Media Coverage of Infant Loss Misses Mark

Posted on January 29, 2015 at 9:24 pm

Last week, a family suffered the loss of their child at the Carolina Community Maternity Center in Fort Mill, South Carolina, the third loss since the center opened in 2009, according to media reports. As is typical, local reporters focus on investigations into the birth center by the Department of Health and the story of one family who wishes they had not chosen the birth center two years ago for the birth of their stillborn child.

I appeal to reporters and media consumers to rise above sensationalist nonsense – stories spun to create additional drama rather than reports of the reality of birth. When a baby dies, the most likely story is not the negligence of parents nor birth workers; most of the time, a child’s death would happen regardless of the place of birth. Statistics showing similar infant mortality outcomes for low risk women whether they are home or at the hospital support this idea.[1] Placing blame is a shallow reaction to the pain of the death of a child. A mature, reasoned response is to open our hearts to the families and caregivers present at the birth, to express our sympathy, and to assume that those intimately involved made the best decisions they could make at the time, because everyone involved cared and wanted that child to live.

And if we are going to seek causes for infant mortality, let us examine with equal scrutiny the deaths of infants of low risk mothers in U.S. hospitals, which die at similar or higher rates than babies born at home or in birth centers.[2]   And let us ask ourselves why here in the United States, where we are told by the media that we have the best health care in the world, we have the worst infant mortality rate in the first world. There are 55 countries that have lower infant mortality rates than the United States. [3]  There are many factors that contribute to infant mortality. But one commonality of the countries with lower infant death rates than the United States is the midwifery model of care.   That is, in many countries around the world with better infant (and maternal) mortality outcomes, midwives are primary care providers for the mother-baby unit, trusted by their system to refer their clients to doctors when they develop severe medical problems. Perhaps we have something to learn in the United States from countries approaching birth with the midwifery model.

 Midwives have shepherded birthing women in their homes or special places of birth for the vast majority of human history, whereas obstetricians in hospitals, originally housing for the indigent sick and dying, have been popular providers for mothers for fewer than 100 years, requiring many private medical dollars and public coercion to shift public opinion in their favor. I encourage those criticizing the choices of others around birth to learn more of the history of obstetrics in this country before putting pen to paper. Two interesting sources are Lying In: A History of Childbirth in America, and Birthing a Slave: Motherhood and Medicine in the Antebellum South.

We in the U.S. have been acculturated in recent history to believe that birth is a medical problem, when in fact it is a physiological process that only rarely goes awry – if left undisturbed. Perhaps because of this view, we are apt to see death as avoidable; we believe so deeply in medicine that we have forgotten that there is a higher power, or that a child is a wise spirit who chooses the course of his or her life. Our medical model approaches birth as if it were a malady to be “treated” and “fixed”, and the baby as if it needs to be “saved” from the process, rather than approaching birth as most midwives in the world do now and have done throughout history – as a process that will most likely proceed as nature intended, especially if a woman, like other mammals, is afforded a quiet, calm space within which to expel her fetus. The best midwives allow this space, believing in the process, while also knowing the warning signs that birth is not proceeding as nature intends, so that they can intervene and/or transport a mother and child to a medical facility. If these warning signs are not present, babies can still die, and rarely, they do. But this happens wherever babies are born, and it is always a tragedy for the families and the caregivers when it does.

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Birth Suite at Carolina Community Maternity Center

Sometimes, when families choose home birth or birth center births and their child dies, they are judged as somehow negligent or complicit in the death of their child.  I have seen many families in the birth process, and they all want their child not only to live but also to thrive and to feel their love; I believe this is universal, with rare exception for mental illness. I challenge the unhealthy pattern of thought in which we impose a popular way of doing things on others. Families must be allowed to choose what they believe to be best for themselves and their children, and then they must be allowed the consequences. For many of us, the potential harm of a technocratic hospital birth is unacceptable; for others, the potential harm of out-of-hospital birth is unacceptable. For all of us, we are bringing our experience and current knowledge to bear in an important decision for our family, and having the choice to do so is fundamental to the health of our society, to our freedom. When we judge what others have chosen without seeking to understand them, we are undermining what I hope we all want: a society engaged in an honest debate in which members seek to find the truth, a society of free individuals looking for the best choices for them, in birth and in the rest of their lives.

A child’s death is tragic, but the tragedy is deepened when that child’s death is used to advance an agenda, or to sell advertising.

[1] http://www.ncbi.nlm.nih.gov/pubmed/23769011. “Conclusion: Home birth attended by a well-trained midwife is not associated with increased mortality and morbidity rates, but with less medical interventions.”

[2] http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12003/full

[3] https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

 

Moving to Motherhood — The Name

Posted on June 25, 2013 at 2:32 am

I chose the name Moving to Motherhood for my business for all the meanings it conveys.  But the most important one is the one that some of us might not think about, and that is: moving to motherhood of ourselves. Many of our mothers are awesome  — I’m sorry to those of you whose moms are not awesome, but what I’m saying applies to you even more — Because my point is that we all know that our mothers are inadequate.  They are just not enough; they weren’t, and they can never be, all that we want from a parent (bringing to mind the song lyric:  “but if you try sometimes, you get what you need!”).  What a heavy expectation we place on that poor woman.  Think of all that she did, all that she still does in most cases.  And we, many of us, are still angry at her, for all that she will never be.

And then we embark on parenthood, and we forget!  Or, we think, in a ridiculous burst of pride (maybe this is necessary for conception?), that we are going to be different!  We will be the perfect mothers that our mothers were not.  Hmm.  News flash:  we are not perfect either.  What a crazy cycle this can seem, of suffering and blame, until we realize how well it really does work, and that our job is not only to be the best moms we can be for our children, but also to use this experience of parenting like we use any other experience – to learn about ourselves, and to grow up, and to accept ourselves (and our mothers) in our glorious imperfection.  By “Accepting Ourselves,” I don’t mean we should each tell ourselves we’re wonderful and treat ourselves to a spa day!  What I mean is:  Observe where we really are, our true level of imperfection, because it is only from reality that we can begin to change.  As good parents to ourselves, we are not self-indulgent, we are real and we are strong.  It is now, as new parents, if we haven’t already done so, that we begin to parent ourselves, and then, if we’re really lucky, to feel gratitude toward our own parents for all that they are, and feel gratitude toward ourselves for all that we are, AND feel gratitude for our children, for all that they teach us.

How does Parenting Ourselves Relate to Birth?

When we give birth to our babies, we give birth to ourselves in a new role as a parent, and, as in any other role we accept in life, the better the conditions for this transition into a new experience, the better that new experience is likely to be.  While we are resilient and may recover from a tough start as a mom, who knows how the imprint of one’s birth experience can move forward with us, affecting us in our roles as mothers and in our impression of our power?  Part of growing up, and parenting ourselves, is to accept responsibility for making this transition to parenting the best it can be, not only for our babies, but for ourselves.  Ask yourself:

  • How do I want to feel when I first greet this baby?
  • What do I want my baby to see and feel in her first moments as an individual on the planet?  And,
  • How can I create the optimal conditions for this first meeting?

We cannot depend on others to make this transition a beautiful one, or the way we want it.  Others have different priorities, and different demands placed on them.  We must determine what we want, and then we can find the helpers that will support us in creating a birth experience that will nourish us and bring us forth into motherhood with vitality, gratitude and power.

That is where I can help.  I am a childbirth doula, and doulas “mother the mother” through the birth experience.  Hiring a doula can be part of this experience of parenting ourselves; it is asking for the help we need to create a supportive environment for the transition into one of the most arduous, and rewarding, self-reflective experiences we might have.  If you’re interested in more information about doulas, check my doula research links, and contact me.