The current issue of The Utne Reader has some excellent articles about midwifery as the answer to the current crisis in maternity care in the United States. For a developed nation, we have some startling mother and infant mortality rates and the reasons pretty much come down to the obstetrics-oriented culture of intervention in childbirth. While all of the academic studies in medical journals, etc. show that midwife-assisted births are safer in uncomplicated pregnancies than births attended by an OB, you rarely will hear that from OBs. While OBs can get plenty of business from the high-risk pregnancies that need them, they still seem jealous of midwives and tend to do things like lie about what good practices are and make sure midwives do not get privileges at hospitals (something the OBs have done in Austin).
I myself have seen both sides: I have experienced how the pitocin and epidural-laden attentions of an OB lead to a stalled, more dangerous labor and then how different it can be with a patient, woman-centered, supportive midwife. It is really, really different. Really different. My sister will be having her second child in April and I can tell from listening to her that she is headed for the difficult, intervention-laden sort of birth that she and I both had with our first deliveries. Now that I know how different and joyful it can be, that makes me sad. You really can't talk to people about it, though. Regardless of what the research says, most people still think of midwifery as hippy-dippy nonsense and they won't listen. It will take OBs getting on the bandwagon before U.S. births get safer and I don't know what is going to make that happen. Maybe the HMOs. I hope so.
2 comments:
We also need health insurance to cover midwifery. I think that had I had a midwife, there would have been a good chance I'd have had to go to the hospital anyway, but I also think people would have taken me more seriously when I kept saying I thought the baby was "sunny-side up."
Yes, we do. I don't even just mean direct-entry homebirth midwives, though - I'm not that crunchy myself. I had a nurse-midwife in a hospital (health insurance did cover it because she worked under the supervision, so to speak, of an OB), and it still was a totally better experience than my first birth. I think it might actually be health insurance companies that fix this one as crazy as that sounds because they are cost-conscious and OBs and their unnecessary interventions and the consequences of those interventions cost too much. Nurse-midwives like mine are being driven out of hospitals by OBs, though, and that leaves women with fewer choices, which I think stinks.
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