Sunday, December 27, 2009

Caught off guard

Last night we went to my aunt and uncle's in town for boxing day supper. It was delicious and very busy and fun, and my aunt and uncle live in the house that I grew up in from 2 to 13 years old so revisiting their house was very nostalgic. They had family friends there whom I had never met, from Massechusetts. Things were all very nice and friendly and civil, and someone told Mrs. Massechusetts that I had applied for midwifery school next fall. She asked some seemingly interested questions regarding the educational process and my current job, which was nice. But then she popped out, "I'm a statistician in the U.S. and I just finished a big project looking into deaths in homebirths. Is it safer to have homebirths in Canada than in the U.S? Because the home birth death rate is really high."
Uhhhhhhhhhhhhhhh...okay, here we go, and we already know a few things about this situation:
(1) we cannot offend her because she is a guest of my relatives
(2) she has been politely inquiring about midwifery but with a backhanded motivation
(3) she has already decided that home births are dangerous.

How to deal?

My mom is awesome. She jumped in and, rather than directly address the question of comparing U.S. and Canadian maternity issues, she just pointed out that the home birth infant mortality rate in Canada is really low--lower than in the hospital--because women are screened for risks before being attended at home by midwives. High risk births are delivered in hospital. I expanded on this and said a few things about the safe parameters of home birth, but felt kinda caught off guard. I have read from several sources that it is really difficult to gather any kind of statistics on home birth, unassisted childbirth, precipitous birth, and back alley give-birth-at-prom-in-the-bathroom-and-ditch-baby-in-the-trash-can birth, and be accurate. For one thing, unassisted births are underreported AND overreported, because people are trying to get around the institutionalized birth and/or government involvement or control in their lives and still stay off authorities' radar. In states where attended home births are illegal, homebirth midwives will not sign birth documents and the birth is recorded as unattended or precipitous. Some unassisted births with no midwife in attendance will not be reported to vital statistics to avoid government involvement and/or to avoid investigation by Child Protective Services.

But how to get into all of this? How to ask: did you include precipitous births? Did you include taxi births? Unassisted births? Home births with midwives are safer than hospital births, for low risk women. Study after study shows this, and many other developed countries have a homebirth, midwifery based system for low risk births and have far better infant and maternal outcomes, and lower surgical birth rates, than the U.S. (or Canada).

Instead, I thought later I could have said:
Have you checke the infant mortality rate of any hospitals in the U.S.? Infant mortality in America is appallingly high, regardless of the place of birth. America has the highest infant mortality rate of any developed country. The next in line to the U.S. is Kazakstan. I don't think home birth is the problem, because only 1% of U.S. births happen at home.

This was tough. How do you politely get out of that one? In the end it was fine, and the discussion moved on, but I'm not sure we were able to convince her in any measure that home birth can be safe if properly managed.

Maybe YOU don't agree home birth can be safe? I can expand upon this topic in future posts if you want, but I was needing to process this interaction here....let me know if anyone wants more information regarding home birth safety.


tamie said...

Sounds like you guys did well, and poop on that woman for asking non-genuine questions and putting you in such a tough spot.

I just re-rented The Business of Being Born. I also just found out that in Belgium, 95% of women give birth at home. The only hospital births are emergencies, or truly high-risk pregnancies. !!!

melissa said...

Yes! In Norway the home birth rate is 70%, and their fetal and maternal death rates are much, much lower than yours or ours. And their cesarean rates are within the WHO recommended limits.


Next you should get your hands on Orgasmic Birth--very cool!!!!

ms emili louann said...

yeah - what is this "orgasmic birth"? i am intrigued, but... skeptical!

also, would you mind if i shared a link to your post on skin to skin? either on my blog or in an email? of course, you get the credit :)

thanks. deary!!

Rachel Clear said...

Oh, Mel. Arrrrgh! I feel your pain!

I have received so many unsolicited emails and personal comments by friends, co-workers, and people I barely even know because of our decision to possibly birth at home. It is FRUSTRATING with an upper-case F. Especially when people say things like, "Yikes. I hear that homebirthers are, like, dying all the time, er something" and I want to say, "You're a jerk and an idiot... go sit down." It's really tough to be so passionate about something SO important and have it come under constant fire, and not just fire, but misplaced fire! Argh!

I have nothing else to add, except that you are awesome, and this post was awesome, and I can relate with your frustration.

Rachel Clear said...

Ooh, and I own Orgasmic Birth, so I could always lend it to Tamie. It's kind of spendy to buy, and I've not found anywhere you can rent it.

Asheya said...

I think a better name for the movie would have been Ecstatic Birth, but it's not quite as catchy!

Sounds like you did well under the circumstances--I'm not sure I could have held back.

tamie said...

Okay, friends, I put Orgasmic Birth in my Netflix queue (thanks Rach for being willing to loan it! but we'd both have to pay postage....wish you were here to watch it with me though!).

Also, Rach, I cannot BELIEVE that people give you unsolicited birth advice!!! I have friends who choose to do their birthing in hospitals, with all the drugs, and seemingly with not much thoughtfulness....but I NEVER give unsolicited advice, even so! Geezus, people, have some self-control!!!

melissa said...

tamie; I'm glad you netflixed OB--I ordered it from Amazon but it was pricey...I'll post a review another girl did on the movie, where she agreed with Asheya that a better title would have been Ecstatic Birth. But I think Orgasmic Birth gets ppls attention!! You should invite Em over to watch it with you.

you have to check out this movie--it's about natural birth, not orgasms. I know, I was put off by the title myself, because I thought 'really? enough women have orgasms during birth that they made a movie out of it?' But it appears (I haven't seen it yet) that it is rather a positive look at natural birth and how good it can be.
And yes, please spread the word on skin to skin, copy my moms post and paste it, so even the lazy blog readers can read it (y'know those who are too lazy to click on links)! It's such important info, I'd love for it to become more common knowledge!

I'm sorry that people judge your birth decisions. Seriously, I wish people would just shut up with pregnant women unless they are lavishing praise and compliments. Rest assured, you will make the healthiest decision for your baby because YOU ARE THE MOMMA, and that means you know best.

I think you are right, the title seems less fitting to the movie than Ecstatic Birth would be! I ordered it and expect it to be waiting for me when I get back home to Langley, where I plan to watch it with Dana who is in town for Christmas! We'll think of you!
And it wasn't really holding back as much as stunned silence....