# Pro-homebirth risk ethics



## alegna (Jan 14, 2003)

Okay, this has a homebirth slant, but I put it out here in the hopes of getting other input as there are parts of it that are not exclusive to homebirth.

We've all heard the argument that some women think that ethically it's best to be in a hospital to "protect" the baby lest anything go wrong. The stats don't support that thinking, but there are women who abide by it.

What if you turn that around. Is it ethically okay to be in a hospital and risk hospital caused injury and infection to a newborn simply because the mom feels safer there?

What about drugs? Epidurals and other pain relief drugs in labor carry a risk (yes a small one) is it ethically okay to take that risk just because you want to?

discuss.

-Angela


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## Arwyn (Sep 9, 2004)

Well, I happen to agree with that ethical assessment (I wouldn't risk going into the hospital - unless I had to - because I wouldn't risk putting myself or my baby in that situation!), but I think the ethic of self-determination is higher. That is, although I don't agree with the risk women going into the hospital to have an epidural are taking, I fully and completely support their right to make that decision for themselves - I completely support everyone's right to be stupid! [disclaimer - that was completely meant to be tongue-in-cheek, not a particular indictment of hospital birthers.]

Now, the fact that it isn't truly an informed choice when they falsely believe homebirth is unsafe is another thread...!

I do think it would be an interesting tact to take with someone who used the "oh, I wouldn't take the risk!" line to disparage homebirth. But I also think it must be done with care, because it would be too easy for a woman choosing hospital birth to feel attacked by a turning of the tables of that statement (regardless that they basically just attacked the person chosing homebirth - more flies with honey, and whatnot).

Ok, I don't know if that actually made any sense because I'm quite tired and cold, and my brain may therefore be a bit sluggish.


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## alegna (Jan 14, 2003)

Thanks for the thoughts- I absolutely agree that the mom gets to make the choice. It's entirely her choice to make (who pays for it, I could argue, but that's a different thread)

I'm just looking at it from the point of view of a mom wanting to make the most ethically sound choice. Like the whole- careful to not drink or have caffine or sugar or whatever then gets drugged up at birth.

Looking forward to others' thoughts.

-Angela


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## sapphire_chan (May 2, 2005)

Forget delivery, what about pregnancy?

Have an ultrasound? Unknown risk, benefit mainly consists of deciding if you need to decide:
amniocentisis? 3% abortion risk to maybe find out that baby might have genetic disorder
Tested for GD, Rh-, hypertension, GB strep? And if the result is positive are you going to have the antibiotics, Rh balancing thingy (the name of which I do not recall), insulin?

And what are the odds of actually getting to make a decision with any of the above in the current model of hospital care? (2%? 1.5%? 99% amoung MDC mamas who *had* to go to the hospital?)


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## LavenderMae (Sep 20, 2002)

I felt so UNsafe when I had my ds in the hospital. It was down right scary. I wish that insurances companies would realize how risky and more expensive hospital births are and how much safer and less expensive it can be at home. Money was my barrier to the homebirth I wanted. If homebirth wasn't wrongly seen as risky or at the very least riskier than a hospital birth then I could have given birth where I felt safer.
I think it comes down to money and as long as birth is big business we aren't going to see the truth about safety out there in the mainstream.
I totally think all women should know all the facts/risks so they can make a truly educated decision. That would not only be ideal but should be standard. It is unethical that it is not the standard.


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## alegna (Jan 14, 2003)

good thoughts.... morning bump.

-Angela


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## Wugmama (Feb 10, 2005)

There are risks and benefits associated with EVERYTHING in life - hospital/home birth, vax/no vax, WOHM/SAHM. Find me one important life decision that does not have pros and cons - I don't think you can. We ALL have to make the decisions we feel most comfortable with - and be willing to live with ALL the potential outcomes of those decisions. When the stakes are high they can be very personal choices. Not everything can be decided just looking at the stats - which are never "if you do this you will have a %100 chance of winning".

I can't for the life of me understand why you would want to propose that having a hospital birth is an unethical choice. As a proponent of homebirths (as it sounds like you are) haven't you had that argument applied to you enough times to realize what a crock that kind of statement is? Do you REALLY feel justified in bringing that up, or are you just trying to start a, "How do you feel when it is applied to you" thread?

There are members here who have had a hospital birth and their babies DIED and now they are left to wonder what if.... There are members here who have had a homebirth and their babies DIED and they are left to wonder what if. So do you want to, or are you honestly inviting the rest of us, to tell some of these mothers that they made an unethical decision about where to birth their babies???

I just don't get it. Like there aren't enough people out there to tear mothers down for one thing or another. No one needs this kind of invitation.

BTW, hospital birth with midwives the first time, plannng a January homebirth the second time -so I've been on both sides of the fence.

~Tracy


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## stafl (Jul 1, 2002)

everybody has to weigh the risks vs. benefits for themselves. Is being clean worth the risk you might fall and bust your head open to take a shower every day? It's not for anyone to make those decisions for anyone else. They call it informed consent for a reason. Inform yourself, and make the best decision given your own situation and your own comfort levels, and stay out of anyone else's freedom to do the same. This same argument (from the other point of view) is exactly why so many doctors and hospitals will not allow/attend vbacs anymore. It isn't anyone else's decision to make, nor should it be, besides the woman who will have to live with the memory of the birth of her children the rest of her life.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *stafl*
It isn't anyone else's decision to make, nor should it be, besides the woman who will have to live with the memory of the birth of her children the rest of her life.









This seems very sad to me. Why do so many of us "have to live with the memory" of our children's births? Shouldn't that be something to treasure more often than something to endure? I've been thinking about this a lot lately. I know that sometimes things do go horribly wrong and there's nothing that can be done...I'd never try to deny the pain of a stilbirth, a birth-damaged baby (whether iatrogenic or just bad luck), or damage to the mother's body. But, I also believe that births that are looked back on later with regret, anger, etc. should be in the minority.

As to "homebirth vs. hospital birth". I'm leaning more and more towards homebirth as time goes on. But, I don't think it's unethical to have your baby in the hospital. I think it may be riskier in some respects, but...if there are 100 cases where a homebirthed baby would do better, and 1 case where a hospital-birthed baby would do better, I don't think it's up to me to tell a mom which way she has to choose. I don't know what factors lead her to where she is.

I hope homebirth becomes much more mainstream. I don't know anybody offline who's ever had one...I don't know anybody offline who knows anybody who's had one. That seems...tragic. Of course, I find everything about the hospital unpleasant (I have an irrational fear of hospitals, schools, government buildings, airports...any large establishment with its own rules, protocols, etc.), so my reaction may be a little extreme. But, I think every woman needs to find the place where she's most comfortable giving birth, because I don't think fear is good for her or the baby.


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## LavenderMae (Sep 20, 2002)

What is unethical is the fact we aren't getting the truth. The medical establishment does not give us all the facts, they actually give us very few. Women are not making informed decisions because it's pretty hard in this culture to become informed. I do not know one woman who had a hospital birth (including myself) who made a truly informed decision. I know women who think they did but they are mistaken. All the info needs to be out there and easily available to everyone. How can you weigh the risk and benifits when you don't truly know what they are?


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *sapphire_chan*
Forget delivery, what about pregnancy?

Have an ultrasound? Unknown risk, benefit mainly consists of deciding if you need to decide:
amniocentisis? 3% abortion risk to maybe find out that baby might have genetic disorder
Tested for GD, Rh-, hypertension, GB strep? And if the result is positive are you going to have the antibiotics, Rh balancing thingy (the name of which I do not recall), insulin?

And what are the odds of actually getting to make a decision with any of the above in the current model of hospital care? (2%? 1.5%? 99% amoung MDC mamas who *had* to go to the hospital?)


Yeah, I feel the same way about pregnancy risks. We can incorporate that into the discussion too if there's interest.

Is it okay to take ANY risk (u/s may or may not be a risk, not enough is known) for NO medical reason (to see that they're in there and find out sex)?

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Sheacoby*
I felt so UNsafe when I had my ds in the hospital. It was down right scary. I wish that insurances companies would realize how risky and more expensive hospital births are and how much safer and less expensive it can be at home. Money was my barrier to the homebirth I wanted. If homebirth wasn't wrongly seen as risky or at the very least riskier than a hospital birth then I could have given birth where I felt safer.
I think it comes down to money and as long as birth is big business we aren't going to see the truth about safety out there in the mainstream.
I totally think all women should know all the facts/risks so they can make a truly educated decision. That would not only be ideal but should be standard. It is unethical that it is not the standard.

This is an interesting bit as I have wondered if perhaps in the future insurance companies will jump on the homebirth wagon as it is so much cheaper for them.

Personally I think homebirth should be the standard of care and you should need special approval from your insurance co. to have a HOSPITAL birth if anything.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Wugmama*
There are risks and benefits associated with EVERYTHING in life - hospital/home birth, vax/no vax, WOHM/SAHM. Find me one important life decision that does not have pros and cons - I don't think you can. We ALL have to make the decisions we feel most comfortable with - and be willing to live with ALL the potential outcomes of those decisions. When the stakes are high they can be very personal choices. Not everything can be decided just looking at the stats - which are never "if you do this you will have a %100 chance of winning".

I can't for the life of me understand why you would want to propose that having a hospital birth is an unethical choice. As a proponent of homebirths (as it sounds like you are) haven't you had that argument applied to you enough times to realize what a crock that kind of statement is? Do you REALLY feel justified in bringing that up, or are you just trying to start a, "How do you feel when it is applied to you" thread?

There are members here who have had a hospital birth and their babies DIED and now they are left to wonder what if.... There are members here who have had a homebirth and their babies DIED and they are left to wonder what if. So do you want to, or are you honestly inviting the rest of us, to tell some of these mothers that they made an unethical decision about where to birth their babies???

I just don't get it. Like there aren't enough people out there to tear mothers down for one thing or another. No one needs this kind of invitation.

BTW, hospital birth with midwives the first time, plannng a January homebirth the second time -so I've been on both sides of the fence.

~Tracy


I think that everyone has to weigh the risks of everything. Yes, it's tragic when babies die in any setting, but it happens, like it or not. I'm not here to make anyone feel bad- I just want people thinking.

I do think that it's valid to discuss the ethics of our decisions. I am not in any way saying that I think that those ethics should be used to force us into a government decision. Rather we should individually use those ethics to make our own decisions.

-Angela


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *alegna*
Personally I think homebirth should be the standard of care and you should need special approval from your insurance co. to have a HOSPITAL birth if anything.

It most certaintly should be and in some countries it is and in said countries their infant/maternal death rate is much lower than it is here. I do think that makes this topic truly an issue of ethics. Our birthing business puts mothers and babies at undue risks and it shouldn't be allowed. Our birthing climate in this country leaves much much to be desired. In the US it is mostly about money and until our ethics as a collective whole changes I don't see that changing.


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## Arwyn (Sep 9, 2004)

Quote:


Originally Posted by *Wugmama*
I can't for the life of me understand why you would want to propose that having a hospital birth is an unethical choice. As a proponent of homebirths (as it sounds like you are) haven't you had that argument applied to you enough times to realize what a crock that kind of statement is? Do you REALLY feel justified in bringing that up, or are you just trying to start a, "How do you feel when it is applied to you" thread?

There are members here who have had a hospital birth and their babies DIED and now they are left to wonder what if.... There are members here who have had a homebirth and their babies DIED and they are left to wonder what if. So do you want to, or are you honestly inviting the rest of us, to tell some of these mothers that they made an unethical decision about where to birth their babies???

I just don't get it. Like there aren't enough people out there to tear mothers down for one thing or another. No one needs this kind of invitation.

This is what I meant when I said:

Quote:


Originally Posted by *Arwyn*
I do think it would be an interesting tact to take with someone who used the "oh, I wouldn't take the risk!" line to disparage homebirth. But I also think it must be done with care, because *it would be too easy for a woman choosing hospital birth to feel attacked by a turning of the tables of that statement* (regardless that they basically just attacked the person chosing homebirth - more flies with honey, and whatnot).

Wugmama, I don't believe the original intent was to attack or shame mothers who choose hospital births. It is an interesting ethical question - what risks are acceptable to take? For someone who won't drink ANY tea in pregnancy (not even decaf) because of the "risk of caffeine" does it really make sense to take the risks of going into the hospital and accepting induction, narcotics, episiotomy? (That was my sister, by the way.) Why is one "risk" - truly minute, if not nonexistant, in the case of minor amounts of caffeine - less acceptable than other - giving birth in the hospital with the use of pitocin and narcotics, both with well documented, unnecessary side effects?

I do think the problem arises (and as you can see, I am guilty of it) in part from the use of "acceptable" or "ok" as though a choice deemed (by some) less ethical is "unacceptable" or "not ok" - what does that, then, mean? Does it mean no one should be allowed to choose the (deemed unethical) "unacceptable" risk? I would venture to say that no one here is of that position. I would hope everyone here believes that the rights of the individual (of self-determination, as I would put it) are vastly more important than what we, as outsiders (ie not the person choosing) would choose based on a judgment of "ethical" or "unethical".

It also relates to a broader question of "the system" (as in, the hospitals, OBs, some CNMs, HMOs, and others who deliberately work to make hospital birth not just the norm, but the only option). Is what "they" are doing ethical, by manipulating data and emotions to convince mothers that homebirth is an "unacceptable risk" (that's a direct quote from _far too many_ OBs)? What use might it serve if homebirth supporters turned the tables and proposed that, for the majority of women, it is hospital birth that is the "unacceptable risk"? I would guess, from your above post, that you would say it doesn't serve our purpose. I would like to hear more from you about these topics.

I really hope we can continue this conversation in a respectful, non-attacking, non-defensive manner.


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## Wugmama (Feb 10, 2005)

Quote:

I do think that it's valid to discuss the ethics of our decisions. I am not in any way saying that I think that those ethics should be used to force us into a government decision. Rather we should individually use those ethics to make our own decisions.
I guess I'm not sure what you mean. Words like "moral" and "right actions" are used in the definition of ethics. Whose ethics to you mean when you say "those ethics should [not] be used to force us into a government decision"? The ethics of those practicing medicine or the ethics (moral actions) of those choosing for themselves where to give birth? Whose ethics do you mean when you say, "we should individually use those ethics to make our own decision"?

If we each use our own ethics, what we feel to be moral and right, then wherever we choose birth would be the correct location for us. It seems to me this isn't what you are saying. It seems to me you are inviting people to each share their own ethics, or moral views, on where mothers should give birth. To come to a concensus in this thread about which location for birth is "moral"? Or just to have everyone say out loud where they think is/was the "moral" place to give birth?

Just seems like an invitations for more judgement to me. I would personally never think someone was immoral because they chose to give birth in a hospital or at home. Seems really over the top to me.

This thread isn't at all what I thought it was going to be when I saw the title.

Certainly not trying to attack you Alegna - it is a sort of interesting topic. I think it would be more interesting to talk about the ethics of ob-gyns in their management of hospital births I guess. I'm just really sick of judgemental attitudes accross the board (including my own at times which I am trying to reign in) kwim?

~Tracy


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## Wugmama (Feb 10, 2005)

I agree with what you are saying Arwyn. But this is one of the questions posed in the original post:

Quote:

Is it ethically okay to be in a hospital and risk hospital caused injury and infection to a newborn simply because the mom feels safer there?
This could easily be translated to, "Is a mother who decides to give birth in a hospital making an immoral decision?".

That is what I was responding to in my earlier thread.

It isn't so easy to read/discuss in this thread when you are 6 months pg, emotional, and facing a birth in 12 weeks. It isn't so hypothetical anymore, it seems rather personal. I bet you can understand.









~Tracy


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## alegna (Jan 14, 2003)

Tracy-

I am saying that I have no suggestion of forcing the "ethical" decision on anyone via laws. I do think that some choices are more ethical than others. I do not think it is as simple as "what you think is right" For example, I think it is unethical to deny your child the right to breastfeed when you are physically able to. Do I think we should hold down mothers and attach their babies to their boobs? No. But I do judge that moms that CHOOSE to formula feed are making an unethical choice. I have no problem with judging other people.







Not baggage that I carry. I think that when I have researched a topic I can judge decisions made on the topic.

I don't have the time or energy to discuss ob-gyns and how they manage birth. The bottom line is that they have no business being involved in normal birth. They are trained for surgery, so that's what they aim for.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Wugmama*
This could easily be translated to, "Is a mother who decides to give birth in a hospital making an immoral decision?".

Okay- is a mom who CHOOSES not to breastfeed making an immoral decision in your eyes? Because in mine she is.

-Angela


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## AllyRae (Dec 10, 2003)

WOW....I can't believe I'm reading people saying it's unethical NOT to choose a homebirth. Wow. So, um, what happens if you live an hour away from the nearest hospital? What happens if you're not comfortable going u/c, but there are no midwives in your state? What if you are just not comfortable having a baby in your home for any reason? I do NOT equate it to choosing to formula feed...sometimes a hospital birth is more warranted for medical reasons, sometimes for personal reasons. But you CAN have a med free intervention free birth in a hospital.

For me, I chose a homebirth. However, due to GBS, it would have actually been unethical for me to have the baby at home because the nearest major hospital was an hour away so I switched to a hospital birth. Now, the baby didn't make it through birth and it doesn't matter where he was born, his death couldn't have been prevented. However, I did not make the unethical choice to have him in a hospital...

I think it's unethical to take away choices. I think it's unethical to pressure women to birth where you want them to. I do not see anything unethical about making an educated decision on where to birth based on the risks and benefits. For some people, a homebirth is not a wise choice, whether it be medical risk factors or proximity to a place where emergency medical treatment could be received. When discussing ethics, it's important to understand that not everyone's situation is identical to your own. But, the ethical decision is to do the research, make the decision based on the facts, and not to allow other people's idea of "right" pressure you into doing something that isn't right for you...

Now, obviously this can be expanded to breastfeeding. YES, there are instances when breastfeeding is unethical--especially if you are on medications required for your own health that will hurt or kill your child. However, most people, when doing the research, will not find themselves in a position where the risks of breastfeeding are greater than the benefits, so choosing otherwise may be unethical. However, choosing to FF is not unethical in itself...if anyone considers ff to be unethical, it's choosing to FF when the benefits outweigh the risks. The same can hold true if someone were to consider hospital birthing unethical.


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## Wugmama (Feb 10, 2005)

I think it is unethical to be judgmental. I don't want to be a part of a discussion where being judgemental is fair game. That is exactly what I was trying to get at - that this seemed like a judgemental thread. Now you have confirmed that it is.

Not interested in judging other mothers - or being judged, so will bow out.

I hope you get what you are looking for from your thread.

~Tracy


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## LavenderMae (Sep 20, 2002)

Is it unethical for mom to get an epidural during labor knowing the risks to the baby and herself? How about is it unethical for mom to have an elective c-section because she doesn't want to do labor? Is it unethical for mom to have an induced birth because she wants baby to be born on X day. Also is it ethical for OB's to administer these things for said reasons, given the risks?


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## rmzbm (Jul 8, 2005)

This is a very interesting thread.








At the start of my 1st pregnancy I thought a homebirth would be best. At that time in my life though I hadn't really "bulit up" my backbone or knowledge yet. I was 41 weeks and leaking fluid so my family practitioner sent me in to be induced. Well, long story short...after 29 hrs. of labor I had a section due to "fetal distress." (Yet to be told how he was distresssed...) Bah!! Fast forward to baby #2. I tried for a VBAC. Same Dr. After FOUR DAYS of labor that...I really can't think of an appropriate word, the pain was...there's just no word, I was really losing touch with reality (THANKS, PITOCIN!!)...I had section #2. When I got pregnant with my daughter I WAS NOT going through that again & scheduled a section. When they had me open they said NOT to conceive again - the scar tissue was all over my bladder...just everywhere. Well, I am having another. (My last...due in March.) I will HAVE (yes, one of those cases it's truly needed) to have a section again. I fault all the "health care" I recieved for all of it. And myself for not knowing better. Personally, my surgeries were great, recovery was wonderful...but that's little consolation for when it comes to all the drugs the babies recieved and all the trauma they endured because of being evicted too soon. (Why do they HAVE to be out by 40 weeks?!) I only bring up how easy the sections were because some women do schedule them for convenience...shame on them!! I wish I could do it over. I never would have went to the hospital the 1st time...amazing how the labor TURNS after that pitocin drip gets turned on. Painful? Yep. Unbearable? I don't think it would have been. Let me tell you - PITOCIN CAN MAKE IT THAT WAY!! Just say NO!!!!!!!!!!!!!!!


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## rmzbm (Jul 8, 2005)

Oh, I also wanted to thank the poster who pointed out the risks of prenatal testing. Good point...I am still deciding how I feel about US, but as for the rest, no thank you!!


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Sheacoby*
Is it unethical for mom to get an epidural during labor knowing the risks to the baby and herself? How about is it unethical for mom to have an elective c-section because she doesn't want to do labor? Is it unethical for mom to have an induced birth because she wants baby to be born on X day. Also is it ethical for OB's to administer these things for said reasons, given the risks?

I think in most cases it is unethical to assume a risk for someone else (the baby) without a REALLY good reason. A balancing reason if you will. There must be some other risk that is at least as heavy as the risk you are assuming. Therefore, IMO, barring any medical reason, yes, it is unethical to induce simply to choose a birthday. It is also, barring any medical reason, unethical to choose a c-section to avoid labor. IMO.

-Angela


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## AllyRae (Dec 10, 2003)

Quote:


Originally Posted by *rmzbm*
amazing how the labor TURNS after that pitocin drip gets turned on. Painful? Yep. Unbearable? I don't think it would have been. Let me tell you - PITOCIN CAN MAKE IT THAT WAY!! Just say NO!!!!!!!!!!!!!!!

Oh man, yes. And while there are valid medical reasons for pitocin drips, to voluntarily want it is beyond me. That stuff is the devil to me...or maybe it's the super long painful contractions that are the devil to me. :LOL


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## LavenderMae (Sep 20, 2002)

I don't really think it's unethical for a woman to choose a hospital birth after waying the risk/benifits , surprising yes. I don't think many women are actually making an informed decision , is that unethical I'm not sure.
Then whole birth climate in this country is pretty darn unethical so it's hard to seperate that from the decisions women are making. It is completely FEAR based and I think a lot of women make their birthing decisions based on fear and not facts.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *AllyRae*
WOW....I can't believe I'm reading people saying it's unethical NOT to choose a homebirth. Wow. So, um, what happens if you live an hour away from the nearest hospital? What happens if you're not comfortable going u/c, but there are no midwives in your state? What if you are just not comfortable having a baby in your home for any reason? I do NOT equate it to choosing to formula feed...sometimes a hospital birth is more warranted for medical reasons, sometimes for personal reasons. But you CAN have a med free intervention free birth in a hospital.

I think it's unethical to take away choices.

Absolutely, there are most definitely cases where hospital birth is clearly the best choice. I am not suggesting that we take away choices at all. I think that we should all have all the choices in the book. On everything.

-Angela


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## stafl (Jul 1, 2002)

Quote:


Originally Posted by *alegna*
I think in most cases it is unethical to assume a risk for someone else (the baby) without a REALLY good reason. A balancing reason if you will. There must be some other risk that is at least as heavy as the risk you are assuming. Therefore, IMO, barring any medical reason, yes, it is unethical to induce simply to choose a birthday. It is also, barring any medical reason, unethical to choose a c-section to avoid labor. IMO.

-Angela









:
and then you say:

Quote:

Absolutely, there are most definitely cases where hospital birth is clearly the best choice. I am not suggesting that we take away choices at all. I think that we should all have all the choices in the book. On everything.
it's not your choice to make for anyone but yourself. It's not your place to decide what is ethical or not. All you can do is inform yourself and make the best decisions given your situation. We shouldn't have to answer to anyone for our decisions, on either side of the story. I don't have to justify to anyone why I chose to vbac at The Farm anymore than my neighbor doesn't have to justify to me why she chose a repeat c/s with the same ob that did her first one. We all have our reasons, and whether you feel we are fully informed or not is not your place to say. I know my OB didn't feel I was fully informed to have made the decisions I did with my second pregnancy and birth. So what? He let me make those decisions, and he stood behind them regardless, the way everyone should, because they were my decisions to make.


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## LavenderMae (Sep 20, 2002)

Then we don't have the right to make ethical calls at all. I mean none of our social movements would have happened if people would not have made ethical calls that may or may not have directly affected them. There are many things that are unethical about how we birth in this country and I think we all need to voice our opinions about them. I wouldn't nor do I want to tell women how to give birth but I do know most women are NOT informed and yeah I judge that.


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *stafl*
I know my OB didn't feel I was fully informed to have made the decisions I did with my second pregnancy and birth. So what? He let me make those decisions, and he stood behind them regardless, the way everyone should, because they were my decisions to make.

What do you mean by he _let_ you make decisions. Who had the power in that relationship? Maybe you didn't mean it that way but that is the birth climate here. Ob's are in power and may or may not _let_ women make decisions about their births.


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## LoveChild421 (Sep 10, 2004)

Quote:


Originally Posted by *Sheacoby*
What is unethical is the fact we aren't getting the truth. The medical establishment does not give us all the facts, they actually give us very few. Women are not making informed decisions because it's pretty hard in this culture to become informed.How can you weigh the risk and benifits when you don't truly know what they are?

exactly how I feel about it.


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## stafl (Jul 1, 2002)

Quote:


Originally Posted by *Sheacoby*
What do you mean by he _let_ you make decisions. Who had the power in that relationship? Maybe you didn't mean it that way but that is the birth climate here. Ob's are in power and may or may not _let_ women make decisions about their births.

I mean exactly that. too many doctors do not let women make their own informed decisions. Mine did. It seems many here would want to prevent women from making their own decisions as well, if it involved choosing a hospital birth or cesarean.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *stafl*
it's not your choice to make for anyone but yourself. It's not your place to decide what is ethical or not. All you can do is inform yourself and make the best decisions given your situation. We shouldn't have to answer to anyone for our decisions, on either side of the story. I don't have to justify to anyone why I chose to vbac at The Farm anymore than my neighbor doesn't have to justify to me why she chose a repeat c/s with the same ob that did her first one. We all have our reasons, and whether you feel we are fully informed or not is not your place to say. I know my OB didn't feel I was fully informed to have made the decisions I did with my second pregnancy and birth. So what? He let me make those decisions, and he stood behind them regardless, the way everyone should, because they were my decisions to make.


You're right- I only get to choose for myself. But I CAN decide what I see as ethical or not. I don't think it's ethical to walk out my door and shoot the first person I see. I can't stop you if you want to do it, but I can think that it's not ethical. On a less severe note- I don't think it's ethical to spank children. However I can't stop my BIL from doing it and there are also no laws against it.

I can judge and discuss what I see as ethical or not without wanting to force anyone to do anything. Free will. We all have the right to make our own decisions. Even unethical ones.

-Angela


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *stafl*
I mean exactly that. too many doctors do not let women make their own informed decisions. Mine did. It seems many here would want to prevent women from making their own decisions as well, if it involved choosing a hospital birth or cesarean.

Why don't women think there is something wrong with that, even if your doctor is so nice to "allow" you to make your own decisions. It should be the women letting or not letting the doctor do things not the other way around. Who is paying whom in the doctor /patient relationship.


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## alegna (Jan 14, 2003)

but yeah. No one "lets" me do anything.

-Angela


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## beansavi (Jun 26, 2005)

I live in a city with one homebirth midwife. She is SUPER respected and loved and the homebirthers rant and rave about her and love her sooo much. She is involved with much of the politics of homebirth, too. She's been doing it for 23 years. She has hosted Ina May Gaskin and others...

When I chose to switch from homebirth to her attending my hospital birth with my second child, a lot of "friends" who really identified themselves as "homebirthers" in their daily lives suddenly gave me a lot of shit. I was totally blown away and saddened

I called my midwife to confide in her and _do you know what she told me? She said that those people angered her._

_She said she was not

"pro homebirth"

but rather she was

"Pro women having choices and freedom"._

When my second was born, a lovely, natural birth where the docs stood out of her way, I hemorraged.

My midwife said she was glad I went with my intuition and switched to hospital, because she would have been overwhelmed trying to get the baby started AND controlling my bleeding.

Let's factor in a woman's intuition, Mamas, when discussing this, and have respect for that.


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## Mamma Mia (Aug 3, 2005)

In my opinion, women have the right to birth wherever they feel comfortable. Regardless of whether hey know the risks for themselves of the baby, women have the right to birth where they choose. This is an intrinsic part of our reproductive rights.

I take issue with you saying that it is unethical for a woman to choose not to breastfeed. (I'll take this moment to say that I am a doula, student midwife, homebirther and CLWer) Breastfeeding is another aspect of women's reproductive rights. There are a host of reasons a woman may choose not to breastfeed, even knowing the dramatic benefits to her child. None of them should be up for judgement. It is her body, and therefore her choice.

Back to the OP, a woman may choose, knowing the risks of hospital birth, to birth there because she still feels safer. Were she to birth at home and not feel safe, there are a lot of complications that could arise form her unease.

On one hand, I think this is an interesting topic, but I just wish it weren't headed in that direction that chooses ethics and morals for women. Were it to be more theoretical, I might have enjoyed it more. Not that we're all here for my amusement!


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## LavenderMae (Sep 20, 2002)

My issue is that very few women are actually making informed choices. Do all the many many women who choose not to breastfeed really know what they are choosing? The same question can be asked about hospital births. Why do a lot of women feel safer in the hospital, why do many believe the hospital is safer? Why do so many women let doctors choose for them?
If we didn't have readily available formula would it still be ethical for women to decide not to breastfeed eventhough it would be very detrimental/deadly to their babies, would it still be a matter of choice? Is it ethical to have massed produced artificial baby food?


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## WC_hapamama (Sep 19, 2005)

Quote:


Originally Posted by *AllyRae*

I think it's unethical to take away choices. I think it's unethical to pressure women to birth where you want them to. I do not see anything unethical about making an educated decision on where to birth based on the risks and benefits. For some people, a homebirth is not a wise choice, whether it be medical risk factors or proximity to a place where emergency medical treatment could be received. When discussing ethics, it's important to understand that not everyone's situation is identical to your own. But, the ethical decision is to do the research, make the decision based on the facts, and not to allow other people's idea of "right" pressure you into doing something that isn't right for you...

Now, obviously this can be expanded to breastfeeding. YES, there are instances when breastfeeding is unethical--especially if you are on medications required for your own health that will hurt or kill your child. However, most people, when doing the research, will not find themselves in a position where the risks of breastfeeding are greater than the benefits, so choosing otherwise may be unethical. However, choosing to FF is not unethical in itself...if anyone considers ff to be unethical, it's choosing to FF when the benefits outweigh the risks. The same can hold true if someone were to consider hospital birthing unethical.

I agree with AllyRae.

I'm not against homebirth, but for myself I have chosen hospital births. I know the benefits and risks of all of the procedures that my OB/GYN might want to do on me or my child. It's called informed consent people.

I think that people who don't look at the benefits vs risks of any issue involving their health is ignorant, a fool perhaps, but immoral? That's taking it a bit too far.

Now breastfeeding... when does breastfeeding become too much to ask? Two of my three current children have food allergies, and when I breastfed my youngest, I had to cut several foods out of my diet for 18 months. I've talked to other women in similar situations who are on diets of 5 foods, for example rice, sweet potatoes, chicken, pears and apples. Can you imagine being on a diet like that for 2 years? Can such a limited diet be healthy for a breastfeeding mother for such an extended period of time? Often in situations like this, many vitamins are also off limits as they can be made from allergenic items.

Is it immoral to formula feed, using an elemental formula that the baby can tolerate, in the interest of Mom's health? I don't think so.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *Sheacoby*
My issue is that very few women are actually making informed choices. Do all the many many women who choose not to breastfeed really know what they are choosing? The same question can be asked about hospital births. Why do a lot of women feel safer in the hospital, why do many believe the hospital is safer? Why do so many women let doctors choose for them?
If we didn't have readily available formula would it still be ethical for women to decide not to breastfeed eventhough it would be very detrimental/deadly to their babies, would it still be a matter of choice? Is it ethical to have massed produced artificial baby food?

I think that this is more for the breastfeeding forum, but I'll bite.

I agree that information should be available so everyone can make an informed choice. Is it ethical to mass produce formula? I don't know, is it ethical to mass produce junk food?

In terms of the US, I don't think it's generally so detrimental or deadly to FF. I agree that there are risks, and even if ABM wasn't mass produced and ti were more difficult for women to choose not to breastfeed it is still their body and their choice. Ideally women would want to breastfeed, there wouldn't be social stigma, past abuse, going back to work 1 week postpartum, but this is not the way the world is. Poverty prevents women from even establishing a breastfeeding relationship.

Honestly, the real ethics issue lies how we treat women in society, not what women choose to do with their bodies or how they choose to raise their children.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *WC_hapamama*
I agree with AllyRae.

I'm not against homebirth, but for myself I have chosen hospital births. I know the benefits and risks of all of the procedures that my OB/GYN might want to do on me or my child. It's called informed consent people.

I think that people who don't look at the benefits vs risks of any issue involving their health is ignorant, a fool perhaps, but immoral? That's taking it a bit too far.

Now breastfeeding... when does breastfeeding become too much to ask? Two of my three current children have food allergies, and when I breastfed my youngest, I had to cut several foods out of my diet for 18 months. I've talked to other women in similar situations who are on diets of 5 foods, for example rice, sweet potatoes, chicken, pears and apples. Can you imagine being on a diet like that for 2 years? Can such a limited diet be healthy for a breastfeeding mother for such an extended period of time? Often in situations like this, many vitamins are also off limits as they can be made from allergenic items.

Is it immoral to formula feed, using an elemental formula that the baby can tolerate, in the interest of Mom's health? I don't think so.

Breastfeeding becomes too much to ask when the mother does not want to do it. Period. You don't need a reason everyone here will understand or support.

I think that even beginning to discuss formula feeding as immoral, aside from Nestle's tactics, the corporate issues etc., is pretty scary to me.

Soon we will be discussing how immoral it is for me to let my dd go to a restaurant and order french fries or to let her eat a big spoonful of ice cream before breakfast. I'm not equating letting my child have junk food with formula feeding, I just think calling FF immoral is dangerous territory.

If we all work out the ethics here, will we be moving on to Activism to enforce these ethics on women's bodies? Or will we just judge them silently (or here on the boards) for their horrendous morals?


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *Mamma Mia*
Honestly, the real ethics issue lies how we treat women in society

This is true. Our birth culture is a true reflection of this.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
If we all work out the ethics here, will we be moving on to Activism to enforce these ethics on women's bodies? Or will we just judge them silently (or here on the boards) for their horrendous morals?

Once more- I am not at all saying that my ethics or anyone elses' should be enforced on anyone.

I think that I am sensing that many here are uncomfortable with the fact that like it or not, things can be ethical or unethical. Sometimes I choose to do things that might be unethical (like buying things from China when Chinese policy goes against my ethics)

I judge people. Sometimes silently, sometimes not. I don't have a problem with that.

-Angela


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *Mamma Mia*
If we all work out the ethics here, will we be moving on to Activism to enforce these ethics on women's bodies? Or will we just judge them silently (or here on the boards) for their horrendous morals?

I really don't think anyone here is saying we should legislate anything. The thought is actually horrid. Informing women though is an excellent idea, then women will actually have a choice of informed consent. Working to change the unethical aspects of managed pregnancy/labor/birth is a good idea and worthy of discussion (especially at a place like MDC).


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## applejuice (Oct 8, 2002)

Having a baby at home and having a baby in the hospital represents two polarities of mindsets in our culture.

Having a baby at home (USUALLY) represents a mindset that childbirth is not an illness, but a culmination of a process that has evolved over time to continue to bring life into the world. It is a peak experience in a woman's reproductive life. People who genuinely prefer homebirth should already make peace with the fact that there are no guarantees in life. Usually a mother who chooses homebirth is educated and takes responsibility for the outcome and for the choices she has made.

The mother who chooses to give birth in a hospital (USUALLY) wants the best that modern medicine can give her in the form of pain relief, technology, and trained personnel. Many women feel safe in this environment with all of the attention given to them with the machines, tubes, staff, drugs, internal examinations, paper signing and note taking. Many doctors and nurses will push procedures on mothers in labor saying, "It is the best thing for your baby!", -OR- "Don't you care about your baby?", -OR- doctors love to play the hero by saying, "If you let me - [fill in with your favorite intervention/procedure], - I can guarantee you a perfect baby!"

DO NOT DENY IT! I have heard this veiled threat many times from a doctor while a mother is having a difficult labor.

Years ago, I remember my mother's contemporaries staying in the hospital for a week, so it was almost like a vacation to lay in bed for a week and be waited on. Now, there is a shorter stay in the hospital, and many women go home to be alone without a spouse to help or even their own mother or MIL to help since everyone needs to work.

So women have been trained to look to the best in technology and science to have their babies, and since many things in our everyday lives are influenced by techonology and science, we tend to think it has our best interests at heart.

According to author Robin Davis-Floyd, women who have self-actualized themselves on the career track, tend not to need to self-actualize through the birth process and the mommy track.

Therefore these women instinctively trust people who work in those fields, and the vestments they wear and the things they do to them with their tools and drugs.

I think a woman should birth where she feels safest, as any mammal does.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *Wugmama*
BTW, hospital birth with midwives the first time, plannng a January homebirth the second time -so I've been on both sides of the fence.
~Tracy

Not till after January!

Good luck with that choice.


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## tinyshoes (Mar 6, 2002)

slightly OT:

Quote:


Originally Posted by *applejuice*
Not till after January!

Good luck with that choice.

I thought I was "pro homebirth" when I chose to _pursue a homebirth_!! with my second.

After my ds's birth........I felt like I had trancended to a space unknown...........something akin to the gulf between womanhood---and motherhood. I wasn't "pro homebirth"...I just could not really imagine pursuing any birth that was not a natural, spontanious event.

Wugmama, I too wish you good luck...I think you'll have an amazing experience!

alegna, I really appriciate this thread.....I have been pondering it all day, and I've tried to write a few posts to this thread, but I just don't know what to say or where to begin or end!

Is it ethical to get doped up at the germy hospital because we're scared of having babies?
Short answer: no.

Is it ethical to live in a place with dirty air? Is it ethical to eat mercury-laden tuna?
Short answer: no.

.......but do I have another choice? Sometimes...and only if I know there's a problem with my air or tuna. AND I NEVER MADE THE AIR OR FISH DIRTY IN THE FIRST PLACE, yet I have the ethical responsibilty.

I should just hook up the popcorn-munching icon, because I am just merping around, not adding anything useful or insightful to this unusual thread...








:


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *tinyshoes*
After my ds's birth........I felt like I had trancended to a space unknown...........something akin to the gulf between womanhood---and motherhood. I wasn't "pro homebirth"...I just could not really imagine pursuing any birth that was not a natural, spontanious event.

Wugmama, I too wish you good luck...I think you'll have an amazing experience!

alegna, I really appriciate this thread.....I have been pondering it all day, and I've tried to write a few posts to this thread, but I just don't know what to say or where to begin or end!

Is it ethical to get doped up at the germy hospital because we're scared of having babies?
Short answer: no.

Is it ethical to live in a place with dirty air? Is it ethical to eat mercury-laden tuna?
Short answer: no.

.......but do I have another choice? Sometimes...and only if I know there's a problem with my air or tuna. AND I NEVER MADE THE AIR OR FISH DIRTY IN THE FIRST PLACE, yet I have the ethical responsibilty.

I should just hook up the popcorn-munching icon, because I am just merping around, not adding anything useful or insightful to this unusual thread...








:











You get it!







There's not an easy answer (there rarely is with ethical questions) Ethics is like a huge jigsaw puzzle and you don't have the picture on the box. BUT just because you don't have the picture, doesn't mean that there isn't a right way to put the puzzle together.

I think the more we discuss this the more clear it becomes that this issue has several facets:

1. Yes, there can be an ethical or unethical decision (sorry if you don't like to hear that- I'll be happy to visit another thread and explain why there is such a creature)

2. You must know that there IS another choice in order to be able to weigh the ethical questions.

3. You must have a great deal of information on the choices in order to decide what the ethical decision is.

4. Yes, there are many many variables, and altering a seemingly minor variable can change a decision from the ethical choice to an unethical choice.

Continue discussion.

(So as not to bog us down, I would like to ask that discussion of whether or not something can be unethical be left alone on this thread for now, for the sake of argument we're assuming that one can decide the ethics of a situation)

DISCLAIMER- anyone who still doesn't get it- no one here is suggesting making laws or rules limiting anyone's choices. Got it? No one is telling you what you HAVE to do. We are simply discussing what seems to be an ethical choice. You are free to disagree on what is ethical for your situation and you are free to choose an unethical choice.

-Angela


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## liseux (Jul 3, 2004)

"Let's factor in a woman's intuition, Mamas, when discussing this, and have respect for that. " Beansavi
--Such a good point!

I`m trying to stay out of this, b/c I can truly see both sides of it and have nothing much to add. I used to be totally unable to comprehend why every woman wouldn`t want a homebirth. Then after some life and death experience & 3 kids, I realized that I never cared that much about me and my "perfect" birth experience, I just wanted the most gentle beginning for my child. This thread seems to be about selfish and/or ignorant mamas who want the easy way for themselves in a hospital, even if their baby is hurt. Lets be realistic, iatrogenic injuries to babies do happen in hospitals probably more than at home, but the vast majority of babies born every day in hospitals do fine and go home with their parents. Some mamas choose the hospital for their babies to be as safe as possible, having a NICU right there matters to them. Even people who are different from us think they are doing the best for their kids, most of the time.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *liseux*
Some mamas choose the hospital for their babies to be as safe as possible, having a NICU right there matters to them. Even people who are different from us think they are doing the best for their kids, most of the time.

True, this is WHY they choose hospitals, however this is usually done with faulty logic as they don't have all the information (or choose to disregard the information)

-Angela


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## WC_hapamama (Sep 19, 2005)

Quote:


Originally Posted by *applejuice*
Many doctors and nurses will push procedures on mothers in labor saying, "It is the best thing for your baby!", -OR- "Don't you care about your baby?", -OR- doctors love to play the hero by saying, "If you let me - [fill in with your favorite intervention/procedure], - I can guarantee you a perfect baby!"

DO NOT DENY IT! I have heard this veiled threat many times from a doctor while a mother is having a difficult labor.

This is not true.

I've had 3 hospital births (4th coming up in December). I've dealt with a total of 3 different OBs and more L&D nurses than I can remember. None of them ever told me such a thing.


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## Arwyn (Sep 9, 2004)

I think we'll have a more constructive conversation if we all have a clear understanding about the differences between ethics and morality.

Ethics are something every medical or midwifery organization (that I know of) have and discusses. Ethics are guidelines to action. A good ethic it's probably safe to assume _most_ health care workers subscribe to is "First, do no harm." Whether their actions are in line with that ethic is what decides whether their actions are ethical.

An example. A person who says they have a good work ethic, or a good work ethic as a goal, would probably try to put lots of energy into work, to show up on time and well dressed etc. Consistently showing up late, being distracted at work, or having a slovenly appearance would be unethical _given their stated ethical code_. Is showing up late immoral? That's a whole 'nother issue.

Morality has to do with ultimate and intrinsic good or evil. It has to do with religion, with God(s), and with holy wars. Morality is up to each person to decide (or to take from their God), and I believe has no place in this discussion. Ethics is a matter of consistency between stated goals and actions. Ethics can be discussed constructively and objectively. Morality, since it generally comes from or pertains to one's religious views, is not something I would consider useful or constructive to discuss.

So I hope we can continue to discuss whether the medically unnecessary risks associated with hospital birth or elective cesarean are ethical, given the inferred context of the ethic of "first, do no harm" (or whatever other ethical stance someone wishes to propose or discuss - I think it would be an interesting question to ponder "under what ethical guidelines are elective cesareans ethical?"). Ethics are, as has been previously stated, complicated and highly nuanced, and a ripe topic for discussion. Medical organizations usually have an entire comittee or board just devoted to medical ethics. But never, in my experience, to morality. I hope we can learn from them.

I also hope we can also all remember that in this discussion on ethics, we are not discussing limiting choices. Just the ethical ramifications of certain choices.


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## liseux (Jul 3, 2004)

I agree with the definition of ethics and I`m glad it was added. I think many unethical things happen in hospitals, but the act of going to a hospital in itself is not unethical. Circumcision is a perfect example of something unethical happening in a hospital, so is giving a new mom formula samples. These are choices that should go away because they are unethical. In birth its more tricky, doing a c/s or a huge episiotomy without a good reason is not ethical, but its complicated by fear of lawsuits and doctors feeling they should err on the side of action, rather than inaction.


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## beansavi (Jun 26, 2005)

Hey, I just wanted to throw out there that, although we have only had formula for about 6o+ years, women have had wetnurses OR breastfed each others babies since the dawn of man.

Two of my closest friends are from a family that originates from the Middle East and our kids were born within months of each other. One of my friends had low milk supply, so when we hung out I would nurse her kid after she ran out and "top her off".

The other friend also had very large nipples and a tiny baby who could not open her mouth very wide. When she was first born, we were trying to figure out if the nipple size was the issue. So, I nursed her baby on my breast and she was still fussy-so we figured it out that it wasn't the size of the nip, just the baby.

In Middle Easern culture, our children cannot marry when they grow up because they are now considered *"Milk Siblings"*.









Isn't that beautiful?!!! Nobody was "unethical" for introducing another milk source, etc. and experimenting outside of Mama...


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## kavamamakava (Aug 25, 2004)

Quote:


Originally Posted by *alegna*
This is an interesting bit as I have wondered if perhaps in the future insurance companies will jump on the homebirth wagon as it is so much cheaper for them.

Personally I think homebirth should be the standard of care and you should need special approval from your insurance co. to have a HOSPITAL birth if anything.

-Angela

I've had all 3 of my babies at home and I definitely don't agree with that. The bottom line is that women need to birth where they are most comfortable. If women KNEW more about the risks of hospital birth and more about what interventions do and more about how some in-hospital care providers harm their body for convenience sake, they may not feel as comfortable at the hospital. But feeling uncomfortable or scared in your birthing environment certainly would inhibit the birthing process.


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## kavamamakava (Aug 25, 2004)

Quote:


Originally Posted by *Mamma Mia*

Honestly, the real ethics issue lies how we treat women in society, not what women choose to do with their bodies or how they choose to raise their children.


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## kavamamakava (Aug 25, 2004)

Quote:


Originally Posted by *alegna*
Once more- I am not at all saying that my ethics or anyone elses' should be enforced on anyone.

I think that I am sensing that many here are uncomfortable with the fact that like it or not, things can be ethical or unethical. Sometimes I choose to do things that might be unethical (like buying things from China when Chinese policy goes against my ethics)

I judge people. Sometimes silently, sometimes not. I don't have a problem with that.

-Angela

But not everyone has the same moral code or considers the same things ethical or unethical.


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## beansavi (Jun 26, 2005)

...and that is the big "dilemma" the world has dealt with since the dawn of man. What problems arise when we impose our ethics on someone else? How does that compare to giving them ethical freedom and some do wrong?


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## Raven (Dec 15, 2001)

I think to focus needs to be shifted. The ethical blunder lies within the hands of the medical profession who LIE to women.


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *Raven*
I think to focus needs to be shifted. The ethical blunder lies within the hands of the medical profession who LIE to women.

Indeed!


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## KittyKat (Nov 17, 2002)

Quote:


Originally Posted by *WC_hapamama*
This is not true.

I've had 3 hospital births (4th coming up in December). I've dealt with a total of 3 different OBs and more L&D nurses than I can remember. None of them ever told me such a thing.

So, you're saying since this has never happened to YOU, then the other poster who HAS heard dotcors say these things must be lying?

Grow up. The world is much bigger than your experiences. There are many women who have been lied to and manipulated this way during labor.

Kathryn


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## liseux (Jul 3, 2004)

"But feeling uncomfortable or scared in your birthing environment certainly would inhibit the birthing process." Kavamamakava

So true!


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## alegna (Jan 14, 2003)

Ethics, from Wikipedia:
Ethics is the branch of axiology - one of the four major branches of philosophy, alongside metaphysics, epistemology, and logic - which - which attempts to understand the nature of morality; to define that which is right from that which is wrong. The Western tradition of ethics is sometimes called moral philosophy.

[Axiology- from the Greek axia (αξια, value, worth), is the study of value or quality]

My summary of said definition:
Ethics attempts to understand the nature of morality, to define right from wrong.

SO- IMO ethics and morallity are closely linked. IMO it could be said to be "immoral" to choose an unethical choice.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *liseux*
I think many unethical things happen in hospitals, but the act of going to a hospital in itself is not unethical.

Two topics from liseux's post- I will address one at a time.

Okay- is there any place that one would choose to birth that would be unethical? Would it be unethical to CHOOSE to birth on a trapeeze, while swinging without a net? Of course. Then is there a case where it COULD be unethical to choose to birth in a hospital? Of course. For example, you KNOW for a fact that the baby will be taken from you without reason and treated harshly and subjected to a serious chance of infection and there is no other reason to be in said hospital, then yes, that choice WOULD be unethical.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *liseux*
Circumcision is a perfect example of something unethical happening in a hospital, so is giving a new mom formula samples. These are choices that should go away because they are unethical. In birth its more tricky, doing a c/s or a huge episiotomy without a good reason is not ethical, but its complicated by fear of lawsuits and doctors feeling they should err on the side of action, rather than inaction.

Okay- we accept that these are unethical happenings. Then does not the woman have an ethical responsibility to protect her child from such things? What if there is no way she can protect her child from them in the hospital? What if it is highly unlikely that she can protect her child in the hospital? IMO in those cases her only ethical choice (assuming no other medical issues of course) is to choose another place to birth.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Raven*
I think to focus needs to be shifted. The ethical blunder lies within the hands of the medical profession who LIE to women.

I agree that there is a huge ethical burden on the system which all but forces women to birth in hospitals and the medical professionals who make those hospitals a bad, bad place to birth (as a rule- I accept that there are execeptions, don't bog us down telling us about all the exeptions)

HOWEVER, women also have an ethical obligation to do their own research and make their own decisions in order to protect themselves and their children.

-Angela


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## Raven (Dec 15, 2001)

Quote:


Originally Posted by *alegna*
I agree that there is a huge ethical burden on the system which all but forces women to birth in hospitals and the medical professionals who make those hospitals a bad, bad place to birth (as a rule- I accept that there are execeptions, don't bog us down telling us about all the exeptions)

HOWEVER, women also have an ethical obligation to do their own research and make their own decisions in order to protect themselves and their children.

-Angela

And what about women who live in countries such as mine? I live in South Africa and the standard of Government care here is apalling. Not only that - the majority of people who have to use Government institutions do not speak English as their first language. I wish I could get you (all) to see how frustratingly impossible it is to be treated with respect!! Let me try though.... Firts of all, you do not see the same Dr for your prenatal visits and during your pregnancy (unless you are high risk) you don't see the OB until you deliver.

The Dr's you see are either CNM's or OBGYN students. It is a first come first serve thing for prenatal visits and there are about 70 people per day so you arrive at 6am and you are lucky to leave at 3pm. You can imagine with the language barrier and the mood of the care-provider (who has to get through 70 people) there is not much room for telling them what is happening and what stuff means.

I remember I had to go to one of these facilities when I was pg with Amber (nearly 6yrs ago). It is law here that if you have a homebirth you have to have a back up hospital so I had to go there for one of my prenatals so I was on their books. Anyway... I was sitting in the waiting area where I could actually hear what the Dr was saying to the woman before me.

"where is your bag?"
[silence]
"[name] where is your bag?"
"ummm....."
"It says here on your chart that you are going to be induced today. Where is your bag?"

This poor woman had no CLUE what this dr was talking about and the dr sure wan't making any attempt to help her understand. I was LIVID.

Also, while I was waiting there were labouring women walking in the corridors. I started chatting to them. Turns out 3 out of 5 of them had been induced that morning. They were not told why.

These women do not have the capacity to do their own research and the medical establishment is not doing anything to help them - even on a BASIC level - understand.

Sorry for the ramble, just trying to offer a different perspective here.


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## alegna (Jan 14, 2003)

Good points Raven, I was admittedly approaching this from a narrow US perspective.







It's hard to cover all the issues around the world in one thread though.

thanks for the reminder.

-Angela


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## annakiss (Apr 4, 2003)

Quote:


Originally Posted by *alegna*
SO- IMO ethics and morallity are closely linked. IMO it could be said to be "immoral" to choose an unethical choice.

Let's try to be careful about this though. Saying that something is immoral is casting a lot of judgment on individuals who, as you pointed out, are going to be ignorant of what exactly their choices are, ethical or unethical, due to circumstances outside of their control. You cannot tell someone that it is hands-down wrong of them to birth in a hospital or formula feed, even if you know that there are clearly more responsible choices. I know you are not suggesting laws that would enforce this, but supposing you are a religious person, do we have to then answer to God about whether we birthed in a hospital? Which ring of Hell is reserved for those who formula feed?


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *annakiss*
Let's try to be careful about this though. Saying that something is immoral is casting a lot of judgment on individuals who, as you pointed out, are going to be ignorant of what exactly their choices are, ethical or unethical, due to circumstances outside of their control. You cannot tell someone that it is hands-down wrong of them to birth in a hospital or formula feed, even if you know that there are clearly more responsible choices. I know you are not suggesting laws that would enforce this, but supposing you are a religious person, do we have to then answer to God about whether we birthed in a hospital? Which ring of Hell is reserved for those who formula feed?

I leave those questions up to those with those beliefs. That is not my system of beliefs so I can not speak to it. I am not bothered by someone thinking that I am immoral for something that I do not think IS immoral. Each person must make their own ethical and moral decisions based on their own belief systems.

And actually, in some cases, I have no problem telling people that their choices were hands down wrong.







And if they think that of my choices, I am more than happy to discuss my reasoning.

-Angela


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## liseux (Jul 3, 2004)

"Okay- we accept that these are unethical happenings. Then does not the woman have an ethical responsibility to protect her child from such things? What if there is no way she can protect her child from them in the hospital? What if it is highly unlikely that she can protect her child in the hospital? IMO in those cases her only ethical choice (assuming no other medical issues of course) is to choose another place to birth." Alegna

If there was no way that you could protect your baby in the hospital, then yes it would be unethical to go there and you`d have to be pretty damn stupid to not avoid it, or at least an uncaring mother. But, that relies on a pretty big "if", one that`s far from reality IME.

There are too many factors, what about a woman who had 3 hb`s and they all went haywire and she realizes that she would feel more comfortable in a hospital. Like my dh says, "the definition of insanity is when you do something over and over again, expecting a different result.

This whole premise is based on something very subjective, that all hospitals are dangerous and bad. If we have evidence to the contrary we have been asked to not mention it in case we bog down the discussion. Alegna, I respect what you`re saying, but I don`t know how it can be discussed with such controlled parameters. Everybody needs to basically agree on the supposition that all hospitals are bad. I think its an interesting subject and I have been on both sides. Maybe I`m missing the point, I`m trying to keep it diplomatic here.


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## annakiss (Apr 4, 2003)

I'm starting to wonder what the practicality of this discussion is. You're not interested in law-making, you don't care what God thinks about it - what are you trying to accomplish here? Unless we can say absolutely that all hospitals are inherently dangerous to birthing women and the larger culture accepts that, then all we're doing is blaming women for their births. I have friends with vaccine-damaged children - should they be blamed for the decisions they made at the time with the information they had? Women aren't going to the hospital in a vacuum. They're going there with the larger culture's understanding that hospitals are safe places to birth. Are women responsible for the well-being of themselves and their babies? Absolutely, but that doesn't mean we need to point fingers at them for mistakes that they make unknowingly. As mothers we have enough guilt.

For instance, my first son was born with a cleft lip and palate. I know now that cigarette smoking can contribute to the incidence of clefts. At the time I got pregnant, I was a smoker. I wasn't planning on getting pregnant, but I made an irresponsible decision about contraception one night. Do I need everyone to blame me for my son's defect when I didn't know I was going to get pregnant and when lots of women smoke throughout pregnancy without incidence? Okay, so I didn't go out of my way to smoke while pregnant and in fact quit immediately after finding out, but it is then unethical to sell cigarettes to women of child-bearing age? I suppose that it's unethical to make cigarettes at all, but they do and I'm not going to tell people they can't knowingly damage their bodies.

We could extend and extend this argument to it being unethical to eat junk food, or it being unethical to watch television or do anything potentially harmful. Doing anything where risks far outweigh the benefits could be labled immoral. But what is the point in determining it if there is nothing to be done? Simply to place blame is all I can come up with.


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## KittyKat (Nov 17, 2002)

"There are too many factors, what about a woman who had 3 hb`s and they all went haywire and she realizes that she would feel more comfortable in a hospital." liseux

Wouldn't that depend on WHY they went haywire?

Was it because the midwife did something/didn't do something?

Was it because the mother in law showed up uninvited and stressed everyone out?

Was it because there was a freak accident like cord prolapse or surprise breech (that the midwife wasn't experienced enough to handle)?

There are so many factors involved in birth. You can't boil it all down to one formula.

I'm all for homebirth (even though my son died and *some people* think he would have been fine in a hospital... what the heck do they know, they weren't THERE?) and for *informed* choices. I'm birthing in a hospital with a CNM this time. They have a reputation of being the most natural birth friendly place in the area. They even offer waterbirth. I'm driving an hour away for this. Most people around here just go to the local maternity factory and sign on the dotted line for an epidural.

If they crack a book at all, it's one like "What to Expect" totally medical establishment, and "listen to your doctor like a good little patient and everything will be fine" except if it isn't...

There are no guarantees. Some people seem to think people in white coats and machines that spit out a fancy readout strip are guarantees. They're not.

Neither is a really groovy midwife with years of experience, lots of herbs and incense and a really calming vibe...

Stuff happens, it's just that with our improved sanitation, antibiotics, and nutrition we've gotten used to expecting that babies get born, they grow up, and barring serious car crashes or incurable cancer, they die at a ripe old age surrounded by thier grandkids. It throws everyone for a loop when a baby dies Everyone starts looking for reasons, for someone to be "responsible" for what happened. Sometimes things just happen, and no one is to blame. That's a hard concept to wrap the human mind around.

Kathryn


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## liseux (Jul 3, 2004)

"I'm all for homebirth (even though my son died and *some people* think he would have been fine in a hospital... what the heck do they know, they weren't THERE?) and for *informed* choices. I'm birthing in a hospital with a CNM this time." KittyKat

KittyKat, I also had a son die and people thinking that if I hadn`t been at home it wouldn`t have happened. I also still fully support hb. When I was talking about a mama choosing a hospital birth after bad hb`s I was just giving an example, but I was thinking about me & trying to leave my personal experience out of the thread. I felt a strong instinct to have a hospital birth with my 3rd and of all 3 births it was by far the best.

There are absolutely no guarantees, anywhere. I resent the hospital people who think they have it all figured out in terms of safety and I resent the homebirthers who imply that everything will be fine if you "just believe in your body."

I agree with Annakiss, this discussion will probably end up making some women feel like crap about their choices. We all do the best we can at the time. I know women who chose to circ and their babies circs had to be redone over and over. As much as I think the original circ was unethical and ill informed it doesn`t serve any purpose to make the mom feel like crap about it. There are better ways.


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## SunRayeMomi (Aug 27, 2005)

I think the use of the words immoral and unethical is a little pointless here, seeing as there may be one definition in the dictionary, but there is no one true perception of it.. For instance, if "unethical" was sitting here staring all of us in the face, some of us may see it and some may not. But the fact is that anyone is allowed to call something unethical if they want to. It's called an opinion, and since this is a discussion, I think we should all feel free to voice our opinions. Maybe we should stop focusing on the literal sense of the word and just try to grasp what each poster is really trying to say. There is no point to tell another poster that their use of any word is incorrect, because obviously to that person it is. Likewise, just because I would rather HB doesn't mean someone going to the hospital should be labled differently than I...but there we go leading back to opinions again.

When I became pregnant I decided that the welfare of my unborn child exceeded my need for "creature comforts". I include epidurals and spinals and morphine and unnecesary US and formula feeding without trying to breast feed first in this category, among other things. Lucky for me, my love for my baby helped me to accept this sacrifice without reservation. I think being a parent has a lot to do with self-sacrifice and some people may not be ready for this right away. I definitely caught some flack from other people over my decision to HB, even though I know for a fact that many of those people were less educated in the area of birth than I was. I am really proud of the courage that I have in my body's ability to give birth, so I did shout it whenever given the opportunity, but sometimes being pregnant you just don't feel like being judged, and you keep it to yourself. I feel I am blessed to have been brought up in a home that stressed health and informed choice. We believe that things such as childbirth don't need medical intervention&#8230; but things such as broken bones do. When it comes to being raised a certain way, I think it's normal to expect people that weren't raised this way to assume chidbirth is a medical event. Sometimes though, they do some reading and come across homebirth and decide that it makes more sense. More power to them, either way, as long as they do in fact do that research. That's the key.

Do I think it is unethical to choose hospital birth over homebirth? No I wouldn't use that word. I do however believe that people who choose things such as elective cesarean and formula feeding without atleast trying to breastfeed first are most likely doing so without properly researching their decisions first. Notice I said most likely, meaning this is not an umbrella statement. No statement such as this can ever be true for everyone, so it helps to not take it too literally. But, for things so important as how you deliver and feed your newborn, if you don't atleast do some soul-searching and research first, then it is a little reckless.

I myself was discriminated against at the hospital when I had to be transported after delivery for stitches. They went so far as to have CPS try and schedule a visit at my home. Unacceptable. I was *so proud of myself* for having just given birth naturally, without putting my daughter into uneccesary exposure to drugs or forceps or vacuum extraction, etc. And what do I get? A visit from CPS because they think I was being reckless for having a homebirth! I tend to think it's reckless to go into the hospital intending to have an epidural from the start or intending to have a cesarean for unmedical reasons. But I don't see CPS knocking on their doors&#8230;&#8230; so why mine? I know of children that were circumcised because their parents didn't see the little box to mark if you DONT want your son to be circed. Why is it you have to specifically opt out of an uneccesary surgery?

I have friends that bring me US pix of their fetus every other month. I usually don't say anything, but I personally think that while one is fine, many "just for fun" is a little irresponsible. However, technology is so readily available and has been for my generation to the point that it is deemed flawless by the general population, so what do you expect? People assume that things are safe or they wouldn't be available. Can you blame them? Heck, things _should_ be safe or not available, I wish it were the case. I also have friends who years before even concieving decided they would formula feed. This just makes me sad. There are things out there that the average infomercial-watching American understands to be true, such as smoking and drinking is harmful to a fetus; breast is best etc. (examples) To those who have never heard these things, not honoring them is only ignorance. But to *knowingly ignore* them is selfish and irresponsible at best. I realize that a lot of people don't realize that there are options out there. I wish I could share my knowledge with people in a way that wouldn't seem overbearing, but as was proven in another thread I started, other mothers don't usually take advice very well. So how can we spread wisdom around if no one accepts advice?

so sorry for the novela!


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *WC_hapamama*
This is not true.

I've had 3 hospital births (4th coming up in December). I've dealt with a total of 3 different OBs and more L&D nurses than I can remember. None of them ever told me such a thing.


IT IS TRUE.

I have had more than one person tell me that their doctor told them they could be guaranteed a perfect baby if they let them do x, y, or z. This is an experience of years of teaching childbirth classes and working in the homebirthing movement.

Seeing 3-4 doctors and L&D nurses is small. Read L&D by Constance Bean, a CCE, R.N., if you want to know what nurses really see and do.

Most doctors are extremely unethical and dishonest. My Father was a doctor and most of his friends were doctors. I grew up around them. If they can get away with lying they will and do. My sister is also a DDS and is President of her State Dental Society.

Having dealt with doctors all my life, I think I more than know.

I am only giving a warning.

If you do not want to listen, that is your perogative. It is still a free country.

Doctors would have it otherwise.


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## WC_hapamama (Sep 19, 2005)

Applejuice, just because some OB's lie about stuff like that, doesn't mean that all or most do.

I know women who have had OB's like that... most of them (the OBs) were the very old school sort that had their training back in the days of twilight sleep and strapping to the table obstetrics.

Anybody that listens to a doctor that promises them a perfect outcome on anything is a fool. It doesn't matter if the doctor is promising a perfect baby, or the perfect boob job.

True, there are a lot of medical professionals out there that have some kind of God complex going. I've had a few of those myself... when I run into them, I switch doctors.

I think a big part of the problem is that many of us were raised to believe that all doctors are the ultimate authority, period. That if the doctor says something needs to be done that we should do it, or that the doctors diagnosis is final... no questioning, nevermind thinking that the doctor may be wrong.

I'm comfortable with my birthing choices because I've chosen practitioners that respect my wishes and who aren't afraid to answer questions or offer other options if I ask. If they weren't that way, they wouldn't be my practitioners.

I do think it's strange that many people submit to medical procedures on themselves and their children without any questions.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *WC_hapamama*
Applejuice, just because some OB's lie about stuff like that, doesn't mean that all or most do.

I already know that. One of my favorite people is Dr. Robert Mendelsohn, but he was a pediatrician.

Quote:

I think a big part of the problem is that many of us were raised to believe that all doctors are the ultimate authority, period.
NOT ME! My Father used to laugh at all of them, and he was one of them. My sister has already told me she would never accept me or my children as patients. That is O.K. I still love her.

Quote:

I do think it's strange that many people submit to medical procedures on themselves and their children without any questions.
I am old enough to remember DES being given to prevent miscarriage, radium boxes on healthy thymus glands, and wholesale tonsillectomies being done to keep from getting colds. I also remember classmates with braces on their legs, classmates losing a year of school due to rheumatic fever, and playmates whose sibling was alittle "slow" because it was commonplace in maternity wards to hold a mothers legs together to prevent the baby's birth until the doctor arrived.

People never learn.

They keep repeating the same mistakes.

If you do not like to get bit, stay away from snakes.


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## LavenderMae (Sep 20, 2002)

Raven, when I pg with my first I was on medicaid and went to the clinic for prenantal appointments and I was treated very much the same as what you described. You had to sign in and then it was first come first serve. They lined us up to weigh us and take our blood pressure then you had to wait some more until a doctor or nurse was ready to see you. I never saw the same doc/nurse twice. I also got the "privilege" of having to see a social worker who was damn determined to get me to admit my bf was a drug addict or abusive. She also hounded me about what kind of birth control I was going to take after I gave birth. I would get to the clinic in the morning and wouldn't leave until late afternoon. It was a bad experience. I am appalled that is the standard of care where you live , here it's just how the poor are treated.


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## pfamilygal (Feb 28, 2005)

For many of my patients (mostly teenagers), the hospital birth is a very good thing. It is the first place where they are introduce to the idea of breastfeeding, infant care and self-care. Many of my patients don't have the first clue about babies ("wow - I didn't think babies pooped until they ate food!"). So they are actually learning a lot at the hospital. That is my favorite part of doing postpartum, being able to teach patients. I've had patients who didn't know you could breastfeed for more than six months ("doesn't your milk just go away?"). Patients who had never changed a diaper, patients who didn't know the baby had a cord (much less how to care for it.). I think this shows how the art of mothering has died in a way. At least in the sense that your mom would show you how to be a mom. For most new mommies the grandma might fly in for a couple days and help with housework and then hit the road. I wish my mom could have stayed with me to show me how to mother. But we don't have the community we used to. I think the abandonment of women and community is the real ethical issue.

As far as epidurals being "unethical" due to the minute risk, if you feel it is unethical for you, don't have one. I am a very tense person in labor. I was induced with my first (due to severe PIH/pulmonary edema/renal insufficiency) and after 17 hrs of pitocin had dilated one freaking inch. I was lying on my left side to keep my bp down and placental perfusion up. I was so tired of all the pain. I told the doctor that we needed to try an epidural. If I didn't start dilating soon we were looking at a c/s (at that point I had not urinated in 3 days). Lo and behold, I relaxed after the epidural and let my body do it's thing. I had a nice vaginal delivery of a perfect healthy newborn and breastfed in the delivery room. He was away from my side for a total of one hour during our stay. With baby #2 I made it 23 hrs before taking the epidural and dilated really fast after finally relaxing with it. I push a whole 2 times and she was delivered up onto my chest and she nursed immediately. Even though she was 34 weeks she only went to the nursery once, for her hearing test. So there are hospitals that are safe and good to deliver in. And epidurals can be a really good thing.

I think homebirth is fascinating, but not an option for me. I have early babies and don't think it would be safe popping out a 33 weeker in the bathtub (oh how I would love a waterbirth though).


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## WC_hapamama (Sep 19, 2005)

Quote:


Originally Posted by *applejuice*
I am old enough to remember DES being given to prevent miscarriage, radium boxes on healthy thymus glands, and wholesale tonsillectomies being done to keep from getting colds. I also remember classmates with braces on their legs, classmates losing a year of school due to rheumatic fever, and playmates whose sibling was alittle "slow" because it was commonplace in maternity wards to hold a mothers legs together to prevent the baby's birth until the doctor arrived.

People never learn.

They keep repeating the same mistakes.

If you do not like to get bit, stay away from snakes.

Ah... you're A LOT older than I am then. I'm only 29.

A lot of the stuff you're describing sounds like the stuff my Grandma and Dad have told me about... Dad is 56.

I remember cringing in horror that first time I took my oldest son to visit my grandmother, when she suggested that I use her kitchen to make that gawdawful formula concoction out of canned milk and karo syrup.

The only worse formula horror story I've heard of is the stuff MIL had to use on DH when she weaned him at 6 months old. He was milk and soy allergic, so the formula they gave him was made from, get this, beef hearts! uke

I don't play with snakes... but I make it a point to know which ones are poisonous so I can take extra precautions around them.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *WC_hapamama*
This is not true.

I've had 3 hospital births (4th coming up in December). I've dealt with a total of 3 different OBs and more L&D nurses than I can remember. None of them ever told me such a thing.

No offense, but your three experiences don't negate anyone else's. I'm glad you didn't have the experience applejuice described, but I bet it's more common (or similar actions/words are) than you think.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *Raven*
I think to focus needs to be shifted. The ethical blunder lies within the hands of the medical profession who LIE to women.

Word, Raven.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
Two topics from liseux's post- I will address one at a time.

Okay- is there any place that one would choose to birth that would be unethical? Would it be unethical to CHOOSE to birth on a trapeeze, while swinging without a net? Of course. Then is there a case where it COULD be unethical to choose to birth in a hospital? Of course. For example, you KNOW for a fact that the baby will be taken from you without reason and treated harshly and subjected to a serious chance of infection and there is no other reason to be in said hospital, then yes, that choice WOULD be unethical.

-Angela

I want to gently point out that not all hospitals treat babies this way.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
Okay- we accept that these are unethical happenings. Then does not the woman have an ethical responsibility to protect her child from such things? What if there is no way she can protect her child from them in the hospital? What if it is highly unlikely that she can protect her child in the hospital? IMO in those cases her only ethical choice (assuming no other medical issues of course) is to choose another place to birth.

-Angela

I think we know that mothers *can* and do protect their babies from circumcision in the hositals and free formula only gets to babies if their mothers give it to them or allow hospital staff to. I'm sure someone around here has heard a horror story, but almost all of the time, if a mother chooses not to give formula or circ it doesn't happen.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
I want to gently point out that not all hospitals treat babies this way.

Of course not. I am merely saying that to choose to birth in one that did, would be unethical IMO.

-Angela


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
HOWEVER, women also have an ethical obligation to do their own research and make their own decisions in order to protect themselves and their children.

-Angela

I think this statement comes form a pretty privileged place. An extremely large number of women in this country (US, I assume you're here as well) do not have access to information. A single mother on welfare working 12 hour shifts needs the few hours of waking time she has not working to be the the child she already has. She doesn't even have time to read if someone handed her concise reading material with everything she needed to know, let alone the fact that she may not even have the reading comprehension to do it.

Again, I get really uncomfortable when people dictate what women have an ethical obligation to do.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
And actually, in some cases, I have no problem telling people that their choices were hands down wrong.







And if they think that of my choices, I am more than happy to discuss my reasoning.

-Angela

I am really amazed by this. Who are you to tell people their choices are wrong? This is the behavior of someone who is insecure in their own actions, not an outspoken advocate for homebirth. Telling people they are wrong "hands down" doesn't take into account their personal situation and more importantly, it alienates them! It is a dangerous road to travel, especially for one hellbent on trying to change the world.

Once, I was more like you. I thought that people who didn't plan to breastfeed shouldn't bother having kids. I once thought that people who knowingly chose hospital birth, if only for pain relief, knowing the risks, were clearly wrong in their choice. I'm glad that I have become less harsh and unforgiving. I think becoming a doula has a bit to do with it because my job is to be with women and help them have the birth *they* want, not the birth *I* think they should have. I've found that allowing for the fact that there are serious cultural, class, race, religious, etc, issues tied into birth and mothering, it's best if I keep a gentle advocate's stance. I'm not going to change anyone's mind by telling them theya re wrong and arguing my case or making them feel guilty. I am able to provide information to people when they are ready to hear it and help them enact changes or different choices in the future. I hope you think about it.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
I think this statement comes form a pretty privileged place. An extremely large number of women in this country (US, I assume you're here as well) do not have access to information. A single mother on welfare working 12 hour shifts needs the few hours of waking time she has not working to be the the child she already has. She doesn't even have time to read if someone handed her concise reading material with everything she needed to know, let alone the fact that she may not even have the reading comprehension to do it.

Again, I get really uncomfortable when people dictate what women have an ethical obligation to do.


You're right that many women do not have as much information at their access as I might have. THAT is why I think that homebirth (as a safer option than the current hospital set-up) should be the general standard of care. Then if women DID research more or decide for whatever reason that they WANTED a hospital birth, they could do that, but for a normal pregnancy and birth the standard would be homebirth.

I am perfectly comfortable saying that all women (in fact all people) have an ethical obligation to do their best to protect their children. That is simple biology.

-Angela


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *annakiss*
I'm starting to wonder what the practicality of this discussion is. You're not interested in law-making, you don't care what God thinks about it - what are you trying to accomplish here? Unless we can say absolutely that all hospitals are inherently dangerous to birthing women and the larger culture accepts that, then all we're doing is blaming women for their births. I have friends with vaccine-damaged children - should they be blamed for the decisions they made at the time with the information they had? Women aren't going to the hospital in a vacuum. They're going there with the larger culture's understanding that hospitals are safe places to birth. Are women responsible for the well-being of themselves and their babies? Absolutely, but that doesn't mean we need to point fingers at them for mistakes that they make unknowingly. As mothers we have enough guilt.

For instance, my first son was born with a cleft lip and palate. I know now that cigarette smoking can contribute to the incidence of clefts. At the time I got pregnant, I was a smoker. I wasn't planning on getting pregnant, but I made an irresponsible decision about contraception one night. Do I need everyone to blame me for my son's defect when I didn't know I was going to get pregnant and when lots of women smoke throughout pregnancy without incidence? Okay, so I didn't go out of my way to smoke while pregnant and in fact quit immediately after finding out, but it is then unethical to sell cigarettes to women of child-bearing age? I suppose that it's unethical to make cigarettes at all, but they do and I'm not going to tell people they can't knowingly damage their bodies.

We could extend and extend this argument to it being unethical to eat junk food, or it being unethical to watch television or do anything potentially harmful. Doing anything where risks far outweigh the benefits could be labled immoral. But what is the point in determining it if there is nothing to be done? Simply to place blame is all I can come up with.

























Yes, that!


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
I am really amazed by this. Who are you to tell people their choices are wrong? This is the behavior of someone who is insecure in their own actions, not an outspoken advocate for homebirth.

Who am I? I am someone who is very well educated in some subjects. And thanks for the assumption, but no, I'm lots of things, but insecure in my actions is not one of them...









-Angela


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
You're right that many women do not have as much information at their access as I might have. THAT is why I think that homebirth (as a safer option than the current hospital set-up) should be the general standard of care. Then if women DID research more or decide for whatever reason that they WANTED a hospital birth, they could do that, but for a normal pregnancy and birth the standard would be homebirth.

I am perfectly comfortable saying that all women (in fact all people) have an ethical obligation to do their best to protect their children. That is simple biology.

-Angela

And so do co-parents where they exist. It is not simple biology when sicussing HB vs hospital birth though. As I said before, even knowing the risks for a child, if a woman feels safer in the hospital, she may stall or freak out and deprive the baby of oxygen during the birth at home. Her stress can lead to loads of complications. And at this point it is moot to say that HB should be the standard of care. It is beyond idealist. People ahve been indoctrinated literally since birth that hositals are where babies are born. You can't make a new law and expect everyone to just go along with it.

You cannot change people from where you want them to be, you can only gently work on changing their hearts from where they are.

I see gentle hospital birth becoming more popular and to me, this is inspiring. Hospitals are hiring more and more CNMs (albeit for $$ reasons) to do L&D. These are positive steps. Just like almost everything else, change wil come slowly. Judging people's actions as wrong or unethical isn't really going to help the situation get better.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
Who am I? I am someone who is very well educated in some subjects. And thanks for the assumption, but no, I'm lots of things, but insecure in my actions is not one of them...









-Angela

I didn't say you were insecure in your actions, but the behavior youa re describing, is the behavior of someone who is. Not the image to put forth when working for change, IMO.


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## applejuice (Oct 8, 2002)

My mom was prescribed DES for me. I was born alittle early. But I am still here. If she had taken it, there is a chance I would never have become a mother.

Some of my contemporaries were not as lucky.


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## tinyshoes (Mar 6, 2002)

Quote:


Originally Posted by *Mamma Mia*
People ahve been indoctrinated literally since birth that hositals are where babies are born.

The recent passing of Rosa Parks at age 92 makes me think about the value of the change one fed-up person can have, on a topic....on a nation.

Just because _this_ generation, and the one before it is cool with hosptial birth doesn't mean the standard of care will never change to homebirth (like it is in the Netherlands, for example.) I'm 28--my mom and grandmother gave birth in the hosptial, but my great-granny.....and EVERY woman ancestor I have before her, did it at home.

I do agree, Mamma Mia, that it _is_ a positive, to see that gentler births are becoming popular, and the vogue of doulas is especially inspirational. The increase in breastfeeding rates in the USA are another indicator of a return to a more natural style of USA parenting. However, we do have a 28% c-section rate, which, according to the WHO, is 18 percentage points above where it needs to be, and the Happy Vaginal Birthing camp would say that only 2-3% of c-sections are neccesary (I'm inventing that number based on stats from The Farm.)

I wonder...are we talking about ethics? or just being lame? For example, thinking about the Netherlands, where midwife-attended homebirths are the norm, and the Netherlands comes somewhere within the Top Ten for infant mortality in the world (vs. 28th or 36th for the USA, depending on your source) do they think hosptial births are unethical? Or just bizarre? lame-o?

Like, if you feel depressed and need therapy, you see a phsycologist. You _don't_ see a neurosugeon! OBs are MDs who are surgeons. Midwives would be akin to the phsycologist...maybe even the phsychiatrist...do you need a _surgeon_ if you just need assistance during an unusually stressful time of life?

I'm just tossin' the idea that the question might not be as deep as ethics...could it be a question of overkill? Are OB-attended births the SUVs of American birth culture?

HEEEEEEEEEYYYY.....what about that????? has there been a thread about the wastefulness of different birth techniques?


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *tinyshoes*
The recent passing of Rosa Parks at age 92 makes me think about the value of the change one fed-up person can have, on a topic....on a nation.

Just because _this_ generation, and the one before it is cool with hosptial birth doesn't mean the standard of care will never change to homebirth (like it is in the Netherlands, for example.) I'm 28--my mom and grandmother gave birth in the hosptial, but my great-granny.....and EVERY woman ancestor I have before her, did it at home.

This is something I am hopeful of. In the big picture, things like this have changed VERY quickly in the US. My husband's parents were probably both born at home (one was for sure, not sure on the other) Sure it was rural Louisiana, but it was the norm. It was just what you did. I think that it is within the realm of possibility that it will change again.

(as an interesting aside, in that area kids were also often nursed until they went to school- at 7)

-Angela


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *tinyshoes*
do they think hosptial births are unethical? Or just bizarre? lame-o?

I was in France last summer and I connected with some Netherlanders.
We talked about their health care system and their birth practices. The people I spoke with told me they consider themselves very progressive and modern with having midwives and homebirths.

They consider Americans overly aggressive and old school in terms of health care and obstetrics...much as they view our foreign policies.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *tinyshoes*
I do agree, Mamma Mia, that it _is_ a positive, to see that gentler births are becoming popular, and the vogue of doulas is especially inspirational. The increase in breastfeeding rates in the USA are another indicator of a return to a more natural style of USA parenting. However, we do have a 28% c-section rate, which, according to the WHO, is 18 percentage points above where it needs to be, and the Happy Vaginal Birthing camp would say that only 2-3% of c-sections are neccesary (I'm inventing that number based on stats from The Farm.)


Answering in bits again- easier for me to think on one topic at a time.

I'm glad you brought up the section rate. I meant to earlier. Around here it's even higher than that, especially in the city. When I ran individual hospitals only 2 came anywhere near the national average (TX is above the national average also) But not only that, most hospitals were above 30%. Several were at 40%. One is rumored to be near 50%. Given that WHO says that maternal and infant health is at issue above 10%, is it ethical to birth in a hospital with a 30% section rate? What about 50%?

-Angela


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *alegna*
This is something I am hopeful of. In the big picture, things like this have changed VERY quickly in the US. My husband's parents were probably both born at home (one was for sure, not sure on the other) Sure it was rural Louisiana, but it was the norm. It was just what you did. I think that it is within the realm of possibility that it will change again.

(as an interesting aside, in that area kids were also often nursed until they went to school- at 7)

-Angela

Wow good post!

Upper class women went to the hospital beginning around 1900, but the big boom in hospital birthing took place after WW2...my own midwife who lived through the period said it was to fill the hospital beds left empty after the war.
Hospitals know when a woman births in their hospitals, they often are bonded to it and the doctors and nurses and the maternity wards are actually big $$$ for hospitals.

Women go on to work in the hospital, volunteer in many capacities.

Having babies inthe hospital is a cultural thing for Americans and the world of the 20th century.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *tinyshoes*
I wonder...are we talking about ethics? or just being lame? For example, thinking about the Netherlands, where midwife-attended homebirths are the norm, and the Netherlands comes somewhere within the Top Ten for infant mortality in the world (vs. 28th or 36th for the USA, depending on your source) do they think hosptial births are unethical? Or just bizarre? lame-o?

I'm just tossin' the idea that the question might not be as deep as ethics...could it be a question of overkill? Are OB-attended births the SUVs of American birth culture?

HEEEEEEEEEYYYY.....what about that????? has there been a thread about the wastefulness of different birth techniques?

Good point. Yes, I think it is partially an issue of lame-o and overkill... BUT as someone who analyzes things very carefully before making decisions (used to drive my mom crazy as a kid- watched other kids go down the slide at the pool for YEARS before I'd consider it) I do think that there is an ethical component.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *applejuice*
Hospitals know when a woman births in their hospitals, they often are bonded to it and the doctors and nurses and the maternity wards are actually big $$$ for hospitals.

Hmm. This is a good point. I wonder if anyone has ever done any real studies on this? I would bet there is a real psychological component to that.

-Angela


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## tinyshoes (Mar 6, 2002)

Maybe I read this in Jessica Mitford's _American Way of Birth_? Obstetrics was once concidered the most DUMB and lame of medical specialties. If you couldn't do anything else, you could at least deliver babies.

Furthermore, delivering babies was a tactic to make and keep customers. What brilliance--deliver that first baby, and you've got a whole family coming to your MD practice for the rest of their lives.

Good point, applejuice...when examined, I think it's clear that L&D is ho$pital bread & butter.

alegna, I do not mean to discount the seriousness of ethics, morality, and SUV-style birthin' running rampant in the USA today. I thought that some of our thread-buddies who might be turned off by the big ol' ETHICS, or those feelin' the blame-game, might appriciate a more "lighthearted" viewpoint, akin to exploring cultural differances vs. Heaven and Hell.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *tinyshoes*
Maybe I read this in Jessica Mitford's _American Way of Birth_? Obstetrics was once concidered the most DUMB and lame of medical specialties. If you couldn't do anything else, you could at least deliver babies.

Very True.

Most obgyns just get by. They are often found on the bottom of their graduating class from medical school.

Gives bottom feeders a bad name.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *tinyshoes*
Just because _this_ generation, and the one before it is cool with hosptial birth doesn't mean the standard of care will never change to homebirth (like it is in the Netherlands, for example.) I'm 28--my mom and grandmother gave birth in the hosptial, but my great-granny.....and EVERY woman ancestor I have before her, did it at home.

I'm not saying that we can't toward a change, or even that we can't achieve a change. I'm saying the language we use to get there is crucial and the judgement and negative attitudes have to go. Women of color have been considered animalistic by whites for a long time. It has led to a stigma in many communities about allowing themselves to let their bodies do their natural thing. These things are important to keep in mind. Cultural stigmas, poverty, etc.

If we are to advocate for more midwifery centered care, support UA, and encourage breastfeeding, we're not going to make any new converts by calling their educated or uneducated choices unethical.

Quote:


Originally Posted by *tinyshoes*
I wonder...are we talking about ethics? or just being lame? For example, thinking about the Netherlands, where midwife-attended homebirths are the norm, and the Netherlands comes somewhere within the Top Ten for infant mortality in the world (vs. 28th or 36th for the USA, depending on your source) do they think hosptial births are unethical? Or just bizarre? lame-o?

Like, if you feel depressed and need therapy, you see a phsycologist. You _don't_ see a neurosugeon! OBs are MDs who are surgeons. Midwives would be akin to the phsycologist...maybe even the phsychiatrist...do you need a _surgeon_ if you just need assistance during an unusually stressful time of life?

I'm just tossin' the idea that the question might not be as deep as ethics...could it be a question of overkill? Are OB-attended births the SUVs of American birth culture?

HEEEEEEEEEYYYY.....what about that????? has there been a thread about the wastefulness of different birth techniques?

I agree with your premise here. You are talking about a country with a different history and culture, a different attitude towards health and birth. We are going to have to make changes one at a time to get there. I think in general, people are coming around. The biggest challenege we face is the medical lobby who make so damn much money on our bodies. It isn't about which is unethical, homebirth vs. hospital birth, it's about why it's unethical to have a medical system based on capitalism and what we can do to change that. It is literally for our health.


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## flapjack (Mar 15, 2005)

Nope. Not necessarily. (Sorry, haven't read all the threads yet.)
Go look at the figures for the UK: in the 1930s and the 1950s, around 2/3 of babies were born at home and beds in maternity homes were reserved for those with special needs- for instance, first-time mums, those with additional needs for support, and so on.By 1970, policies had changed so that every mother should be able to have her baby in hospital and benefit from that standard of care, should she want. The Patients Rights charter and the Maternity Rights charter in the 1990s (95??) preserved the right for a woman to give birth at home and for a woman to have to consent to each and every intervention individually.
The upshot? 2% homebirth rate nationally, down from 70% in less than 50 years. Almost identical to the US, yet the finances aren't an issue.
The only conclusion I can come to is that this isn't about the money, because we don't pay for healthcare- as a PP mentioned, it's partly about the state desperately trying to reinforce the idea that a family's first loyalty is not to each other but to the state, and they should obey/trust outsiders. It's also about an innate distrust of women's bodies.
Unfortunately, the American media is so darned influential and so much of American culture is being exported (think McDonalds in Russia- or anywhere else in the world) that unless the women of the US stand up and change their system, you could see the homebirth rate in countries like the Netherlands start to fall as it has in the UK. It's already happening with infant feeding- birth could be next. Just something to think about, especially for those of you who live there.
As far as the risk thing goes, I think human beings are being audacious when they believe that we should be the one species with a 100% live birth rate. I have been pregnant 7 times. I have two children living, have miscarried early three times, and my daughter was stillborn at 24 weeks (at home, as she would have been if she had gone to term.) I think ultimately we need to learn enough humility to know that a live baby is not all that's important- what is important is that each individual involved can keep their dignity and accept themselves and the choices they made in the face of overwhelming emotions.


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## Mamma Mia (Aug 3, 2005)

Flapjack, are you saying doctors and hospitals in the UK make the same amount of money for natural vaginal births and cesareans? What about the pharmaceutical compainies who make money from every intervention?


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## SunRayeMomi (Aug 27, 2005)

Quote:


Originally Posted by *Mamma Mia*
I think we know that mothers *can* and do protect their babies from circumcision in the hositals and free formula only gets to babies if their mothers give it to them or allow hospital staff to. I'm sure someone around here has heard a horror story, but almost all of the time, if a mother chooses not to give formula or circ it doesn't happen.

Allow me to quote myself, since I know my other post was so frickin long I bet no one read it:


_Quote:_

I know of children that were circumcised because their parents didn't see the little box to mark if you DONT want your son to be circed. Why is it you have to specifically opt out of an uneccesary surgery?

It happens

Also,



_Quote:_

_originally posted by *pfamilygal*: For many of my patients (mostly teenagers), the hospital birth is a very good thing. It is the first place where they are introduce to the idea of breastfeeding, infant care and self-care_.

Again quoting myself:









I agree that some teenagers are sadly under-informed. But we can't assume all are of course. I myself was discriminated against at the hospital when I had to be transported after HB delivery for stitches. They went so far as to have CPS try and schedule a visit at my home. NOW?! I was so proud of myself for having just given birth naturally, without putting my daughter into uneccesary exposure to drugs or forceps or vacuum extraction, etc. And what do I get? A visit from CPS because they think I was being reckless for being a teenager and having a homebirth! They also gave me a D&C FOR NO REASON other than I had a homebirth, and I was too weak from the experience to stick up for myself. I tend to think it's reckless to go into the hospital intending to have an epidural from the start or intending to have a cesarean for unmedical reasons. But I don't see CPS knocking on their doors&#8230;&#8230; so why mine? Do they do this at your hospital, or did I just have a sign on me that said, "I just gave birth, wanna make me punch you?"


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## beansavi (Jun 26, 2005)

But when you say they are making this decision on faulty logic, what statistics are you basing this on? Is your own logic faulty? Come on! How can you have the audacity to say this without backing it up with statistics? Are your statistics based on casual conversations with others who simply share your opinions? It sounds very immature to me without the facts to back it up.

Peace,

Quote:


Originally Posted by *alegna*
True, this is WHY they choose hospitals, however this is usually done with faulty logic as they don't have all the information (or choose to disregard the information)

-Angela


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## beansavi (Jun 26, 2005)

I believe it is just as unethical to impose stereotypes on women who choose to natural birth in a hospital, as if they are uninformed or don't want to be better informed.

Just because someone is a homebirther, doesn't automatically mean they are better informed, either. I know several people who homebirthed because it was cool and they wanted to be considered a part of that group/community or it was a status symbol. They are quick to judge others as if they need to be in that position for selfish reasons. Is it any better to blindly follow a group of people without deciding for yourself? Maybe some hospital birthers just don't follow groups as much and are still _transitioning_-like me:

_2 natural midwife attended hospital births, homebirth coming in January.
_
Hmmmmm. It works both ways!

Let's consider the best in each other before we assume the worst.

Quote:


Originally Posted by *Raven*
I think to focus needs to be shifted. The ethical blunder lies within the hands of the medical profession who LIE to women.


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## SunRayeMomi (Aug 27, 2005)

Quote:


Originally Posted by *beansavi*
_I believe it is just as unethical to impose stereotypes on women who choose to natural birth in a hospital, as if they are uninformed or don't want to be better informed._

Totally. If a pg woman desires a natural birth but ends up opting for an epi, at least she went in there with some good intentions. There's nothing wrong with changing your mind. I would like to think that all women do their research when it comes to such a life-altering event as childbirth. But dammit, they don't.









Quote:


Originally Posted by *beansavi*
_Just because someone is a homebirther, doesn't automatically mean they are better informed. I know several people who homebirthed because it was cool and they wanted to be considered a part of that group/community. They are quick to judge others as if they need to be in that position for selfish reasons._


You are so right. Any hey, it's a pretty cool thing if I may say so myself. I chose to homebirth for specific reasons, but I also get some comments like "OMG that's so cool, you're so brave!" (now that I made it through alive- of course when I was pg I got this look







) and stuff like that, which is more or less ignorance dressed as a compliment. Sorry, I mean ignorant as in "Brave? Nope, just well-informed and confident in my ability to birth..." I wish more people had this confidence. I wish I could just go around with a wand







and *poof* it onto pg women.







how cool would that be? But it's my experience that MOST (not all, but most) women that decide on HB do it because they educated themselves on it. Not because they thought it was "cool".
Conversely, I would be willing to bet that a woman that goes to the hospital expecting a totally intervened hospital birth and willing to do whatever doc suggests DID NOT do so after reading up on the facts. I would say this happens when people are uninformed, and interventions don't happen at a HB people.


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## applejuice (Oct 8, 2002)

Quote:

I know several people who homebirthed because it was cool and they wanted to be considered a part of that group/community or it was a status symbol.
That is the worst reason to have a home birth. The only place a woman should give birth is where she feels comfortable. I remember women having babies in the 'groovy hippy commune' because everyone else did, only to be in labor for days because they could not let go and have the baby.

I am angry at people who put their own personal fears on me even when presented with the facts.


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## applejuice (Oct 8, 2002)

Quote:

The only conclusion I can come to is that this isn't about the money, because we don't pay for healthcare- as a PP mentioned, it's partly about the state desperately trying to reinforce the idea that a family's first loyalty is not to each other but to the state, and they should obey/trust outsiders. It's also about an innate distrust of women's bodies.
It is a world wide cultural abberation of the 20th century.


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## WC_hapamama (Sep 19, 2005)

Quote:


Originally Posted by *Mamma Mia*
No offense, but your three experiences don't negate anyone else's. I'm glad you didn't have the experience applejuice described, but I bet it's more common (or similar actions/words are) than you think.

Unless you live in my area, there is no way to know just how common the level of care I received is. Most of the women I've spoken to who have kids the same age as mine have told me that their OBs have been very respectful of their wishes. Granted their wishes may not have been the same as mine, but still, their doctors respected their wishes. Most of the women I've talked to about this are like me where they don't blindly do what the doctors tell them.

It probably helps that I live in an area that tends to embrace a lifestyle that is a bit more granola crunchy than mainstream. Pain med free hospital births, breastfeeding and the like are a bit more common here than some places.


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## liseux (Jul 3, 2004)

This thread is over the top subjective and without real facts to back it up. Which, I guess is the point.

Comments like this, "I remember women having babies in the 'groovy hippy commune' because everyone else did, only to be in labor for days because they could not let go and have the baby." Applejuice
So now a woman who labors for days can`t let go and have the baby? Sounds like that woman must be a total idiot, if she was a perfect informed homebirthing goddess who trusted her body then what would it take, 3 hours? This leads to the kind of high school mentality that keeps women judging each other and keeps us drinking the HATORADE. There are women on this board who felt sad that they missed out b/c they had short labors. There are people who have healthy babies born in waterbirths that are pissed b/c they forgot to drink their special tea and light their candles. This is crazy to me and one thing about a lot of hospital birthers is most of them are not constantly comparing their experiences and outdoing each other.

Other comments like there aren`t interventions in hb or that OB`s are like bottom feeders, I think its obvious that anecdotal evidence is only acceptable in this discussion if it supports the original premise. If you have anecdotal evidence that shows that even smart women go the hospital or that not all OB`s suck, well, don`t mention it. How about real facts?


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *tinyshoes*
alegna, I do not mean to discount the seriousness of ethics, morality, and SUV-style birthin' running rampant in the USA today. I thought that some of our thread-buddies who might be turned off by the big ol' ETHICS, or those feelin' the blame-game, might appriciate a more "lighthearted" viewpoint, akin to exploring cultural differances vs. Heaven and Hell.

That's cool- room here for that too. I am just one of those weird-o nerds who actually enjoys the mental exercise of things like logic and ethics of every-day situations.










-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*

If we are to advocate for more midwifery centered care, support UA, and encourage breastfeeding, we're not going to make any new converts by calling their educated or uneducated choices unethical.


Honestly this thread isn't about converting anyone. It's about exploring the deeper implications of decisions that are often not fully researched and considered.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *flapjack*
As far as the risk thing goes, I think human beings are being audacious when they believe that we should be the one species with a 100% live birth rate. I have been pregnant 7 times. I have two children living, have miscarried early three times, and my daughter was stillborn at 24 weeks (at home, as she would have been if she had gone to term.) I think ultimately we need to learn enough humility to know that a live baby is not all that's important- what is important is that each individual involved can keep their dignity and accept themselves and the choices they made in the face of overwhelming emotions.

Thank you for bringing this up. I agree wholeheartedly. Humans are an arrogant bunch these days.

I know that many many people would disagree with your last bit:
"I think ultimately we need to learn enough humility to know that a live baby is not all that's important- what is important is that each individual involved can keep their dignity and accept themselves and the choices they made in the face of overwhelming emotions."

but I agree.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *beansavi*
I believe it is just as unethical to impose stereotypes on women who choose to natural birth in a hospital, as if they are uninformed or don't want to be better informed.

Just because someone is a homebirther, doesn't automatically mean they are better informed, either. I know several people who homebirthed because it was cool and they wanted to be considered a part of that group/community or it was a status symbol. They are quick to judge others as if they need to be in that position for selfish reasons. Is it any better to blindly follow a group of people without deciding for yourself? Maybe some hospital birthers just don't follow groups as much and are still _transitioning_-like me:


All hospital birthers that I know personally have done NO research on out of hospital birth. None. Zip. Zilch. I'm sure that there are many that HAVE researched their options, but I don't think that I would be out of line to say that MOST (51% or better) women in the US who birth in the hospital have not researched any alternatives. THAT is a shame in my mind (and IMO, unethical, as I believe that we are obligated to do our best to make ethical choices and to do so we must search out information on those choices)

I'm sure that there are uneducated homebirthers- I even met one of those. IMO that is just as unethical as uneducated hospital birthers.
[However, I would venture that MOST (again 51%) homebirthers in the US have made a researched decision, as it is not the default decision]

hmmm, interesting conclusion.

Perhaps what is unethical is not the choice of birth-place, but the lack of research/thought that goes into such a choice.

-Angela


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *WC_hapamama*
Unless you live in my area, there is no way to know just how common the level of care I received is. Most of the women I've spoken to who have kids the same age as mine have told me that their OBs have been very respectful of their wishes. Granted their wishes may not have been the same as mine, but still, their doctors respected their wishes. Most of the women I've talked to about this are like me where they don't blindly do what the doctors tell them.

It probably helps that I live in an area that tends to embrace a lifestyle that is a bit more granola crunchy than mainstream. Pain med free hospital births, breastfeeding and the like are a bit more common here than some places.

Okay, you and I both live in "granola" areas where it is less likely to happen. Our areas do not dictate the norm. You can't use your area or experience to discount someone else's. All you can really say is, "Thank goodness this is nearly unheard of where I live!"


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *liseux*
This thread is over the top subjective and without real facts to back it up. Which, I guess is the point.

Comments like this, "I remember women having babies in the 'groovy hippy commune' because everyone else did, only to be in labor for days because they could not let go and have the baby." Applejuice
So now a woman who labors for days can`t let go and have the baby? Sounds like that woman must be a total idiot, if she was a perfect informed homebirthing goddess who trusted her body then what would it take, 3 hours? This leads to the kind of high school mentality that keeps women judging each other and keeps us drinking the HATORADE. There are women on this board who felt sad that they missed out b/c they had short labors. There are people who have healthy babies born in waterbirths that are pissed b/c they forgot to drink their special tea and light their candles. This is crazy to me and one thing about a lot of hospital birthers is most of them are not constantly comparing their experiences and outdoing each other.

Other comments like there aren`t interventions in hb or that OB`s are like bottom feeders, I think its obvious that anecdotal evidence is only acceptable in this discussion if it supports the original premise. If you have anecdotal evidence that shows that even smart women go the hospital or that not all OB`s suck, well, don`t mention it. How about real facts?

Yeah, many, many women have prodromal labor because of malpositioning, amongst other things. I think saying someone "couldn't let go" is a judgement I'd like to avoid.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *SunRayeMomi*
Allow me to quote myself, since I know my other post was so frickin long I bet no one read it:

It happens



Allow me to quote myself as well.

Quote:


Originally Posted by *Mamma Mia*
I think we know that mothers *can* and do protect their babies from circumcision in the hositals and free formula only gets to babies if their mothers give it to them or allow hospital staff to. *I'm sure someone around here has heard a horror story, but almost all of the time,* if a mother chooses not to give formula or circ it doesn't happen.


----------



## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
All hospital birthers that I know personally have done NO research on out of hospital birth. None. Zip. Zilch. I'm sure that there are many that HAVE researched their options, but I don't think that I would be out of line to say that MOST (51% or better) women in the US who birth in the hospital have not researched any alternatives. THAT is a shame in my mind (and IMO, unethical, as I believe that we are obligated to do our best to make ethical choices and to do so we must search out information on those choices)

I'm sure that there are uneducated homebirthers- I even met one of those. IMO that is just as unethical as uneducated hospital birthers.
[However, I would venture that MOST (again 51%) homebirthers in the US have made a researched decision, as it is not the default decision]

hmmm, interesting conclusion.

Perhaps what is unethical is not the choice of birth-place, but the lack of research/thought that goes into such a choice.

-Angela

I highly doubt that you don't know a single hospital birther who has done ANY research on hospital birth. Just because they didn't read your info, doesn't mean they didn't do research. Most pregnant women birthing in the hospital know if they have L&D rooms ro seperate rooms, what the basic policies are, and find out about any issue that's important to them. I'm a little shocked that you know so many women who conflict with your values so much.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *Mamma Mia*
Yeah, many, many women have prodromal labor because of malpositioning, amongst other things. I think saying someone "couldn't let go" is a judgement I'd like to avoid.

No, I only told you part of the story.

The groovy hippy commune had a thing for singing and chanting. Everytime they did that, her labor slowed down. That is a sign something is not working. She was in active labor for five days, when she finally delivered, her pupils very were dialated, her labia was flared outward and she was drained. The baby did fine. The mother was completely exhausted of energy and the most telling sign was that she was unable to care for the baby herself for nearly eight weeks; she was in bed mostly for the baby's first three months.

Obviously something should have been done to help the mother rest and progress, and not let the situation drag on.

I was there, and I think I know a little bit better what was going on. If any woman felt better being in the hospital, then they should be there, and not anywhere else.


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## Belle (Feb 6, 2005)

Quote:


Originally Posted by *alegna*
I'm glad you brought up the section rate. I meant to earlier. Around here it's even higher than that, especially in the city. When I ran individual hospitals only 2 came anywhere near the national average (TX is above the national average also) But not only that, most hospitals were above 30%. Several were at 40%. One is rumored to be near 50%. Given that WHO says that maternal and infant health is at issue above 10%, is it ethical to birth in a hospital with a 30% section rate? What about 50%?

I wanted to touch on this. I gave birth to my first (and only, so far) in a hospital that had a 30% section rate. We had gone on a hospital tour early in our pregnancy and simply did not know which questions we should ask. I read _What to Expect while you're expecting_ and it didn't have the questions in it that I _should_ have asked.

It wasn't until I took Bradley classes that I actually began to question the care that I was receiving.

We went on another tour of our hospital at 34 weeks and asked the nurses about the C/S rates, epidural rates, procedures for Rh- moms, the ability to eat and drink during labor, etc. The lady who gives the tours at the hospital said that the hospital encouraged moms to take the virtual tour online rather than come to see the hospital in person. She didn't have the answers to our questions so we had to talk to a nurse. When asked about the C/S rates she said it was 30%, but then hastily added that the only reason it was so high was because they didn't allow VBACs anymore. My dh and I were a bit horrifed at that. This was my first experience in learning that women were actually forced into surgery because thay had no other option.

We went over our birth plan with my OB at our next visit. He's a very cheerful and gegarious person and he frowned before he even read it. Most of the stuff on there he agreed to but I learned at that visit that he did not trust birth to be anything but dangerous. For instance he insisted that I have an IV. He warned that if I eat in labor that I might throw up. and so on.

At the time I didn't feel comfortable switching providers so late in my pregnancy. I don't feel that it was ethically wrong of me do do so based on my experience at the time. I had only heard horror stories about birth. I thought that's just how birth had to be.

My birth with my dd was not bad at all. Luckily my regular OB was on vacation during the birth and the on call OB was more supportive than he was.

I'm planning a home birth when we get pg with our next one and I made the mistake of telling my SIL this. Her ds was born via emergency c/s due to iatrogenic distress and she believes her son was saved by her doctors. I can privately think he would have been safer at home but I respect her decisions about birth and her choice not to VBAC #2. But she has no problems whatsoever in telling me that I'd be putting myself and my baby in danger. I think it is unethical not to respect someone elses informed decsions.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
I highly doubt that you don't know a single hospital birther who has done ANY research on hospital birth. Just because they didn't read your info, doesn't mean they didn't do research. Most pregnant women birthing in the hospital know if they have L&D rooms ro seperate rooms, what the basic policies are, and find out about any issue that's important to them. I'm a little shocked that you know so many women who conflict with your values so much.

What I said was that no hospital birther I know has done any research on OUT of hospital birth. And that is true.

-Angela


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## applejuice (Oct 8, 2002)

Quote:

How about real facts?
Refer to the Dr. Lewis Mehl study done in 1978 of home -vs- hospital births and outcomes. It is still the gold standard of home/hospital birth comparisons.
http://www.gentlebirth.org/format/myths.html
http://www.storknet.com/cubbies/home...irthsafety.htm
http://www.texasmidwives.com/Safety_stats.htm - 14k -
www.mothering.com/articles/ pregnancy_birth/homebirth/no-place.html -
www.compleatmother.com/homebirth/hb_safety.htm
www.naturalfamilyhome.com/birth.html -


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *alegna*
What I said was that no hospital birther I know has done any research on OUT of hospital birth. And that is true.

-Angela

Yes, it is true. Doctors, etal, really do not care about out of hospital outcomes.

Drs. believe in what they are doing, so why investigate anything else?


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## applejuice (Oct 8, 2002)

Quote:

This was my first experience in learning that women were actually forced into surgery because thay had no other option.
That was your first experience?

You should know that "once a section, always a section" has been the dictum of the obstetrical community since 1916.

I think technology and surgical technique have improved since then.

The problem is between the surgeons' ears.

Quote:

But she has no problems whatsoever in telling me that I'd be putting myself and my baby in danger. I think it is unethical not to respect someone elses informed decsions.
Every family has one of those...or we are related.

I hope your next baby is born happily at home...







easy labor/happy baby vibes your way.


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## WC_hapamama (Sep 19, 2005)

Quote:


Originally Posted by *applejuice*
You should know that "once a section, always a section" has been the dictum of the obstetrical community since 1916.

I think technology and surgical technique have improved since then.

The problem is between the surgeons' ears.

I think that our lawsuit happy society factors pretty heavily into why many doctors and hospitals "do not allow" VBACS. With the way that malpractice insurance is skyrocketing for OB/GYNs, and how many people will file lawsuits will he, nil he, the OB/GYNs and hospitals are probably not supporting VBACs more because they don't want to be liable if something goes wrong, whether it's their fault or not.


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## beansavi (Jun 26, 2005)

Let's not generalize each other, Mamas. We women have enough to work against without proving to each other that our decisions prove we are informed or not.

I think it is just a basic human trait that most humans want to follow a trusted leader and resist thinking for themselves. I believe there are psych profiles/graphs to back this up-saw one at my counselor's office a while back.

So, of course, the birthing habits of American women fall into this...

I mean, um, look at our last election????

Quote:


Originally Posted by *liseux*
This thread is over the top subjective and without real facts to back it up. Which, I guess is the point.

Comments like this, "I remember women having babies in the 'groovy hippy commune' because everyone else did, only to be in labor for days because they could not let go and have the baby." Applejuice
So now a woman who labors for days can`t let go and have the baby? Sounds like that woman must be a total idiot, if she was a perfect informed homebirthing goddess who trusted her body then what would it take, 3 hours? This leads to the kind of high school mentality that keeps women judging each other and keeps us drinking the HATORADE. There are women on this board who felt sad that they missed out b/c they had short labors. There are people who have healthy babies born in waterbirths that are pissed b/c they forgot to drink their special tea and light their candles. This is crazy to me and one thing about a lot of hospital birthers is most of them are not constantly comparing their experiences and outdoing each other.

Other comments like there aren`t interventions in hb or that OB`s are like bottom feeders, I think its obvious that anecdotal evidence is only acceptable in this discussion if it supports the original premise. If you have anecdotal evidence that shows that even smart women go the hospital or that not all OB`s suck, well, don`t mention it. How about real facts?


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## liseux (Jul 3, 2004)

Applejuice, those are good links and I think they help the discussion. I never doubted the safety of homebirth although it is harder for me personally to get excited about it b/c I lost a baby due to complications from his homebirth. I know I would have had the same outcome in a hospital b/c it was just that bad. Yet so many hbirthers that I knew would tell me they were sorry to hear about what happened and then ask me as many questions as they could to figure out what I had done wrong. I felt this hb superiority at every turn and I can`t help it if I represent the horror story. Death still happens, hospital & hb rates are the same in those studies. I would be like you guys, (I used to be & I mean that respectfully), the one who believes every single woman should start out at home, if I had a good outcome. I would probably be trying to convince everyone I knew that my way was the best way if only I had a good outcome. Spending time in the hospital, seeing every single new baby coming into the nursery showed me a much bigger world and opened my mind to all different kinds of families.

I think facts are needed b/c it seemed like this thread was so tightly controlled, really random things were allowed to be discussed as long as the person talked the party line. But if someone disagreed with the original premise then other experiences she may have added were asked to not be added to the discussion.

I thought this was a good point from the first link, "And no research has been done that proves hospitals to be the safest places in which to give birth." I agree completely that instrument delivery, c/s etc is more likely in a hospital,first because its there and its not available at home and second, b/c most hb mamas are low risk, and healthier and more in tune than a hospital mama may be.

I think when you compare the US to Holland & Scandinavia that`s not the best comparison b/c those are countries that have a totally different way of taking care of their citizens. There isn`t the same poverty as here. A person there may get asylum and not be allowed to become a citizen but they will be treated very well by the Govt. Here anyone can basically become a citizen but will be working very hard in the meantime, getting very little help form the govt, living in poverty without health insurance. In Western Europe they also have a startlingly low birth rate and ours is huge in comparison. We have very varied populations of all different income levels and poorer people do not get the same care. That`s partly why our rates of c/s and other complications are higher. Many women in the US still have no prenatal care at all. I think there`s more factors involved in this picture than OB`s suck and women are uninformed.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *WC_hapamama*
I think that our lawsuit happy society factors pretty heavily into why many doctors and hospitals "do not allow" VBACS.


IN our culture, if a doctor does a caesarean, he has done everything medically possible to "SAVE" that baby from the dangers of the birth process - "the valley of death". If the baby dies anyway, it is an act of G-d. But the doctor is free and clear of any legal malfeasance since a caesarean is the top of the line of all of the obstetrical procedures.

When a woman delivers by caesarean section, doctors say that she "delivers from above", as though there was something celestial or heavenly about the procedure.

The problem is that our society venerates the medical profession and the medical professionals have a G-d complex. This has to stop. Our culture, our mindset has to change before anything else changes.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *liseux*
... it is harder for me personally to get excited about it b/c I lost a baby due to complications from his homebirth.

I am sorry about the death of your child, and I hope you were allowed to properly grieve over the baby by your caretakers. I hope you were helped to understand how it happened and if it will repeat. Again, I am sorry. I had a baby sister die when I was young, but I have been spared this one sorrow in my life.

Quote:

I think when you compare the US to Holland & Scandinavia that`s not the best comparison b/c those are countries that have a totally different way of taking care of their citizens. There isn`t the same poverty as here. A person there may get asylum and not be allowed to become a citizen but they will be treated very well by the Govt. Here anyone can basically become a citizen but will be working very hard in the meantime, getting very little help form the govt, living in poverty without health insurance. In Western Europe they also have a startlingly low birth rate and ours is huge in comparison. We have very varied populations of all different income levels and poorer people do not get the same care. That`s partly why our rates of c/s and other complications are higher. Many women in the US still have no prenatal care at all. I think there`s more factors involved in this picture than OB`s suck and women are uninformed.
Europe has become very multicultural in the last forty years. There are many people there even in the Netherlands who are from the former colonies and the midwives are required to speak the languages of the people. In Sweden, there are many Nigerians. So there are many cultures. In the UK, the crumbling Empire invited the people in their colonies to England for a while, so there are many cultures there.

I agree there are more factors to consider. But our culture teaches us to trust professionals. We trust teachers to teach our children to read, we trust policemen to enforce the law, we trust firemen to put out the fire, we trust the pharmacist to give us information and the drugs we need, we trust EMTs to make snap judgements in times of emergencies, and we trust obstetricians to deliver a healthy baby and help the mother recover.

But they are all human like us and very fallable - they are just specially trained and WE NEED TO BE EDUCATED and INFORMED or we are hurting ourselves.


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## liseux (Jul 3, 2004)

Applejuice, I agree with everything you said in your last post, especially about how most Americans view doctors.

I want to clarify that when I wrote about people getting asylum in European countries I meant the huge mix of people you do see in Europe. In Germany for example you can come from North Africa or Saudi Arabia or Turkey and get asylum and live very well (in comparison to a similar situation here) and get excellent health care. Most of the people (yes, a very multicultural mix now) will never become German citizens, but their children will. Many immigrants in Europe get such good care from the Govt that they don`t work b/c its more than they lived on while working in their homeland. I know lots of people who ended up in the US but had a transition time in Germany. Here, anyone can become a citizen but they will be super poor for awhile and working like crazy. So, my point was that in Europe, they have less babies and they get better care. There are hospitals here that are like baby factories and I think that affects the rates of complications also. I still think we should at least have a midwifery standard in hospitals, with women learning about the process as they go, and having hour long appointments if they prefer.


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## liseux (Jul 3, 2004)

Applejuice, thank you for your kind words about my son. The only reason I mention it in this thread is to illlustrate how weird it can be to be a hbirthing mama with a bad outcome, other hbirthers can be very insensitive and judgemental when the worst outcome can happen to any of us. There is an arrogance I see all the time, the whole "believe in yourself and nothing will happen". It seemed this thread was going in that holier than thou kind of direction so I wanted to speak up not for me, b/c I`ve had time to process and know that what happened wasn`t my fault, but for other mamas newer to loss. Hopefully we can all learn from each other and accept each other where we are.

In my case what happened could happen again & I became high risk so the hospital was my only option. Its very hard to face that when you`ve been totally against it for so long. The only way is to get totally involved in your care, learn as much as the doctors about yourself, stay alert and remember you are the consumer. There`s nothing unethical about that.


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## aprilushka (Aug 28, 2005)

I think it's difficult to talk about home vs. hospital as a matter of ethics (or morals) -- there are too many variables for each family.

However, what I do think is unethical in the system is when women feel they have to make a choice because other options are closed to them-- such as VBACs feeling like they have no choice but to go unassisted, because their hospitals have banned them and either there are no local mws who do them or by law the local mws can't (disclaimer-- I think unassisted is great for those who choose, but I don't think anyone should be looking at a situation where that is their only choice other than major abdominal surgery). I also think the way so-called "informed" choice is administered is unethical when it comes to birth matters, because the information is generally sorely lacking. In the end, I think what choices are available and how they are presented are the bigger questions than what women are choosing.


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## kavamamakava (Aug 25, 2004)

Quote:


Originally Posted by *alegna*
Two topics from liseux's post- I will address one at a time.

Okay- is there any place that one would choose to birth that would be unethical? Would it be unethical to CHOOSE to birth on a trapeeze, while swinging without a net? Of course. Then is there a case where it COULD be unethical to choose to birth in a hospital? Of course. For example, you KNOW for a fact that the baby will be taken from you without reason and treated harshly and subjected to a serious chance of infection and there is no other reason to be in said hospital, then yes, that choice WOULD be unethical.

-Angela

Although the closest hospital to me has a family birthing wing and they never take your baby out of your room.


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## kavamamakava (Aug 25, 2004)

Quote:


Originally Posted by *SunRayeMomi*

I feel I am blessed to have been brought up in a home that stressed health and informed choice. We believe that things such as childbirth don't need medical intervention&#8230; but things such as broken bones do. When it comes to being raised a certain way, I think it's normal to expect people that weren't raised this way to assume chidbirth is a medical event. Sometimes though, they do some reading and come across homebirth and decide that it makes more sense. More power to them, either way, as long as they do in fact do that research. That's the key.

Do I think it is unethical to choose hospital birth over homebirth? No I wouldn't use that word. I do however believe that people who choose things such as elective cesarean and formula feeding without atleast trying to breastfeed first are most likely doing so without properly researching their decisions first. Notice I said most likely, meaning this is not an umbrella statement. No statement such as this can ever be true for everyone, so it helps to not take it too literally. But, for things so important as how you deliver and feed your newborn, if you don't atleast do some soul-searching and research first, then it is a little reckless.

I myself was discriminated against at the hospital when I had to be transported after delivery for stitches. They went so far as to have CPS try and schedule a visit at my home. Unacceptable. I was *so proud of myself* for having just given birth naturally, without putting my daughter into uneccesary exposure to drugs or forceps or vacuum extraction, etc. And what do I get? A visit from CPS because they think I was being reckless for having a homebirth! I tend to think it's reckless to go into the hospital intending to have an epidural from the start or intending to have a cesarean for unmedical reasons. But I don't see CPS knocking on their doors&#8230;&#8230; so why mine? I know of children that were circumcised because their parents didn't see the little box to mark if you DONT want your son to be circed. Why is it you have to specifically opt out of an uneccesary surgery?


I agree with your point about birthing jiving with how you were raised. It's so easy for me to choose to home birth because that's what I know. That's what I've been exposed to all my life and that's part of my philosophy on health and birth.
Also, I had a hospital transfer to get stitched after the birth of my first child. Due to the fact that I was a homebirth transfer, the on-call surgeon took too long to come and then I had some complications and needed to spend the night. At least the hospital was really good to me, my son and partner spent the night there with us and no one contacted CPS. Sorry you had to deal with that


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## SunRayeMomi (Aug 27, 2005)

Quote:

I think it is unethical not to respect someone elses informed decisions.









I also have opinions that I express privately to myself, and when I was pg I did not appreciate the comments I got when I told ppl I was homebirthing. The thing that irked me the most was that these were people I knew to have never done a stitch of research on the subject. How did they then feel they knew what was best for me? So I keep my mouth shut nowadays, unless I know the person I am talking to respects my knowledge enough to take it to heart.


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## eilonwy (Apr 3, 2003)

Quote:

I do not know one woman who had a hospital birth (including myself) who made a truly informed decision. I know women who think they did but they are mistaken. All the info needs to be out there and easily available to everyone. How can you weigh the risk and benifits when you don't truly know what they are?
I've read over this entire thread, but I can't get over this. Do you honestly believe that women who think they've made an informed decision which culminated in a hospital birth are all mistaken? Seriously?! That's got to be one of the most judgemental, obnoxious things that I've ever read. Just because they came to a different conclusion from yours, they're mistaken? But you couldn't possibly be wrong, could you, there's no way that anyone would choose a hospital birth after truly knowing what the risks and benefits are. Please.

Do I think it's unethical to choose a hospital birth? Absolutely not. I think it's sad that most women don't have the resources to make a different decision, and that's certainly unethical but who's really to blame-- doctors, schools, television, the government? We can blame everyone but ourselves for this (because we are never wrong, we know what's best for everyone), can't we?

The biggest ethical crisis I see when it comes to birth is people who decide that they are activists because they had homebirths. I think that if the way pregnancy and childbirth are typically managed in this country is, by your own standard, unethical then it is _at least_ as unethical for you to fail in your duty: diseminating information to those who need it, and helping women to make truly informed decisions. It's damn near impossible for most "birth activists" to listen long enough to find out what's needed, and that's really depressing to me.

Is the c-section rate "too high" at your local hospital? Why is that? Who can change it, if not the patients? Hospitals are businesses, they're out to make money and if women demand a different standard of care from them, they will get it. Is homebirth safer than hospital birth? Under what circumstances? Why don't people know this, and _what can be done to change it?_ What circumstances would, in your mind, justify or necessitate obstetrical care? Why and when? If that's not consistant with real life, then do something to change it.

I think that these discussions are unethical, and I think that they're a step backwards for most people. They don't help people to make changes in their communities, and they don't foster a sense of community with other women who are in different situations but need the same information (i.e. they're pregnant). They cause the divide to grow wider-- people who believe that homebirth is the only possible informed decision retreat farther from the mainstream (and, thus, from the women who need to learn about their positions) than ever, and people who believe that hospital birth can be, in some/many/all circumstances a perfectly reasonable, informed choice are made to feel, once again, that they are irresponsible/immoral/unethical/generally rotten people. Irony of ironies, it's the women who are willing to consider the possibility that hospital birth might be warranted who are the most likely to change things in the birthing culture of America. How? By listening, by paying attention, by bringing things to the attention of the medical establishment from which homebirthers have so thorough disaffected themselves.

Doesn't that upset you enough to want to change things?


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *eilonwy*
I've read over this entire thread, but I can't get over this. Do you honestly believe that women who think they've made an informed decision which culminated in a hospital birth are all mistaken? Seriously?! That's got to be one of the most judgemental, obnoxious things that I've ever read. Just because they came to a different conclusion from yours, they're mistaken? But you couldn't possibly be wrong, could you, there's no way that anyone would choose a hospital birth after truly knowing what the risks and benefits are. Please.

Do I think it's unethical to choose a hospital birth? Absolutely not. I think it's sad that most women don't have the resources to make a different decision, and that's certainly unethical but who's really to blame-- doctors, schools, television, the government? We can blame everyone but ourselves for this (because we are never wrong, we know what's best for everyone), can't we?

The biggest ethical crisis I see when it comes to birth is people who decide that they are activists because they had homebirths. I think that if the way pregnancy and childbirth are typically managed in this country is, by your own standard, unethical then it is _at least_ as unethical for you to fail in your duty: diseminating information to those who need it, and helping women to make truly informed decisions. It's damn near impossible for most "birth activists" to listen long enough to find out what's needed, and that's really depressing to me.

Is the c-section rate "too high" at your local hospital? Why is that? Who can change it, if not the patients? Hospitals are businesses, they're out to make money and if women demand a different standard of care from them, they will get it. Is homebirth safer than hospital birth? Under what circumstances? Why don't people know this, and _what can be done to change it?_ What circumstances would, in your mind, justify or necessitate obstetrical care? Why and when? If that's not consistant with real life, then do something to change it.

I think that these discussions are unethical, and I think that they're a step backwards for most people. They don't help people to make changes in their communities, and they don't foster a sense of community with other women who are in different situations but need the same information (i.e. they're pregnant). They cause the divide to grow wider-- people who believe that homebirth is the only possible informed decision retreat farther from the mainstream (and, thus, from the women who need to learn about their positions) than ever, and people who believe that hospital birth can be, in some/many/all circumstances a perfectly reasonable, informed choice are made to feel, once again, that they are irresponsible/immoral/unethical/generally rotten people. Irony of ironies, it's the women who are willing to consider the possibility that hospital birth might be warranted who are the most likely to change things in the birthing culture of America. How? By listening, by paying attention, by bringing things to the attention of the medical establishment from which homebirthers have so thorough disaffected themselves.

Doesn't that upset you enough to want to change things?











And I am a homebirth activist, radical type. ITA with this post! Passionate and well written. Magnifico.


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *eilonwy*
I've read over this entire thread, but I can't get over this. Do you honestly believe that women who think they've made an informed decision which culminated in a hospital birth are all mistaken? Seriously?! That's got to be one of the most judgemental, obnoxious things that I've ever read. Just because they came to a different conclusion from yours, they're mistaken? But you couldn't possibly be wrong, could you, there's no way that anyone would choose a hospital birth after truly knowing what the risks and benefits are. Please.

First off thanks for calling me obnoxious, nice. Secondly if you would have read my post w/o judging you could have clearly seen I was talking about the women I know, not ALL women. Most women I know who had hospital births didin't think about it at all and those that did didn't think to look into any alternatives to a hospital birth, only looked into what procedures are done and if they wanted them. THAT IS MY PERSONAL EXPERIENCE. NO WHERE DID I SAY MY EXPERIENCE WAS UNIVERSAL.


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *Sheacoby*
What is unethical is the fact we aren't getting the truth. The medical establishment does not give us all the facts, they actually give us very few. Women are not making informed decisions because it's pretty hard in this culture to become informed. I do not know one woman who had a hospital birth (including myself) who made a truly informed decision. I know women who think they did but they are mistaken. All the info needs to be out there and easily available to everyone. How can you weigh the risk and benifits when you don't truly know what they are?

Taking things out of context and then putting your spin on it is also quite obnoxious! This how I see it, if you have experienced something different then post about it but you don't have to knock me personally or try to discredit my experiences.


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## eilonwy (Apr 3, 2003)

Quote:


Originally Posted by *Sheacoby*
First off thanks for calling me obnoxious, nice. Secondly if you would have read my post w/o judging you could have clearly seen I was talking about the women I know, not ALL women.

And if you had read mine, you would have noted that it was the *statement* that I referred to as obnoxious, and not you. Yes, you did say "all the women that I know (not most, as you later assert)" but you went on in other posts to assert that you believe that no woman would ever choose a hospital birth if they made a truly informed decision. It was an attack on your position, not your character.

Quote:

Most women I know who had hospital births didin't think about it at all and those that did didn't think to look into any alternatives to a hospital birth, only looked into what procedures are done and if they wanted them. THAT IS MY PERSONAL EXPERIENCE. NO WHERE DID I SAY MY EXPERIENCE WAS UNIVERSAL.
You strongly imply that your experience is, if not universal, the norm. Either way, I don't see it as a helpful statement to make. It strikes me, personally, as devisive and counterproductive. I'm sorry if I wasn't more clear about that, but I was posting at 3 in the morning with a screaming baby on my lap.







I'll try to be more careful in the future.


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## Raven (Dec 15, 2001)

Can I remind you all to please keep this conversation within the parameters of the UA.


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## LavenderMae (Sep 20, 2002)

I changed ALL to MOST because I realized later that I haven't actually talked about this issue with ALL the women I know. Most of them but not all. So the ones I have discussed it with do fall into the category I already mentioned.
I think you are wanting to read more into my post than what is actually there. I didn't strongly imply anything, that's all you. I'm not exactly sure why you have called my post out to be most offended by and I'm pretty sure you are not among the women I know, so my post have nothing personally to do with you. If you really took in everything I was expressing you'd have realized I don't fault women for not being informed our birthing culture sets it up to be hard for us to be. I even included myself among the uninformed.
I never said there are no informed women who who birth in hospitasl but I do believe a lot of informed women choose home births. That however does not mean if an informed woman chooses a hospital birth she can't truly be informed.

Bottom line this is how I feel

Quote:


Originally Posted by *sheacoby*
All the info needs to be out there and easily available to everyone.


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## SunRayeMomi (Aug 27, 2005)

Quote:


Originally Posted by *Mamma Mia*
Allow me to quote myself as well.


I am confused. Are we supposed to do some circle-dance here or something where we just keep quoting eachother into infinity?


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## SunRayeMomi (Aug 27, 2005)

Quote:

people who believe that homebirth is the only possible informed decision retreat farther from the mainstream (and, thus, from the women who need to learn about their positions) than ever,
well stated


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## eilonwy (Apr 3, 2003)

Quote:

Taking things out of context and then putting your spin on it is also quite obnoxious! This how I see it, if you have experienced something different then post about it but you don't have to knock me personally or try to discredit my experiences.
Once again, I never "knocked you personally." Nor did I try to discredit your experiences-- what I said was that the statement "I know women who think that they made informed decisions but they're wrong" was obnoxious. It would have been more fair and perhaps more accurate to say that it was extremely judgemental, but at three a.m. it just felt like a slap in the face. I felt sorry for all the women you were lumping together with that statement, and it just felt very, very wrong. Once again, I apologize if you misunderstood, but I was absolutely not making any attacks on your character.

Quote:


Originally Posted by *Sheacoby*
I think you are wanting to read more into my post than what is actually there. I didn't strongly imply anything, that's all you. I'm not exactly sure why you have called my post out to be most offended by and I'm pretty sure you are not among the women I know, so my post have nothing personally to do with you.

Who says I took it personally? I'm sorry, but that statement was very judgemental and was extremely offensive to me, but not on a personal level-- I felt offended for all women. It really sounded like you were saying that it's absolutely impossible for a woman to be truly informed and educated and still decide to birth in a hospital. You did say later that it wouldn't necessarily be unethical for a woman to make that decision if they were informed, but went on to reiterate that most women aren't making informed decisions.

Quote:

If you really took in everything I was expressing you'd have realized I don't fault women for not being informed our birthing culture sets it up to be hard for us to be. I even included myself among the uninformed.
I never said there are no informed women who who birth in hospitasl but I do believe a lot of informed women choose home births. That however does not mean if an informed woman chooses a hospital birth she can't truly be informed.
What you said was:

Quote:



"I don't think many women are actually making an informed decision , is that unethical I'm not sure."
"I think a lot of women make their birthing decisions based on fear and not facts."
"My issue is that very few women are actually making informed choices....Why do a lot of women feel safer in the hospital, why do many believe the hospital is safer? Why do so many women let doctors choose for them?"

In short, we're not actually disagreeing on the fundamental problem, which is one of information. I never said that we were. For the last time, I said that *one statement that you made struck me as obnoxious*. I don't think that I'm reading too much into that, it just came across as extremely rude to me.







I did not make any assertions about your character, or even about the rest of your posts, just that one statement. I'm through apologizing about it. I already said that I could have chosen my words better, and quite frankly I think that you could have done the same. That's all. Who's blowing things out of proportion?


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *eilonwy*
Once again, I never "knocked you personally." Nor did I try to discredit your experiences-- what I said was that the statement "I know women who think that they made informed decisions but they're wrong" was obnoxious.

Allow me to put my take in here. I think what she was saying is that the women that SHE knows who had a hospital birth and thought that they made informed choices did not, in fact, make informed choices. I could say the same thing. The women that I know personally who chose hospital birth think that they made informed choices. I know that they did not as they did not look at any non-hospital birth information. Now, I know that MANY women that birth in the hospital DO make an informed choice to be there. I simply do not know any of them in real life. I also think that, at least in this area, they are not the norm.

-Angela


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## Mamma Mia (Aug 3, 2005)

I apologize, I wasn't agreeing with the personal stuff, but the main point of the post. I should have narrrowed my quotes a bit.


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## applejuice (Oct 8, 2002)

Quote:

Is the c-section rate "too high" at your local hospital? Why is that? Who can change it, if not the patients? Hospitals are businesses, they're out to make money and if women demand a different standard of care from them, they will get it. Is homebirth safer than hospital birth? Under what circumstances? Why don't people know this, and what can be done to change it? What circumstances would, in your mind, justify or necessitate obstetrical care? Why and when? If that's not consistant with real life, then do something to change it.
Women need to vote with their feet, by taking them out of the stirrups, walking out of the maternity wards and staying home to labor.

I was born at home, 7 of my 8 sibs were, and my 4 children were.

I am a rabid homebirth advocate, yet I know after working for thirty years in this area and watching midwife after midwife be arrested for things doctors would line up for miles and to defend a fellow collegue from.

The problem in this country is that we have a culture bias in favor of medical intervention.


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## SunRayeMomi (Aug 27, 2005)

was your last post for me? If so, what did you mean by personal attacks? Just curious


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *alegna*
Allow me to put my take in here. I think what she was saying is that the women that SHE knows who had a hospital birth and thought that they made informed choices did not, in fact, make informed choices. I could say the same thing. The women that I know personally who chose hospital birth think that they made informed choices. I know that they did not as they did not look at any non-hospital birth information. Now, I know that MANY women that birth in the hospital DO make an informed choice to be there. I simply do not know any of them in real life. I also think that, at least in this area, they are not the norm.

-Angela

Thank you, that IS what I was saying. I know the women I know do NOT represent all or even most women.
eilonwy, thank you for saying your weren't knocking my character because it did feel like it. I do think we mostly agree.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *SunRayeMomi*
was your last post for me? If so, what did you mean by personal attacks? Just curious









I agreed with a lot of what eilonwy said, but not the part that was personally directed. That's what I was referring to. I'm hoping I haven't made you feel like I've attacked you. It was never my intent.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
Allow me to put my take in here. I think what she was saying is that the women that SHE knows who had a hospital birth and thought that they made informed choices did not, in fact, make informed choices. I could say the same thing. The women that I know personally who chose hospital birth think that they made informed choices. I know that they did not as they did not look at any non-hospital birth information. Now, I know that MANY women that birth in the hospital DO make an informed choice to be there. I simply do not know any of them in real life. I also think that, at least in this area, they are not the norm.

-Angela

Angela, ITA with you here.


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## SunRayeMomi (Aug 27, 2005)

Quote:


Originally Posted by *Mamma Mia*
I agreed with a lot of what eilonwy said, but not the part that was personally directed. That's what I was referring to. I'm hoping I haven't made you feel like I've attacked you. It was never my intent.










No no of course not







I think I was just losing the thread of the conversation for a minute


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## littlemama06 (Oct 29, 2005)

I am young, un-informed compared to the knowledge and info you all have. But I can't see how having a baby in a hospital could be unethical, immoral. Isn't it about choice, to choose to have a child where you want to,when you want to,if you want to.

It is a little similiar to the pro-choice/prolife debate.when I have told people I am pro-choice they have asked how i could be for abortion.I am not pro- abortion,I am just for a women's right to choose.It is her choice...it is not, to me, a matter of ethics or morality.To me it would be immoral to judge.

I am not sure where I will have my baby,home,hospital,birthing center. But where ever I do it will be an informed decision I make and not something I feel I should do based on the moral views of others.


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## alegna (Jan 14, 2003)

You make good points. I am also pro-choice. I believe that LEGALLY women should have the right to choose abortion. I also believe that LEGALLY women should have the right to choose to birth in a hospital. HOWEVER, there are situations where I believe abortion is unethical. There are also situations where I believe hospital birth to be unethical. Make sense? If I know that the chances are very high that my child could be physically or emotionally damaged by being born in a hospital, then ethically I have a responsibility to protect my child by birthing elsewhere.

Of course you should not make your decision based on someone elses moral views. You should make the decision based on your own moral views.

-Angela


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## honeybee (Mar 12, 2004)

I'm coming in on this late, but after spending ds's entire nap period reading these posts, I couldn't resist at least posting my $0.02.









I think the whole climate of birth in our contry is screwed up. Many routine obstetrical practices are unethical.

But, I just can't say that choosing a hospital birth is unethical... whether you're truly informed about the risks or not. I just do not think you can separate the cultural context from peoples' decisions. If one BELIEVES the hospital is the safest place to give birth and that homebirth is unsafe, how can you say they are making an unethical choice, even if the "facts" don't back that up? If you KNOW something to be true, why would you feel the need to research it?

I am a researcher by nature, but the reality is most people aren't. Many truly don't have the skills or the understanding of statistics, etc. to really understand how evaluate studies effectively. And, of course, there is the excellent point a pp made about poverty and access to information, etc.

I would say I was fairly well informed about the risks with my first birth. Actually, reading Henci Goer and posts like these on boards had me pretty freaked out about going to a hospital to birth. I was really paranoid that the whole thing would be one big fight. BUT, I wasn't in any way, shape, or form ready for a homebirth. It took a lot of changing of my cultural paradigm for me --which included experienceing a hospital birth!--- for me to be ready for that step. Luckily, I HAD done my research, took some precautions (like choosing my caregiver and hiring a doula), and had a really good hospital experience. So, knowing the risks, was it really "unethical" of me to choose to birth at the hospital--especially when I felt educated enough to know how to avoid the risks???

This time around, I'm eagerly anticipating a homebirth. I'm learning a LOT more about the whole process of birth. I wasn't UNINFORMED before, but now I have access to different sources and types of information.

We do the best we can with what we know at the time.


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## AnditheBee (Oct 3, 2003)

Quote:


Originally Posted by *WC_hapamama*
I think that our lawsuit happy society factors pretty heavily into why many doctors and hospitals "do not allow" VBACS. With the way that malpractice insurance is skyrocketing for OB/GYNs, and how many people will file lawsuits will he, nil he, the OB/GYNs and hospitals are probably not supporting VBACs more because they don't want to be liable if something goes wrong, whether it's their fault or not.

I know for certain that this is why I can't get a VBAC locally (something that used to be done here). Our OB's will lose their insurance if they support someone who intends to have a homebirth, or if they support/perform VBACs, as will our hospital if it allows them to be performed there. This is what happens when a corporation is making decisions on medicine--the result is bad medicine! One of the newer OB's in town wanted to meet with the local midwives and develop a friendly working relationship, but the insurance company threatened to pull her coverage if she did. *That* is unethical.

Hospital birth itself is not, IMO, unethical. What is unethical is the way some birthing women are treated--like sheep being penned for shots or shearing--put through "the assembly line" of birth without adequate respect, information, or real concern for their health. Also unethical is the no-choice situation I and other VBACs are so often put into. It forces doctors to risk harm to their patients via surgery they don't need, and undermines the legitimate use of cesarean for women/babies who need it.


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## SneakyPie (Jan 13, 2002)

"And actually, in some cases, I have no problem telling people that their choices were hands down wrong."

That attitude would fit right in with the OBs.

Of course it's not unethical to choose a hospital birth. If the maternal or neonate death rates out of hospitals were 1 in 50 or something like that, sure. But they aren't. And I don't think there's enough reason for me to turn the "it's wrong to try homebirth" argument around on pro-hospital mothers. The original argument is totally flawed but I don't see a need to replace it with another flawed and judgemental statement.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
HOWEVER, there are situations where I believe abortion is unethical.

Well I personally can't see a situation where abortion is unethical unless it's forced. I'm also pro abortion. I think it's a wonderful form of birth control. Feel free to add me to your ignore list and/or hate everything I say accordingly. That said, I'll shut up about because I know we're uber-not-allowed-to-talk-about-it and I don't want to cause trouble.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *SneakyPie*
"And actually, in some cases, I have no problem telling people that their choices were hands down wrong."

That attitude would fit right in with the OBs.

Of course it's not unethical to choose a hospital birth. If the maternal or neonate death rates out of hospitals were 1 in 50 or something like that, sure. But they aren't. And I don't think there's enough reason for me to turn the "it's wrong to try homebirth" argument around on pro-hospital mothers. The original argument is totally flawed but I don't see a need to replace it with another flawed and judgemental statement.

I agree with quite a bit of this. I do think it's safer, based on my own research and experience, to birth at home. I still think that women who have all the facts can choose hospital birth and it's not unethical. Women should birth where they are most comfortable. Period.


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## the_lissa (Oct 30, 2004)

I love you Mamma Mia.


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## ZeldasMom (Sep 25, 2004)

Quote:


Originally Posted by *alegna*
Is it ethically okay to be in a hospital and risk hospital caused injury and infection to a newborn simply because the mom feels safer there?

Yes. But ideally it should be an informed choice and all women should have access to home birth midwifery so the decision to birth in a hospital is a real choice and not just something that happens by default.

Great question. Sorry, but I have not had a chance to read the replies (my online time is kind of feast or famine lately), look forward to doing so soon!


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## alegna (Jan 14, 2003)

Okay- then is ANY place the mom feels safe ethically okay? (even if it is not, in fact safe?)

-Angela


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## tinyshoes (Mar 6, 2002)

Quote:


Originally Posted by *alegna*
Okay- then is ANY place the mom feels safe ethically okay? (even if it is not, in fact safe?)

-Angela

I can see what you mean, Angela.

I was going to post about my mother--but didn't want to snark it up...but now I'll go ahead and contribute this perspective.

My mother would have felt unsafe laboring without her cigarettes, whether at home or in the hospital. She smoked throughout her first two pregnancies, and during labor, at the hospital (everyone smoked at the hospital, remember?)

But now Mainstream America would deem smoking while pregnant unsafe, uncool, and therefore quite possibly unethical.

(And Mainstream America isn't exactly consistant...no pregnant woman should use narcotics....uh, unless she's in a hospital gown, I guess...Then it's







)


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## alegna (Jan 14, 2003)

THANK YOU! Someone got it.







My concern is that we're just saying that the hospital is ethically okay because 1. it's the HOSPITAL and 2. it's what we're used to. If it was some other place, holding the same risks a lot of people would FREAK.

-Angela


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *the_lissa*
I love you Mamma Mia.









Wow! Thanks!


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *alegna*
Okay- then is ANY place the mom feels safe ethically okay? (even if it is not, in fact safe?)

-Angela

Pretty much. Her birth, her choice.


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## Mamma Mia (Aug 3, 2005)

Quote:


Originally Posted by *tinyshoes*
I can see what you mean, Angela.

I was going to post about my mother--but didn't want to snark it up...but now I'll go ahead and contribute this perspective.

My mother would have felt unsafe laboring without her cigarettes, whether at home or in the hospital. She smoked throughout her first two pregnancies, and during labor, at the hospital (everyone smoked at the hospital, remember?)

But now Mainstream America would deem smoking while pregnant unsafe, uncool, and therefore quite possibly unethical.

(And Mainstream America isn't exactly consistant...no pregnant woman should use narcotics....uh, unless she's in a hospital gown, I guess...Then it's







)

The hysteria about drinking and smoking in pregnancy is mostly about controlling women's bodies. Light drinking and smoking in moderation during pregnancy really isn't a serious threat to a fetus. Ultrasound can lead to IUGR, and fetuses (fetii?







) have a strong reaction to u/s soundwaves. There are risks to many procedures considered safe and ethical, even among the radicals here. I'd write more but I need to go for now.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mamma Mia*
Ultrasound can lead to IUGR, and fetuses (fetii?







) have a strong reaction to u/s soundwaves. There are risks to many procedures considered safe and ethical, even among the radicals here. I'd write more but I need to go for now.

Interesting side-track since you bring it up, I don't consider routine u/s ethical. If there is a medical reason, sure. But to find out gender? Nope. No good reason? Nope.

-Angela


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## ZeldasMom (Sep 25, 2004)

Quote:


Originally Posted by *Mamma Mia*
Pretty much. Her birth, her choice.

This is my take too. I agree with whoever said that there is too much emphasis on controlling women's bodies when it comes to birth. I take the view that mama knows best. I'm all for helping women get access to information and resources. But then I think we need to step back and trust them to make the decisions that they feel are best.


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## eilonwy (Apr 3, 2003)

Quote:


Originally Posted by *alegna*
Okay- then is ANY place the mom feels safe ethically okay? (even if it is not, in fact safe?)

I don't know that this is a valid point against hospital birth. Regardless of the scare tactics which are so favored here at MDC, hospital birth is not, in fact, outright dangerous.







Sorry, but there's no comparison to be made between giving birth in a hospital and giving birth while swinging from a trapeeze 150 feet up; even taking into account medical errors and iatrogenic birth injuries, there's no comparison.

Is any place the mom feels safe ethically okay? Personally, I'd say no-- however, there are different levels of safety and everyone has a different idea of risk assessment. Comparing hospital birth to homebirth is reasonable-- the outcomes are very similar. Comparing hospital birth to giving birth in a tree, not so much.









Quote:

Interesting side-track since you bring it up, I don't consider routine u/s ethical. If there is a medical reason, sure. But to find out gender? Nope. No good reason? Nope.
What defines "a good reason," in your own personal estimation? Is it safe to assume that perhaps your idea of a good reason may not jive with anyone else's? I mean, it's a total judgement call. Some people think that peace of mind about your baby is a very good reason to have an ultrasound, others think that you shouldn't have one unless you're pretty well convinced that your baby has died in utero. Still others think that finding out the sex and thus saving themselves from months of arguing with their spouse about names or obsessing about the daughter/son that they're not going to have is a good reason. Some people think that you shouldn't have an ultrasound for any reason during a pregnancy, and others think that if you've already had a child with birth defects it's reasonable to have an ultrasound in every subsequent pregnancy. Everyone has, once again, a different set of criteria by which they assess risk. And once again, I think that what's unethical is that it's very hard to come by solid information and evidence, especially around here where everyone thinks that they know what everyone else should do, but they don't even try to find the (in this case, very little) research that's been done on the subject to try to convince others. Lots of scare tactics, yes, but very little rational discussion.


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## SunRayeMomi (Aug 27, 2005)

Quote:


Originally Posted by *alegna*
Is it ethically okay to be in a hospital and risk hospital caused injury and infection to a newborn simply because the mom feels safer there?

When a mom has done her research first and has conceded that she would in fact feel safer at the hospital than anywhere else, and also has determined to take her delivery into her own hands and out of medical science's, yes.

But how much research is enough? Is there a par amount of researching hours that we should all strive for when it comes to such things? I feel like when it comes to researching my decision to homebirth, I fall short of the standards implied in this thread. But then again, my mom is a midwife, so I guess I more or less skipped the research lab and went straight to interning







Anyway, I am doing more "researching" now that I'm moving toward pregnancy and birth #2 than I did with #1. But I had my dd1 at home and not the hospital. So I guess I passed "the ethics test" as is implied here


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## orangebird (Jun 30, 2002)

Quote:

Originally Posted by applejuice
Many doctors and nurses will push procedures on mothers in labor saying, "It is the best thing for your baby!", -OR- "Don't you care about your baby?", -OR- doctors love to play the hero by saying, "If you let me - [fill in with your favorite intervention/procedure], - I can guarantee you a perfect baby!"

DO NOT DENY IT! I have heard this veiled threat many times from a doctor while a mother is having a difficult labor.

Quote:

This is not true.

I've had 3 hospital births (4th coming up in December). I've dealt with a total of 3 different OBs and more L&D nurses than I can remember. None of them ever told me such a thing.
No, what applejuice said is absolutely true.

My first baby was born in the hospital and I was told such things. The nurses told me that my baby would probably die if I didn't follow their commands and stay in bed and consent to an epidural.

On top of that, I am a nurse who attends a few births now and then and just from my experience, I have heard nurses and doctors make threats of such nature.

Maybe you, one person, hasn't experienced it, but it is out there. I have heard it from both sides of the fence.

Yes, not _all_ doctors and L&D nurses lie, but enough of them do to make the hospital not such a safe place and quite a risk. You never know when to believe these people, the people you have paid to be able to trust. So very sad indeed.


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## applejuice (Oct 8, 2002)

Thank you, mara. I knew I was not imagining or hearing things.


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## WashingtonMama (May 4, 2006)

There is alot to be said for homebirths, but sometimes going to the hospital is in your best interest. I speak from two misguided home birth experiences...the second being a rupture. There are some midwives who do not monitor you as you should be monitored. I expereinced that just recently. Homebirths must be thought through very carefully. You never know what will happen.


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## faeriewisp (Mar 13, 2005)

OK, I just invested a lot of time in reading this thread, and even though I feel like it will never amount to anything more than running around in circles, I had to reply.

If I decided to have this next baby in the hospital it would be an unethical thing for me to do, unless it was absolutely medically neccessary. But I would never make such an unethical decision, because I always follow my head and heart.

I had my first baby in the hospital, and it was a very ethical decision. I was 19, single and alone, and falsely confident with my copies of What To Expect and a Bradley Method book. Losing control of myself in that hospital gave me so much first hand knowledge on the process of birth. I was then able to go forward with my eyes opened and look for another way, a better way, and I had my second baby at home. If say for instance I had had an accidental unassited birth the first time around, I really think I would have just gone to the hospital for the second birth. It wouldn't have sparked my curiosity or caused me to search for my rights.

Each situation is so different that it really is impossible to talk about this as a question of ethics.

Yes there are are ethical and unethical people in the world. There are ignorant people and well-informed people. I don't think there's much point to discussing this. It'd be better to have a more pro-active topic. How do we get the information out there to more women?


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