Just want to throw in another perspective (again!!). In the Netherlands we
do not routineously give epidurals. Women attend relaxation classes during
pregnancy that help them to cope with the pain during labor. These classes
work. Insurance compagnies happily pay for them, bc it is shown that women
who have attended these classes have shorter labor stage and need less
interventions.

epidurals are only used if necessary: eg woman has lots of pain in a
endless during delivery. but if the woman doesn't want to, she doesn't get
it.

For the first exam in her pregnancy every women goes to a midwife. That is
around 12 weeks. The midwife screens the woman, and decides if this case
need to be treated as a medical case, or as a 'normal' case. If it's a
medical case the woman goes to the gyneacologist, otherwise the midwife
controls the woman and attends the delivery. During the pregnancy women can
swap from midwife to gyn, or vice versa, depending of what happens. About
one out of three pregnancies are considered 'medical', that is, has a
higher risk than normal, and are controlled by the gyneacologist. We say: a
midwife is for normal pregnancies and normal deliveries, and the gyn is for
the high-risk pregnancies and deliveries .

A women who is controlled by a gyn, will give birth in a hospital, the
women who give birth with a midwife are allowed to choose between the
hospital (still attended by the midwife) and at home. Half of them choose
to give birth at home. Several researches have shown this is as safe as
hospital births, and are in fact a bit faster and have a bit fewer
interventions. Though the difference isn't very big.

when something happens during the delivery, eg the midwife sees meconium in
the water, the woman is transported to the hospital. This is not seen as a
failure of the births-at-home system, but instead seen as a sign the birth
system is safe: only when needed the medical system is in charge. We live
in a small countru, so 99% of all people can be in a hospital within 20
minutes.

The deliveries in the hospital either attended by a midwife or by a
gyneacologist are also pretty mother and baby friendly: woman is surrounded
by friends, if she want to, she is allowed to take a bath, to shower, walk
around, etc and push in the position she wants to.

We have a c-section rate of 8%. Breech babies do not routineously result in
a ceasarian. These ougth to find place in the hospital, bc stage 3 of the
delivery have to be faster.

There is no such thing as a VBAC (as a 'political' phrase). Women who had a
c-section aren't routineously adviced agaist a vaginal birth. It depends on
the reason for the c-section.

We have one of the lowest perinatal mortality rate of the world, together
with the Scandinavian countries. This is due to the birthing system , but
also due to good screening during pregnancy and good postnatal care. Every
woman who wants to gets a maternity nurse over her house for 7 to 10 days
after the delivery. This is true for home births and hospital births as
well. This maternity nurse controls mother and baby, and runs the household
during 8 hours a day. The midwife also attends the women every day, till 7
days after delivery.

Midwifes are very good educated and trained. Much better than in surrouding
countries, where midwifes often are kind of supporter of the gyn. These
midwifes aren't allowed to work in our country, unless they've run extra
classes.

Now, if only the bf situation was that good, I would be very happy!!!
Unfortunately bf isn't seen as important. almost half of the people who
start with breastfedeing, stop nursing during the first week. Probably on
advice of the midwifes who think the women needs her rest, and bc of the
bad advice the maternity nurses give. :(

Annelies Bon
Breastfeeding Resources http://utopia.knoware.nl/users/abon/bfbronnen.html
breastfeeding counsellor of the Dutch bf org "Borstvoeding Natuurlijk"
mailto:[log in to unmask]
living in a small city, Almere, near Amsterdam, The Netherlands


ps, my sons were born at home. My oldest boy was suctioned, and the midwife
said jokingly; 'look, he tries to suck on it". I had much trouble with
latching on but this was also due to other things. He probably had a severe
headache. His back head was twice as long as it became later. He looked
like he was delivered by vacuum. He was 4490 gram and his head was (and
still is) above the p99 on the growth charts. He also got lots and lots and
lots of sugar water what made him nausuated.