Tangle
"HB is not safe
Yes I do think the study has been misused in that manner by some.
Birth is more risky if the mother is malnourished and has received no antenatal care - regardless of the place of birth
I agree, but I would be inclined to lean towards that overall if large numbers of malnourished, antenatal care free women gave birth in hospital the number of poor outcomes might be minimised. Giving birth outside of a hospital setting in those circs smacks of double jeopardy. But I fully admit that is hunch, not data.
There must be pockets in the UK of social issues leading to poor diet and a certain ambivalence towards getting antenatal care, combined with a norm of giving birth in hospital. Is there anything that can be gleaned there to form some kind of comparison with the Rotterdam findings ?
I accept that there are some women in the UK who do turn their backs on antenatal care for exactly the reasons you give - but to my knowledge they are a very small minority and I'm very dubious that this is the root cause of the problem in Rotterdam.
I?m unconvinced that attitudes such as ?pregnancy is not a pathology? and a considerable reverence for natural birth are not informing the prenatal attitudes and practises of midwives in Rotterdam.
They don?t strike me as being particularly proactive about prenatal testing (see below). That combined with the hard line on natural birth (to the point there has been a system created where it is financially punitive to attempt to get your mitts on a medicalised birth cos you don?t want a home birth, your insurance may not cover a hospital birth if it is not considered a medical necessity) does ring alarm bells for me.
If they are not proactive about prenatal testing then women with financial stumbling blocks (insurance issues keep being mentioned) or socially based resistance to prenatal oversight may see that laid back attitude as being a an indicator that prenatal care is just not a big enough a deal to be worth the hassle, or getting past their disinclination.
I think having to ask for testing rather than it being offered is perhaps a bigger deal than it might seem on the surface.
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?Ante-natal care
Ante-natal care is usually delivered at the consulting rooms of your chosen carer. It follows the common pattern of monthly assessment until 32 weeks, providing all remains normal and thereafter more frequently.
Ultrasound scans are not routinely performed if you are under the care of a midwife. Everyone is entitled to one ultrasound scan to determine dates. This is not always offered and it is best to ask if not mentioned at your first visit to the midwife. If the midwife has no reason for concern you will not have another scan during your pregnancy. This can be rather strange and it is best to discuss it with your midwife. They are usually very flexible.
Blood tests are done routinely. If you want to know what they all are, just ask your carer. As with most things, information is not freely offered but given when requested.
Amniocentesis (buikprikje) or villi biopsy (vlokkenstest) are available when appropriate. Insurance will cover the cost of the investigation if it is medically recommended. You may have to travel to a teaching hospital for such special requests.
Having a Baby - InTouch Rotterdam the Netherlands
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The above and in amatter of minutes with google be able to find one of the higher profile Rotterdam midwives floating around the net talking about ?Unnecesareans? in the style of your slightly more radical natural birth proponent , isn?t proof of anything.
But it does leave me room to think my concerns are not completely without a hint of potential foundation.
?Arguably, this is exactly what has happened with hospital birth in the UK - it has become normalised and poor outcomes are increasing as the system cannot cope with the rising load?
I wouldn?t disagree at all. During the period of transition the normalisation of hospital birth can?t NOT have impacted both the ability to provide care and the attitudes that lie behind the care proffered.
Perhaps the pace at which it took place and the slightly evangelical enthusiasm behind it led to a lack of forward planning which may have led to a ?hangover? of said transition evident in the system today.
(glowers menacingly at mental image of entire hospital staff, bar the 2 nice midwives who were determined that I wasn?t going to be a statistic in the name of birthing philosophy).
With any future changes it would be nice if we could actively take steps to avoid the mistakes of the past.
?Yes, of course everyone wants a birth to end with a healthy mum and a healthy baby but to me the mental health of the mother is an integral part of that and one that is too often ignored or trivialised.?
Absolute agree. I don?t think anybody is saying ?don?t care about the baby, give me the experience I want? regardless of whether they want a homebirth or an elective C-section without evident medical grounds.
What I think they are saying is all risks considered, I would like my sanity\emotional well being to be more than an irrelevant afterthought that can be dismissed on a whim.
I think that relates to women wanting home birth, epidurals, elective c-sections and everything else you can pick in between.