HW#41: Independent Research

Aspect: ACOG versus midwives arguments

A.) Annotated Bibliogaphy:
1.) Arnold, Jill. "New ACOG Opinion on Home Birth Touts Rights, Nixes HBAC and CPMs." Theunnecesarean.com. Unnecesarean, 21 Jan 2011. Web. 29 Mar 2011. .

--> This article argues from the perspective of the ACOG on home birth. They argue here that though they believe women should have the right to decide where to give birth, women should know the risks of homebirth. They also emphasize that timely transportation to a hospital will lead to good home birth outcomes.
I think this is a useful source because these are some of the arguments from ACOG who aren't really for home births. Even if a women decides to give birth with midwives, ACOG still wants them to visit hospitals which I find odd. Since I also read 'Birth in the USA' I can't help but question on what evidence ACOG is saying that home birth has an "increased risk of neonatal death," compared to hospital birth.
This resource furthered my opinion that ACOG may be lying about some of their arguments of why hospital birth is better than home birth. This source made me want to look up the actual data ACOG bases their opinion on.

2.)"The American College of Obstetricians and Gynecologists Issues Opinion." ACOG. American Congress of Obstetricians and Gynecologists, 20 Jan 2011. Web. 29 Mar 2011. .

--> This is the ACOG website, so obviously they are arguing against homebirth. They use the same arguments as used from the first source I chose, but with more advice that seem alarming to me. Here, ACOG lists conditions of women who should not have home births-making midwives seem as though their capabilities during the birth process is limited severly. They also emphasize the use of screening and prenatal care in home births.
I would have been convinced by these opinions if I had not read the book for the birth unit. ACOG's opinions on home births still seem vague and questionable. ACOG also urges prenatal care if women are choosing to do home births. I'm not sure if ACOG's arguments that hospital birth is 'more safe' than home births is reliable enough.

3.)Blue, Laura. "Why Do U.S. Infants Die Too Often?." TIME 13 May 2008: n. pag. Web. 29 Mar 2011. .

--> This article seems a bit on the Obsterics side, but admits the problems of hospital care in the U.S. as a statician. Babies in the U.S mortality rate for babies is horrible despite it being a developed country. The main reason is because babies are too small or has a low birth weight. The writer also mentions about medical interventions, inducing labor, and pre-term C-sections.
This is written from the view of a statician, so clearly numbers are showing that medical interventions and C-sections are causing U.S baby mortality rates to keep rising. This shows that OBGYB's interventions are not for the benefit of the mother or child.

4.)Warren, Jaime. "Cytotec: From Ulcers To Inductions." CaesareanBirth.Com (2003): n. pag. Web. 29 Mar 2011. .

---> This article talks about the risks of Cytotec, the most cheapest and most commonly used drug for inducing labor in hospitals. These risks are more severe than Pitocin, and causes death or severe damage to the fetus. Doctors in hospitals continue to use Cytotec even though it is only FDA approved for treating ulcers.

5.)"Misoprostol." PubMed health. National Center for Biotechnology Information, 01 Sep 2008. Web. 29 Mar 2011. .

--> To confirm the dangers of Cytotec, I looked up the drug itself. (Misoprostol is another word for Cytotec). Clearly, Cytotec has dangers for preganant women, and still is used for inducing labor. It can cause miscarridge, premature labor, and other birth defects.
This supports that something is wrong with hospital birth. OBGYN's are allowed to use a drug that is not recommended for pregnant women. Cytotec puts the baby (and the mother's) life in danger, and it is unnecessary.

B.)So far, from these resources I was able to confirm the dangers of giving birth in hospitals, and the amount of statistics/data that show that hospital birth is not really as safe as ACOG says. I am considering to write an essay for the project, emphasizing the dangers and risks of hospital births in the USA. I feel as if the public does not know enough because of the assumption that hospitals are reliable all the time. Hopefully, the essay can convince people who are for hospital birth that perhaps this dominant practice of going to a hospital is questionable-and only helps doctors to take advantage of this assumption.

HW#40: Insights from Book Part 3

You find yourself at a cocktail party with the author of the book you just finished reading. To demonstrate that you really read it, you say, "Hey - thanks for writing "Born in the USA: How a Broken Maternity System myst be Fixed to put Women and Children First". Your main idea, explaining the dangers of the maternity care system in the USA and your solutions to those problems made me rethink about pregnancy & birth."

But the author, surprised to be talking to someone who instead of sharing their own birth story actually rephrased the main idea of the text he spent months giving birth to asks, "Really, which parts were most effective or important for you?" When you answer, "Well, in the last third of the book you focused on the actual solutions and alternative ways of improving the broken maternity system we have in the U.S, which further developed the first 2/3rds of the book. But let me be more specific." And then you listed the top 3 ideas/pieces of evidence/insights/questions from that final third of the book (and somehow even listed page number references).
1. Communication between Obstetricians and midwives are essential. (page 206)
2. Litigation helps protects women, letting them speak out if they know their childbirth process was unnecessary and dangerous. (page 225)
3. Women should be able to choose their care provider, their birth place, and have her own birth plan that will be carried out even in hospitals. (page 248)

At this point, realizing that he's having a unique conversation with a serious reader of his book, the author asks - "But what could I have done to make this a better book - that would more effectively fulfill its mission?" You answer, "Well, let's be clear - your text sought to provide narratives, historical analysis, journalistic analysis, and policy analysis from the perspective of both mothers whose choices are limited in giving birth and the obstetricians for the book-reading-public to better understand pregnancy & birth in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be, to actually find obstetricians who can speak more in depth about their ignorance on the normal birth process. But I don't want you to feel like I'm criticizing. I appreciate the immense amount of labor you dedicated to this important issue and particularly for making me think about how our society depends on Obstetricians without questioning their medical and unnecessary interventions & the reasons why OBGYN's use these inerventions (because of fear of litigation and ignorance of seeing childbirth as a natural process. In fact, I'm likely to consider home birth and look up actual data to make sure Obstetricians aren't putting myself and a potential child at risk if I do give birth in a hospital as a result of your book." The author replies, "Thanks! Talking to you gives me hope about our future as a society!"

HW#39: Insights from Book part 2

1.) Wagner, Marsden. Born in the USA: How a Broken Maternity System must be Fixed to put Women and Children first. California: University of California Press, 2006. Print.

In general, the book and the film exspress a strong opinion for home birth over hospital birth. The book had a few things that was not mentioned in the film that I found important or interesting though.

-Having midwives was like common sense in 1452 in Germany.
-The start of the 19th century, marked the turning point of negative attitudes toward midwives. They were accused of witchcraft.
-There were cases in California where midwives were harassed and had random searches.
-Males in general are afraid of child birth and having no control (That's why they dissaprove midwives/home births)
-Despite research, ABC's (Alternative Birth Centers) are outlawed in Illinois.
-"Obstetricians are sued more than physicians in any other specialty." (Page 152)

2.) In the second hundred pages, the author goes more into depth about the difference between Obstetricians and midwives. Though research supports that midwives are safe, obstetricians make an effort to make themselves seem like the best choice. Obstetricians want control and are afraid of the process of birth.

Response: My attitudes toward OBGYN's completely changed. I was hoping that all doctors prioritize what is best for the patient/client over themselves. They're selfish that they put themselves before the mother/child. The system is corrupt and puts midwives in a disadvantage when doctors should be learning from them.

3a.) The public should know that, "Obstericians are sued more then physicians in any other specialty." (Page 152)
3b.) The public should know that there are legal protections for pregnant and birthing mothers that most women and health care professionals know very little of. (Page 173)
3c.) The public should know that ACOG allow obstetricians to use litigation to maintain monopoly. (Page 169)
3d.)The public should know that Obstetricians are afraid of litigation, causing them to turn to C-sections. (Page 154)
3e.)The public should know that midwives have been harassed before. There was a case in California where a midwife was randomly searched at her home because she was a midwife.
4.)I wanted to confirm about the liability issue with Obstetricians. I found a survey by ACOG that confirmed what the book said about sues and litigations.
"90.5% of respondents indicated they experienced at least one professional liability claim filed against
them during their professional careers, an average of 2.69 claims per ob‐gyn."
I also found that for claims on Obstetricians, "impaired infant claims" were the most common, with death of the baby as the second claim.
(http://www.acog.org/departments/professionalLiability/2009PLSurveyNational.pdf)

HW#38: Insights from pregnancy and birth book-part 1

"Born in the USA" By: Marsden Wagner, M.D., M.S.

1.) The book is broken into chapters that goes into depth of one of the problems involving OBGYN's the author believes should be informed to women in general. These chapters all revolve (so far) about the information doctors never tell patients for their own benefit.

2.) The last paragraph of the first chapter shows an overview of what the author will be investigating throughtout the book, "This book is designed to further an understanding of problems in the maternity care system in the United States." (Page 12) The essential question is would be, What is wrong with the U.S maternity health care system and what solutions are there?

Response: The problems of the maternity system is clearly written in the book, and I find the author reliable enough to gain my trust. He goes out of his way to write a book and hold speeches because of his strong belief in the right of women to be informed of their birthing process. I don't think there is a simple solution because the whole system would have to undergo change.

3.) The major insight from the book is that doctors in the maternity care system put themselves before patients. "The second reason obstetricians want more women to have C-sections is to avoid litigation. Obstetricians are desperate to stay out of courtrooms where, unlike in hospitals, they are vulnerable..." (Page 39)There were other reasons mentioned as well such as for their own convenience and taking less time for the process.

Response: This is both a shock and dissapointment to me. This insight made me realize how clueless I am about too dependent I am on doctors. This is frustrating because I really thought C-sections were only conducted for necessary reasons.

4a.) The public should be clearly notified of the rate of unnesessary C-sections in the U.S.
b.) The public should know that ACOG has no scientific data to support their clain that hospital birth is safer than home birth.
c.)The public should know that 'choosing to have a C-section even when its not medically necessary' can lead to the mother and/or baby to die.
d.)The public should know that C-sections usually happen on weekdays when its more convenient for the doctor, not necessarily the patient.
e.) The public should know that mothers give birth in a certain position only for the doctors benefit. Doctors are not even willing to be below the women even if it will make the birth process more natural.

5.) The author uses the voices of different perspectives to argue his point. He mentions actual birth stories of mothers, statistical data, and questions authorities in meetings. I find the evidence reliable because it is data that is usually hidden from the public. The evidences he uses to back up his claims are redundant though in each chapter.

HW 37: Comments on Birth & Pregnancy Stories

Comments to other group members:

To Raven:

"I found your post really interesting. The post made me re-think about the difficulty and feelings that comes across people during the process of birth. A line in particular that I liked was, "When she became pregnant it was no longer about herself, it was about “I have a baby growing inside of me, what I need to do to take care of this child?” She also began talking about how through raising children you are able to reflect and change some of the things you were brought up with." This is a pattern I notice with the people I interviewed as well. I think its because a new life brings joy but also a responsibility. And, raising a child is no easy task so mothers always learn a few life lessons along the way. This makes me wonder if there is such a thing as an 'ideal' way to raise a child if the parent is also in a way learning from the new life."

To Ben:

"I found your post really interesting. I also interviewed a teen mother where the father also stayed by her side. I was really moved because I saw photos of the couple holding and smiling at the new born. This furthered my question of whether teen pregnancy is really all that bad if it is raised by loving parents. A line I liked was, "In fact, he did not even mention the possibility of abortion to her, and when she finally brought it up as something she would prefer not to do, he agreed 100 percent. This was practically shocking to me; its as if this 17 year old boy who has not even finished high school yet feels that he is ready and wants a child." This may seem irrational at first, but I also think that the idea of birth provokes the decision of not doing abortion if it is the killing of a new life."
-------------------------------------------------------------------------
Comments on my HW#36

From Raven:

"I enjoyed reading the account of your birth and it’s interesting that you mentioned the experience a person has with giving birth. I have always wondered what makes someone more experienced with giving birth than the next person and that is something I hope to learn in this unit. I also liked the line: “Living in Japan, my mother was affected by the assumptions people made about marriage and birth. This made me wonder if the culture here, in America, affects our decisions about pregnancy and birth as well.” I do believe the cultures in our society do influencec the way we view the process of pregnancy and birth because we follow the cultures of our society. I enjoyed reading your blog."

From Mom:

"I really enjoyed reading your post. I was also surprised about the teen mother, but through your post I found myself agreeing. If the mother has no regret with the child and really cherishes the new life, society should not be putting mothers down just because of age. A line I liked was, "My interview with her contradicted all my negative images of teen pregnancy. This dosn't mean we should have babies at a young age-but I'm starting to think it isn't always bad as long as your responsible enough."

From Ben:

"I was inspired by the amount of interesting ideas that I had not previously thought about that you were able to fit into this post. For instance, the way you describe your mothers reasons for having a child was largely based on cultural practices was very eye-opening for me. However, your most thought provoking line in my opinion was, "At first I felt bad for her, but I learned from her that having a baby at a young age isn't a 'mistake.' At least she dosn't think so. Why does our culture put down teen pregnancy so much?" This sentence really made me realize that so many people in our society look down on teen pregnancy, and yet usually don't provide any legitimate reasoning or evidence for their opinions. Great job!"

From Angela (Younger Commentor)

""Why does our culture put down teen pregnancy so much?"
I have to agree with this line because where my family is from, in Mexico it is quite common for most teenagers to be pregnant at this age, if not by their 20's. It seems that depending the culture, it will either reject or accept this idea. It was great that you got 3 people with 3 different experiences on the exact same subject and I feel that you also may have changed my mind a little. Maybe as long as you have the right support pregnancy shouldnt be looked as bad."