Hard News by Russell Brown

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Hard News: Feminist as crazy old man

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  • Russell Brown,

    And how many heart by-passes... does a c-section cost compared to a natural birth.

    I'm going to go out on a limb here and say "none".

    It would certainly cost considerably more than the home birth we had for our second child: one not-so-well-paid (but brilliant) midwife vs a theatre team and a hospital bed for a week. There's no comparison.

    But perhaps that's not an ideal comparison, and it certainly wasn't cost to the system that motivated our choices. But all the right-on rhetoric of the time was about not letting doctors "medicalise childbirth", and we certainly had that in mind.

    Do we still believe that? Or is not-medicalising-childbirth out of fashion?

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • recordari,

    Small sample?? 100% success though!!! 3 out of 3. Heh.

    You can add our three (all girls) to that sample. That's 6 out of 6. Although we can't understand the teeth thing. The fluoride certainly isn't helping. And I'm not intending to start a discussion on fluoridation.

    Having said this, some friends (female friends - yes I have some) have found the whole 'breast is best' argument so overpowering that when other factors made this road, which they would have preferred, not an option, they were wracked with guilt and feelings of inadequacy. While there are some powerful arguments for this approach, there has to be an alternative that doesn't make people feel second rate, and living in fear that their kids will become axe murderers because they couldn't 'latch on'.

    I'm now officially out of my depth. Can someone more qualified step in?

    AUCKLAND • Since Dec 2009 • 2607 posts Report Reply

  • B Jones,

    Read the debates on The Skeptical Obstetrician for the answer to that, Russell. Her view, and she expresses it very spikily, is that US midwives don't have good enough training to conduct homebirths, and the statistics show that it is riskier than hospitals, regardless of what can go wrong at hospital. She seems to agree that a high caesarian rate is a bad thing, but since you can't tell in advance which caesarians are unnecessary, there's no easy answer.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • giovanni tiso,

    US midwives don't have good enough training to conduct homebirths, and the statistics show that it is riskier than hospitals

    Not in New Zealand they don't. Why do these conversation always end up discussing how things work somewhere else? It's like the bloody cheese thing. Can't believe how many times we were told that Justine couldn't eat soft cheeses, when in fact she could since we pasteurise milk used in cheese production in this country.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • B Jones,

    I think the guilt and inadequacy comes from the whole competitive parenting culture rather than the health lobby. I haven't seen it from any of the people I've dealt with, then again, I've been doing things the Officially Approved way. The woman next to me in hospital asked for formula from the get-go - one nurse politely asked if there was any particular reason she wanted to do that rather than breastfeed, she explained that she'd had such a hard time last time, and as far as I could tell they left it at that, and brought her formula when she asked.

    The whole natural childbirth/la leche movement can be a bit more judgy, I've heard. No personal experience though.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • B Jones,

    Giovanni, you're right, the standards are much tighter here for midwife training, though I don't know if we've got the equivalent mortality figures.

    Pasteurisation doesn't entirely rule out listeria, I understand, which can grow in fridges. The version of the cheese thing I settled on was that soft cheese was ok providing it was straight out of the packet.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • recordari,

    The whole natural childbirth/la leche movement can be a bit more judgy, I've heard. No personal experience though.

    We had a la leche 'specialist' in our anti-natal group, probably because multiples are notoriously more difficult, and in need of more judgy panty-ness than singletons.

    AUCKLAND • Since Dec 2009 • 2607 posts Report Reply

  • Islander,

    B Jones - I have two sisters who are midwives (both of them also RNs, one also with a degree in nursing, and the other with a pyschiatric qualification.)

    One of them was heavily involved with LLL (she's the one who brought in her milk to feed her first child), and both of them strongly pro- natural childbirth. Neither of them in the *least* judgypants. Both of them have a respect/care focus that goes mother/baby/others - and since they are highly experienced nurses as well as midwives- they dont hesitate, in a domicillary situation, to call in other expertise as soon as need be-

    it says quite a bit about how their own expertise is valued that now they both work in Oz - where they are paid nearly twice as much.

    Big O, Mahitahi, Te Wahi … • Since Feb 2007 • 5643 posts Report Reply

  • giovanni tiso,

    Giovanni, you're right, the standards are much tighter here for midwife training, though I don't know if we've got the equivalent mortality figures.

    Last time I looked into it, home births in NZ had better outcomes than hospital births, although one needs to consider of course that at risk pregnancies are scheduled at the hospital to begin with and will skew the numbers somewhat.

    I think the guilt and inadequacy comes from the whole competitive parenting culture rather than the health lobby.

    We were surprised once at a party to find a woman who (totally umprompted by us, I swear!) declared her outrage at Sheila Kitzinger's books. We found them rather helpful and not at all judgey, she found them deeply offensive. You bring your own worldview into these things it seems to me. In terms of the people we interacted with, they seemed keener to present us with options than to lecture us abut the course we should take for the good of our child and the nation. With the possible exception of our Plunket nurse, but that was post-birth and we didn't bother with Plunket for our subsequent children.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Paul Campbell,

    We had both our kids with midwives in California - we used a great mixed-practice obgyn that has both midwives and doctors.

    However we didn't go the home-birth way, most CA hospitals have "home birth suites" - working with our midwife was easy and while there still is a doctor vs. midwife thing going on there we had no problems - our 'real doctor' from the practice showed up for a little while at some point to bless the proceedings, but mostly stayed away

    Biggest problem for us is that both our kids were born in Jan/Feb and US work-based health insurance changes Jan 1 - both times my company changed insurance providers leaving us with doctors/midwives that didn't have the right to practice at the hospitals the new insurance covered - that left us with a much bigger co-pay and an upside financial risk should things go pear-shaped - stupid bloody system

    Dunedin • Since Nov 2006 • 2622 posts Report Reply

  • Sofie Bribiesca,

    Hear hear, GT. Although I totally agree with homebirth, my sisters midwife didn't show, so it was left up to me (along with trying to find the Father on a Blues Brothers tour somewhere in this country),and I don't think I had any experience. May I throw in here that the Mother of the kids I look after does work on the 9th floor of Ak Hospital amongst the most difficult births in NZ and I would totally trust her judgement on any decisions regarding a difficult situ. Choice is yours, and thanks for that NZ.

    here and there. • Since Nov 2007 • 6796 posts Report Reply

  • Ross Mason,

    Re Home v Hospital births

    Dare I sugest we take another look at the death rate for new borns and the birthing mothers from the odd century ago and say "Thank You" to clean hands and evidence based medicine.

    My family history (pre 1900) is stricken with deaths at 1 day to 6 months of babies and husbands on their third marriage 'cos the other two karked out in the delivery bed. It was almost normal.

    I don't care which one is used. But I object to the parties involved not being fully educated and informed prior to proceedings and certainly wish that decisions are based for the care of mother and baby rather than fashion.

    But what scares the hell out me the most is that the west expect perfection in "My Child". And it ain't necessarly so. And the more we understand that there is significant room for error on the part of nature and people the better we will come to terms with the results of the creation of Human Life.

    With the reversal in the population of rural and city, the knowledge of "Life on the farm" and all that goes with it is being lost.

    We need to replace it with something that still educates as well.

    Any ideas?

    Upper Hutt • Since Jun 2007 • 1590 posts Report Reply

  • Isabel Hitchings,

    LLL actually have policy against being judgy-pants - the brief is to help women meet their breastfeeding own goals and to supply information with which women can make up their own minds about what works for them and their family (that's not to say that, as in any group, there won't be individuals who lack social skills).

    Christchurch • Since Jul 2007 • 719 posts Report Reply

  • giovanni tiso,

    Dare I sugest we take another look at the death rate for new borns and the birthing mothers from the odd century ago and say "Thank You" to clean hands and evidence based medicine.

    Yeah, well, when you look at your options you don't think what would be the best course if I was giving birth at home in 1931? Of course the medicalisation of birth has saved a hell of a lot of lives in its day, and continues to do so. And of course people who choose to give birth at home nowadays do so also because they know that if things start turning they can avail themselves of the nearest hospital.

    If you care for evidence-based, then look at the statistics for the here and now, talk to a healthcare professional and make an informed decision without ridiculing the people who may choose to go another way. Thanks.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Danielle,

    Pasteurisation doesn't entirely rule out listeria, I understand, which can grow in fridges.

    I would like to point out - with some resentment, as cold smoked seafood and deli meats are some of my favourite things, particularly in summer - that listeria infection rates in NZ average at about 25 per year, and only 5 of those infections are related to pregnancy or newborns. There are over 60,000 births in New Zealand per year. Which means that your chances of contracting listeria are... well, I failed maths in sixth form, but they are *infinitesimal*. I cannot work out why I have received something like *five* brochures on this issue, unless they just want to make every pregnant person as paranoid as possible.

    (In keeping with this illogical paranoia, I've given up practically everything I love to eat anyway, and spend most of my down time panicking about whether or not I washed a lettuce leaf enough. Sigh.)

    Charo World. Cuchi-cuchi!… • Since Nov 2006 • 3828 posts Report Reply

  • Islander,

    Tautoko. Giovanni.
    Also, tautoko Ross Mason's comments. Those so inclined might like to read a lovely book called "Mutants" by Armand Marie Leroi (born in Wellington to a diplomat's family.) Errors- mistakes - mutancies - are *very widespread throughout the natural world* but this excellent book details some of the whys & wherefores for human ones.

    Big O, Mahitahi, Te Wahi … • Since Feb 2007 • 5643 posts Report Reply

  • Russell Brown,

    If you care for evidence-based, then look at the statistics for the here and now, talk to a healthcare professional and make an informed decision without ridiculing the people who may choose to go another way. Thanks.

    Ah, Ross is always right even when he's not ...

    We were near a trip to hospital amid a tearful I-can't-do-this-any-more spell, but a magnificent bit of bullying by the midwife (pointing out what a PITA packing up and going to hospital would be) got things back on track.

    The best part is when everyone else goes and you're left in your own house with your new baby. We didn't get the choice with the first one, and we wouldn't have chosen it anyway, but for number two it was a beautiful thing.

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • B Jones,

    Danielle - I hear you. Low risk, but high impact. I got very resentful of the whole cheese police thing, and declared that they'd have to pry my daily flat white out of my cold dead hands.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • steven crawford,

    The best part is when everyone else goes and you're left in your own house with your new baby

    :)

    Atlantis • Since Nov 2006 • 4442 posts Report Reply

  • Bart Janssen,

    On the subject of elective caesarians...

    mmm kinda. Not too long ago it was noticed that more babies were being born on Friday than any other day of the week in developed countries.

    It turned out that the numbers were being skewed by caesarians which were massively biased away from the weekends. And biased heavily towards Friday when it looked likely that the best day might be on a golfing day.

    But in the main you are right B. There really isn't much optional about a caesarian - they are usually being done to save either mother's or child's life or both.

    Auckland • Since Nov 2006 • 4460 posts Report Reply

  • Hilary Stace,

    I've heard there are regional variations, with caesarians more likely to happen in tertiary hospitals (big hospitals in main cities) where they are set up to do them, and not so likely in smaller places. Anyone know if this is correct?

    I do know that childbirth is one of the most personal and political topics there is, and every birth is different. It would be good if we could support mothers to give birth where and how they choose, without setting up some expectation about how it should be.

    And then celebrating the new little human regardless of circumstances, genetic inheritance, mild imperfections or whatever.

    Wgtn • Since Jun 2008 • 3222 posts Report Reply

  • B Jones,

    They told me at Wellington Regional that the caesarian rate is higher at tertiary hospitals because the women with high risk pregnancies are transferred there - if you live up the coast and they think you'll need a caesar, they'll take you down to Wellington for it rather than Kapiti or Kenepuru, where they aren't set up to do them.

    For the same reason, not surprising that caesars happen on weekdays. If you know you're going to have one, may as well schedule it for a convenient time rather than 1am on Sunday morning. Inductions they try and work out so you go in at night and have the baby in the morning. Doesn't always work like that, but.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • Max Call,

    teeth

    My father ,myself, my brother and my two daughters have never had a filling. All of us were breastfed. My father grew up on an orchard with no added fluoride in the water.

    Could the luck of genes have something to do with it?
    we have always wondered why we are so lucky!

    Fruit Bowl of New Zealand… • Since Jun 2007 • 153 posts Report Reply

  • Lucy Stewart,

    My father ,myself, my brother and my two daughters have never had a filling. All of us were breastfed. My father grew up on an orchard with no added fluoride in the water.

    Could the luck of genes have something to do with it?
    we have always wondered why we are so lucky!

    Quite possibly. As could how often you cleaned your teeth and how much sugar you ate as children. But, generally, fluoridation and good dental hygeine are the most reliable ways to ensure ongoing dental health - genetics is a chancy thing to rely on when most of the variation is environmental!

    Wellington • Since Nov 2006 • 2105 posts Report Reply

  • steven crawford,

    I just had a thought. Because reading big documents that get linked into blog discussions can become a bit of a chore, I have extracted the essence, and why it relates strongly to the "What about the menz" component of some internet discussions.

    There are, however, four basic components to the
    concept of "male-inclusive". First, the need to articulate a male-centred point, or points, of view, which reflect the diversity of men and boys in the Canadian population. Second, the need for male victims to search for balance as they struggle to heal the emotional, physical, mental, and spiritual aspects of their lives. Third, the need to honour and protect female victim gains and acknowledge the contributions women have made in breaking the silence about violence and abuse. Fourth, the need to evolve a vision of combining both males and females stories into a coherent and inclusive perspective that all of us will be able to own and use in the struggle to reduce and eliminate interpersonal violence and abuse in our society. Sadly, as male victims stories reveal, we are still a long way from realizing any of these goals.

    Please note, this is a serious document that aims to address a community health problem. It is not a counter attack on feminism. I strongly urge everyone to read it, properly, as this could help reduce misunderstandings and in turn improve the quality of discussions around the uncomfortable stuff.

    The uncomfortable Document

    Atlantis • Since Nov 2006 • 4442 posts Report Reply

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