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Reducing Infant Mortality

  1. #49
    TNT
    TNT is offline Banned
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    I am very interested in this discussion because I agree with the basic premise of the video that interventions are on the whole over used. I did a natural birthing course before the birth of my first child and a number of the very same points were raised, in the context that it was important to understand this medicalisation of child birth when aiming for a natural birth in a medical setting. As I was giving birth at a private hospital with very high casesarean rates and also being an older first time mother the odds were not in my favour, but I wouldn't be accepted at a birthing centre (due to my medical history and age). The aim was to help me and others understand that the priority for many in that hospital setting was not an invervention free birth and therefore both myself and my husband would likely have some work to do to achieve this. As a result we bought our own private midwife along to the birth as a doula and it made a hugh difference. Unfortunately I didn't achieve an intervention free birth the first time, but having her there made me totally confident that we have done all that we could (at least in that setting) to avoid it and so I was very comfortable with the outcome.
    I also realised going into the birth that it would be very, very painful and hard work (the course was very blunt about this and we saw lots of vidoes etc which made it clear it would not be easy) and so I really understand what thanka2 is sayng in this context; I think most people would say they wanted a drug free birth but because of their lack of knowlege about what is actually involved - totally normal- and how long they are likely to be in a lot of pain for when labour actually starts (and you can labour for a very long time before you are even 3 cm and ófficially' in labour) and the fact that it is likely you will be offered an epidural or pain relief when you are at your most vulnerable, means it is very difficult to achieve unless you have fully prepared yourself - and even then you may not.
    Having said all that I totally understand the 'screaming for an epidural' situation - I did this myself at transition with my second birth. Luckily for me the very supportive midwife who recognised I was in transition and knew how important a drug free birth was to me suggested I go the the toilet before the anaesthatist arrived; being in this position lead to 3 massive contractions which meant I was fully dilated and ready to push. The other midwife was ready to give me the epidural (they were both from the hospital this time, but one I had met several times before the birth and we had discussed birth and interventions in details) and if she had been the only one there, I would've accepted it at the time and regreted it later. The enviroment and people involved can make all the difference.
    I did not have either of my babies in HK and if I had one here I would be making a lot of enquiries to carefully choose my ob as for many of the reasons given by thanka2 I think it would very hard to achieve for a first time mum here, having done it before gives both the mother and the dr greater confidence that it is possible.
    Last edited by TNT; 12-17-2010 at 07:42 PM. Reason: spelling and punctuation

  2. #50
    thanka2 is offline Registered User
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    Quote Originally Posted by laial View Post
    By the way, if a mum wants to have an epidural, she is a grown adult and can make her own decisions - so let her have one. It is not for anyone else to judge her decision. Same goes with caesarean sections and everything else - even though I am an advocate for normal vaginal deliveries, if a mum wants a caesarean for whatever her reasons are, given that she knows the facts, it is not for anyone else to judge or comment her decision.
    My question is are women really informed of the facts in detail? Is that common practice? Is it required? Are they given the facts and studies about the drugs in some abridged form to look over before they even set foot in a hospital so they can truly make an informed choice? In my country, even when I go to the supermarket pharmacy to pick up my prescription drugs, the law dictates, that I must have a consultation with the pharmacist in which they go over the specifics of the medication and any possible side-effects/dangers of taking it. Then, I must sign a form stating that I was informed. This is simply if I want to pick up an antibiotic for strep throat. It would be interesting to know if the same sort of system exists when it comes to informed consent with birth interventions.

    Women do and will make their own decisions as it should be. My problem arises from a system that seems to skim over topics that should be discussed in more detail. It's one thing to say, "I was informed. I know and I choose this for myself and my child" (in the case of elective interventions) than to say, "Well, it can't possibly do any harm--my doctor/nurse/midwife etc. did not present any information to the contrary so I make this decision believing that the risks are nil." And from my experiences with doctors in Hong Kong that often do a lot to scare their patients right off the bat ("you'd better do this, this and this or your child will end up with this, this and this"), it is strange to me that they wouldn't make it a point to really paint use of interventions in the most graphic light possible as it seems they have a knack for, and for lack of a better expression, fear mongering.
    Last edited by thanka2; 12-18-2010 at 05:51 PM.
    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  3. #51
    thanka2 is offline Registered User
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    Quote Originally Posted by TNT View Post
    I am very interested in this discussion because I agree with the basic premise of the video that interventions are on the whole over used. I did a natural birthing course before the birth of my first child and a number of the very same points were raised, in the context that it was important to understand this medicalisation of child birth when aiming for a natural birth in a medical setting. As I was giving birth at a private hospital with very high casesarean rates and also being an older first time mother the odds were not in my favour, but I wouldn't be accepted at a birthing centre (due to my medical history and age). The aim was to help me and others understand that the priority for many in that hospital setting was not an invervention free birth and therefore both myself and my husband would likely have some work to do to achieve this. As a result we bought our own private midwife along to the birth as a doula and it made a hugh difference. Unfortunately I didn't achieve an intervention free birth the first time, but having her there made me totally confident that we have done all that we could (at least in that setting) to avoid it and so I was very comfortable with the outcome.
    I also realised going into the birth that it would be very, very painful and hard work (the course was very blunt about this and we saw lots of vidoes etc which made it clear it would not be easy) and so I really understand what thanka2 is sayng in this context; I think most people would say they wanted a drug free birth but because of their lack of knowlege about what is actually involved - totally normal- and how long they are likely to be in a lot of pain for when labour actually starts (and you can labour for a very long time before you are even 3 cm and ófficially' in labour) and the fact that it is likely you will be offered an epidural or pain relief when you are at your most vulnerable, means it is very difficult to achieve unless you have fully prepared yourself - and even then you may not.
    Having said all that I totally understand the 'screaming for an epidural' situation - I did this myself at transition with my second birth. Luckily for me the very supportive midwife who recognised I was in transition and knew how important a drug free birth was to me suggested I go the the toilet before the anaesthatist arrived; being in this position lead to 3 massive contractions which meant I was fully dilated and ready to push. The other midwife was ready to give me the epidural (they were both from the hospital this time, but one I had met several times before the birth and we had discussed birth and interventions in details) and if she had been the only one there, I would've accepted it at the time and regreted it later. The enviroment and people involved can make all the difference.
    I did not have either of my babies in HK and if I had one here I would be making a lot of enquiries to carefully choose my ob as for many of the reasons given by thanka2 I think it would very hard to achieve for a first time mum here, having done it before gives both the mother and the dr greater confidence that it is possible.
    I appreciate your input TNT. You said very well many things that I was thinking, actually. We also attended a lengthy natural birthing course (would be interesting to know which one you did--you can PM me if you like) that lasted 12 weeks and required a lot of research and homework as well as practical practice for labor. I feel like I was also well-prepared (as much as I could be for a first birth) for the painful reality of labor and a gameplan for how I was going to deal with it. And I chose to commit early on to a natural childbirth, despite the pain. I didn't leave myself "a way out" (so to speak) but just set in my mind that "Okay, labor is going to be painful and difficult and unpredictable but no matter what, as long as it is within my power to choose (barring true emergencies) I choose a non-intervention birth." I think having that mindset changed my entire perspective for the duration of my pregnancy and birth.

    I felt I was also educated about the medicalisation of labor and birth as well as interventions. We watched numerous videos on c-sections, epidurals and augmentation just to prepare myself mentally. I felt it was important that although my choice was not to utilize any of the above, to have a knowledge of what they are and how they are administered should an emergency arise that required some intervention. I guess I didn't give myself the "benefit" of remaining in the dark on these subjects. (and I HATE to see blood and surgeries in videos so it really took some effort to watch these!)

    And your point about the hospital systems having different goals from that of a couple seeking to go through an non-intervention birth is spot on! It really is a collision of different views and schools of thought when it comes to this topic, I think. The training that OBGYNs, midwives and doulas go through is similar in some ways but differs on key points. It's a difference in approach and priorities, I think. And yes, yes, yes, I agree that the setting makes a HUGE difference. For example, a relaxing, calming atmosphere with professionals who see you as a person and not a medical problem to be dealt with, coupled with a woman's confidence in herself, her body and her choice of medical personnel can create a more stress-free atmosphere which is conducive to birth. I think the psychological impact of the birthing environment are far too often downplayed and we all know the power that our mind has over our bodies. If a woman is stressed because she starts to experience major birth pain that she had not mentally anticipated and then medical personnel are all too willing to try to work things out for her, this can create a fear response and in the throes of labor it's simply too overwhelming to mentally sort things out--the body tenses up which inhibits labor and in turn makes things more painful--it's a vicious cycle.

    Anyway, thank you for sharing. Appreciate it! :)
    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  4. #52
    thanka2 is offline Registered User
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    Quote Originally Posted by thanka2 View Post
    My question is are women really informed of the facts in detail? Is that common practice? Is it required? Are they given the facts and studies about the drugs in some abridged form to look over before they even set foot in a hospital so they can truly make an informed choice? In my country, even when I go to the supermarket pharmacy to pick up my prescription drugs, the law dictates, that I must have a consultation with the pharmacist in which they go over the specifics of the medication and any possible side-effects/dangers of taking it. Then, I must sign a form stating that I was informed. This is simply if I want to pick up an antibiotic for strep throat. It would be interesting to know if the same sort of system exists when it comes to informed consent with birth interventions.

    Women do and will make their own decisions as it should be. My problem arises from a system that seems to skim over topics that should be discussed in more detail. It's one thing to say, "I was informed. I know and I choose this for myself and my child" (in the case of elective interventions) than to say, "Well, it can't possibly do any harm--my doctor/nurse/midwife etc. did not present any information to the contrary so I make this decision believing that the risks are nil." And from my experiences with doctors in Hong Kong that often do a lot to scare their patients right off the bat ("you'd better do this, this and this or your child will end up with this, this and this"), it is strange to me that they wouldn't make it a point to really paint use of interventions in the most graphic light possible as it seems they have a knack for, and for lack of a better expression, fear mongering.
    "Because I'm an obstetrician...I read the American College of Obstetricians and Gynecologists website--and throughout the website for their physicians there is sentence after sentence about the sanctity of the woman's right to self-determination and how we should never interfere with her ability to either choose or refuse a procedure. What happens, though, in modern medicine is that patients are not given true informed consent...what they're given is skewed informed consent."- Stewart Fishbein, MD, FACOG, Obstetrician
    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  5. #53
    thanka2 is offline Registered User
    Join Date
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    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  6. #54
    thanka2 is offline Registered User
    Join Date
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    Location
    HK
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    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  7. #55
    thanka2 is offline Registered User
    Join Date
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    Location
    HK
    Posts
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    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

  8. #56
    thanka2 is offline Registered User
    Join Date
    May 2009
    Location
    HK
    Posts
    1,623
    “Many women have described their experiences of childbirth as being associated with a
    spiritual uplifting, the power of which they have never previously been aware …
    To such a woman childbirth is a monument of joy within her memory.
    She turns to it in thought to seek again an ecstasy which passed too soon.”

    ~ Grantly Dick-Read (Childbirth Without Fear)

    Mother of Two
    JMW, boy, born November 29, 2007, 9:43 pm, USA
    MJW, girl, born March 17, 2011, 4:14 pm, HK

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