Induction of Labor Associated with 67% Increased Risk of C-Section

My epidural from the horrible birth of my son in 2001

Natural birth has been at the foundations of  Everything Birth from its conception. It began in 2001 as a small resource center offering natural birth classes and workshops.   Everything Birth’s owner, Crystal White, wrote, “My first child was born in 1997, and at the time I was still contemplating grad school and what direction my career should take. The more research I did on birth, intervention, and the unbelievably high cesarean rate in the US, I knew that somehow I wanted my career to be involved with birth.”  The year Everything Birth, Inc. was born was also the year my own son was born in a hospital. His birth experience was very traumatic given I was induced and the threat of cesarean section loomed over me the entire time with “gentle reminders” from the OB that my window of time for delivering naturally was running out.

As the years passed, the midwifery movement has grown and we have seen the occasional study stressing the increased safety of  a midwife assisted childbirth over a hospitalized childbirth. Over the years, I have often wished that these studies had been available just a few years sooner. I felt that same way as I read the most recent study on the risks of unneeded inductions of labor.

This month, a very important childbirth study was published in  the journal Acta Obstetricia et Gynecologica Scandinavica. Led by Rosalie Grivell, BSc, BMBS, FRANZCOG, of the University of Adelaide’s Robinson Institute, this childbirth study has the potential to dramatically change the way society views childbirth. A summary of the study, which included 28,626 pregnant women was highlighted in the research magazine Science Daily. It seems science is catching on to what midwives and birth doulas have been insisting. Science daily reported that the “induction of labor at term in the absence of maternal or fetal indications increases the risk of cesarean section and other postpartum complications for the woman, as well as neonatal complications.”

  • Induction of labor for non-recognized indications was associated with a 67% increased relative risk of cesarean section.
  • Induction of labor for non-recognized indications was associated with a 64% increased relative risk of infants needing NICU care.
  • Induction of labor for non-recognized indications was associated with a 44% increased relative risk of infants needing intensive care treatment.

In addition to those findings, the study found that for the best maternal health outcomes and the lowest risk of mothers needing an epidural or spinal analgesia occurred with birth at or after 41 weeks’ gestation. We discussed the reasons for this in a previous post called The Due Date Debacle.  More than just the implications this study will eventually have on hospital births, I feel that this childbirth study stands to provide an enormous amount of information to help women with healthy pregnancies subside any culturally induced fears about choosing a midwife to handle the birth of their child.

Midwife Assisted Home Births and Why Most People Should Have Them.

Chiropractors Howell, Pinckney, Brighton, Home birth, birth center, gentle birthing, statisticsI need to preface this entire post by saying, I gave birth all three times in a hospital and a doctor assisted my births. I’d love to tell you that next time I will deliver the old fashioned way, with a midwife by my side, but there won’t be a next time. My tubes are tied.  So, I’m basically I gigantic hypocrite. In my defense though, I know a lot of things now that I didn’t know then. The medical community as a whole knows a lot of things now that they didn’t know then too.

Rising health care costs have urged new studies. I imagine a governmental committee staring at their accounting book unsure of what to do, when a woman (secretly crunchy) at the meeting musters up the courage to say what she’s been holding back for years, “Well, midwives are cheaper… and technically safer.” All the men turn to look at her annoyed, when the committee chair person says, “Yes… I remember a woman sending me some information about that once.”  Whammo…  A study is funded.

It probably didn’t happen that way, but whatever. The point is…

According to the CBC News, a Canadian study by Dr. Patrician Janssen from the University of British Columbia found that the rate of death per 1,000 births in the first month of life was:

  • 0.35 for planned home births
  • 0.57 for hospital births with a midwife
  • 0.64 for hospital births with a physician

The Canadian Medical Association Journal declared in their 2009 September issue that planned midwife assisted home births have statistically better outcomes than hospital births. The researchers  in the study examined over 2,800 planned home  births that were assisted by  registered midwives over the course of four years and compared the statistics to hospital births in the same area of the country.

The home birth group experienced significantly less:

  • C-sections
  • Episiotomies
  • Artificial rupturing of fetal membranes
  • Use of oxytocin
  • Electronic fetal monitoring

But those statistics shouldn’t be surprising. What may be surprising is that the home birth group also experienced fewer incidences of:

  • Birth trauma
  • Meconium aspiration
  • Need of resuscitation at birth
  • Need for oxygen therapy beyond 24 hours.
  • Postpartum hemorrhage
  • Maternal health problems
  • Severe tears
  • Death

I know doctors would have you believe otherwise, but in actuality, registered midwife assisted home births are less likely to result in death than hospital births.

Among the hospital birth group, there were six incidences of infant death during delivery. Among the home birth groups, there were zero.

ZERO.

If you want the specifics, the study looked at 2,889 home births attended by regulated midwives, 4,752 planned hospital births attended by the same group of midwives, compared with 5,331 births in hospital attended by a physician. All of this happened with the same demographics of people to ensure the truest data possible. None of the groups included high risk pregnancies, trying to keep everything the same.  A high risk pregnancy would automatically be referred to a hospital for birthing.

I’m not saying that infant death cannot occur in a home birth setting, but this study shows that infants are conclusively less likely to die with a midwife assisted birth than with a hospital birth.

Midwife assisted births are safer than hospital births.  Midwife assisted births are nicer than hospital births.  Midwife assisted births are gentler than hospital births.  Midwife assisted births are CHEAPER than hospital births.

Of course, if your insurance doesn’t cover midwives, then that last statement isn’t really true for you for all intents and purposes, but midwife assisted births being cheaper than hospital births may end up being our weapon as we push for birth reform.  Get a copy of the study. Send it to your insurance agency.

You never know when one letter is going to reach the right hands at just the right  time.

 

 

Barbara Katz Rothman.

What a surprise I had this morning when I opened my e-mail.  I had a reply from no other than Barbara Katz Rothman.  I am still buzzing from the excitement.

Recently I have been sending out requests for midwives,birth educators, and birth enthusiasts to answer some questions.  Today we are lucky to have a response from such an esteemed writer and educator.

What is your favorite waterbirth story?

I don’t have a favorite ‘waterbirth’ story — water can be lovely and restorative and helpful for labors, but I’ve seen too many people turn ‘waterbirth’ into a goal, or a plan, as if the water itself mattered.  It’s the birth that matters, and the woman should have access to whatever makes her comfortable and birth well.  If a tub of water might help, it’s nice to have around.  But once it’s there, it’s often like some magnet — you spent money on it, put in time installing it, have it there and feel you ought to use it.  It is,  in its own ironic silly way,  much the way that so many medical technologies work.  Once they are there and so convenient to use, people feel obligated to use them.

What is your favorite homebirth story?

Home birth is not about the place — it’s about the control and comfort of the woman.  For most American woman, home is the perfect place to give birth, the place she will be most ‘at home’  and can have real comfort and control.  But not always — take an extreme example of a woman in an abusive relationship.  Or any woman who doesn’t feel like she has power in her own home –many cultures have moved the birthing woman to the midwife’s home, the equivalent of a ‘birth center’ run by midwives, because a woman in her own home might have to bow to the wishes of her husband or her mother-in-law, might have to show restraint in front of her children or others in her home.  So when I think of ‘homebirth’ I think of a place where a woman is truly at home, truly in charge of her setting.  I’d like her mothering to take place with that level of control too — I want every woman to be ‘king of her castle,’ ruler of her own space, to birth, to mother, to live.

My favorite home birth story is, as well it should be, my own two home births.  I’ve written about them — they formed the ‘prologue’ and ‘epilogue’ to my first book on birth, IN LABOR, and continue to influence my thinking about birth right through to my most recent book, with Wendy Simonds, updating that into LABORING ON.  Birth is so powerful an experience, that doing it in a way that lets you own it, do it, not have it done to you, is inevitably going to make women feel powerful.  I took that power and let it shape my work ever since..

Barbara Katz Rothman, Ph.D.(NYU, 1979) is Professor of Sociology at the City University of New York and the author of numerous books. Her work is interdisciplinary and international; its scope encompasses medical sociology, childbirth and midwifery issues, bioethics, race, disability, and the sociology of knowledge.

Books

  • In Labor (Norton, 1982 and 1991), updated and rewritten as Laboring On with co-author Wendy Simonds (Routledge, 2007)
  • The Tentative Pregnancy, originally published in 1986 (Viking, Norton edition 1993) the first book length study of women’s experiences with prenatal testing, was published in Germany in 1991
  • Recreating Motherhood (Norton, 1989 and revised, Rutgers University Press 2000) was the 1991 recipient of the Jessie Bernard Award of the American Sociological Association
  • Centuries of Solace: Expressions of Maternal Grief in Popular Literature (Temple University Press, 1992), co-authored with Wendy Simonds
  • The Encyclopedia of Childbearing (Oryx Press and Holt Publishers, 1993), named an Outstanding Reference Book by the American Library Association
  • The Book of Life (Beacon, 2001, originally titled Genetic Maps and Human Imaginations, Norton, 1998)
  • Weaving a Family: Untangling Race and Adoption (Beacon, 2005)
  • Advances in Medical Sociology, series editor
  • Bioethical Issues, Sociological Perspectives (Elsevier, 2008), editor with Elizabeth Armstrong and Rebecca Tiger

Bless,

Jess

Basic Homeopathic Midwife Kit

This is just a must have for all midwives! Designed by a homeopath and midwife to ensure you have everything you need!

27 Remedies in 200C pellet form:

Aconite, Antimonium tart, Arnica, Arsenicum alb, Belladonna
Bellis per, Carbo veg, Caulophyllum, Chamomilla, China, Cimicifuga, Coffea cruda, Crotalus hor, Gelsemium, Hamamelis, Hypericum, Kali carb, Kali phos, Lachesis, Laurocerasus, Millefolium, Nux vom, Phosphorus, Pulsatilla
Secale, Sepia, Staphysagria