I just watched “The Doctors” on birthing. They called the show “The Alternative Birthing Debate”.
I thought I’d live-semi-transcribe it for you. Some of this is quickly paraphrased, but the quoted material is not misquoted in ways (I hope) that misrepresent the speakers. Typos and grammos probably abound.
I could have point-by-pointed it, but I thought it might be more fun to do this interactively. Your challenge, as the Hoydentariat, is to come up with more than a dozen things wrong with this show – factual errors, feminist headsplosions, whatever you like – by morning. I reckon if we try, we can get to two dozen. Number your critiques.
~~~
Opener: “Homebirth: Is it safe? What are the risks? And should every women have the right to do this birthing method at home?”
We know that the show is all about health and safety and not at all about the medico-industrial complex spinning cash by playing on women’s insecurities, because the show opens with an advertorial for CO2 laser skin resurfacing for wrinkles. The laser resurfacing is demonstrated on an eggplant, and they promise us a later before and after on a 48 year old woman, Gay, complete with Queer-Eye style fashion makeover.
The panel consists of a male doctor in a white coat, a white male doctor in scrubs, a black female OB (Doctor Masterson) in civvies. There is no midwife in sight.
“All of you know about homebirths, where moms, sometimes with midwives, are delivering babies – sometimes in a bathtub. I want to know your opinion – is this a good thing or a bad thing?
“The bottom line is we as doctors want safety first.
White coat guy: Four of my siblings were born at home…
Chorus: “They were lucky!!!
WC: “No no no. Homebirth can be a safe experience if it’s done the right way. With a doctor present. My father was a doctor, you see. You hear these awful horror stories about non certified midwives who are afraid to get help when something goes wrong.
Others: And sometimes with certified midwives, too!
Scrubs guy calls this show a “Debate”. There are three doctors talking about how midwife-attended homebirth is OMG HORROR INSTANT GUARANTEED DEATH, and none who actually know anything about homebirth. There is still no midwife in sight. They are using some meaning of “debate” with which I am unfamiliar.
The pre-ad flash teaser consists of a near-tears woman saying “My mother called 911. And the ambulance came, and took my baby from my arms, and he was dying.”
Return from ad. We see the Laser Woman, only from the rear, in a new dress, Queer Eye guy talking about how awesome she looks. Audience goes wild.
Next they show a couple, Billy and Jenny. Jenny is six months pregnant with first child.
“We are considering our options and our birth plan, and we have to make our decisions pretty quick”. She expresses her wish for a natural birth, a homebirth, and talks about how they are working with a midwife and how she doesn’t want an epidural, and she wishes to feel fully ‘present’ for the birth of her child. She has explored hypnobirthing and water birthing for pain alleviation. “Hospitals are definitely for sick people, and I don’t feel that birth is a sickness”. “We want to know whether birth at home would be safe, or whether we are taking an unnecessary risk.”
Interview. Scrubs guy: “What made you think of a homebirth in the first place?”
Jenny explains that they do try to lead a fairly ‘natural’ lifestyle, with organic foods, etc. Therefore they began to do research looking into their birthing options. They have an obstetrician. “Our OB is open, but every time I ask him what I can do to prepare for this birth, he just says “Well, that’s all up to you.” I would think that if that were my field, I would look at other forms of birthing. But this is all so new to me, and when I get a blanket answer to everything, I’m left with a lot of questions.”
Dr M explains condescendingly that they’re here today to “help her make an informed choice”. There is still no midwife in sight.
Scrubs guy asks them whether they’ve met anyone who has had a homebirth. They say no. The team has brought people in to tell them about their experience.
Stephanie (Pilates instructor) and Marcel – gave birth in birthing pool in her own home.
They show some of her birth video with woman’s voiceover, talking about using her low voice, keeping herself comfortable, talks about how she prepared for her birth.
Doctor Masterson: You know, I don’t care what you do in labour. If you want to swing from the chandeliers you can do it! So long as you deliver that baby. But it’s just like a party, you know? When things go wrong, they can go wrong fast.
Scrubs guy: Up next: a mother who says not only does she regret choosing an alternative birth for her son, but it also almost ended up costing his life.
Commercial.
“It’s really overwhelming choosing a birthing method today. We have hypnobirthing, homebirthing… a traditional, old-fashioned hospital birth.”
Scrubs guy: Talks about how the couple haven’t yet made their decision. “There’s another option. Have you considered a birthing centre?”
Jenny: “Yes, we looked at a birthing centre. We were wary of the environment itself – it was like, sort of, half a home, and half like a doctor’s office.
Scrubs guy: “Which is kind of the point!”
Jenny: “Yes. There was something about the environment that was very uncomfortable.”
Doctor Masterson: “Birth centres are set up so they feel a bit like a home. But they’re not set up for emergencies.”
Goes to woman in audience. She talks at length about how normal her pregnancy was, and about how she birthed beautifully in a home jacuzzi. They then found out that the baby had a congenital kidney abnormality, the kidneys were very swollen, and they had ruptured the lungs on the way out during the birth. “My mother just knew, and after 45 minutes she called 911 and the ambulance came and took my baby from my arms. They wrapped him in a silver blanket, and he was dying”. He has since had a number of operations and is now ok.
They go to a doll lying on a coffee table and say that they’re going to demonstrate shoulder dystocia.
Cut to a computer simulation. The woman is absent, nothing but a lower spine and pelvis, lying supine, and the CGI baby gets its shoulder caught under the pubic bone.
Doctor Masterson describes a number of manoeuvres – McRoberts (pushing the legs right up in exaggerated lithotomy position), fundal pressure, Woods Screw, episiotomy, breaking the clavicle (Masterson says “shoulder”), cutting through the rectum, symphysiotomy (cutting through the symphysis pubis, which Dr M calls “cutting through the pubic bone”), pushing the baby back up and doing a C section (Zavanelli manoeuvre).
The Gaskin manoeuvre is not mentioned, nor are any of the other preventive measures that midwives use. Like not forcing a woman onto her back in the first place.
Jenny: “What percentage of the births that you see in the hospital have an issue like this?”
Dr. M: 10 to 15%, depending on the population.”
Scrubs guy” “I know there were big words in there, but the bottom line is – you don’t want to do this at home”.
Doctor Masterson: “We as OBs take on responsibility. Believe me, you don’t want to take on responsibility for the birth of your child.”
Doctor Masterson: “The other thing that can happen is fetal distress. I know some midwives will bring monitors to the home. But this is the only way we can monitor the baby and discover fetal distress”. They show a CTG strip and describe a “crash” and how when this happens, they need a C section within five minutes.”
Scrubs guy describes postpartum haemorrhage. “We’re here to give the pros and cons of home birthing. Sometimes there can be a compromise. Our next guest may have the answer.”
Scrubs guy: “There are two major complications you have to worry about, right?”
Doctor Masterson: “Yeah, we’ve talked about the umbilical cord, and PPH, and shoulder dystocia. The umbilical cord can get stuck around the baby’s neck, and when that happens, you’ve got to act quickly. That’s why lots of hospitals now have what’s called “LDRs”, or labour and delivery rooms. They mimic the homebirth experience, but with medical emergencies taken care of.”
Scrubs guy talks to another couple in the audience, “You went to an LDR, and you talk about a spa, and all that, and how wonderful it was.” Woman described hypnobirthing and her birth preparation with that method. Her OB was familiar with HypnoBabies and worked with them through that process.
Scrubs Guy: “This hypnobirthing concept is so intriguing to me. Why don’t we do more of that?”
Doctor Masterson: “We’re getting there, we’re getting there. And hospitals are more and more moving toward these LDRs. They look better than my bedroom at home!”
Billy and Jenny describe the feelings of fear around birthing in a hospital, doctors intervening on schedules. “How much that that actually go on?”
Doctor Masterson: “ZIPPO! We just don’t go into obstetrics for a nice schedule.”
Billy: “That’s great to hear.”
Scrubs guy: “Homebirth can be a wonderful experience, that’s what people say. I know you, [turns to Doctor Masterson] You’re very concerned for the health of babies. I’m going to tell you a bit about why Doctor Masterson cares so much about this.” Apparently Doctor Masterson has worked in obstetrics in Africa. Dr M’s voiceover: “The biggest risk for women used to be childbirth, until we switched it into hospital.”
Crowd goes wild.
Dr M: “The biggest risk for women used to be childbirth. Until we switched it into hospital. Every minute a women dies in childbirth, and it’s so easy to solve – just like how we solved it here. We set up clinics, and hospitals, and equipment. This is close to my heart, because it’s not necessary, and it’s fixable. Things can go wrong, but if you’re prepared for them, you’re all set.”
Scrubs guy winds up. “If you want more info, log onto thedoctorstv.com.”
Next up: more on plastic surgery, and whether certain foods can help you in picking the sex of your baby. Someone says something about “shedding baby weight”.
I leave.
I dip in a few minutes later. They’re saying something about jewel tones being in this season, and about how high heels are awesome because they say “Let’s make love all night”. The resurfaced woman is enthusing about how her face is making new collagen now, and about how she’s now confident enough to get back into the dating market.
I leave.
I dip back in. Oprah is asking me whether I love what I look like naked. I switch off.
[h/t Joyous Birth forums]
Related Posts:
- Hutton’s Ontario Homebirth/Hospital Birth Study by Lauredhel
- Canadian study finds mothers & babies much less likely to be injured in homebirth by Lauredhel
- Word of the Day – Hyperbole by Mindy
- Homebirth to become illegal in a year. by Lauredhel
- Independent midwife clients granted a brief reprieve – or are they? by Lauredhel
* Quicklink to recent open threads
bluemilk: 
mindyhoyden: 
vivsmythe: 
CastIronBalcony: 
puzzlement: 
ChallyWrites: 
ilauredhel: 
Doctor Masterson: “We as OBs take on responsibility. Believe me, you don’t want to take on responsibility for the birth of your child.”
I am having flashbacks to the machine that goes PING!!! from Monty Python.
high heels are awesome because they say “Let’s make love all night”.
Yep, because nothing makes me want sex more than sore feet and aching calf muscles.
1. Well, the first thing is it assumes the audience will have free access to all of these options (homebirth, hospital, LDRs, hypnowhatsit) and can choose any at their leisure – instead of homebirth being a case of financial neccessity, or trepidation towards the medical system.
2. This is emphasised by the white-upper-middle-class couple who are priviledged enough to care about having a “natural” lifestyle.
3. Hospitals are definitely for sick people, and I don’t feel that birth is a sickness
The association of disability and hospitals makes the lady uncomfortable. That’s ablism.
4. If you want to swing from the chandeliers you can do it! So long as you deliver that baby.
Prioritising the baby’s health over the mother’s.
5. a traditional, old-fashioned hospital birth
A very traditional hospital birth would have her dying of an infection within the day. Normalises medical authority.
6. I know there were big words in there
Well, he’s being a patronising git.
7. Apparently Doctor Masterson has worked in obstetrics in Africa.
She’s comparing homebirthing to being in a third-world country. Also, Africa’s a big place – did they specify the country and region? Could be Madagascan jungle, could be Cairo. Medical services are very dverse around the continent.
8. Apparently Doctor Masterson has worked in obstetrics in Africa.
She doesn’t specify what in particular makes a hospital better, just says they’re better. Doesn’t give any evidence or cite any practices – just implies that being within the walls of a hospital will make birth safer.
9. The entire emphasis of the show is medical emergencies during birth. This constant drumbeat makes the argument that homebirth is an unneccessary risk, and any birth that isn’t in a hospital is potentially fatal.
10. None of the doctors discussed the origin of Jenny’s discomfort with hospital environments.
1) No one seems to give a shit less about the woman. What she wants, how she feels, her safety (which is obvious that only on the back birthing is discussed?), or even the simple fact that until that fetus comes out and is a baby the woman is the patient.
2) Class privilege. Pregnant women are not doctors. They know exactly jack and squat.
I find it hard to go past the bit where you pointed out the craaaziness of calling this whole thing a “debate”. For me, that really encapsulates everything that is wrong with this TV piece, but all the same I am going to love checking in on this post and seeing everyone’s very clever criticisms.
11. Chorus: “They were lucky!!!
Priviledges preconception of situation over lived experience.
12. And should every women have the right to do this birthing method at home?
Suggestion that rights are conditional, suggestion that some women are more deserving of rights than others, suggests that an unnamed authority is responsible for women’s rights – not women themselves.
13. she wishes to feel fully ‘present’ for the birth of her child
Implies that women who have drug-assisted births are somehow not fully participatory; that they are removed from the process and thus do not have a real experience.
14. If you want to swing from the chandeliers you can do it! So long as you deliver that baby. But it’s just like a party, you know?
Diminishes the woman’s experience of homebirth as something trivial, ingnoring the actual techniques used by the mother.
15. not only does she regret choosing an alternative birth for her son, but it also almost ended up costing his life.
Misleading phrasing. Implies there are two separate reasons for regretting the homebirth, instead of one being the cause for the other. Presumably if the son had not had a medical emergency, she would not regret the homebirth.
16. a traditional, old-fashioned hospital birth
“Hospital birth” gets favourable adjectives, while the others don’t get any. In a list of “overwhelming options”, hospital birth is presented as the simple and obvious choice: tested, proven and trusted.
17. the baby had a congenital kidney abnormality, the kidneys were very swollen, and they had ruptured the lungs on the way out
Though it confirms the show’s argument that emergencies are better treated at a hospital, the child’s condition was not caused by homebirth itself and was not exaggerated by it. If anything, it demonstrates that ambulance services are important (and we knew that).
18. depending on the population
Doesn’t tell us anything about the population, and why different populations might have different results.
19. They mimic the homebirth experience
As far as I can tell, she hasn’tmentioned anything favourable about the homebirth experience, so why would anyone in the audience want to mimic it?
20. They look better than my bedroom at home!
Not only misses the point, but never met it.
21. Homebirth can be a wonderful experience, that’s what people say. I know you, [turns to Doctor Masterson] You’re very concerned for the health of babies.
Creates a dichotomy of anecdotes vs the very lives of babies. Subsequently establises the doctor as a super-authority whose expertise is worth much more than “what people say.”
22. Every minute a women dies in childbirth, and it’s so easy to solve
No one was advocating no medical assistance at all – just medical assistance in the home. Plus, a lot of those deaths are caused by inadequate hygiene. Plus, it’s fripping insulting to compare middle-class first-world homebirth to lack of healthcare in “Africa” – firstly demeaning homebirth as primitive, and secondly, trivialising the awful conditions of some nations’ healthcare.
*Blows smoke from keyboard, slips it back into holster*
Oh, and:
23. The biggest risk for women used to be childbirth, until we switched it into hospital
Links homebirth and maternal death. From Wikipedia:
*head explodes all over the place, rendering me incapable of speech that doesn’t involve swearing and name-calling.*
[Disclaimer: 2 of my siblings were safely born at home with a midwife and a doctor present. There is a gorgeously cute picture of me at 11 years old holding a days-old baby brother and reading Gaskin's "Spiritual Midwifery".]
24. [Discussing shoulder dystocia risk]
According to http://www.shoulderdystociainfo.com/incidence.htm – which has a complete biography listed on the site – incidence is difficult to establish since even the definition of shoulder dystocia isn’t fully standardised, but most reports are between 0.5% and 1.5%. That makes them off by at least an order of magnitude here.
25.
No discussion of the fact that the bloody monitors routinely over-diagnose foetal distress, resulting in unneeded interventions which cause trauma to everybody involved. Don’t have a citation for this one – it’s past my bed time so no looking up.
26.
Doctor Masterson: “ZIPPO! We just don’t go into obstetrics for a nice schedule.”
At this point my head exploded so I can’t reply coherently. EVERY woman I know who’s given birth in a hospital or even a birthing center has been forced to “comply” with deadlines and threatened with escalating interventions if the deadlines aren’t met. 34 years ago my mother was told that I was in foetal distress and she concented to a forceps delivery for me – she later found out there was no foetal distress ever found, but the doctor was about to go off shift. I hope nothing that grotesque happens these days, but the stuff described above is from friends who’ve given birth last year.
27. Error of omission: Lots of discussion of risk of the mother/baby dying because of a home birth, but absolutely no mention of problems caused by hospital birth or problems that were inevitable no matter where the birth occurs. Hospital birth problems such as recovery (potential complicated) from major abdominal surgery (ie: ceasarian section), possibility of “superbug” infections, etc.
28. Error of omission: I seem to recall from Hoyden’s reports about the QLD trial that midwife-attended births have a lower complication rate that hospital births. They certainly didn’t mention this, and strongly implied (or even said?) the opposite was true.
Going to sleep now. I’d love to see a point-by-point takedown of this, Hoydens! Please?
Ricky Buchanan’s last blog post..Amazon Kindle 2 Includes Text to Speech Capability
23. ten to fifteen percent of deliveries have shoulder dystocia?
Seems very high to me.
For a “traditional old-fashion method” of child birth, the hospital birth has a very short history. In Canada, it wasn’t until the 50s that “most” births occurred in hospitals.
We can trace the rise of parenting books written by male doctors to that time, too. Those babies that were birthed while women were drugged into unconsciousness were raised using Dr Spock.
I… am… just going to go back to reading this awesome book and ignoring the television.
“3. Hospitals are definitely for sick people, and I don’t feel that birth is a sickness The association of disability and hospitals makes the lady uncomfortable. That’s ablism.”
I disagree, profoundly. Hospitals are for treating sick people. That’s not a judgement, that’s a neutral statement. It’s nothing like ablism. Should we say “hospitals are for treating healthy people” when it’s clearly a nonsense?
“We can trace the rise of parenting books written by male doctors to that time, too. Those babies that were birthed while women were drugged into unconsciousness were raised using Dr Spock.”
This is not true. Historically most parenting books were written by men, and FOR men, until relatively recently. And the original edition of Dr Spock starts with the line that you will either have your baby at home, or in the hospital.
That’s not a judgement, that’s a neutral statement.
Well no, she’s saying that the presence of sick people colours her perception of a place.
Jenny’s statement implies that there are only two states of being – sick and healthy – and because she doesn’t see herself as sick, she must not need anything a hospitcal can provide. This ignores the fact that hospitals are for anyone who needs any sort of medical treatment, not just for a homogenous lump of people distinguishable from the general population.
There are plenty of people in hospitals that aren’t “sick” – people with broken legs, people in drug trials, outpatients going for checkups, dehydrated people, elderly who need monitoring – but she’s lumped them all in together as “sick”, excluding herself from that category.
“Well no, she’s saying that the presence of sick people colours her perception of a place. ”
Well no, she’s not. She’s saying that pregnancy and birth !=sickness. Normal pregnancy and birth are a stage of a woman’s life, not something that requires hospitalisation. A view with which I profoundly agree.
I’d say having a broken leg is being sick, or being dehydrated, or being an outpatient (presumably you’re not 100% well or you don’t need outpatient treatment!) I don’t agree that the intent here was to “lump” people who are unwell together and then flee from them. I think the point – as it generally is with birth activists – was that pregnancy is a normal life event, not a sickness.
Sure, I see your point. It’s a good point. I agree that pregnancy and birth aren’t sickness. But pregnancy (and a whole bunch of other things) can require medical care, and a hospital is a place where people get medical care. Her argument wasn’t that pregnancy is a natural process, but that it isn’t sickness. It was probably just inarticulately phrased, but the particular words create a binary of sickness and health. Reality isn’t “us and them”, it’s “all uof us sometimes need medical care”.
presumably you’re not 100% well or you don’t need outpatient treatment!
Frankly, I don’t know many people who are 100% well. Doesn’t make them sick people, just ordinary.
I can’t speak for other countries, Rebekka, but I can speak for Canada. In Canada, the tipping point for hospital births was between 1940 – 1945. In 1940, 45.3% of births were in hospitals, and by 1945, 63.2% of them were. By 1950, it was 76%. (Giving Birth in Canada, Table 1 on page 175.)
The first Dr Spock book was published in Canada in 1947, and when recalling that time, women often refer to it as “The Bible”. It was telling women how to raise their children, and with the growing interest in Progress! and rejection of the “old ways” as being outdated and unhealthy and boring, it was widely embraced in Suburban Canada.
I can’t at all speak for anywhere else, but on this one I’m pretty certain – by the time Dr Spock was published here, most children were born in hospitals. And Dr Spock is aimed very firmly at women.
Yeah, but I don’t think by saying “hospitals are for sick people” you’re necessarily saying sick people are “them” and not “us” – sick people are all of us when we’re sick, it’s just that doesn’t include an uncomplicated pregnancy and birth. Most of us have been in hospital at some point in our lives.
I absolutely agree with her that birth is not an illness, not just that it’s a natural process (and the term natural is so loaded anyway that I don’t think it’s a useful one to use to describe pregnancy or birth). I don’t think there’s anything wrong with that as a statement – and I still don’t think it’s abelist. It’s simply a statement of fact. Going through puberty isn’t an illness. Going through menopause isn’t an illness. They are just normal life events for women.
I can see your point about setting up binaries between healthy and sick being unhelpful, but I don’t see that making a statement that hospitals are for sick people is doing that. Nor is making the statement that pregnancy is not an illness. Being sick isn’t some sort of failing, and I don’t believe that you can rationally read that into what she said.
“I can’t at all speak for anywhere else, but on this one I’m pretty certain – by the time Dr Spock was published here, most children were born in hospitals. And Dr Spock is aimed very firmly at women.”
I have the original 1946 edition of Dr Spock’s baby and childcare, and I can tell you that even if most women in Canada were birthing in hospitals by then, unless they changed the edition specifically for Canada, the book begins with the statement that you can have your baby either at home, or in hospital.
And I wasn’t disgreeing that Spock was aimed firmly at women – I was disputing the statement that “We can trace the rise of parenting books written by male doctors to that time, too” – *most* parenting books, historically, were written by men – many of them doctors. And the rise of parenting books written by men and *aimed at women* was very definitely earlier than the 1940s. The two trends – hospital birth and parenting books written by male doctors – don’t coincide, much as it would be neat if they did.
I think anything else I could say would be arguing just for the sake of arguing, rather than discussing the content of the post.
The idea that there’s an old-fashioned traditional way of being born in a hospital really ignores the fact that it doesn’t really date back that far (at least in Canada), and didn’t become the “norm” until the 1940s/50s. I was born in a hospital. Neither of my parents were. (My father has a delightful story about his birth – it was really cold that January so they stuck him and his twin brother *in the oven* to warm them up.) It also ignores race and class in the equation. First Nations women in Canada were giving birth at home for a lot longer than non-First Nations women were, and I suspect that recent immigrants would have a different experience than people who were raised in Canada.
Giving birth in hospitals became more “normal” in the post-World War II years here. Was it the same in Australia?
Jenny: “What percentage of the births that you see in the hospital have an issue like this?”
Dr. M: 10 to 15%, depending on the population.”
Obstetrics, Dr. M, UR doin it RONG!
Any doctor with a shoulder dystocia rate that high should have their work carefully reviewed.
Doctor Masterson: “The other thing that can happen is fetal distress. I know some midwives will bring monitors to the home. But this is the only way we can monitor the baby and discover fetal distress
Oh, apart from a foetal pinard used intermittently, or a doppler, observation of changes to progress etc. And as someone else pointed out, there’s the massive number of false positives, and the many instances of foetal distress caused being by medical intervention.
The umbilical cord can get stuck around the baby’s neck, and when that happens, you’ve got to act quickly.
Aren’t a large percentage of babies born with the cord around the neck? It certainly can cause problems if it’s looped around multiple times and subsequently too short. And if it’s knotted, that’s potentially problematic. But just “around the baby’s neck”… does he understand that babies don’t need to breath through their windpipes until after they’re born and separated from the umbilical cord?
Dr M’s voiceover: “The biggest risk for women used to be childbirth, until we switched it into hospital.”
The biggest risk for women was when childbirth was first switched into hospital. Turns out those early obstetricians with their autopsified hands weren’t so good for women. We’ve come a long way thanks to antibiotics, not so much thanks to continuous fetal monitoring.
Is this a time to bring out the old joke;
What do you call a med student who graduated bottom of their class?
…
…
…
Doctor.
There are, without a doubt, many fabulous obstetricians. These are not them.
Lots of you, especially The Amazing Kim, have done a sterling job on the antifeminist aspects of this show! I was going to come in and takedown the obstetric-facts side of things, but you’ve pretty much done that too. I was gobsmacked at just how much bullshit they could pack into a relatively short segment. I would like to think that these sorts of shows have little cultural pull, but unfortunately I’d be wrong. I see these ideas parrotted over and over and over again, and it’s disheartening and scary.
To pull out just the major stuff: as a few of you identified, the incidence for shoulder dystocia is just a blatant lie, by over an order of magnitude. The recorded incidence is typically around 0.5-1.5%, but that is without accounting for iaotrogenic factors like bed dystocia and failure to wait, so the true incidence may not be that high.
The idea that a doctor is the only safe option for a homebirth completely denigrates and erases midwives, in a way that I found particularly appalling. There is absolutely nothing a doctor can do at a homebirth that a midwife can’t, and there is a whole lot that a midwife can do at a homebirth that a doctor never sees, let alone practises, in their training. “Mid-wife” = “With woman”; obstetrics training does not involve being with a woman throughout her labour and birth.
If there are barriers to midwives calling for help in emergencies, obstetricians need to take a long hard look at what those barriers are, and where they’re coming from. Hint: most of the time, it’s not from midwives or from women.
The kidney thing. I was left saying “whaaaaa?” There is no indication at all that homebirth was a factor in this baby’s problem. When the baby was sick, an ambulance was called, and the baby got help, just as would happen if any of us or our children became sick at home. It sounds as though the system worked just as it should, and the people involved are suffering from a particular severe case of post hoc ergo propter hoc.
The obstetrician who says she is all in favour of women “hanging from chandeliers” while birthing is not just trivialising positioning and non-pharmaceutical pain management, she is lying. When she demonstrates shoulder dystocia, she leaps to a position that suggests lithotomy or supine. It is very obvious that this is the position she catches most babies in. Yet, when mothers are encouraged to choose their own positioning, they very rarely choose a position that involves being on their back. So this obstetrician does not just have issues with her framing and medico-centricity, she just. plain. lies. And I’m guessing she also tells these lies directly to the women who come to her for help. This is not cool.
The umbilical cord stuff is all bullshit. The number of people I’ve heard who claim the obstetrician OMGSAVEDTHEIRBABY’sLIFE because THE UMBILICAL CORD WAS TWICE AROUND HIS NECK!!1! beggars belief. Midwives are very well accustomed to looping a bit of cord over a baby’s neck at birth; it’s a simple procedure, nothing complicated, and not an emergency. Very, very occasionally, there is a very tight cord that needs dealing with, and midwives deal with it, just as they were trained to do.
On this note, if you’ve heard a few elective C section stories for nothing to do with cords – post dates, social, presumed macrosomia, pre-eclampsia – you’ve heard a few mothers talk about how “it was a good thing I had a C section in the end, because the surgeon said when they got in there, the cord was around the baby’s neck!” This scary spectre of cord-around-the-neck is used as another way surgeons justify unnecessary operations, and leave women riddled with yet more lies around their experience.
Yes, major issues with not addressing why the women felt uncomfortable in the birth centre. And another lie, about birth centres “not being set up for emergencies”.
Fetal monitoring – more lies. There is no evidence supporting routine CTG monitoring in labour, and lots and lots of evidence saying that it doesn’t improve outcomes while increasing interventions.
LDRs don’t “mimic the homebirth experience”. The homebirth experience involves (a) being in your own space, and (b) not having someone hanging over you with frequent vaginal examinations, schedules and a knife at the ready.
Doctor Masterson says “we’re getting there” in regards to incorporating hypnobirthing into the hospital birth experience. I believe this is likely to be another lie.
And then she lies about how interventions have nothing to do with doctors’ schedules.
Actually, looking back, I’m pushing it to find any truths she has told. Sigh.