Monday, December 10, 2007

Yet another reason why women need to keep themselves informed and not rely on what "others" tell them...

I am DISGUSTED!!!!!!

I came across a blog that refers to the C-section rates at different hospitals, by state. Knowing that the estimated C-section rate is over 30% this year (get that, one THIRD of all pregnancies ending with a c-section...I'm sure they were ALL necesary and therefore the safest choice for the mother and baby right?), I was curious, so I took a look at some of the hospitals I'm familiar with.

http://www.calhospitalcompare.org/profile.aspx?h=266&c=7

One imparticular is the hospital I was born at. (See link above) Since I was born there, they have added a "State of the art" maternity wing and are heralded by word of mouth for having the best care available. Again, I was curious on how that translated. I fully expected the C-section rate to be higher than I would like, say 5-10%, but it was24%. Sad but true.

Yet this is not what disgusted me. With its superiour word of mouth, you'd expect it to be a great place to give birth, and by great place I mean healthy for the mom and the baby, and I guess for those who are there to visit too. And people think so. It has a Superior hospital rating from those who were there.

But look at the safety factor. Yes, they have a neonatal ICU, which is great assuming that your baby is going to have (or will likely have) complications at birth, but check out the patient safety piece. They are BELOW average in appropriate use of antibiotics, only average in the appropriate timing of antibiotics, and got a POOR rating on the appropriate discontinuance of antibiotics. Now, we don't know necesarily what this means, if they are more conservative in these areas or more liberal, but you'd expect a hospital with such a great reputation to have a much more better safety factor wouldn't you?

Not necesarily, or so I've learned. The truth is that people believe what they are told. People believe that because the billboards and websites show a gleaning white facility that the doctors and nurses must absolutely know what they are doing and are providing the safest location possible to give birth. What they don't know is that infection, particularly at a hospital where people are going to because they are ill and are in desperate need of care (that is what a hospital is for, right?), well, it happens! No matter how much the facility tries to keep things sterile and safe the environment by nature will always pose a risk to patients. Particularly those patients who are new to the world and haven't built up an immune system yet.

Now for those who are in dire need of medical care because they too are sick (again, thats why you go to a hospital correct? You don't go just because everything is fine?, I don't anyway...) then the benefit theoretically outweighs the risk of infectionm, or that is the goal.

So why do perfectly healthy mothers who by all indication are giving birth to perfectly healthy babies choose to subject themselves and their babies to the conditions where they have such an increased risk for harm? Why do mostly healthy mothers who by all indication will give birth to normal babies choose to subject themselves to it?

Because thats what they are told to do. Think about it. Where did you learn to give birth/prepare yourself for birth/be preganant? Probably from everyone around you. You saw that people go to an OB (that is the most common method of receiving pre-natal care), so you expect that when you get pregnant, regardless of your health/previous experience/etc. you too will go to an OB. But the truth is that OB's are trained surgeons, trained to diagnose illness and hardships. Again, this sounds great, until you learn that there are simple things you can do on your own to preven those illnesses and hardships that your OB will never tell you about. For example. Have you ever heard of preeclampsia (SP?) . I should probably do the research on this again, but when I did before it showed that if you eat 80-100 grams of protein each day the risk of developing pre-eclampsia drops to virtually none. Crazy huh? Bet your OB didn't teach you that one! Instead, they are trained to watch your "symptoms" throughout your pregancy and wait for the inevitable blood pressure increase and weight gain until you develop the condition, and they act according to what they've been trained to do....operate. Take that baby out. Afterall, at that point the only thing you can do to stop the preeclampsia is to deliver the baby. Ok, so maybe they induce if they think you and the baby are up to it, but the point is that *its possible* none of that would have to happen if you had a bit of preventative care you should have received in the first place. (edited to add "its possible"...I don't mean to indicate that ALL cases of preeclampsia will be avoided with diet)

See, in the past, learning from others was a good thing. We learned from our mothers, our grandmothers, aunts, sisters, and other strong women on how to be a healthy pregnant mommy and give birth to healthy strong babies. 100 years ago, 200 years ago...for however long women have been giving birth they've done so and managed to continue population growth without a 30% c-section rate. They did preventative stuff, like walk a lot and rest a lot. They learned to move around during labor and give birth in a variety of positions that let mother nature (gravity) help. They learned that birth is messy and hard work and that you needed your energy to do it so you needed to eat as you saw fit and drink plenty of water. They learned that sometimes babies take a long time to cook, some shorter, but the baby will come when its ready. They learned that you needed the support of your family, those thtat have gone before you, your mother, your sisters, etc. And, they learned that birth isn't always successful. So they tried new things, and experimented and found other new things to help with successful births.

And somehow we've gotten to the point where it is today, where mothers and doctors for no other reason than the desire to have a perfect schedule decide to poke and prod at a mother and baby, forcing the contractions to start when the baby wasn't quite ready, ripping a hole in the protection the baby needs to stay alive and infection free, give the mother somtehing to help with the pain caused by all the equipment and meds she's been hooked up to which will make her crash as soon as the baby is born rather than nurse like the baby will naturally want to do for bonding, comfort, health, etc...and then when this all doesn't work because the baby doesn't come fast enough to fit that tight schedule and the baby is starting to become "stressed" and is now in danger (but wasn't just a few hours ago when all was fine and dandy in the untouched womb) the doctors rush mommy to the operating room, hopefully daddy can get ready in time, where she has little to no involvement in the birth of her baby, she can't see it, she can only feel pressure where people are doing something that just isn't "natural", and hopefully she will be able to get a quick glimpse as the doctor throws the baby in the air over the curtain and says "Say hi to your baby" like its a new puppy, then rushes him/her off to the NICU because the baby isn't breathing quite right and is sluggishly responding and, maybe there is a problem with the lungs.

And its all completely "normal"...afterall...birth is a dangerous, complicated procedure where skilled physicians must monitor the mother and baby at all times to ensure a healthy, delivery (like the one described above).

Outrageious? Not so much. Start looking around and listening to the birth stories your friends are telling you. Its all the same..."we went in for an induction...the baby wasn't responding...the baby's heart rate was elevated (or dropping)....failure to progress...c-section..." at least for 1/3 of the birthing population this year.

This isn't to say that ALL c-sections are unnecesary or preventable, or that the mothers would rather sacrifice the health of their babies for their comfort and ease of scheduling. Some mothers need c-sections for valid reasons (and everyone has a different definition of what a valid reason is). What is clear is that some of them could have been prevented if they only knew...if they only knew what they were really capable of rather than listening to the limitations others place on them.

Maya Angelou said (not a direct quote, or maybe it is, I don't know) "I did what I knew to do...when I knew better I did better". When are we as a society of women going to get together and "know better"...not in the scientific way of measuring facts and figures and misusing statistics to bring a lawsuit blaming someone else for the injury to our children (or ourselves) at birth, but in a way that we will know what truly is normal, healthy pregnancy and birth and that we will encourage each other to do what is truly best and make it through a healthy "normal" delivery that involves little to no mechanical interventions, few strangers, and lots of love and attention, true CARE for the mother and baby (and rest of the family)? When are we going to stop listening to the noise coming at us from all directions and listen to what God intended this to be?

Check out some links for some other hospitals:

Near the one above:
http://www.calhospitalcompare.org/profile.aspx?h=247&c=7
http://www.calhospitalcompare.org/profile.aspx?h=136&c=7
http://www.calhospitalcompare.org/profile.aspx?h=276&c=7
http://www.calhospitalcompare.org/profile.aspx?h=169&c=7

In the DFW area:
http://www.dshs.state.tx.us/THCIC/Publications/Hospitals/iqireport2005/query1.asp?volume=&procedure=&condition=&utilization=Primary+Cesarean+Section+Delivery&area=Dallas-Fort+Worth-Arlington+MSA&year=2005&sort=Hospital+Name
http://www.dshs.state.tx.us/THCIC/Publications/Hospitals/iqireport2005/query1.asp?volume=&procedure=&condition=&utilization=Vaginal+Birth+After+Cesarean+%28VBAC%29%2C+Uncomplicated&area=Dallas-Fort+Worth-Arlington+MSA&year=2005&sort=Hospital+Name

10 comments:

The Duece Crew said...

I love how you put your opinions out there....You are informing the uninformed. I put some opposing opinions on my blog. I enjoy the controversy.
http://mamadoingtheimpossible.blogspot.com

leigh

Anonymous said...

Your information about being able to prevent preeclampsia through diet - namely protein - is absolutely incorrect. I fear your information may lead mothers who develop this to believe that preeclampsia is their own fault for having a poor diet. A am a mother who suffered from preeclampsia and HELLP and lost my twins and nearly my own life in 2003. It was not because of a lack of protein.

Anonymous said...

Another comment - please check out www.preeclampsia.org for the most up to date and correct medical information.

Anonymous said...

I came across your blog b/c of a google alert on preeclampsia. While I agree with some of what you are saying about not birthing in hospitals, for many of us with no prior health problems, birthing at home could have meant dire consequences for mom or baby. I developed preelampsia close to term and was watched closely and induced -- I was closely monitored during the induction process (which of course was the only way to cure my disease -- induction or c section) -- my son was born with something called TTN (transient tachypnea of the newborn) -- it did not and would not have shown up in early screenings or ultrasounds. Simply, his lungs just weren't ready for real air yet -- again he was close to term, and the induction had nothing to do with his problem. Many term babies (not induced) have the same condition -- they just do not adjust well from womb to air. Anyway, he needed oxygen and antibiotics (he had developed a fever). Had we not been in a hospital, both myself and my son could have poor outcomes. My blood pressure was closely monitored post partum, and indeed shot up to well above stroke level and had to be treated with medication. Had we tried a home birth, I fear that things would have not turned out well for us. While I agree that for some moms, hospitals aren't necessary -- unfortunately, you don't know which moms those are until the birth process is over. Things happen that we cannot predict.

As an aside -- and my real reason of commenting to you (I've never responded to a blog before) -- preeclampsia is not a condition which can be prevented. Believe me, I've done the research -- as I am currently trying to conceive another child I want nothing more than to avoid that terrible disease. I'm not going to get into all the research here, but a high protein diet can actually be dangerous for a woman who develops preeclampsia. It absolutely does not prevent the disease from happenning, but can make it worse. If you're interested in learning more about that particular disease, go to www.preeclampsia.org -- there are stories, expert opinions, facts, and theories about this very dangerous and poorly understood disease. The women that paricipate on those message boards could/would have died if they had gone the non hospital route -- and many of their babies would not have survived with out high level NICUs. (Many lost their babies anyway) --

I am certainly one that finds flaws in our healthcare system, and many times hear/see stories about healthcare gone wrong. Unfortunately, for me and many of the women I know -- healthy moms and babies are all we care about. And if the chances are higher that we all come out alive when under the care of a watchful OB and hospital -- that is the choice we have to make.

Marie said...

About the preeclampsia reference...

I looked at the site (everyone, please do so for yourself) and found nothing to dispute my claim other than people who had preeclampsia and do not agree with them.

Again, what I said was that the protein would VIRTUALLY eliminate the chances of preeclampsia...I specifically put that in there because I don't think that anything with our bodies is every absolute and there will always be someone who comes up with a case out of nowhere that disputes what you have to say, which is why science is the way it is....analysis of data and statistics.

In any case, this is not the point. The point was (and still remains) that you rarely get all of the information when visiting a doctor. You will almost never get all sides of an issue. Doctors are busy people and have to "dumb it down" for the rest of us who haven't been to medical school and don't have all the facts (by the way, neither does ANYONE with a higher education degree, including a medical doctor). We only get what they have decided to practice, unless you bug them and ask the tough questions.

Here's another example. In many states erythromicyn (sp) is applied to the eyes of a newborn baby to prevent infection of the eyes. This was started to prevent infections leading to blindness that was caused by the transmital of STD's during vaginal delivery. It is now MANDATORY in many states and if not the state then the hospital that the baby receive the antibiotic. Most mothers are told that the baby receives the application to prevent infection. Infection? You mean my baby could get an infection? Sure! Apply away....I don't want my baby to be blind...

But the consequences are limited bonding in the first 24 hours (some of the most critical hours for bonding) and successful breastfeeding is hindered when the baby's vision is blurred temporarily while the application is in place.

If I were given the choice...blindness or the difficulties, clearly (I think most moms would) choose the difficulties.

But wait, I was never told about the STD thing...it wasn't critical information right? NOPE! I don't have an STD...I was tested before pregnancy, and during pregnancy (routinely) and have been in a monogamous relationship since then. If I had known and was worried I could have been tested several more times just to make sure my husband wasn't unfaithful or something. Myself and my baby don't need that antibiotic! It was a choice we made. I had to sign a waiver preventing it and had to insist it wasn't given to my baby. I saw the risk of complications much higher than the risk of infection (in my case) because I had the facts. THere are other procedures I allowed during my birth either because I wasn't enough informed about or because despite what some people claimed I felt the risk of complications outweighed the risk of whatever side effects the procedure would have.

This is what I'm fighting for.

Marie said...

Anonymous-
I want to make sure that I tell you how sorry I am that you experienced what you did. Losing your babies was tough. I'm sure of it. I had a miscarriage before I had my son and even though the situation was different I'm sure I know at least a small amount of the pain you go through.

Women who lose a child will blame themeselves, its a fact. Ask any mother who has lost a child and she (at least initially) wondered what she could have done to prevent it. The bottom line is that sometimes it happens. Its cruel. Its painful. It sucks. And there are no words that can make it better.

Nevertheless, we try as much as we can to do the best thing for our children (and ourselves) to keep us all healthy. I would suspect that even though your loss was not attributed to a lack of protein you still would try to eat healthy in pregnancy and do the best for your child. There is evidence that high protein helps pregnancy and very little to suggest it harms it. Therefore, I will stick with what I've said.

All that doesn't matter though when someone goes through pain. I pray for comfort and healing as you continue in your journey of life. I also hope that you have the opportunity (which I'm sure you have and will continue to have...thats how it works) to help women who go through loss to heal and get past the self-blame phase.

Marie said...

Ah...so that's how I've gotten a few new readers...usually its just my friends :)

I'm sorry that you experienced what you did. And I hope you conceive quickly with a healthy pregnancy in the future.

I believe that almost all conditions have a preventable nature. So arguing about preeclampsia would be no different. That being said I also believe that almost all conditions have a random component to them...this life is just not perfect and crappy things are going to happen, whether we deserve them or not.

I trust that you have seen evidence about protein being harmful...I have not seen "evidence" for it. And, I'm hypercritical of what many claim to be evidence. As a training researcher I see how lame the researrch process (and the conclusion process) is...we could probably look at the same study and come up with completely different conclusions.

I'm not here to argue about protein and preeclampsia...let it be known here and now that everyone should do their own research about it. There are reputable people on both sides that will say one thing or another...but the bottom line truth is that the debate will be blind to most women who simply go to the OB and don't do any other research on their own. They won't have an idea that this controversy exists, so they can't make a good decision on it. I bet there are a ton of women who experienced preeclampsia who think "I wonder if that would have helped me"...that isn't a bad thing...its when they blame themselves that it becomes a problem. I am not here to say that its all your fault...I'm also not here to say that there isn't anything you can do about it.

The truth is I DON'T KNOW....none of us do.

And, as for homebirth. I for one am not a fan. Well, I probably won't be having one myself. If someone wants to...by all means go for it! My personal comfort level at this point in my life is not for an UC either. When (if) we are able to have another child we are still deciding whether we will have with the OB in a hospital or with a midwife in a birthing center, or something else. I don't know yet.

Anonymous said...

I posted earlier about my own experience with preeclampsia and my son who had TTN.

I would like to clarify my point about PE and high protein diets. You are correct in saying that research can be read many ways. And I totally agree that most things that happen to us have a preventable element to it. Unfortunately, for PE specifically, nothing preventable seems to work across the board. Some things have seemed to help some people, but in randomized trials, nothing works across the board. There are many things that make the disease difficult to study -- one is, most people just don't get PE. So figuring out why they didn't get it is difficult. There are also many things that can lead to PE -- chronic hypertension, clotting disorders, etc -- not just one cause, therefore not just preventative.

The fact is, high protein diets HAVE been studied for preeclamptics -- and the current data says it doesn't help. So to state in your blog that many people read (today people searching for answers on preeclampsia) that high protein can virtually prevent it is irresponsible. Obviously, anyone who would take the advice of a non medical professional isn't making great decisions, but nonetheless -- to state something that has no current research to back it up is probably not the best thing to do.

I will sum up though by saying I completely agree with you about the medical "industry" not fully disclosing all options available to women as being even more irresponsible than your statements on a blog. You are correct about doctors not giving us all the facts and us having to be in charge of our own health care. I applaud your efforts in researching things for yourself and making informed decsions. I do the same thing. Even more so now that I have suffered from a disease that I was given little to no information on by my health care providers. But the fact is -- in many cases -- emergencies specifically, the doctors are still saving our lives.

In other words -- I agree with a lot of what you have written here. I do, however disagree that we can prevent bad things from happenning to us by some simple thing such as a diet the doctors just happenned to forget to tell us will work. It's probably not a great idea to take medical advice and care out of the equation.

amelia said...

have you read marsden wagner's Born in the USA? i just finished it and loved it! i think you would appreciate his honest look at obstetrics here in the states...

Marie said...

To my anonymous friend...

Thank you for your clarifications.

I am not at all a fan of taking medical care out of the equation. I do, however, believe that we as a society need to be more educated about reproduction. I don't believe that doctors should be looked to as the end all of knowledge and that what I hear from my doc in the 15 minutes I see her at my appointment will be the ultimate in prenatal care knowledge...it just isn't possible. But as a society we sit and believe that if all we do is listen to our doctors they will tell us everything we need to be healthy before, during, and after pregnancy, then all will be well. And if it isn't, then it must have been some tragic situation that couldn't have been prevented, because, after all, if my dr could have prevented it then she would have right?

i do nt and will never say that nutrition alone will promise a healthy preganncy. That would be irresponsible as you've claimed. I don't think anything can guarantee a healthy pregnancy or birth. Nothing. There is no guarantee that because I had a great birth experience last time that I will have another one next time. I do believe that we can prepare ourselves for the best possible outcome by knowing as much as possible and by doing as much as we can to prepare ourselves for what we face, nutrition included. We can argue till we are both blue in the face about preeclampsia and protein/nutrition, but the truth is that promoting good nutrition will never be a bad thing. Equally so, promoting that a woman should be educated on as many theories about pregnancy and birth as she can will never be irresponsible.