Nov.). Rendering unto Caesar cesarean decisions. OBG Management.
Cesareans: Are they really a safe option? by Henci Goer
Bruce Flamm: “I have heard some doctors say that all women should have babies by C-section, that vaginal births are archaic. ” from Are Women Having Too Many C-sections?
19) Midwives Still Hassled by Medical Establishment,” Caroline Hall Otis, Utne Reader, Nov./Dec. 1990, pp. 32-34

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