Kim: While I respect your opinion in the particular case to which you
referred, the statistics do NOT bear-out the claim that hospital births are
safer for low and even moderate risk women. Out of hospital
births--ATTENDED BY A TRAINED PROFESSIONAL--clearly win out for both
complications/morbidity and mortality in the epidemiologic analyses. The
problem is for every baby like the one you mentioned, their are literally
hundreds to thousands of babies who are placed at INCREASED risk merely by
being born in the hospital. This is not only from nosocomal infections.
The cascade of interventions that occurs in this setting ranges from
seemingly innocuous undressing a woman (stripping her of her identify and
changing the power relationships), IV fluids/NPO (possibly diluting the
normal hormonal levels), and the supine position (compressing the vena cava
and reducing pelvic outlet) to arbitrary limits on pushing/labor, AROM,
many internal exams, external fetal monitors (with such high false positive
rates that Stanford Medical Center banned them in 1990), excessive use of
pitocin, epidurals, blah, blah, blah. The cascade dominos into higher
"fetal distress," vaccuum extactions, and c-sections. Even in 24 hour
fully staffed set-up hospitals, the average time from decision to "section"
to the actual section is 20 minutes. Virtually all responsible
out-of-hospital birth attendants DO have necessary rescusitating equipment
with them at the birth site and transport within reasonable time periods
when deemed necessary. I am not a midwife, but I have investigated this.
Please do not jump to the conclusiong that the small skewed sample you see
in an NICU represents the average birth.
If you are interested in finding out more from empirical studies and
reviews, I'd be happy to send you my article (please send me a SASE with 2
stamps to Dr. Chris Hafner-Eaton 1807 NW Beca Ave, Corvallis, OR 97330)
*Hafner-Eaton, C and Pearce K. "Birth Choices, the Law and Medicine:
Balancing Individual Freedoms and Protection of the Public's Health,"
Journal of Health POlitics, POlicy and Law, vol. 19, no 4: 813-935; W 1994.
*Other Out of Hospital Birth articles and monographs you might look up include:
*Cranley, MS, K. Hedahl, and S. Pegg. 1983. "Women's Perceptions of
Vaginal and Cesarean Deliveries." J. of Nursing Research, 32(1):10-15.
*DeClercq, ER. June 1993. "Where Babies Are Born and Who Attends Their
Births: Findings from the Revised 1989 US Standard Certificate of Live
Birth." Obstetrics and Gynecology, 81(6):997-1004.
*Davis-Floyd, Robbie. 1992. Birth as an American Rite of Passage.
Berkeley, CA: University of California Press. 1-7, 69-75, 292-305.
*Durand, AM. March 1992. "The Safety of Home Birth: The Farm Study."
American Journal of Public Health, 82(3): 450-452.
*Hoff, Gerard Alan and Lawrence J. Schneiderman. 1985. "Having Babies at
Home: Is it Safe? Is it Ethical?" in Hastings Center Report (December):
19-27.
*Hueston, WJ and Mary Rudy. 1993. "A Comparison of Labor and Delivery
Management Between Nurse Midwives and Family Physicians." The Journal of
Family Practice, vol. 37, no. 5.: 56-60.
*Institute of Medicine and the National Reserach Council. 1982. Research
Issues in the Assessment of Birth Settings: Report of a Study by the
Committee on Assessing Alternative Birth Settings. Washington, DC:
National Academy of Science Press. pp. 10-34, 45, 67-77, 171-181.
*Jordan, Brigitte. 1980. Birth in Four Cultures: A Cross-Cultural
Investigation of Childbirth in Yucatan, Holland, Sweden, and the United
States. Montreal: Eden Press Women's Publications.
*Kitzinger, Sheila. 1991. Homebirth: The Essential Guide To Giving
Birth Outside the Hospital. New York: Dorling Kindersley, Inc. pp. 8-11,
38, 5-52.
*Lederman, RP, E. Lederman, B. Work, and D. McCann. Nov. 1, 1978. "The
Relationsh of Maternal Anxiety, Plasma Catecholamines, and Plama Cortisol
to Progress in Labor" American J. of Obstetrics and Gynecology,
132(5):495.
*Lederman, RP, E. Lederman, B. Work, and D. McCann. Dec. 15, 1985.
"Anxiety and Epinephrine in Multiparous Women in Labor: Relationship to
Duration of Labor and Fetal Heart Rate Pattern." Obstetrics and
Gynecology, 153(8):870-877.
*McIntosh, Kristin. 1989. "Regulation of Midwives as Home Birth Attendants"
in Boston College Law Review 30 (March): 477-522.
*Mehl, LE. 1977. "Research on Alternatives in Childbirth: What Can It
Tell Us About Childbirth Practices?" in Stewart and Stewart (eds): 21st
Century Obstetrics Now! Marble Hill, Mo: NAPSAC Reproductions.
*Midwives Alliance of North America. Feb. 1993. "Survey of Midwives'
Charges." as cited in Mothering, Fall 1993:75.
*Mitford, J. 1992. The American Way of Birth. New York: Penguin Books.
pp. 52, 133, 193, 243-252, 260.
*OB/GYN News. 1981. "Are Primary Cesarean Section Rates too High?"
American College of Obstetricians and Gynecologists.
*Odent, M. 1992. The Nature of Birth and Breastfeeding. Westport, Conn:
Bergin and Garvey. pp. 1-19, 45-48, 56-61.
*Sager, JT, PJ Haug, CW Turner, and RM Hebertson. Oct. 1991. "Developing
Models to Evaluate Pregnancy Outcomes." Medical Decision Making, 11(Supp):
S33-36.
*Sargeant, Carolyn and Nancy Stark. 1989. "Childbirth Education and
Childbirth Models: Parental Perspectives on Control, Anesthesia, and
Technological Intervention in the Birth Process" in Medical Anthropology
Quarterly 3(1): 36-51.
*Smith v. State of Indiana, ex. rel. Medical Licensing Board of Indiana,
459 N.E. 2d 401 (1984)
*Tew, M. 1990. A Safer Birth: A Critical History of Maternity Care.
New York: Routledge Press. pp. viii-x, 289-98, 266-8.
*Thorpe, JA, Parisi, VM, Boylan, PC and Johston, DA. 1989. "The Effect of
Continuous Epidural Anesthesia on Cesarean Section for Dystocia in
Nulliparious Women." American Journal of Obstetrics and Gynecology,
161(3): 670-675.
*Wolfson, Charles. 1986. "Midwives and Home Birth: Social, Medical and
Legal Perspectives" in The Hastings Law Journal 37(May): 909-957.
*World Health Organization. 1985. "Having a Baby in Europe: Public
Health in Europe 26." WHO Regional Office, Copenhagen.
: ) : ) : ) : ) : ) : ) : ) : ) : ) : ) : ) : ) : )
: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC email: [log in to unmask] : )
: )HSR & Health Educational Consultant voice/fax: 541 753 7340 : )
: ) **CHANGE THE WORLD, NURTURE A CHILD!**
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