PLAYER57832 wrote:Just to clarify, home births are going to show almost only healthy home births (things like Downs, etc are still "healthy" in this regard -- Downs alone does not complicate a birth). This is because midwives are trained to recognize when situations are beyond their abilities. Even if they get into "situations" during birth, they will rush the woman or woman and child to the hospital.
So, my comparison to people dying in beds means a bed is dangerous is apt. More complications absolutely occur in hospitals, because mothers with problems GO to a hospital for help, not because the hospital causes the problems.
So the figures for homebirths would not include those that started labour at home but through complications were switched to hospital, I wonder how often this happens.
PLAYER57832 wrote:Just to clarify, home births are going to show almost only healthy home births (things like Downs, etc are still "healthy" in this regard -- Downs alone does not complicate a birth). This is because midwives are trained to recognize when situations are beyond their abilities. Even if they get into "situations" during birth, they will rush the woman or woman and child to the hospital.
So, my comparison to people dying in beds means a bed is dangerous is apt. More complications absolutely occur in hospitals, because mothers with problems GO to a hospital for help, not because the hospital causes the problems.
So the figures for homebirths would not include those that started labour at home but through complications were switched to hospital, I wonder how often this happens.
That would depend, they could be listed either way, but if the midwife is competent, those should be very few. At least 1/2 the midwife's job is sending those women who really need advanced care to the trained people.
One thing not mentioned is that it used to be the case, and I believe still is, that most Dutch women receive prenatal care from their family doctors. It is all well integrated.
In the five European countries with the lowest infant mortality rates, midwives preside at more
than 70% all births. More than half of all Dutch babies are born at home with midwives in
attendance, and Holland’s maternal and infant mortality rates are far lower than in the United
States… (Midwives Still Hassled by Medical Establishment, Caroline Hall Otis, Utne Reader,
Nov./Dec. 1990, pages 32-34)
Correlation =/= causation. The mortality rate is also influenced greatly by lack of prenatal care, lack of insurance and lack of resources.
Now this doesn't mean that there aren't American hospitals which are bad at this and may very well cause preventable deaths, but it's more of a case of those hospitals just being underfunded and understaffed than them being bad simply because they're hospitals. I would think that the amount of infant deaths in the hospitals in the Netherlands (accounting for serious complications) is also lower than that of the US.
Not to mention that there are also far less teenage pregnancies and far less unwanted pregnancies.
"Some motherfuckers are always trying to ice skate uphill."
Duane: You know what they say about love and war.
Tim: Yes, one involves a lot of physical and psychological pain, and the other one's war.
When it comes to incompetence -- that trancends any profession. To the extent that you see incompetent doctors more than incompetent midwives, its due to the fact that there are so many more doctors trained in obstetrics. Also, becuase doctors deal with more serious situations, there is far more room for error. Even then, you have to be very careful when saying that even a birth injury, that is a child who was healthy is not after birth, was caused by a doctor's error. Many, many things in medicine come down to judgement calls. No human being is perfect. A doctor can make a completely reasonable decision, based on the circumstances and still have it come out wrong.
This gets to the other thread -- medical costs. By relying so heavily on this idea that a Lawsuit is the best way to solve malpractice, or is the only way someone can hope to get their care paid, it actually forces doctors to order many more unnecessary tests, to spend far more time simply documenting procedures to cover themselves in the event of a question or even lawsuit later. So much of what a doctor does now has to do with "bookkeeping" that the time left for patients is less and less.
