I had a different UO, but I guess I'll change it and say I'm a huge HP fan! I discovered them after the third book came out, and it was a really good time in my life (newlyweds), so I have pleasant memories associated with them. It's been a blast introducing them to the boys, and I look forward to doing it again with baby girl.
Okay, my original UO will likely tie into ggandlee's, who said she has strong feels about who delivers newborns. There is no argument out there strong enough to convince me to deliver a baby at home. I get the concerns with hospitals, and I know that women have been birthing babies without doctors for millennia, but it's not a process devoid of danger for both the mom and baby. There are reasons death rates for delivering mothers and their babies are so significantly reduced, and it has everything to do with modern medicine.
I already leaned that way, but I just got the full story on a friend's birth experience (her twins are our babies' age). Her son's heart stopped during labor, and she was rushed to the OR where they got him out and resuscitated him. It happens, and sometimes for no foreseeable, explainable reason.
Agree, there's so much that can go wrong! I'd prefer to be in the safest place (in my opinion) possible. I want a NICU, OR, Extra doctors, etc available just in case!
I had a different UO, but I guess I'll change it and say I'm a huge HP fan! I discovered them after the third book came out, and it was a really good time in my life (newlyweds), so I have pleasant memories associated with them. It's been a blast introducing them to the boys, and I look forward to doing it again with baby girl.
Okay, my original UO will likely tie into ggandlee's, who said she has strong feels about who delivers newborns. There is no argument out there strong enough to convince me to deliver a baby at home. I get the concerns with hospitals, and I know that women have been birthing babies without doctors for millennia, but it's not a process devoid of danger for both the mom and baby. There are reasons death rates for delivering mothers and their babies are so significantly reduced, and it has everything to do with modern medicine.
I already leaned that way, but I just got the full story on a friend's birth experience (her twins are our babies' age). Her son's heart stopped during labor, and she was rushed to the OR where they got him out and resuscitated him. It happens, and sometimes for no foreseeable, explainable reason.
Fully agree. Hannah came out with the cord wrapped around her neck and they had to suction her throat right away. Her first apgar was a 3 I believe. No way in heck would I choose to deliver outside of a hospital. Plus drugs.
I had a different UO, but I guess I'll change it and say I'm a huge HP fan! I discovered them after the third book came out, and it was a really good time in my life (newlyweds), so I have pleasant memories associated with them. It's been a blast introducing them to the boys, and I look forward to doing it again with baby girl.
Okay, my original UO will likely tie into ggandlee's, who said she has strong feels about who delivers newborns. There is no argument out there strong enough to convince me to deliver a baby at home. I get the concerns with hospitals, and I know that women have been birthing babies without doctors for millennia, but it's not a process devoid of danger for both the mom and baby. There are reasons death rates for delivering mothers and their babies are so significantly reduced, and it has everything to do with modern medicine.
I already leaned that way, but I just got the full story on a friend's birth experience (her twins are our babies' age). Her son's heart stopped during labor, and she was rushed to the OR where they got him out and resuscitated him. It happens, and sometimes for no foreseeable, explainable reason.
I agree. You hear of people having home births because it was an "easy pregnancy" or they don't anticipate complications. Well, a lot of people have easy pregnancies with no complications...until there are complications!
To me, it's like wearing a seatbelt, or vaccinating your child, or not putting blankets into the crib with a newborn baby...we are more educated now, we know the risks, we have the technology to prevent or improve a lot of situations...so why take the chance, especially with an innocent baby that has no say in the matter?
I have never even attempted to get into the HP craze. Haven't read the books or seen the movies because I have no desire to. That being said, I can get into just about any movie once I start it, even if it's not my style. So if I ever did watch one I would prob end up having to watch all.
My UO: I hate the word booty. Just don't like it. Lately I've heard parents using it with kids and it's weird. What do you guys tell the kids when you are labeling their parts? We tell A to sit on his bottom.
FFTC: I considered a home birth, but not seriously because I knew it was ill-advised due to my heart murmur. I did want to deliver at a birth center but Pete wasn't comfortable with that. Pretty sure if we have another we'll go to the hospital again.
My mom delivered me at home. There were huge fires that night and the power went out at the house. All our relatives were there. My parents are hippies.
Considering that in the US the maternal mortality rate is actually rising vs declining, and our infant mortality rate is higher than 27 other developed countries.... I'm not ready to jump on the "it's not safe to give birth at home" bandwagon. Many developed countries still utilize home births as the main way their mothers give birth, and it is obviously safe otherwise they would be utilizing hospitals more. I think that since every pregnancy is different, so is every birth. The rise in induction and Pit use is what has lead to a higher C/S rate, NOT that more mom's NEED C/S even without these interventions. Personally, if I could have convinced Tim to do it and I hadn't developed Pre-E, I would have loved to give birth at home. I was less than 2 mins from a hospital. I would have had some of my OB nurses friends and a midwife with me, and I feel that I would have been perfectly safe. Instead, I was induced and ended up with a C/S.
I think that it comes down to your own personal comfort level. If you wouldn't feel safe at home, then your labor might not go easily. If you feel safest at a hospital, do what you do. But, I wouldn't cite our embarrassing maternal and infant mortality rates as the reason to make that choice.
Post by klongoria11 on Jan 22, 2015 11:18:43 GMT -5
cagoldi I just call it a butt. I tell her to sit on her butt all the time...well, mostly when I'm trying to strap in the car seat and she would rather stand and kiss herself in the baby mirror. I don't know what I'll call other parts though. I don't remember what my parents called them, or if they called them anything. Maybe they were just things we didn't mention....
cagoldi we say bottom...that was what we said growing up, too. I hate "tush" and (worse) "tushie". *cringe*
Several months ago my mom and I were using the ladies room at a museum. There was a mother with her young daughter in a stall and we heard her instruct the girl to "dry off her lady bits." Gross. Why not just say dry off? Or now use your wipe? And why not just call it her vagina? It was weird.
I have a biased opinion. I have seen normal, routine, healthy full term deliveries go bad. However, that is why I have a great deal of respect and healthy fear for the birthing process. I'm sure that my likely unpopular opinion here will come as no surprise to any of you.
I feel that OBs, as opposed to family doctors and midwives, are the best, safest, and most appropriate people to be delivering babies. They receive four years of specialty training in all things OB/gyn related, whereas family doctors receive three years of training to learn everything from OB/gyn to pediatrics to internal medicine. Family doctors and midwives are not trained or able to surgically deliver an infant. I have personally seen many routine, healthy deliveries that suddenly have very unexpected severe fetal distress and require a stat c-section. A family doctor and a midwife are not able to do that, they have to call for help, which takes much longer. Sure, a family doctor and a midwife are great, and when everything goes according to plan, can be wonderful. If you are failing to progress and need a c-section, a family doctor or midwife can call for back up help from the OB, and everything will be fine. However, in unforeseeable situations of sudden, severe fetal distress, hypoxia and ischemia, any additional delay of even seconds or minutes can make a huge difference to the baby's neurological outcome and need for resuscitation. I realize that some people prefer a midwife or family doctor over an OB because they feel more comfortable with them, or because they are more social and interactive, but when push comes to shove, I will always, always want the person that can surgically extract my infant in a matter of seconds if necessary by my side and in charge of my delivery.
Along this same line, I agree with ladystrat that the only appropriate place to deliver an infant, in my opinion, is in a hospital with an OR and NICU team immediately available. I know that hospitals are less warm and friendly and not very comfortable, but it is a safety issue for both mother and baby to have immediate access to an OR and neonatologist if needed. Whether it is for a possible stat c-section, control of severe post-partum hemorrhage, or whatever, any birthing location that does not have an OR immediately available (read: down the hall), and neonatologist for a potentially more complicated and involved resuscitation, is very high risk for a bad outcome, in my opinion. Thankfully, normal routine deliveries do not go bad very often, but it does happen. It happens enough and I have seen it myself way too many times to scare the crap out of me. A nice, cozy, comfortable birthing center (without an OR or pediatrician present) sounds lovely and peaceful. However, I think it is short sighted and even selfish of the mother to put her comforts and preference ahead of the safety of her baby. As for home births, oh God help me. Personally, I feel home births are just negligent and people are ignorant to take such a risk. Should something terrible happen, a few minutes to transport to the local hospital can make the difference between a dead or permanently neurologically devastated baby and a healthy one.
Flame away. I stand by my modern medicine, facilities, and specialty trained colleagues.
Considering that in the US the maternal mortality rate is actually rising vs declining, and our infant mortality rate is higher than 27 other developed countries.... I'm not ready to jump on the "it's not safe to give birth at home" bandwagon. Many developed countries still utilize home births as the main way their mothers give birth, and it is obviously safe otherwise they would be utilizing hospitals more. I think that since every pregnancy is different, so is every birth. The rise in induction and Pit use is what has lead to a higher C/S rate, NOT that more mom's NEED C/S even without these interventions. Personally, if I could have convinced Tim to do it and I hadn't developed Pre-E, I would have loved to give birth at home. I was less than 2 mins from a hospital. I would have had some of my OB nurses friends and a midwife with me, and I feel that I would have been perfectly safe. Instead, I was induced and ended up with a C/S.
I think that it comes down to your own personal comfort level. If you wouldn't feel safe at home, then your labor might not go easily. If you feel safest at a hospital, do what you do. But, I wouldn't cite our embarrassing maternal and infant mortality rates as the reason to make that choice.
From what I've read on the maternal mortality rate, we can point to complications related to diabetes, obesity, kidney & high blood pressure/heart problems, as some of the leading causes in its rise. One in 5 pregnant women in the US does not have insurance, and thus a lot of these women have unmanaged diseases or conditions that are exacerbated by pregnancy. Other developed countries do not have the rates of these diseases that we do. I think you could also point to the rise in multiple births, which tend to be more common here but are also more risky for both mom and babies.
My BIL is an OBGYN resident and sees the stuff I mention above on a daily basis (and then some!) One pregnant patient he consulted with is 28, severely diabetic, and losing her eyesight b/c she has refused to manage her condition and thinks that the doctors don't know what they're talking about, to put it nicely. It's an uphill battle with some people.
When you have an unhealthy adult population (which we do in this country), you are going to see more health issues at all stages of life, and pregnancy is no exception. I won't speak to induction & c-sections rates because I don't know enough about it, but I don't think one can point to giving birth in hospitals as the sole (or even main) reason that infant and maternal mortality rates are increasing.
As for inductions and the use of pitocin, sure, it can lead to a higher c-section rate. However, there are very good reasons for being induced. I was given pit after my water broke and almost 18 hours later I was not contracting regularly or progressing. In that situation of prolonged rupture of membranes, the risk for infection in the both mother and baby is extremely high. It would have been inappropriate for me to not receive pit to augment my labor. There are other great, medically necessary reasons to induce labor with pitocin, and you should always talk with your doctor about potential scenarios prior to delivery. If you end up being induced and then go on to require a c-section, just think about what could have happened otherwise had you not been induced or had the c-section. Severe maternal and infant infection, fetal distress, hypoxia, and ischemia, severe maternal pelvic floor injury and necrosis due to failure to progress, progression to full eclampsia, stroke, death, etc. Physicians are constantly weighing risks and benefits in everything that we do. Your OB's job is to be objective at all times and make sometimes difficult decisions in order to deliver your baby in the time and manner that optimizes both maternal and infant safety. I feel that a mother's comfort and ideal birth plan are always secondary. It sucks that anyone have to be induced or end up having a c-section when that is not what you planned on; however, if that is the safest option at the time for that mother/baby pair, then unfortunately, that is the most appropriate thing to do.
Considering that in the US the maternal mortality rate is actually rising vs declining, and our infant mortality rate is higher than 27 other developed countries.... I'm not ready to jump on the "it's not safe to give birth at home" bandwagon. Many developed countries still utilize home births as the main way their mothers give birth, and it is obviously safe otherwise they would be utilizing hospitals more. I think that since every pregnancy is different, so is every birth. The rise in induction and Pit use is what has lead to a higher C/S rate, NOT that more mom's NEED C/S even without these interventions. Personally, if I could have convinced Tim to do it and I hadn't developed Pre-E, I would have loved to give birth at home. I was less than 2 mins from a hospital. I would have had some of my OB nurses friends and a midwife with me, and I feel that I would have been perfectly safe. Instead, I was induced and ended up with a C/S.
I think that it comes down to your own personal comfort level. If you wouldn't feel safe at home, then your labor might not go easily. If you feel safest at a hospital, do what you do. But, I wouldn't cite our embarrassing maternal and infant mortality rates as the reason to make that choice.
It's been a couple years since I've read much on the matter, but IIRC comparing our maternal death rate with other countries is difficult for many reasons. For one thing, more women are AMA, and more women have DM or hypertension and that contributes to the amount of high-risk pregnancies. I think that it has also been suggested that women with neurological conditions that would have been undiagnosed and untreated in the past are now living into adulthood.
I *think* that in some European countries they track infant death differently. Maybe it was that many don't count first day deaths as infant death? Perhaps ggandlee can confirm.
If anything, when you dig in to these numbers and see where the majority of preterm deliveries occur and see that a lot of Medicaid patients are having babies via scheduled C/S it's more of an issue of income disparity and the treatment of a certain class of patients, less about the safety of the medical interventions themselves.
Considering that in the US the maternal mortality rate is actually rising vs declining, and our infant mortality rate is higher than 27 other developed countries.... I'm not ready to jump on the "it's not safe to give birth at home" bandwagon. Many developed countries still utilize home births as the main way their mothers give birth, and it is obviously safe otherwise they would be utilizing hospitals more. I think that since every pregnancy is different, so is every birth. The rise in induction and Pit use is what has lead to a higher C/S rate, NOT that more mom's NEED C/S even without these interventions. Personally, if I could have convinced Tim to do it and I hadn't developed Pre-E, I would have loved to give birth at home. I was less than 2 mins from a hospital. I would have had some of my OB nurses friends and a midwife with me, and I feel that I would have been perfectly safe. Instead, I was induced and ended up with a C/S.
I think that it comes down to your own personal comfort level. If you wouldn't feel safe at home, then your labor might not go easily. If you feel safest at a hospital, do what you do. But, I wouldn't cite our embarrassing maternal and infant mortality rates as the reason to make that choice.
From what I've read on the maternal mortality rate, we can point to complications related to diabetes, obesity, kidney & high blood pressure/heart problems, as some of the leading causes in its rise. One in 5 pregnant women in the US does not have insurance, and thus a lot of these women have unmanaged diseases or conditions that are exacerbated by pregnancy. Other developed countries do not have the rates of these diseases that we do. I think you could also point to the rise in multiple births, which tend to be more common here but are also more risky for both mom and babies.
My BIL is an OBGYN resident and sees the stuff I mention above on a daily basis (and then some!) One pregnant patient he consulted with is 28, is severely diabetic, and is losing her eyesight b/c she has refused to manage her condition and thinks that the doctors don't know what they're talking about, to put it nicely. It's an uphill battle with some people.
When you have an unhealthy adult population (which we do in this country), you are going to see more health issues at all stages of life, and pregnancy is no exception. I won't speak to c-sections and all that b/c I don't know enough about it, but I don't think one can point to giving birth in hospitals as the sole (or even main) reason that infant and maternal mortality rates are increasing.
A resounding yes to all of this. We are an obese nation with extremely unhealthy lifestyles, and therefore have higher rates of complicated pregnancies. Add a lack of access to medical care (or resistance to seek or comply with medical care) in to mix, and it is no wonder why we have higher rates of morbidity and mortality in all areas of medicine in our country. We do nothing to hold people accountable to have a healthier lifestyle. Some women will smoke a pack of cigarettes a day, are 200 lbs over weight, have diabetes and high blood pressure, their medications for which they are noncompliant, do an occasional line of coke, and then wonder why they might have a complicated pregnancy or preterm delivery. It isn't a mystery.
ggandlee so well said! I hate the current culture of vilifying hospitals and OBs. I think it's great that patients are taking more of an active interest in their healthcare, but in doing so, we now have instances where individuals think that they are just as, if not more so, qualified to dictate their treatment despite little to no training and "research" consisting of what they've read on WebMD.
I'm an educated person of above average intelligence, but I am by no means more knowledgable about obstetrics than my OB who has been practicing medicine longer than I've been alive.
Are there bad practices on both the hospital and OB front? Of course. It's not a perfect system and no one is claiming that it is. But I would much rather have an abundance of caution when it comes to my children than take an unnecessary risk.
As someone whose (spontaneous, seemingly normal and healthy) labor turned to complete shit, I would never consider anything but a hospital birth for #2. We wouldn't have even known that C was in distress without the constant monitoring I was under. Let alone been quickly rolled into the OR for a CS that I've never once regretted. It's just not worth the risk, IMO.
ETA: I'm not overweight, a smoker, etc. I'd probably be the ideal candidate for a home birth, but no thanks.
I have a biased opinion. I have seen normal, routine, healthy full term deliveries go bad. However, that is why I have a great deal of respect and healthy fear for the birthing process. I'm sure that my likely unpopular opinion here will come as no surprise to any of you.
I feel that OBs, as opposed to family doctors and midwives, are the best, safest, and most appropriate people to be delivering babies. They receive four years of specialty training in all things OB/gyn related, whereas family doctors receive three years of training to learn everything from OB/gyn to pediatrics to internal medicine. Family doctors and midwives are not trained or able to surgically deliver an infant. I have personally seen many routine, healthy deliveries that suddenly have very unexpected severe fetal distress and require a stat c-section. A family doctor and a midwife are not able to do that, they have to call for help, which takes much longer. Sure, a family doctor and a midwife are great, and when everything goes according to plan, can be wonderful. If you are failing to progress and need a c-section, a family doctor or midwife can call for back up help from the OB, and everything will be fine. However, in unforeseeable situations of sudden, severe fetal distress, hypoxia and ischemia, any additional delay of even seconds or minutes can make a huge difference to the baby's neurological outcome and need for resuscitation. I realize that some people prefer a midwife or family doctor over an OB because they feel more comfortable with them, or because they are more social and interactive, but when push comes to shove, I will always, always want the person that can surgically extract my infant in a matter of seconds if necessary by my side and in charge of my delivery.
Along this same line, I agree with ladystrat that the only appropriate place to deliver an infant, in my opinion, is in a hospital with an OR and NICU team immediately available. I know that hospitals are less warm and friendly and not very comfortable, but it is a safety issue for both mother and baby to have immediate access to an OR and neonatologist if needed. Whether it is for a possible stat c-section, control of severe post-partum hemorrhage, or whatever, any birthing location that does not have an OR immediately available (read: down the hall), and neonatologist for a potentially more complicated and involved resuscitation, is very high risk for a bad outcome, in my opinion. Thankfully, normal routine deliveries do not go bad very often, but it does happen. It happens enough and I have seen it myself way too many times to scare the crap out of me. A nice, cozy, comfortable birthing center (without an OR or pediatrician present) sounds lovely and peaceful. However, I think it is short sighted and even selfish of the mother to put her comforts and preference ahead of the safety of her baby. As for home births, oh God help me. Personally, I feel home births are just negligent and people are ignorant to take such a risk. Should something terrible happen, a few minutes to transport to the local hospital can make the difference between a dead or permanently neurologically devastated baby and a healthy one.
Flame away. I stand by my modern medicine, facilities, and specialty trained colleagues.
I normally agree with you but this is asinine. You do realize that the vast majority of people who live in small towns or rural America don't have access to OR's/NICU's in every hospital, right? And that it's completely unnecessary to have a NICU in every single hospital "just in case"?
If the UK/Germany (which, btw, are seeing similar rates of obesity and other "unhealthy adult populations"), most Scandinavian countries and virtually all the rest of western Europe can deliver babies safely with midwives and NOT in hospitals, the US is doing something wrong.
My UO is lame in comparison, but I think it's rude to clear a table before all parties are finished. DH is a very fast eater. He crouches down, sticks his elbows out, and shovels food into his mouth. He doesn't talk during a meal and was raised with the belief that you eat to sustain yourself and that's all that food is (byproduct of parents who can't cook, I suppose). As a result, he can eat an entire meal in 2 minutes and I've taken about 3 bites of mine.
When a server notices that he's finished, they clear his plate, making me feel the need to rush even though we've had our food for about 5 minutes. I've experienced that at casual restaurants as well as those that are higher end.
The next one who tries might get poked with a fork.
Considering that in the US the maternal mortality rate is actually rising vs declining, and our infant mortality rate is higher than 27 other developed countries.... I'm not ready to jump on the "it's not safe to give birth at home" bandwagon. Many developed countries still utilize home births as the main way their mothers give birth, and it is obviously safe otherwise they would be utilizing hospitals more. I think that since every pregnancy is different, so is every birth. The rise in induction and Pit use is what has lead to a higher C/S rate, NOT that more mom's NEED C/S even without these interventions. Personally, if I could have convinced Tim to do it and I hadn't developed Pre-E, I would have loved to give birth at home. I was less than 2 mins from a hospital. I would have had some of my OB nurses friends and a midwife with me, and I feel that I would have been perfectly safe. Instead, I was induced and ended up with a C/S.
I think that it comes down to your own personal comfort level. If you wouldn't feel safe at home, then your labor might not go easily. If you feel safest at a hospital, do what you do. But, I wouldn't cite our embarrassing maternal and infant mortality rates as the reason to make that choice.
It's been a couple years since I've read much on the matter, but IIRC comparing our maternal death rate with other countries is difficult for many reasons. For one thing, more women are AMA, and more women have DM or hypertension and that contributes to the amount of high-risk pregnancies. I think that it has also been suggested that women with neurological conditions that would have been undiagnosed and untreated in the past are now living into adulthood.
I *think* that in some European countries they track infant death differently. Maybe it was that many don't count first day deaths as infant death? Perhaps ggandlee can confirm.
If anything, when you dig in to these numbers and see where the majority of preterm deliveries occur and see that a lot of Medicaid patients are having babies via scheduled C/S it's more of an issue of income disparity and the treatment of a certain class of patients, less about the safety of the medical interventions themselves.
I don't know exactly how other countries track perinatal and infant mortality rates, rates of miscarriage and stillbirth, but I know that there is very wide variation, which obviously affects their numbers.
Correct me if I'm wrong, but isn't part of the issue with regard to the US's higher mortality rates the method of reporting used? According to the Washington Post,
"One factor, according to the paper: "Extremely preterm births recorded in some places may be considered a miscarriage or still birth in other countries. Since survival before 22 weeks or under 500 grams is very rare, categorizing these births as live births will inflate reported infant mortality rates (which are reported as a share of live births)."
ggandlee I agree with you that in many cases augmented labor with pitocin is necessary and I of course consented to the use of pitocin and subsequent C/S for the health and safety of my daughter. Once in that situation, I do not think that anyone would say... "Eh, no thanks, I refuse regardless of the consequences."
I guess I'm just not scared of birth in that way. I am thankful for modern medicine. I am so happy to be having children in this day and age, so that if needed, any and all interventions can be used to save my child. Birth is so medicalized, that I think it does a disservice to people to scare them about all of the things that could go wrong instead of remembering that women have been doing this for millions of years. Education is fine, but listing the millions of things that could have even the most remote possibility of happening is too much. Pregnancy is not cancer, it is not a broken bone, it is not even the brink of death... it is pregnancy. I understand that you are a doctor, and believe me I have banged up against this wall before, but I do not feel that it is fair to label me (or anyone else) selfish if we prefer a not as medicalized birth process.
Also, the closest NICU is an hour away from me, so it was also inappropriate for me to give birth at my a local hospital?
My midwife was the 2nd on my C/S, some are trained in that way.
If you are in a hospital--any hospital, even a small one in a rural area--they are likely going to have the basic equipment and means necessary to stabilize a patient until transport to a larger hospital is ready (via ambulance, LifeFlight, etc). I could be wrong, but I don't think GG means that every hospital must have a NICU.
I will take my chances in a small-town hospital vs. my bedroom every. single. time.
I had a low risk pregnancy and even though B got stuck and they had to vacuum her out, my labor probably could have been managed at home. That being said, I distinctly remember having a moment while I was in labor where I thought that I could potentially die. It wasn't fear so much as an observation. The fact that it wasn't so long ago that childbirth was the leading cause of death for women was never far from my mind.
Then Comes Family, LLC is a participant in the Amazon Services LLC Associates Program, an affiliate advertising
program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.