Misinformation

Many times when researching certain topics, people’s bias will get in the way of their honesty, and many times they don’t even realize it. It’s a political season, and while I’m not wanting to get into politics here, I think it’s pretty obvious that certain people in the media prefer certain candidates–you can tell it by the pictures they choose, the audio clips they play, and what becomes “news.” Think back to Howard Dean’s 2004 “victory yell” to rouse his supporters, and how that was played ad nauseum, and basically finished his Presidential run that year, because it made him look slightly off-balance. (Though I was and am no Dean supporter, I think the media screwed him. Had it been someone they liked, it might have aired once but they would have found other things to talk about; or they might have talked about how strong and powerful the “yee-hah” sounded.)

When it comes to researching your options for birth, there can be similar slanting done, so it is important that you fully understand all the risks and benefits of anything. For instance, the medical establishment will play up the fears of “something going wrong” during a home birth. Some will even say that babies are statistically twice as likely to die during a home birth than during a hospital birth. This is misinformation. There are some studies that looked at home birth that did find such statistics, but upon closer inspection the conclusion is inaccurate. One study was in Australia, but included a lot of women that were not low-risk. Another study was in Washington state, and looked at birth certificate data, and said that all births that occurred outside the hospital from 34 weeks onward were “planned home births.” Upon closer inspection, many of these births were planned hospital births, but the woman didn’t make it there on time; others were unattended by a midwife, so should not have been included. One large, well-designed study of midwife-attended home birth in North America does exist. It included all home births in the year 2000 attended by certified professional midwives, over 5,000 births, and determined that there is a similar infant death rate in these home births compared to hospital births, while there was a much lower rate of interventions (including episiotomy, forceps- and vacuum-assisted births, and Cesarean sections). Also, the rate of premature birth and low-birthweight babies was much lower in the home-birth set than in the hospital-birth group. One problem that existed in the study (which the researchers admit in the original article) is that the year 2000 statistics were not comparable because of lack of information on certain issues (for instance, most of the home-birthing set was non-Hispanic white, and the national stats didn’t differentiate between sub-sets of race; also, there was a higher rate of women who were older and/or had had numerous pregnancies in the home-birthing set, etc.). You can read their further explanation here.

When talking about various birth interventions (use of IVs, epidurals, C-section, Pitocin for inducing or augmenting labor, Cytotec [a.k.a. misoprostol or “miso”] for inducing labor, use of forceps or vacuum, continuous fetal monitoring, etc.) these same questions and problems arise. For a more detailed look at each of these interventions and what the medical literature says, I would encourage you to read Henci Goer’s book The Thinking Woman’s Guide to a Better Birth. One problem that I have with looking at certain studies and statistics for these interventions (aside from the fact that some of them are almost mind-numbingly boring or use confusing jargon :-)), is that when interventions are used, it is with the assumption that they were necessary or at least beneficial. I do not assume that. Sometimes they must be, but other times I would definitely question the necessity. For instance, looking at inducing birth, many studies might look at two or more different ways of induction, and seeing which is the most effective and/or least harmful to the mother or baby; but these presuppose that induction is a good thing. It can be sometimes; but I do believe it is over-used today, and a lot of mothers and babies are paying the price. Henci Goer critiqued a study on “early vs. late epidurals” which apparently showed no increased C-section risk if an epidural is given early in labor. However, one of the main criticisms she has with the study is that there was no “control group” of women who did not have any pain medication at all–the two groups in the study both got drugs, only the route of administration was different. And, the C-section rates for the two groups were around 17% and 20%, while most planned home-birth studies demonstrate a C-section rate of less than 5% (some as low as 1-2%).

It is imperative that you know the real risks of things that happen in labor and birth. There is a lot of misinformation out there. Some people still say that drugs given to women in labor do not reach their babies, or do not affect them. The truth is, everything in the mother’s bloodstream gets to the placenta, and gets into the baby’s bloodstream. Epidurals can cause a sudden drop in maternal blood pressure, which can send the baby into fetal distress, necessitating an emergency C-section. There are many more risks to all of these interventions. My point is not to scare you, but to inform you, because you may not hear it otherwise. When the procedure’s benefits outweigh the risks, then it is worth it; but many procedures are done routinely, when there is little benefit. When a procedure is offered to you, will you know enough about it to truly give informed consent?

4 Responses

  1. Hi!
    I found your blog through another I read and just wanted to say I really enjoy your posts.
    As a Bradley Method instructor for over 15 years I can really relate to your newest posts. Misinformation about childbirth is so prevalent and I hear it constantly in classes. Many couples come to class totally clueless about birth, not that I blame them, but it’s their doctors that aren’t informing them, or misinforming them as it may be.

    Anyway, I would like to link you to my blog if that is okay and see if you would link me to yours.

    Thanks!

  2. I read this post after you commented on my blogpost about caesareans. Thanks for your comments; it’s really good to get such detailed responses. My one experience of birth so far was thrilling and beautiful (though painful) and I love to talk about birth. I believe it’s immensely important to publicise the issues you discuss because so many women have experiences very far from beautiful.

    The information women are given and not given makes a huge difference to how they plan their births. Here’s my personal angle, for what it’s worth. I was down for the standard hospital package, mostly because when I got pregnant I had to make the decision at an early stage – because of competition for hospital appointments – well before I had done much research of my own. My antenatal appointments were split between the hospital and my GP. I was very happy with most of the care I got from the GP practice, but I am quite angry about the way I was steered into predictable channels at the first consultation. First the doctor (not in fact the woman I saw for the rest of my pregnancy) told me 25% of pregnancies end in miscarriage, an even higher figure than the one I’d read and one that got me superstitiously scared so I didn’t dare think about how I would actually give birth until that hideous, suspenseful first trimester was over. Then she said: ‘Do you want to go public, semi-private, or private? You won’t want a home birth, will you.’ SO the expectation was that I’d have a hospital birth, and the only choice was about how much to pay for it. Home birth was closed off at the start as not a realistic possibility. It was only through my yoga classes that I found out that there might have been a third option, the midwife-led Domino scheme offering quick release or a home birth managed from one of the maternity hospitals. By the time I came to have my baby, my reading and the experience of friends had led me to believe that for an uncomplicated pregnancy like mine a home-birth would have been the best plan, and I was trying to persuade myself that I wouldn’t have been able to relax at home given we don’t own our flat and that I would be fine in the hospital. In the event, of course, I had my baby in the flat after all.

    Most pregnancy groups and classes (at least the ones I looked at) don’t take women until the second trimester, when care decisions are already made. Maybe something could be done to set up better non-medical networks for women in early pregnancy? I suppose there’s always the internet forums, but my experience is that they were a source of horror stories: I learned to stay off them…

  3. Dot, I know there are some pregnancy classes that do take women early in pregnancy–Hypnobabies and “Birthing from Within” come to mind; but I know they are fairly small (compared to Lamaze & Bradley) here in the States, and am not sure about Ireland. By the time I found out I was pregnant, I had already read enough birth stuff (when my sister and friend were pregnant) to have decided that I would have a home birth, so that was already determined. From then on, I just sort of stayed in a little “circle” of positive birth places–for instance, reading books that my midwife or Bradley instructor recommended, or books that “other people bought” on Amazon after reading other recommended books. You can check out some other people’s blogs and other websites listed on my blog, and then explore others of their links, and you will be able to find a wealth of positive birth stories and home- and natural-birth information. Yahoo email groups might also have some lists that are centered in your corner of the globe. Since these are generally internet sites, they are not confined to America (although most of the ones I am on do focus primarily here). You might be able to get on some good pro-normal birth lists and ask for references to European sites.

  4. Hi,

    We are on 2 kids and about to do number 3 – the other 2 in water so birthing positions interesting to look at!
    Is there a place on your site where you review products for child carrying?

    This is something we have just bought to market:

    [url=http://www.obi-baby-carrier.com/]Obi baby carrier[/url] and I am keen to get feedback from professional parents on it.

    Best Wishes,
    Martin Watts

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: