Thursday, 31 May 2007

Advice' could cut Caesarean rate

A computer decision analysis system could help cut the rate of Caesareans performed in the UK, experts claim.

How dumb does one have to be to see the monetary difference between the natural process of human birth and major abdominal surgery? Which do you think would earn a doctor more money?

Here is something I don't get. Millions of women give birth every day. Before modern times, or without educated [medical] assistance, a big chunk of those women die too. But I cannot think of a single person I know with a mother who died in childbirth. Having a baby is, by no means, a small feat, but it is a daily occurrence, and many women come back from the process just as strong as before. So why are we, young women without children, yet, made to feel terrified about the process? Why don't we get a full view of the whole process, from the basic knowledge of the two stages of labor, to that nasty little fact that your bowels release as you push. It is birth, not a trade secret. Why don't we know more about it?

Well, we can start with the obvious - that men won't go through it and they are a mixture of horrified, jealous, and disinterested. This is something women do, and have always done, without any help from men. And even when we want men’s help, they do like my ex did when we were making an entertainment center. They don’t take the back seat as a resource, they want to take center stage and control the whole process. Many women can and do give birth without outside assistance. This makes men insecure, and we have a system of interference that has come in several different ways. Here are a few I can remember off hand

Birth on the back: possibly the worst position for birth, increases the need for episiotomies, but it does provide a comfortable view for the doctor assisting this natural process, made more difficult by tilting the birth canal up.
Episiotomy: Vaginal tearing happens, this is an incision. Any medical student can tell you that jagged cuts heal faster than incisions
Inducement before the due date: A fad that has caught on - it fooled a friend of mine. She was due on the 19th, I think, then suddenly, on the 18th, we got the announcement that her baby was born, but there were complications. Pretty scary complications, traumatic complications, but she lived and can have more kids. I told this to my mother, and she interrupted the story and said "AND THEY WONDER WHY!" *NEWS FLASH* the doctor or nurse that delivers the baby gets paid for that delivery, regardless of who the pre-natal doctor was. Inducing birth is a way for those doctors to ensure that they are present for and get the money from that mother, regardless of the adverse effects to mother, child, and family.

In the 19th century, the AMA was a group of patriarchal "thugs" for lack of a better term, trying to discourage the use of traditional healers, including midwives. They didn't seem to go after dentistry in the same way. Standardizing medicine and eliminating some of the evils of "traditional" healers has been very good, but it also managed to pathologize birth. The AMA seemed to reject the knowledge of midwives and instead used their knowledge and fucked up birth, in one way or another, to this day. Oh, babies are born, and mothers are happy and alive, but the process suddenly became a nightmare. And doctors still don't want to listen to midwives. Why not?

What does it take to become a midwife? Do we even know? I’d like to know. Why not embrace the practice? Is it because midwives are normally women learning in a gynocentric way? Is the knowledge from medical school so magical that no other person could possibly know how to help pregnant women? Lets stop this "I have a degree, so only I can tell you to take an anti-inflammatory, then ice and elevate your arm" bullshit. Doctors are experts, but we don't need to go to them for everything. And who says that doctors have cornered the market on medical expertise? The field is only about 150 years old, maybe younger, but traditions like midwifery are much older. Why don’t we draw the wisdom out of these traditions? We learned that leaches are beneficial in some cases, so why not other traditional practices? Lets get off our high horse and learn from history.

But I’m coming to see that all sexism is based on the desire for men to be as sure about paternity as we are about maternity. Keeping women pigeonholed into certain social roles, encouraging them to marry only one man, and have sex with only one man, and the extremes of stoning adulterers and keeping a woman under house arrest by marrying her, providing for her so she doesn’t “need” a job, denying her a driver’s license, and then moving out to a remote suburb. That is the easy and selfish way, and it has worked, to some degree, for men, for men with no compassion, for quite some time. It sucked for women, it still does. And it actually isn’t THAT reliable. A woman who is kept prisoner by her mate because he thinks she will cheat is probably more likely to cheat than not, just because she will grow to resent that man. A more reliable, but more difficult approach is the enlightened approach. This happens when men realize that women care about men’s insecurities over paternity. And they discuss their motivations and accept limitations. Men need to accept their insecurity and work to reduce it and women need to respect it. It is a very simplistic approach to the basic premise of communicating with people and trying to understand them and trying to work together. Who knows what the paternity success rate is for the traditional and the enlightened method might be, but it is easy to tell that, with the latter, each partner is more likely to feel secure and happy.

So, how did I got off on that tangent? Oh yes – controlling the way women give birth is one of those typical patriarchy trying to control women things. Midwifery was a woman’s thing, but the AMA grabbed it, and now, only a male doctor could deliver a baby, while a woman was flat on her back – oh, the vagina might tear and get messy? Make an incision then stitch it up! Ooops, cut too far that time….