Birthing mother abused for refusing male nurse 2

[sakura184]

I was actually quite glad the thread reached 1k as I'm not really enjoying it at all, but I've started this on me just in case there is anything else to add.

It ended on the note of talking about the subject of baby centered care.

I think negligence, forced intervention and poor treatment in hospitals can be just as responsible for a damaged baby as a woman who decides to go it completely alone.

One thing I will say, is that we can't have it both ways. We can't insist women are listened to and then blame the hospital when/if it all goes wrong.

But it seems that some women are being overriden by doctors, mainly by arrogance , but perhaps also a fear that they may be sued or something, I don't know. the doctor knows best model still seems to be the norm in hospitals. Women need to be listened to and catered to a lot more

see what you mean, I mean I would yeh?

What does this mean? With the yeh?

America is just a mess overall with regard to birth

Healthcare, especially women's health is a mess in the US.

It makes you realise what you take for granted in the UK.

sorry! I mean I would train properly if I wished to be a healthcare professional, yeh.

I'd also probably not go to someone who was a "lay cardiologist" or a "lay dentist" because I think medical professionals should be trained professionals. But lots of people will go to lay midwives (CPMs).

I see what you mean, I mean I would yeh? But it's an undergraduate degree then a postgraduate nursing qualification with a specialism in midwifery, and then they have to practice within regulations and boundaries and can't do the lovely home births that they really want to.

I still don't get it. Why wouldnt you get those qualifications, if you could? You could still take on high risk births outside the regulations couldn't you?
The fact these women are , quite literally, uneducated, tells me about their class. And says a lot about what's going on, and frankly says a lot about how powerless birthing women are and how futile it must be to try to change the system to a more female friendly model

You could still take on high risk births outside the regulations couldn't you?

You could, but if found doing it, you'd lose the accreditation you'd spent money qualifying for.

And you wouldn't have valid insurance if you operated outside the regulations.

I don't know know why I wouldn't because I would. I can only imagine that they do not wish to work within the existing system OR they are unable to get the qualifications for whatever reason.

Midwifery education in the UK is reasonably good, and it has a very high drop-out rate and is very hard to get into. I can imagine that people who don't make the grade or who leave a program would be tempted to go another route if one was available.

As to being able to take on high-risk births outside the regulations there are two facets to this:

1. You would not want to. You would have the training and education to understand the risks and would not want to encourage or support that risk.

1. Your employer, insurance provider, and regulatory body would likely have grounds for termination of your job/insurance/registration if you were found to be working outside your scope of practice. So you might want to keep your career that you worked so hard to get.

Maybe have a look at this Sakura, it is by the same doctor who wrote the piece for the New York Times (linked above). It shows some of the concerns relating to NCB ideology and the impact on women. I think her recommendations for truly women-centred care make a lot of sense, although I would add that ability to choose a female care-provider is also crucial :)

www.skepticalob.com/2019/07/women-cant-reclaim-their-agency-from-doctors-by-ceding-it-to-midwives-and-lactation-consultants.html

Here's some stuff about infant mortality and how it's recorded:

However, the method of calculating IMR often varies widely between countries, and is based on how they define a live birth and how many premature infants are born in the country. Reporting of infant mortality rates can be inconsistent, and may be understated, depending on a nation's live birth criterion, vital registration system, and reporting practices. The reported IMR provides one statistic which reflects the standard of living in each nation. Changes in the infant mortality rate reflect social and technical capacities[clarification needed] of a nation's population. The World Health Organization (WHO) defines a live birth as any infant born demonstrating independent signs of life, including breathing, heartbeat, umbilical cord pulsation or definite movement of voluntary muscles. This definition is used in Austria, for example. The WHO definition is also used in Germany, but with one slight modification: muscle movement is not considered to be a sign of life. Many countries, however, including certain European states (e.g. France) and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and increases their rates of perinatal mortality. In the Czech Republic and Bulgaria, for instance, requirements for live birth are even higher.

Although many countries have vital registration systems and certain reporting practices, there are many inaccuracies, particularly in undeveloped nations, in the statistics of the number of infants dying. Studies have shown that comparing three information sources (official registries, household surveys, and popular reporters) that the "popular death reporters" are the most accurate. Popular death reporters include midwives, gravediggers, coffin builders, priests, and others—essentially people who knew the most about the child's death. In developing nations, access to vital registries, and other government-run systems which record births and deaths, is difficult for poor families for several reasons. These struggles force stress on families[clarification needed], and make them take drastic measures[clarification needed] in unofficial death ceremonies for their deceased infants. As a result, government statistics will inaccurately reflect a nation's infant mortality rate. Popular death reporters have first-hand information, and provided this information can be collected and collated, can provide reliable data which provide a nation with accurate death counts and meaningful causes of deaths that can be measured/studied.

And

Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages (spontaneous abortions) or those who die during or immediately after childbirth as stillborn. Therefore, the quality of a country's documentation of perinatal mortality can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the demographer Ansley Coale, who finds dubiously high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries. It suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths, but also that those countries do not follow WHO recommendations for the reporting of live births and infant deaths

Another seemingly paradoxical finding, is that when countries with poor medical services introduce new medical centers and services, instead of declining, the reported IMRs often increase for a time. This is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. Thus, even if the new health services reduce the actual IMR, the reported IMR may increase.

And

The exclusion of any high-risk infants from the denominator or numerator in reported IMRs can cause problems in making comparisons. Many countries, including the United States, Sweden and Germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but according to United States some other countries differ in these practices. All of the countries named adopted the WHO definitions in the late 1980s or early 1990s, which are used throughout the European Union.

However, in 2009, the US CDC issued a report that stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries. It also outlined the differences in reporting requirements between the United States and Europe, noting that France, the Czech Republic, Ireland, the Netherlands, and Poland do not report all live births of babies under 500 g and/or 22 weeks of gestation. However, the differences in reporting are unlikely to be the primary explanation for the United States' relatively low international ranking. Rather, the report concluded that primary reason for the United States’ higher infant mortality rate when compared with Europe was the United States’ much higher percentage of preterm births.

en.m.wikipedia.org/wiki/Infant_mortality

Loops I've got to honest and say I'm not a big fan of the skepitalob blog. I find it can be too anti midwife because it's American and doesn't reflect how midwives practice in the UK.

That piece is good though.

Midwives and doctors need to be both respected for their different skills and they should enhance each other rather than be ideological enemies. When the two disciplines work at odds with each other its women who fall through the cracks.

The Morecambe Bay report found this tribalism between disciplines and internally amongst midwives was a factor in what went wrong in Cumbria.

When questions were asked following the deaths of babies, a group of midwives - who dubbed themselves "the musketeers" colluded to give the same story. Relations between midwives and doctors were "seriously dysfunctional".

And

By 2011 the trust had the highest mortality rate in the country, with 600 “excess deaths” in the previous four years. Yet watchdogs who carried out an inspection the previous year gave it a clean bill of health.

They were not told about an internal review carried out by the trust, which the year before had highlighted concerns about the “dysfunctional” relationship between midwives and doctors, which was jeopardising safety.

Concerns were also raised that the Nursing and Midwifery Council failed to act when concerns were raised - the midwives were put ahead of patients because there was no review into whether certain midwives were fit to practice. Which is the purpose of the NMC. It was a closing of ranks and helped to cover up poor record keeping. Inside the organisation treated families who tried to complain 'as difficult'. This was despite evidence passed to them by police.

I don't particularly think Midwifery is always more women centred than consultant care.

Both are guilty of allowing women to be a football ideologically.

I think if a home birth midwife lost a mother or a baby she'd be absolutely vilified. It'd be a total witchhunt. That's why I'm confident these women know what the fuck they're doing

Huh? You can know what you are doing and things can still go wrong. You would blame the midwife? Or you think nothing can go wrong because the midwife won’t allow it because she knows what she is doing? What?

Women are not having high-risk births at home due to hospitals being a hotbed of misogyny. They are doing it because of the pervasive idea that birth is natural, problems are caused by doctors, bodies know how to give birth, everything is a "variation of normal" and they are the experts in their own births.

Misogyny? I don't know, but women in the US absolutely avoid hospital births because of the practices in maternity care that are disrespectful and not evidence based. Not allowing VBACS, not allowing any food, insisting on delivering laying down on their backs, insisting on inductions where they aren't warranted, just to name a few.
Then, because their system is so doctor focused and really denigrates other approaches, those women are stuck with midwives operating outside the system as the only way to avoid a bad hospital, and it's difficult for them to transfer to hospital if it becomes necessary, not just because of worry they will have legal repercussions but because there are no protocols to do it and so it isn't a smooth process.

It really isn't just women being seduced by natural birth woo.

The traumatic births that haunt women for decades. Today in the Daily Mail.

www.dailymail.co.uk/femail/article-7257843/The-traumatic-births-haunt-women-DECADES.html

I think this is a good answer to what @loopsdefruit was saying about risk. There are different kinds of risk that you need to weigh up and if you are traumatized for years because of what happens during your birth, that will affect you relationships with your child and your other children. It's not selfish to care about birth experience at all.

"Even when a traumatised woman is aware of her symptoms, she will often find them misdiagnosed as post-natal depression — which is characterised by low mood and a lack of joy or pleasure, rather than the heightened sense of threat we see in trauma — or dismissed entirely."

This is so true. It's like, being utterly miserable and traumatized has become so normal for mothers, when we should be outraged.

There's also that really weird tendency to blame mothers. That mother in the OP article, if only she had been more prepared! If only she had not had so much anxiety! Someone even said that she might have "seemed ungrateful" to staff. But these crazy women what can you do.

Even just having an caesarian, you're off your feet for six weeks. That's no big deal only if the first six weeks of life connecting with your baby are no big deal. In the article above, she says that maternal trauma is linked to caesarians. And that's only one thing.

Even just having an caesarian, you're off your feet for six weeks

What? That isn't true.

You could still take on high risk births outside the regulations couldn't you?*

You could, but if found doing it, you'd lose the accreditation you'd spent money qualifying for.

And you wouldn't have valid insurance if you operated outside the regulations.*

Exactly. Why risk it? So these women are more likely disenfranchised women, helping other disenfranchised and, frankly, terrified women, because let's be honest who would to go to a lay person rather than a professional. Like loops said, you wouldn't go to a lay dentist would you? So there is something terribly terribly wrong with the system, with hospitals basically, if women are doing this.

And the issue of the mothers putting their babies at risk. It seems that a lot of mothers would rather put their babies at risk than have a hospital birth and that tells us a lot. It tells me they've probably had a hospital birth and something abominable happened.

I'm not talking for me here, as I've said if I thought a hospital birth had been safer I'd have had one but the evidence I found from
Different sources told me a homebirth was safer for my low risk healthy pregnancy at the age of 25 ( then 27)

@lassoffyvie

Yeah, you're right. I said it wrong. I mean, you can't drive or pick up your toddler. It takes time to recover. And your body takes energy to heal as well as the other baby stuff. But yes you can walk.

So these women are more likely disenfranchised women, helping other disenfranchised and, frankly, terrified women, because let's be honest who would to go to a lay person rather than a professional. Like loops said, you wouldn't go to a lay dentist would you?

They might be.

But they also might be ideological quacks out to make money out of the opportunity that the cracks in the system leave.

Many are operating illegally. That's always going to open up risk to extremely vulnerable women who effectively can't afford an alternative regulated midwife.

Maniak

I read that some women get so fucked over by hospitals that they end up with both and episiotomy and a c section. Imagine trying to recover from that

Many are operating illegally. That's always going to open up risk to extremely vulnerable women who effectively can't afford an alternative regulated midwife.*

No I'm sorry I just don't think women are that interested in going to jail. I think they'd rather have an education so they can practice midwifery within the confines of the law.

The problem is not what you say. The women they assist are extremely vulnerable -- to the extent that they need to use a lay midwife because they feel it's the only option for them, because (I'm guessing) they're terrified of hospital births. Now please tell me, what the fuck are hospitals playing at to instill such terror?

I will not entertain arguments that the midwives are instilling terror of hospitals I think it's the women's own experiences in hospitals that are driving them to underground midwives

Well yeah. And it's not just the physical injuries. There can be full on psychological trauma. Even what the pp described about having to regularly be naked and examined totally unnecessarily. I mean, these are techniques used in torture.

I wish I had gone for home births. It never occurred to me though.

No I'm sorry I just don't think women are that interested in going to jail. I think they'd rather have an education so they can practice midwifery within the confines of the law.

If there is money to be made from operating outside the law because there is a demand for a service because alternatives are unaffordable, there will always be people who take advantage of that.

Some of them might be very well meaning rather than outwardly malicious, but if they aren't regulated they don't practice ethics and might be ideologically biased in the way they practice which endangers women they might be intending to help.

The lack of medical training is a problem. It allows fallacies and antedata to dominate rather than a detached approach which is based on evidence based practice.

What struck me through reading through the US stuff last night was how these midwives operating outside the law don't keep records and notes. That means they can't be scrutinised and held to account for bad practice easily.

Maniak

Well yes I mentioned my ante natal care. I remember having to pee into cups a lot, which was a bit embarrassing, but I passed it through a hatch so I never had to hand the pee cup actually to another person: it was all done to avoid my embarrassment, which was nice.
Neither midwife deemed to necessary to do an internal examination during my pregnancies: the first internal I had was when I was in labour with my first. With my second midwife I never got a single internal exam.
What I think it is is this: while an internal exam might tell you something about a woman's body, some midwives just don't think it's worth bothering with.

I wonder how many male midwives and ob/gyns share this laissez fare attitude to internal exams. I suspect they all believe they're totally necessary at all times. typical

If there is money to be made from operating outside the law because there is a demand for a service because alternatives are unaffordable, there will always be people who take advantage of that.

They literally remind me of the witches persecuted during the witchcraze because they were making money one of the only ways women could, through midwifery.

Then they all got murdered because male physicians couldn't compete with them because women always preferred a female assistant in birth and therefore women were the go-to.

I wish these women could get educated and licensed so they can help women better , but basically they're poor women aren't they