Reversing a generation of guidance on childbirth, Britain’s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.As the cesarean section rate in American climbs toward 40 percent, it's time to go over some basic facts about health care:
Women with uncomplicated pregnancies — about 45 percent of the total — were better off in the hands of midwives than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
- hospitals are as dangerous as war zones, and kill tens of thousands of people every year;
- cesarean section is major surgery, just as likely to go wrong and kill you as any other kind;
- the general trend of medical care in America is driving more and more women toward medicalized, surgical birth, and if you want to avoid that you have to take the situation into your own hands and not let doctors take it over unless your life is really in danger.
By the "general" trend I mean this: most American women have their babies with private practice OBs who have hospital privileges but work for themselves. Some Americans idolize this model of care and fulminate against bureaucrats and administrators who try to intervene, but when it comes to childbirth this model is awful. OBs are busy people who are trying to see lots of patients in their offices as well as supervise births; and they really want to be present at the birth because that is where they make most of their money. Their incentive is to make sure that their patients give birth during the time they are scheduled to be in the hospital. So what they do is schedule their patients to be induced for labor the day they reach 39 weeks -- or the next day after that date that the OB is in the hospital -- and if the patient has not delivered in 16 hours they invent some reason to do a c-section. Where the OB works for the hospital, as part of a team, and doctors or midwives have regular, 24-hour rotations, the c-section rate is much lower.
I can't see any way to reduce the ever-rising rate of surgical births under the current American model. What we need is a completely different model, like the one provided by birth centers. Or if you really need a hospital birth because of complications, go to a teaching hospital or some other place where the doctors are on rotation rather than trying to make it on their own.