To think the US paediatrician system is weird

[shaniahoo]

I'm on a few parenting groups that are American and the way they talk about their pediatrician is so alien to me. The ped seems to have a lot of power. Like, the hard line of these groups is that you always follow your ped's advice and nobody is allowed to question what a poster's pediatrician told them. But a lot of it seems like non-medical parenting advice? Everyone has their ped tell them when to start solids and they follow that - so they might tell you to start at 4 months so you do that or if they tell you to start at 6 months you do that. And everyone has to have their paediatrician "clear" their baby to start solids before they start. And the ped "clears" you to start sleep training or tells you you must do it or must not do it, and you do what they say. I suppose the equivalent here is the HV but you don't see them nearly so much and there's no sense among parents that you must do whatever your HV says.
AIBU to think this takes autonomy away from parents? Or is it great that they have so much advice and support?

Home births are not illegal but it has been well publicised in the UK that many/most midwives can not get insurance for home births.

this is the claim, but as we get more and more experience with the vaccine it seems that a rise in the incidence of shingles is happening regardless and therefore the approach is not working.

Yes that is true that the rate of shingles has risen.

This is false.

Home birth itself is not illegal. in a couple of states, it's not legal for midwives to attend them.

Certified nurse-midwives perform approximately 10% of American deliveries. If you're low risk, and want a midwife to attend you in hospital, you have fairly good odds of finding one. Keep in mind that the US has only slightly fewer midwife led births than Canada--the OB-led system is not unique to us. And Canada has better outcomes than either the US or the UK.

One issue with home birth is that typically they are attended by non-nurse midwives who are educated to a lesser standard (they don't require college at all and are only trained for home).

No, the CDC recommendation was in 2017
www.gsk.com/en-gb/media/press-releases/cdc-s-advisory-committee-on-immunization-practices-recommends-shingrix-as-the-preferred-vaccine-for-the-prevention-of-shingles-for-adults-aged-50-and-up/

The Uk recommendation was in 2021.

Talk about cherry picking, you might not have noticed that the 1 in 3 number in the US is across the whole population, so including the immune compromised. The 1 in 4 number in the UK is in people 70 and above.

I'm still waiting for you to explain this one (from your earlier post)?
and the mortality rate is significantly higher in the US from shingles.

I get it. US healthcare BAD. UK healthcare GOOD. Why not just say that's your preconceived bias, based on things you've heard, and not bother pretending it's a nuanced and educated position?

Ok, off to make dinner. Have a nice night.

PS - correction above - for some reason I typed 2 weeks after birth. Medicaid traditionally ends 2 months after childbirth.

No 1 in 4 adults in the UK have shingles in their lifetime. It si less common than in the US where the incidence is 1 in 3.

Many of the adults in my UK family have had shingles. Only one actually saw a doctor for it. The others are all unrecorded.

My mum tried to see her GP when she got shingles but was told there was a two week wait so she gave up trying.

The one person who did eventually manage to see a GP had to wait so long that it was far too late for antivirals and they are now just treating the horrendous neuropathic conditions she’s developed.

Also to give some context and show how the US is, in some ways, 50 countries:

The maternal mortality rate in the USA is 17.4.
In Louisiana, it is 58.1.
In California, it is 4. (CA engaged in a concerted effort to reduce maternal mortality and has had striking results.)

for comparison, it is 6.5 in the UK, 3 in Israel, and 1.6 in Denmark.

By the way, comparing infant mortality may be tricky as some researchers say the US uses a more expansive definition than some other countries. But again, IMR is 3.92 in California, 8.12 in Mississippi. It's 3.6 in the UK. So yes, the UK is doing better, but how much better is very locally dependent--and since California is a very diverse state economically and racially, that difference is not explicable by those factors.

www.theguardian.com/us-news/2017/oct/05/new-york-staten-island-university-hospital-c-section-ethics-medicine

Forced c sections for a start.

Add to that forced vaginal exams for admission to hospital.

Coercion to have epidurals, episiotomy, birthing on back, etc.

Male genital mutilation after birth.

As above coercion to have vaccines and internals before getting the pill.

I have had shingles and can always get an on the day appointment with my GP but appreciate that is not the same for everyone.

@knitnerd90 How does the US definition vary from other countries? They record infant under 1 years old and under 5 years old. Since this is about deaths I can't see any other way of recording it than actual deaths?

They record live births differently, any baby that takes a breath I think whereas some countries only count over a certain birth weight I think, so some very very premature babies that live just for a few minutes would be counted in the us but might not in some other countries.

Just googled and you are right for the United States. But the UK counts for stats of live births and baby of any gestation born with signs of life or stillbirths after 24 weeks. So that is a wider definition than the US,

@Aphrathestorm
The country you have in mind is North Korea.

Americans are forced to circumcise their sons???

Not true. Yes it is common here (getting less common), but as for "forcing" anyone, that is ridiculous.

Actually if you are low income you are more likely to be "forced" to NOT have your son circumcised because a lot of state Medicaids are refusing to pay for it now. So in that situation I would guess that you are glad that they are being forced to NOT have it done (unless they pay for it themselves). So force is good thing when its something you agree with I would assume.

I was coerced into an induction I didn’t want nor needed and lied to about checking my bishop’s score with my first and given an episiotomy without my knowledge with my second and I was fully aware and able to consent to one nor was it even mentioned to me when it was done (the midwife told me when I was on the post-natal ward), all here in England. I also know other women who had babies who had similar experiences of lack of consent and questions brushed off, again in England.

Maternity care here is not that great either. It’s not just the US.

Read the article you cited again and you'll clearly see that no major medical organization supports overriding a mother's right to refuse treatment.

"Male genital mutilation"? No parent is forced to consent to having an infant circumcised!

Epidurals are available if women want them (and thank God for that!), but the rest is nonsense.

Honestly, just believe what you want and ignore the prior UK posters that have given birth in the US and had good experiences. Or keep trying to dig up scary articles of US women who have had bad experiences. Or even scroll the front page of MN to read threads by women in the UK who describe their birth experiences in UK hospitals as " traumatic".

No one is saying lots of women in the US and UK do not have good births.

Once again, no knowing what you're talking about will reduce the legitimacy of your arguments every time. I know it doesn't matter to you, and you'll just jump to the next. Did you even have a look at the world bank chart on infant mortality that I posted earlier? It's very nice. It even has a slider so you can sort results by country and income level. If had, you'd see that the US and the UK are extremely close, statistically.

In the US, the definition of live birth will vary from state to state, with each state determining its own reporting criteria. Below is from Oregon (a fairly liberal state). I know facts won't matter to you, but it's worth having a read below.

@Wallaw I accepted your definition of live birth that you posted applied to the US. Then you berate me for believing what you said.
Bloody hell!!!

No, just posting a bunch of utter nonsense about male genital mutilation and forced medical procedures as if it's some kind of norm.🙄

@GulfCoastBeachGirl I did not post about that. That was someone else.

Huh? The only thing I've previously posted about definitions was this

Also, you would do well to bear in mind that there are differences in the way countries count infant mortality, with the US more likely to count infants on the threshold of viability as live births than many other countries which are more likely to count them as miscarriages or stillbirths.

Perhaps you're confusing me with someone else? I've posted quite a lot of information for you, but you don't seem to have looked at any of it.

Good night

The birth situation in the US isn't always amazing, but that reads a bit like someone got all their information from The Business of Being Born. Episiotomy rates have declined dramatically.

As someone who gave birth in both hospitals, the UK is not necessarily better, just different. Let's not forget that midwives' ideology and the Campaign for Normal Birth killed women and babies.