The Business of Birthing

Yes, we have seen the Rikki Lake movie. And yes, it was informative, although very, very, biased.

Since starting our childbirth class throughKaiser last week, Alex and I have spent a decent amount of time talking birth plan, child rearing, and all the various viewpoints that come from all angles on the matters. Everyone has an opinion, and everyone thinks their opinion is the right one. I fear I fall somewhere, boringly, in the middle of it all. No grandiose plans to forever forbid my children from television, nor plans to indulge their every video game fantasy. No qualms about maybe needing an epidural, but no aversion to giving natural childbirth a try. I rely heavily on Western medicine, but am open to the ideas the East provides.

So in order to consolidate and summarize the information I have gleaned from Kaiser, the Internet, pregnancy/baby books, the movies, and friends and family, here is what I've come up with that's been interesting and weighing on my mind ...

The maternal mortality rate in the USA is relatively high given we are a first-world, developed country. There are 40 other countries with lower death rates that us. For example, in Ireland the rate is just 0 per 100,000 births. The rate here is about 14 per 100,000.

Only six states are legally required to report maternal deaths.

Cesarean rates have increased in the US by more than 71% since 1996.

The risk of death from a c-section is 3x that of a vaginal birth. But the rates are skewed because most women with high-risk pregnancies must deliver via Cesarean. And women with high-risk pregnancies are at a higher risk of complication, and thus are more likely to die during childbirth or postpartum.

Yes, there are business, financial, and time factors that contributes to the number of c-sections now being completed in this country, but I have yet to see the details of this outlined. And I'm hard pressed to believe that the midwives and OBs I know are in it for the money.

Interestingly, while the US maternal mortality rate is high, it is not necessarily representative across demographics and SES. For example, an African-American woman is 4x as likely to die from pregnancy and childbirth complications than a white woman. The majority of those who fall in the higher risk groups are those of minority groups, who do not have access or are not receiving appropriate prenatal care.

Twenty five percent of women receive no prenatal care, increasing their risk of related death by 3-4 times.

So my conclusion from all this? It's not necessarily pitocin, C-sections, or Western medicine to blame for our relatively high maternal mortality rates, but our lack of care for the impoverished women and children of this country. It really shouldn't be a luxury, but a basic human right.

Then again, this doesn't mean being induced or having a C-section doesn't scare the hell out of me. It doesn't mean I'm all aboard the epidural or narcotic train - but only because I learned yesterday that means I won't be able to get up and labor out of bed, which I find terrifying simply because I'd have limited mobility if I wanted to get up and pace from anxiety or pain. And since they apparently won't even give me Valium during birth - even though I have not self medicated for nearly 8 months now- I have to keep my options open. And "ahi" breathing and squatting over a yoga ball is probably not gonna cut it.