Is that the 'real' America?

[Hattie05]

Just watched maternity ward on discovery health.

It was set in an American hospital, and every single woman was strapped down, encouraged to have epidurals, and the slightest worry were sent to theatre for c-section.

Is this a true representation for America's maternity care? Any American mumsnetters here to answer?

I was really surprised, thought American's would be hot on natural births.

thanks,

I really think there's no such thing as "typical" America. it's too big and vast a place; the culture is too varied.

The only things I would say is that most hospitals would try to say no food or drink during labour, and you must have an IV when you go in... but if people are able to shop around, there are plenty of hospitals with other policies. Also they wisk the baby away & wash the creature immediately after birth (the thought of that makes me go ballistic). Also, there are usually lots more people attending a hospital birth, including an OB-GYN who is probably a man (that is too weird, for me!).

I worked in a health food shop in California for 4 years in the late 1980s & many of my female coworkers or their wives had home births for their first babies, attended only by a single midwife, and raved about how wonderful the births were. If I went back to live there I'm sure I'd fall in with a crowd like that all over again.

'including an OB-GYN who is probably a man (that is too weird, for me!). '

I never could get my head round this, zeb. I mean, would you go to an automechanic who never owned his own car?

Pardon my French, but I could probably get a PhD in cock, at the end of the day, I still don't know what it's like to have one between my legs, so far be it from me to tell someone what to do w/his - well, passionate orders excepted .

But then, I was a hippy dippy who lived in Boulder.

Hi everyone, this is such a coincidence about our two threads today. Didn't even know about this one until Hattie05 mentioned it on my thread.

One really, really interesting part of my experience is that I used a midwife clinic (which is not at all the norm here) in the hopes of a non-intervention birth and they were actually much, much worse than (I believe) an OB would have been. They seemed to be more concerned about keeping their c-section stats down than whether ds and I were just going to labor until one or both of us died.

If I had gone with a typical birth scenario here I would have 1)had a late-term scan which would have shown that the baby was breech and 2) had a scheduled c-section - which would not have been at a teaching hospital!

I have had two friends who had c-sections at other hospitals and were not strapped down, so am hoping that that part of my experience (which was really, really terrible) is not now the norm at private hospitals.

As far as male OB's go, in general I have tended to use female OB's. However, during the birth of my son I had:
pre-natal care from 4 different female midwives in the last trimester who all assured me he was head-down (for some reason I was paranoid about this and kept asking - premonition?)

a high risk OB and intern - both females - who checked me in the midst of it all, telling me he was engaged and to "carry on"

and finally, my blessed savior OB who came in, pronounced ds frank breech within seconds and had him out of me within the hour who was ...MALE!

Dh looked at me later and said, "Sorry, hon, it was a bad day for the Goddesses, wasn't it?"

I didn't know whether to laugh or cry.

Naomi Wolf's book Misconceptions is very interesting on this subject. I felt fairly despairing of American attitudes to childbirth having read it. Wolf couldn't get what she wanted fgs, it all sounded awful, very medicalised.

I did notice when I watched it just before having ds (in the pool with just a midwife and not a doctor or theatre in sight) that the 18 year old black girl who had no idea she was pregnant was expected to labour and birth with no pain relief, whilst they hauled some poor white baby back up the birth canal and did a cs because it was breech.

Wolfe takes simpering and moaning to an art form, however. I mean, she makes Gwenyth Paltrow seems laid-back.

Wolfe takes simpering and moaning to an art form, however. I mean, she makes Gwenyth Paltrow seems laid-back.

I guess my take on it all, at this point, is that, in going for a very un-American, progressive style of birth, ds and I almost died and I wound up with PN PTSD. Whereas, if I had followed the more medical style of birthing here that wouldn't have happened. I still think the idea of laboring flat on one's back with legs in stirrups is ridiculous, and thankfully OB's are starting to get away from that. But the scary thing for me is that the midwife clinic I went to was supposed to be topnotch and the most likely to refer you if anything went wrong. However, while under their care I had -
a thyroid level that got dangerously low, even after I had advised them that I was on medication for low thyroid.

pre-term labor at 30 weeks which was managed appropriately the day it happened and then never referred to again. My query as to partial bed-rest was dismissed.

escalating hypertension that was virtually dismissed

alarming fluid retention, i.e. disappearing ankles and toes the size of small sausages, that was really never addressed

So my attitiude now is completely different than it was 3 years ago. While it would have been nice to have had one of the wonderful birth experiences that I have read about on MN and elsewhere, I do not think it is worth the risk of what I went through in trying to have it. If dh and I are able to conceive again, I will definitely go for a scheduled c-section and a highly medicalized approach to my pre-natal care. What I did before went against all of my training in healthcare and the cost was too high. I had decided that birth was such a "natural" experience that I really didn't need a lot of OB's interfering in it. I forgot that before a lot of this technology was available a lot of mothers and babies "naturally" died.

US birth culture is on the whole very medicalised.
The whole of the care is more medicalised (so is the French and the South American).
This is one of the reasons there are over 5000 doulas in the US as some women are not prepared to have it all medicalised or at least wnat an advocate there.
I was speaking to a US doc who said that doulas were preventing some doctors to do what ever they wanted (usually speeding up matters as it is getting late!) as at least the doula was a witness to possible unncessary intervention ....
There are natural childbirth gurus like Ina May Gaskin.
There have been articles in the NY Times about not allowing VBACS anymore... and then the trends flips back....

But then you have midwives like mine who wanted me to labor up to 72 hours after my membranes had ruptured never even realizing that the baby was frank breech. An OB would have done a c-section withing 24 hours and we would have been much better off.

LOL, expat, just read your post!

I had a male ob/gyn and he was brilliant. Had been working in the field for 20 years and was very knowledgeable. Didn't bother me in the slightest that he was male.

When I went into labour it was his weekend off (typical) so his replacement came in - also a man. A gorgeous one too!

My main problems were: 1. Not being told I needed to tak emy own blankets and pillow to hospital, so dp having to rush back and get them. 2. Being followed back down from having epidural by some guy who as soon as we got in our room handed us a bill for the anaesthetist.

at the bill for epidural!!

Which country were you in caribbeanqueen?

jabberwocky, do you think your 'natural' birth went so badly because it's such an unusual approach in the usa?
The midwives maybe don't have the same skills and expertise and experience as they do in the uk where a midwife led birth is the norm?

I am American and it was reading a book by Ina May Gaskin (thanks pupuce - I was wracking my brains for her name!) when I was 18 that inspired me to have homebirths - which I eventually did, in the UK. I felt strongly about it, but don't know if I would have been able to follow it through if I had been pg there. At the time knowing about the interventionist / medicalised nature of American approach pushed me more towards homebirth - but that was before I even had a boyfriend..

I am American, but have had both of my children here in the UK. However, my sisters both have had children in the US. They are both fairly anti-intervention. I was happy to go with the norm here and go for natural childbirth (well, with epidural). But then things didn't go well and I ended up in an emergency caesarean (and I mean emergency), and in retrospect I believe the situation could have been forseen and I never should have been induced at 2 weeks overdue. I could go on... but enough said on that. As a result I am absolutely in favour of the medicalised approach. I think pregnant women should be cared for by obstetricians, and babies should most certainly be delived in hospitals be obstetricians. I would never have it any other way.

yuk! for the most part i don't trust like or trust doctors. i'm glad my dealings w/them during pregnancy and birth was minimal.

it's a bodily function, NOT an illness or medical condition.

Ooooo... expat, I completely disagree. Having a pee is a bodily funtion. Having a baby is lot more complicated. I am the youngess of three girls (and one boy, but he doesn't count on this subject) and my mother and both of my sisters before me had all their children without a single complication and so I just thought that would be the case for me too. But oh WOW was I wrong. I'll never think that again. I would have been better off with DD's birth if they had scanned an ontervened about two weeks before they stupidly induced me. She was never going to come out naturally alive.

I am a frim believer that medical intervention saves lives, and that's a very good thing.

medical intervention would have put me over the edge. my anxiety was sky-high to begin with.

my mum had c-sections w/both of us.

if i'd have been in the US, i probably would have had a c-section w/dd1. i'm SO glad i wasn't there. she was a forceps delivery, but i can imagine who much worse my PND would have been if i'd also been recovering from major abdominal surgery, which wasn't necessary.

w/dd2, i was allowed to labour in the position that felt best for ME, not what was most comfortable for the midwives field of vision. and again, im SO glad - i laboured on all fours and suffered only a graze.

Well, we'll just have to agree to disagree on this one.

But, out of curiosity, why do you think a c-section would contribute to PND? I have no experience of PND, so if this is really ignorant questions I apologise.

well, i've had 4 major surgeries on my knees. i felt like utter SHITE after each one, and that was w/o PND. so i can only imagine how having to recover from major abdominal surgery w/a mental illness and a tiny baby to care for would have been like.

glad i was allowed to labour for as long as i could.

Oh yes, I remember you very impressive understanding of the human knee. I too have had an ACL reconstruction. And to be honest I think the recovery from that was worse than the section.

Anyway, glad you got what you wanted. I suppose that's how it should be: however mum wants it. Sections for me and all fours for you.