On care

This morning I listened to the first installment of NPR’s special series on pregnancy, childbirth and parenting called Beginnings. It will air throughout the summer, and will explore these transformative experiences as they occur in different cultures and among different groups of people. A wonderful and eye-opening project. The first story was about women in Mozambique, where one in 37 will die of pregnancy or birth complications, and one child in seven will not live past five years old. (Have 37 friends? Know seven children?). The story indicated that Mozambique has tried addressing the problem by encouraging all women to come to the hospital to give birth, then described a typical maternity ward. Believe me, if I or my child were likely to die I would prefer my hut and the women of my tribe to a hard bed in a room full of strangers in a dirty hospital. The story concluded with an interview with another caregiver, a nurse in a new maternity center in another city, who in addition to her midwifery training has been trained to perform cesareans, hysterectomies and surgery to treat sepsis. A slightly better hope for the women she can care for. Now if they could expand on that idea, and offer training to the village women in non-surgical interventions and basic aseptic technique…

The other thought on my mind this week is good old American obstetrics. Oh how lucky we are to live in America where mommas and babies are healthy, born in clean hospitals to friendly doctors and wrapped up in lovely little nurseries, right? Where might you think we rank among the nations in infant mortality? Would you have guessed 37th? Right between Cuba and Malta, and behind nearly every European nation and Japan (and South Korea, and Slovenia…). The reason this has been on my mind this week is that the focus of my little daily countdown book has been on working with your doctor. Some gems:

Was that your doctor whooshing in and out again? …the reality is most doctors can only spend between ten and fifteen minutes with you. Rather than complain or feel disappointed, accept the reality and be prepared.

And a quote from a mom: “I found that if I told my doctor ‘I have three questions I really need answers to today,’ then I didn’t feel rushed and I always got the answers.”

Seriously? Do you know what that guy is MAKING for taking care of you? And you’re begging and biting back complaints and “accepting the reality”? That is the person who’s going to put his hands on you, in you, and the first hands to grasp your child. And you should not feel disappointed that he can only remember your name because it’s on the chart on the door? My advice, if you’re healthy, get a midwife and if you’re less healthy, get a nurse-midwife who practices in a hospital.

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One response to “On care

  • DragonKat

    If interested, here’s a brief reading/viewing list on the subject of maternity care and the need for both changes within the exisiting system AND options outside or complimentary to the system (such as homebirth, free-standing birth centers and hospital-based birth centers):

    Silent Knife:Cesarean prevention and Vaginal Birth After Cesaren by Nancy Wainer Cohen

    The Thinking Woman’s Guide to a Better Birth by Henci Goer

    Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block

    Birth Matters: A Midwife’s Manifesta by Ina May Gaskin

    Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner (former director of Women’s and Children’s Health at the World Health Organization)

    Obstetric Myths Versus Research Realities: A Guide to the Medical Literature also by Henci Goer (older than the above book by same author)

    And documentary video:The Business of Being Born (2008) Directed by Abby Epstein

    All of the above are available on Amazon.com.

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