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?