In response to Aiyana Gregori's questions regarding her preceptor's routine
practices [Issue 2:10]:
It sounds like your preceptor has the right attitude toward birth, at least
in theory, but some of his routine practices seem to contradict his basic
ideals about birth being a biological process and his role being only to
allow women to birth in peace.
He seems to have a reasonably low c-section rate, but what about other
interventions? Does he do a lot of forceps or vacuum deliveries,
episiotomy, etc, due to women who are induced when neither their bodies or
babies are ready for birth? Induction causes a higher incidence of
instrumental delivery, which raises the risk of infection (according to
Judy Barret Litoff, "American Midwives--1860 to the Present" (Greenwood
Press, 1978), pp. 108-113), usually due to failure to progress. Well,
that's because the baby was not yet ready to be born! There is no reason to
induce a healthy woman with no medical indications other than 40 weeks. The
due date is only an estimate. And if the average is 40 weeks, there will be
some women who go longer. Forty-two weeks or even 44 weeks is not dangerous
in and of itself; some babies take that long to prepare for birth. The
placenta does not deteriorate just because the pregnancy has gone past the
estimated due date. As long as both mom and baby are doing well there is no
reason to induce at 40 or 41 weeks.
There is also no reason to do a c-section simply because the baby is
estimated to be 10 pounds or more, besides the fact that prenatal
estimations of weight are notoriously inaccurate, often by a pound or more,
even with the use of ultrasound. Shoulder dystocia has more to do with
positioning of babe and mom than birth weight. Many ten pound babies are
born vaginally with no complications at all. The birth attendant's ability
to loosen a stuck shoulder is important too, and something that must be
learned. And always consider the fact that by having a c-section, the
maternal death rate is up to 16 times greater than a vaginal birth
(according to the British Medical Journal).
He does seem to be on the right track, but if he really believes that birth
is a natural process, he needs to let it be that. And let birth happen in
its own time and its own way. There are lots of studies that show the
increased risk associated with these interventions; it would do you good to
find them so that you have all the facts at your disposal to make a
decision. Many are available on the Internet and very easy to find. The
British Medical Journal is a good place to start (www.bmj.com).
-Michal Lynn Moyer, aspiring midwife
Reprinted from Midwifery Today E-News (Vol 2 Issue 12 March 24, 2000)
To subscribe to the E-News write: enews@midwiferytoday.com
For all other matters contact Midwifery Today:
PO Box 2672-940, Eugene OR 97402
541-344-7438, midwifery@aol.com, Midwifery Today
|
|