Did you know caesarean’s peak at 4pm and 10pm? Oddly the same time doctors’ shifts typically end. ~Dr. Michael Brodman, Chairman, Dept. of OB/GYN, Mount Sinai Hospital referenced this study in the film The Business of Being Born.
I am starting the process of picking my OBGYN or Midwife or Both and I want to schedule my preconception visit within the next month or two. I think it’s safe to say at this point I clearly want a natural delivery and that I don’t want any interventions unless, well, absolutely necessary. So let the research begin. The question, “Where is the safest place and who is the safest most qualified person to delivery my baby?”
Fact #1: Where?
- According to the 2007 Unicef Innocenti Research Centre Report, of all the developed nations, you don’t want to have your baby in America. “America’s negative maternal and child health outcomes relative to other developed nations ranked [us] 41st in maternal mortality, 29th in infant mortality, and 30th in preterm births.” Based on the report by: Michael C. Lu & Jessica S. Lu LINK
Fact #2: Who?
Check out The Business of Being Born, it’s on-demand on Netflix, best movie yet!
- Midwives only attend 8% of births in the US whereas they attend 70-80% in the other countries ahead of us in the pretty blue Unicef chart above.
- The number of Home Births in the US is only about 0.65% of all deliveries. Whereas the Netherlands, the leading country on infant mortality has 30% of their births at home with a midwife.
Fact #3: When?
- November 2009 CDC NCHS Data Brief says: “The percentage of preterm births in the United States has risen 36% since 1984… In 2004, 1 in 8 infants born in the United States were born preterm, compared with 1 in 18 in Ireland and Finland. Preterm infants have much higher rates of death or disability than infants born at 37 weeks of gestation or more, so the United States’ higher percentage of preterm births has a large effect on infant mortality rates.”
- Many American doctors induce an early labor or schedule a cesarean section before 37 weeks. In 2006, labor was induced in nearly 16 percent of preterm births and 36 percent were C-section deliveries. NPR
Fact #3: Why?
- African-American babies are far more likely to die than white ones, which is often taken as evidence that poverty and lack of health insurance are to blame. That’s entirely plausible until you notice another racial/ethnic gap: Hispanics of Mexican or Central or South American ancestry not only do consistently better than blacks on infant mortality, they do better than whites. LINK
So, if money isn’t a factor, then why are American women and our babies worse off? Is it the growing obesity epidemic? Is it our lifestyle? Yes, I think those things can greatly affect fertility and infant mortality. However, I also think an entire medical infrastructure geared towards interventions might be playing a key role as well.
I am going to look into having a midwife perhaps along side an OBGYN. Whether it’s at home, a birth center or in a hospital is still up in the air. But, I think we have to rule out a home birth because it’s not covered by our insurance. I am leaning towards a water birth in a birthing center - just the idea of it relaxes me. I am really fortunate to be going through this process in Portland, Oregon. This state is much more accustom to natural births, so if we go the hospital route it will be easier to do the natural thing with the support of the staff. But it will all come down to whether or not I am low risk. Fingers crossed.
My plan: Interview several OBGYNs and Midwives to figure out who will be my birth attendant. Second interview for my birth educator, these must be two different people not affiliated with the same practice. It’s like creating a built-in second opinion. I will be using a certified Bradley instructor. Bradley students have a 90% success rate of having a completely natural delivery! Ask your birth educator what their success rate is. Tour hospitals and birthing centers to find a place to labor!
