Midwifery: February 2003 Archives

Cesareans on Demand


Cesareans on Demand are creating 'traffic jams' at hospitals, according to this article from the Washington Post.

More Midwifery


Let me clarify a bit. I do work within the system. I provide prenatal and gynecological care in on office at a Community Health Center, and I attend births in a tertiary care hospital (complete with NICU, 24 hour anesthesia coverage, and a trauma center/emergency department). My patients have the options of continuous or intermittent fetal monitroing, water for labor and /or birth, epidural and other anesthesia, induction/augmentation of labour, forceps, vacuum, cesareans available as needed without having to be transported to another facility. In some ways that makes what I do easier, on others more difficult. Just because something is available does not mean it has to be used. I work with several obstetricians and a perinatologist, and I train OB residents in normal labor and birth (and also alternative care for some of the variations!). I truly believe that God created women with the innate capacity to give birth, albeit with sweat, toil, and hard work (the translation of the Hebrew etzev from Gen 3:16 and 3:19 - usually translated sorrow or pain for Eve, and sweat or toil for Adam). Yes, sometimes the process goes awry. (sometimes men have heart attacks while shoveling snow, too). I am truly grateful for the assistance that medicine can offer in these cases, saving the lives and health of mothers and babies. I am also grateful for the existance of medical and surgical interventions for other pathology. But I am concerned that we have created a pathology in birthing that is a reflection of our anti-child/perfect child only culture.
I am not sure this is coming out the way I am trying to say it! I am not criticizing decisions or outcomes of any individuals, here. I am expressing my concerns about a trend that I have watched happen, and that I think can be traced back to deeper cultural pathology that may have started several decades ago with the concepts of 'planned parenthood' and 'I am in control of my fate'. We have seen how these attitudes have infected and poisoned our other institutions like marriage, family, the church, government, etc.



In some ways, being a midwife in our current culture is truly a quixotic profession. Especially for those of us who practice in the mainstream of health care. I often envy colleagues who have free-standing birth centers or attend families in their own homes. It doesn't help either, that there was a nearly successful campaign to completely eliminate midwifery as a profession in the USA. Some days it feels like I am dancing on a tightrope with no safety net. Other days I feel like the rope in a tug of war. The war is one of culture and belief. There is a saying in midwifery "Birth is as safe as life gets." Yes, it is, but life has only one guarantee - it eventually ends on this earth. We have a culture that no longer accepts risk or pain except in 'extreme sports'. Why is it acceptable to risk injury and death for football or other sports, but not for a woman to risk the same for the sake of giving life? I have great awe and respect for those women who have endured cesareans or other difficult births not just once but repeatedly. At the same time, I have disdain for the culture that coerced many of these women into the first (often unnecessary) cesarean. I also have grave difficulties with women and their families who want to plan and control their birth through scheduled induction of labor or medically non-indicated cesareans. And yet, I also have a professional obligation to advocate for women to have the birth experience that is best for them. I also have to work within a system that is focused on cost-effective and lawsuit-proof care. Then I also add in my personal ethical and moral standards, and it really gets sticky sometimes. Did I say rope in a tug of war? How about a sweater being fought over by a pack of dogs!

The Pill


Yesterday I heard a promo for American Experience | The Pill on Marketplace. I wasn't able to see the show (choir rehearsal) but I was struck by a line in the promo -"contraceptive mentality". Of course, they seemed to think this was a good thing......
Anyhow - if any of you saw it, would you let me know what you thought? I am actually considering getting a copy of the video. But I don't want to seem to support something I actually oppose.

Morning After Pill


Entopic Pregnancies


risk factors for ectopic pregnancy
thanks to Not For Sheep for the link. Ectopic pregnancy is a veritable epidemic currently, and the risk is a great argument for chastity and moderation.

As a Midwife


I get all kinds of interesting letters from persons who assume that my political position must 'of course' agree with theirs. An example is below. I suggest that some readers of this blog might find it valuable to use the link below and the information in this propaganda post to mount our own campaign of support. Please note, all the following in italics is exactly as it was presented in the letter I received. Let's turn it upside down!
"President Bush has announced his plan to select Dr. W. David Hager to head up the Food and Drug Administration's (FDA) Reproductive Health Drugs Advisory Committee. Dr. Hager's views of reproductive health care are far outside the mainstream and would be a setback for reproductive technology.
Dr. Hager is a practicing OB/GYN who describes himself as "pro-life" and refuses to prescribe contraceptives to unmarried women. Hager is the author of "As Jesus Cared for Women: Restoring Women Then and Now." The book blends biblical accounts of Christ healing women with case studies from Hager's practice. In the book Dr. Hager wrote with his wife, entitled "Stress and the Woman's Body,"he suggests that women who suffer from premenstrual syndrome should seek help from reading the Bible and praying. As an editor and contributing author of "The Reproduction Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies and the Family," Dr. Hager appears to have endorsed the medically inaccurate assertion that the common birth control pill is an abortifacient.
The committee has not met for more than two years, during which time its charter has lapsed. As a result, the Bush Administration is tasked with filling all eleven positions with new members. This position does not require Congressional approval. The FDA's Reproductive Health Drugs Advisory Committee makes crucial decisions on matters relating to drugs used in the practice of obstetrics, gynecology and related specialties, including hormone therapy, contraception, treatment for infertility, and medical alternatives to surgical procedures for sterilization and pregnancy termination.
Hagar's mission is religiously motivated. He has an ardent interest in revoking approval for mifepristone (formerly known as RU-486) as a safe and early form of medical abortion. Hagar recently assisted the Christian Medical Association in a "citizen's petition" which calls upon the FDA to revoke its approval of mifepristone in the name of women's health. Hager's desire to overturn mifepristone's approval on religious grounds rather than scientific merit would halt the development of mifepristone as a treatment for numerous medical conditions disproportionately affecting women, including breast cancer, uterine cancer, uterine fibroid tumors, psychotic depression, bipolar depression and Cushing's syndrome. Women rely on the FDA to ensure their access to safe and effective drugs for reproductive health care including products that prevent pregnancy. For some women - such as those with certain types of diabetes and those undergoing treatment for cancer - pregnancy can be a life-threatening condition. We are concerned that Dr. Hager's strong religious beliefs may color his assessment of technologies that are necessary to protect women's lives or to preserve and promote women's health.
Hager's track record of using religious beliefs to guide his medical decision-making makes him a dangerous and inappropriate candidate to serve as chair of this committee. Critical drug public policy and research must not be held hostage by anti-abortion politics. Members of this important panel should be appointed on the basis of science and medicine, rather than politics and religion. American women deserve no less."
Please email President Bush at president@whitehouse.gov
or call the White House at (202) 456-1111 or (202) 456-1414 and say:
"I oppose the appointment of Dr. Hager to the FDA Reproductive Health Drugs Advisory Committee. Mixing religion and medicine is unacceptable. Using the FDA to promote a political agenda is inappropriate and seriously threatens women's health"
Jill W. Sheffield, President, Family Care International, 588 Broadway, Suite 503, New York, NY 10012, Tel: (212) 941-5300



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About this Archive

This page is a archive of entries in the Midwifery category from February 2003.

Midwifery: January 2003 is the previous archive.

Midwifery: March 2003 is the next archive.

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