I’m going to talk about childbirth in the USA…..
Having written before about how great the medical care is here, and how excited I was about “continuity of care”, I…um….decided to discontinue that care. Pleasant enough as Dr. D and her nurse were, I had started to have a few misgivings.
I’ll provide a bit of background. In the UK, you never once see a doctor during your pregnancy, unless you have any complications or risk factors. So from Week 1 to Week 41, I only ever saw my lovely community midwife, Jo (I was supposed to see a consultant at one point, because my bump was “measuring small”, but on the day of my appointment, he failed to notice me sitting in his waiting room, and went home early. Because, you know, women with 8-month pregnant bellies sitting right outside your office door are pretty hard to spot).
Evie was born in a midwife-led natural birthing centre in the UK. There were no doctors there either. In case of emergency, the nearest hospital was 20 minutes away, and there was no access to any pain relief stronger than gas and air (Entonox). The reasons I chose to give birth in a birthing centre 45 minutes from home, rather than the local hospital 10 minutes down the road, were manyfold. I’d heard bad things about how under-staffed and over-stretched the labour ward was, resulting in some pretty scary stories from mums who had delivered there. But mainly, despite coming from a family of doctors and nurses, and having worked in countless medical establishments throughout my own career , I just don’t like hospitals. They smell funny, they are always ridiculously over-heated, they’re full of sick people. Hospitals just make me nervous – and let’s face it, that consultant I almost met didn’t exactly help to sway my opinion.
All of the above, combined with the knowledge that my birthing partner was going to be my extremely needle-phobic husband, who started to faint when I just told him about the blood draws I’d had, meant that choosing the birth centre was an absolute no-brainer for me.
So why on earth I thought a hospital birth in the US might be different, I have no idea. I think maybe I was seduced by the ease of access and parking, the nice clean, modern feel to the place, and the availability of good coffee and chocolate brownies in the cafe. Who knows, maybe I can use the age-old baby brain excuse?
And then I watched a couple of episodes of One Born Every Minute. The US one, which is, oddly, narrated by Jamie Lee Curtis (does she really need the money!?!?). Let’s just say it put my hospital aversion right back on track. Beyond the track, in fact – right there, in your face, flashing big red beacons and screaming “Nooooo, stay away!”.
I can’t quite believe how backwards such a so-called progressive nation is, when it comes to childbirth. Every single one of these women laboured on their backs. They were all given pitocin almost immediately. In the UK, if you show up to the hospital and you’re not in active labour yet, they’ll send you home with instructions not to return until your contractions are less than 5 minutes apart, and lasting more than a minute. In this show, the women were told “Oh, you’re only 2cm. Well, we’ll get you on the pitocin, and hopefully get things properly started. Would you like an epidural?”. Of course, they were then hooked up to the continuous electronic fetal monitoring – so, effectively, strapped to the bed, on their back, until the baby was born. Or, more often than not, until labour failed to progress, and they were rushed off for an emergency C-section, or a brutal forceps delivery. Anyone who dared to confess that they had hoped for a drug-free delivery was sneered at, with a dismissive “Okaaaay honey, but just so you know, you will be begging for that epidural soon enough. Just let us know when you’re ready”.
This goes against absolutely everything we are taught in the UK, whether you get your antenatal classes from the National Health Service, or from the National Childbirth Trust. Aside from the increased risks associated with all those interventions and unnecessary drugs, doesn’t anyone stop to think “Hey, let’s get a helping hand from gravity here – how about standing up?”?
You may well be sitting there yelling at me not to believe everything I see on TV. And yes, of course you’re right – you only have to look at this charming picture from their website to get an idea of the message the show’s editors are clearly trying to convey:
Oh the drama, oh the PAIN – will somebody please get that poor, poor woman some drugs!!!
Before I judged a whole nation (and even my own chosen hospital) on the heavily edited “evidence” from one small Methodist hospital in Ohio, I thought I’d better do a little research of my own.
It was quite an eye-opener.
In Washington State, 30.4% of women going into hospital to have their baby end up with a Caesarian. The rate recommended by the World Health Organisation is 12%.
97% of births here are in the hospital setting. More babies are born in prison (or a “federal facility”) than in a birthing centre or at home.
93% of women reported having electronic fetal monitoring – that scene where they are strapped to the bed by all the wires and gadgetry (that’s the technical term, you know!) – and pitocin augmentation rates (i.e. using oxytocin to “get things moving”) range up to 60%!
At the hospital where I had planned to have Hank, their Caesarian rate is a shocking 38% – the 2nd highest in the entire state of Washington. The epidural rate is 70-90%, and nobody gets gas and air.
My eloquent summary of all the statistical gobbledegook above?
Birth centre? Errr….that’ll be a no brainer!!!
So, I made my appointment to tour the Puget Sound Birth Center just after Christmas. And I signed up on the spot! Admittedly, I may have been slightly swayed by the queen-sized beds in the “birthing rooms” that look more like 5-star hotel rooms, complete with en-suite bathroom and huge jacuzzi tub (well, they’re birthing pools obviously, but details schmetails).
I’m happy with my choice. In fact, I just feel this huge sense of relief now that the decision has been made. There are just three midwives, and you rotate through them all as you attend for antenatal visits – this means that, regardless of which one is on call when you go into labour, you will know her well already. And irrespective of shift patterns and sleep deprivation, that same midwife stays with you right the way through from filling that hot tub…err, birthing pool, dammit….to loading you and your precious new bundle into the car to go home.
Saying that I’m looking forward to giving birth would be something of an overstatement (!!), but I’m very happy to report that at least I’m no longer dreading it! I don’t think you can really ask for much more than that.