Someone with even less training than nurses....

[Man o War]

Home-Birth Midwifery Is Legalized in Alabama

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Members don't see this ad.

 

[vm26]

Home-Birth Midwifery Is Legalized in Alabama

wonder what kind of malpractice they have to carry

 

[Man o War]

wonder what kind of malpractice they have to carry

Sounds like they don't even have a licensing board set up yet, not sure if that will be part of that process.
Crazy.

 

[urge]

Home-Birth Midwifery Is Legalized in Alabama

Women have been giving birth for thousands of years without OBs or nurses.

Just to put it in perspective.

 

[deleted162650]

Women have been giving birth for thousands of years without OBs or nurses.

Just to put it in perspective.

Yes. And roughly 1 in 100 died in the process.

 

[Man o War]

Women have been giving birth for thousands of years without OBs or nurses.

Just to put it in perspective.

We didn't vaccinate back then either. That didn't turn out so well.

 

[wickedskillz]

Yes. And roughly 1 in 100 died in the process.

not to mention how many babies died....

 

[anonperson]

Women have been giving birth for thousands of years without OBs or nurses.

Just to put it in perspective.

Always find this mode of thinking amusing. It's not like medical research has advanced in the last few hundred years.

OB much like anesthesia is a victim of its own success. It's been so safe that people start to devalue what services are provided.

I did residency in a semi rural part of PA. Amish folk exclusively deliver with their midwives. Saw a dead kid from uncontrolled maternal diabetes. Easy diagnoses of cholestasis of pregnancy getting missed. They weren't a litigious group so it worked out OK.

Most likely outcome is most woman and babies will do ok. A few women and babies will suffer but hey, if you get to deliver in your bathtub I guess that's some magical experience that I don't fully comprehend.

 

[urge]

Yes. And roughly 1 in 100 died in the process.

We didn't vaccinate back then either. That didn't turn out so well.

not to mention how many babies died....

Always find this mode of thinking amusing. It's not like medical research has advanced in the last few hundred years.

OB much like anesthesia is a victim of its own success. It's been so safe that people start to devalue what services are provided.

I did residency in a semi rural part of PA. Amish folk exclusively deliver with their midwives. Saw a dead kid from uncontrolled maternal diabetes. Easy diagnoses of cholestasis of pregnancy getting missed. They weren't a litigious group so it worked out OK.

Most likely outcome is most woman and babies will do ok. A few women and babies will suffer but hey, if you get to deliver in your bathtub I guess that's some magical experience that I don't fully comprehend.

And why should the legal system get involved to prohibit something natural that has been going for thousands of years?

 

[IkeBoy18]

Just watched this podcast on npr the other day. Good luck to them.

U.S. Has The Worst Rate Of Maternal Deaths In The Developed World

Maternal Mortality Is Rising in the U.S. As It Declines Elsewhere
Deaths per 100,000 live births

 

[wickedskillz]

i'm not advocating for the legal system to get involved, just for common sense to permeate

 

[Man o War]

And why should the legal system get involved to prohibit something natural that has been going for thousands of years?

I personally believe when you know better, you do better.
Medicine was practiced by all kinds of people with no formal training as far back as we can find. Fortunately as medicine advanced we figured out that probably wasn't the best way to do things, so we developed medical training and made it illegal to practice medicine without a license.
This is a classic argument we see by mid level providers now, that because we did it for years and years it should be allowed now.
Are you proposing to completely deregulate who is allowed to treat patients?

 

[urge]

I personally believe when you know better, you do better.
Medicine was practiced by all kinds of people with no formal training as far back as we can find. Fortunately as medicine advanced we figured out that probably wasn't the best way to do things, so we developed medical training and made it illegal to practice medicine without a license.
This is a classic argument we see by mid level providers now, that because we did it for years and years it should be allowed now.
Are you proposing to completely deregulate who is allowed to treat patients?

Helping someone birth at home is not the practice of medicine. Your argument doesn't apply.

If you were to insist that assisting a birth is the practice of medicine you would have to penalize all the policemen and others who have assisted birth while on the road.

 

[urge]

Just watched this podcast on npr the other day. Good luck to them.

U.S. Has The Worst Rate Of Maternal Deaths In The Developed World

Maternal Mortality Is Rising in the U.S. As It Declines Elsewhere
Deaths per 100,000 live births

There are no midwives in the rest of the world?

Oh wait, there are!

Midwife - Wikipedia

 

[Man o War]

Helping someone birth at home is not the practice of medicine. Your argument doesn't apply.

If you were to insist that assisting a birth is the practice of medicine you would have to penalize all the policemen and others who have assisted birth while on the road.

Not anywhere near the same thing.
So are you saying we should just let anyone who deems themselves qualified to acquire and treat patients?

 

[urge]

Not anywhere near the same thing.
So are you saying we should just let anyone who deems themselves qualified to acquire and treat patients?

I'm saying if a woman wants to give birth at home, alone, with the neighbor, or with a midwife, it is not anyone's business.

 

[urge]

Just watched this podcast on npr the other day. Good luck to them.

U.S. Has The Worst Rate Of Maternal Deaths In The Developed World

Maternal Mortality Is Rising in the U.S. As It Declines Elsewhere
Deaths per 100,000 live births

I would stipulate the reason for this graph is that the American woman has a much lower standard of living than the rest in the graph and is forced to work a full time job with minimal maternity benefits.

There are countries on that list where maternity leave is 2 year long with about 60% salary.

Look at this list of best maternity leave countries. Not surprising a lot of low mortality countries are on the list.
These 10 countries have the best parental leave policies in the world

 

[aneftp]

Does it how unqualified people are by education level?

We got unqualified people running this country.

Just a little tidbit. The only part or the us govt that runs somewhat correctly is the us Supreme Court. Even those on board have political ideology. But guess how many non lawyers have been us Supreme Court justices??? Zero. That's right. Zero non lawyers on us Supreme Court. It's not a requirement to be a lawyer but there has no non lawyer on the us Supreme Court.

Guess how many us medical doctor have been head of major policy decision on health in this county? Very few. That's why the us healthcare system is messed up. U got people who don't know about healthcare on the front line making decisions

 

[chessknt]

I'm saying if a woman wants to give birth at home, alone, with the neighbor, or with a midwife, it is not anyone's business.

Yet if a child has a life threatening illness that the parents decline treatment for we are legally required to overrule their bad judgement in the defense of a minor. I think a similar argument could apply since a birth results in a new person who needs to be advocated for instead of a fetus.

 

[anonperson]

Helping someone birth at home is not the practice of medicine. Your argument doesn't apply.

If you were to insist that assisting a birth is the practice of medicine you would have to penalize all the policemen and others who have assisted birth while on the road.

Those are exceptions to the rule.
No different than someone (lay person or otherwise) performing CPR out in the field or applying the pads from an AED.

Obstetrics is the practice of medicine. If you don't believe that, than not sure what I can tell you.

Can a woman deliver at home? Yes, they physically can and no one can stop them. It's the nature of the labor and delivery process.

But a government shouldn't condone sub standard care.

They practice obstetrics in a time warp in many parts of African and Asia due to lack of resources. The "good old times" according to privileged people in the United States. In Uganda for example, very common to see women come in laboring for days with a dead kid, eventually need a C section, and then a few months down the road develop a rectovaginal fistula from the ischemia from laboring so long that leads them to be divorced, socially ostracized and isolated from their communities due to leaking $hit. Ask them what they would prefer regarding their care.

 

[Planktonmd]

Yes. And roughly 1 in 100 died in the process.

That's actually a conservative number, I think the rate was much higher than 1%.

 

[leaverus]

are there any male midwives?

 

[deleted162650]

are there any male midwives?

They're called midhusbands.

 

[nimbus]

This is America, land of personal liberty. So as dumb as it may be, I do believe people should be able to choose where the birth takes place. Whether it's the hospital or the living room or the forest or the beach. We shouldn't have forced medicalization of the process. In fact, beach births sound really magical. Could become a trend.

 

[GravelRider]

I'm saying if a woman wants to give birth at home, alone, with the neighbor, or with a midwife, it is not anyone's business.

This is America. We love getting all up in people's business. Look at the debates that still exist over things like abortion and gay marriage.

 

[narcusprince]

Merica!

 

[pgg]

Wow.

There's a shallow (gene) pool ...

 

[periopdoc]

After hiding their data for many years, Midwives Alliance of North America finally released their death rates.

Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States

For primips, the Intrapartum/Neonatal death rate was 3.43/1000 compared to 0.44/1000 for in-hospital labors (CDC data). For non-primips, the rate was 1.03/1000 vs 0.36/1000 for in-hospital.

The data is damning enough on its own, but even worse when you consider that homebirthers are heavily skewed Caucasian (who have a markedly lower intrapartum/neonatal death rate even when controlled for other factors).


CPMs do not carry significant malpractice insurance, and their disasters get transferred to hospitals (who take on the liability and the statistics for the outcomes). CPMs don't get sued, but the physicians who are forced to assume care at the last minute do.

I'm all for personal choice and responsibility, and so I think women should have he right to choose these, barely trained, birth assistants, or have an unassisted home birth. But, I am also for consumer protection and truth in advertising.

I think these CPMs should be required to share their statistics. A publicly available data registry of outcomes, with mandatory reporting, should be a part of the legalization process at the state level.

I'm also for personal responsibility. If you choose a home birth with a CPM, you should lose the right to sue the OB/Hospital/anesthesiologist for anything short of willful malpractice.

Women have the right to know that the risk of their baby dying in labor and delivery is significantly higher if they have a home birth assisted by a CPM vs a hospital birth. They are being told the exact opposite by the CPMs and the media.

 

[periopdoc]

My favorite anecdote is of a woman who was having a CPM assisted home birth that went awry when the CPM failed to diagnose a breech presentation until a foot popped out. Patient was transferred to hospital where the OB called for a stat c-section. Before the OR could be activated, the fetus became profoundly bradycardic, and the OB performed a forceful, breech, vaginal delivery.

Years later, the woman is still pissed that the OB tried to talk her into "an unnecessary C-section." Unnecessary, because the OB was able to get the baby out vaginally. Several years later, she still refuses to find fault with the CPM for failing to diagnose a potentially tragic complication of labor, and blames all long-term complications on the OB and the medical system.

I have several other anecdotes of failed home births where the predominate concern of the mother was not the wellbeing of herself or her child, but was unhappiness that her birth plan was derailed.

 

[Planktonmd]

Merica! View attachment 219646

Please tell us this picture is not real!

 

[deleted126335]

CPMs rarely get sued for bad outcomes because the parents are complicit in their child's death. They made the choice to actively seek out an alternative "experience". To sue the CPM is to say I f#cked up and am complicit in my child's death. Far easier to move on and get pregnant again as soon as possible...and do it right.

 

[wickedskillz]

part of the answer is that a lot of the countries that top the low maternal mortality list also have funded healthcare and I would assume better pre-natal care and follow up as a result. also higher education rates, which possibly suggests more likely to get pre-natal care.
also, i wonder when people will start wanting cholecystectomies naturally in the comfort of their living room?

 

[mcworbust]

Home-Birth Midwifery Is Legalized in Alabama

Darwin Award nominee....

 

[periopdoc]

part of the answer is that a lot of the countries that top the low maternal mortality list also have funded healthcare

Red herring.

Most of the countries at the top of that list have a homogeneous, Caucasian population. It is becoming increasingly possible that African ancestry may be an independent risk factor in pregnancy (even when controlled for socio-economic status, pre-natal care etc). This is on top of the issues of access to, and faith in, the medical system. Among the industrialized countries, America has the largest population of women with African ancestry.

Further, unlike the US, most countries do not include late maternal deaths (42 days to 1 year post-partum) in their maternal death statistics.

The supposed increase in US maternal deaths since 1993, is almost entirely accounted for by increased surveillance, and the change in coding to include late maternal deaths.


Factors Underlying the Temporal Increase in Maternal Mortality in the United States

 

[anonperson]

Red herring.

Most of the countries at the top of that list have a homogeneous, Caucasian population. It is becoming increasingly possible that African ancestry may be an independent risk factor in pregnancy (even when controlled for socio-economic status, pre-natal care etc). This is on top of the issues of access to, and faith in, the medical system. Among the industrialized countries, America has the largest population of women with African ancestry.

Further, unlike the US, most countries do not include late maternal deaths (42 days to 1 year post-partum) in their maternal death statistics.

The supposed increase in US maternal deaths since 1993, is almost entirely accounted for by increased surveillance, and the change in coding to include late maternal deaths.


Factors Underlying the Temporal Increase in Maternal Mortality in the United States

Bingo.

Black women, Hispanic women are at increased risk of pre eclampsia and diabetes in general which increases maternal and fetal complications. Black women are at increased risk for pre term delivery which increases fetal risk significantly.

Other countries do not deal with the heterogeneity of population that the United States does.

 

[fakin' the funk]

And why should the legal system get involved to prohibit something natural that has been going for thousands of years?

Because the citizens want it to. Because they expect better than prehistoric mortality rates.

 

[deleted126335]

People have a right to be stupid up to a point. This one is close to the line.