Janet Fraser, a home birth advocate and founder of the site Joyous Birth, recently experienced a personal tragedy when her baby died at her home in Australia on March 27 during her free birth or unassisted childbirth (where a woman gives birth at home without the aid of a midwife or doctor).

When a tragedy like this occurs, people are often left scratching their heads wondering how something like this could happen, what went wrong, and lastly, who’s to blame? I don’t know if we need to point a finger to make ourselves feel better, but it seems to be human nature to ask, “why did this happen?”

While I did not consider giving birth at home without a midwife in attendance for my home birth, I know a handful of women who chose an unassisted birth and I respect them for it. I believe these women did a great deal of research in advance, knew what they were doing, trusted their bodies and their babies and were prepared to go to the hospital if any issues arose. Although I don’t know her, I trust that Janet Fraser would fall into this category as well. Not everyone agrees with me though and some, like Amber Watson-Tardiff, are suggesting that what Fraser did by having her baby unassisted was “reckless, neglectful and borderline criminal.”

Jessica Gottlieb of Eco Child’s Play says, “I support women who chose a home birth. But a free birth? I cannot see the wisdom in it. Neither can Ms. Fraser’s baby.”

Watson-Tardiff goes on to say, “I hope she is at least subject to an investigation for child endangerment.”

Ronda Kaysen of MomLogic says she sees the value of home birth as a way of reducing medical intervention, but believes giving birth without medical assistance is “absurd.”

Fraser’s “free birth” argument, which on the surface appears feminist, is actually the opposite. It doesn’t empower women to take control of their own bodies. It sends them and their babies into the dark ages of medical care - where women give birth with no medical care at all and face the very real possibility of death as a consequence.

For the record the police are investigating the death and have said “it was not clear whether the baby was stillborn or died after delivery. If a baby is stillborn, there is no autopsy. If a baby is alive at birth and dies soon after, it is considered a matter for the coroner.”

I guess I give Fraser the benefit of the doubt and assume that like most mothers she was doing what she thought was in the best interest of her baby. Although she coined the term birth rape (birth interventions done against the woman’s wishes), I don’t believe she would put her child in harm’s way rather than accept a potentially life-saving intervention. Then again I don’t know Fraser and have not spoken to her, so I can only speculate just as others are doing, but I prefer to give her the benefit of the doubt. However, I do believe that whenever a child dies, there should be an investigation into the death.

While many are blaming Fraser for her baby’s death since she did not have a doctor or midwife in attendance, no one seems to mention the fact that babies die in the hospital, where doctors are present, all the time.

Laura Shanley, author of the book Unassisted Childbirth and owner of the Bornfree! website who blogs at Letters from Laura - Thoughts on Unassisted Childbirth, brought up that point and shared another perspective many of us may not have thought of when she shared the following statement with me:

I don’t know Janet, but of course my heart goes out to her. An Australian friend of mine has told me that despite what the media is saying, Janet’s baby was stillborn and the outcome wouldn’t have been different had the baby been born in the hospital. Regardless of whether or not this is true, I find it sad that so many people are blaming Janet for her baby’s death. A baby is stillborn in an American hospital every fifteen to twenty minutes. According to a story on my local newscast, this is double what it was ten years ago. Yet almost no one blames hospital birth mothers (nor should they) for these babies’ deaths. This is because it’s assumed that if a baby dies or is stillborn in the hospital, everything possible was done to save the baby’s life. The possibility that at least some of these deaths might have been caused by early inductions, c-sections and other interventions is rarely discussed.

I can tell you, however, that as a homebirth advocate I have received numerous letters over the years from grieving mothers who wonder if their hospital born baby might have survived (or avoided injury) had they been born at home. The fact is, in most cases we may never know. Sometimes medical intervention saves lives, and sometimes it takes them. This is why I encourage parents to do their own research and decide for themselves where and with whom they want to give birth. In my case, I chose to give birth at home unassisted because from the research I had done I felt that the majority of problems in birth – both now and in the past - could be traced to three main causes: poverty, unnecessary medical intervention, and fear which triggers the fight/flight response and shuts down labor. Despite what most people believe, the act of birth itself is not dangerous. But our cultural beliefs and practices can make it so. In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home. Regardless of the outcome of this case, I will continue to speak out about unassisted childbirth as I believe that in most cases it’s the safest and most satisfying way to give birth.

Genie, an Australian blogger who writes at Home Is Where the Heart Is, blogged extensively about her thoughts regarding Janet Fraser and defends her choice to have her baby unassisted at home. She feels the insinuation that women who birth at home do it to feed their own ego at the expense of their child is “a crock.”

Women choose to homebirth with their baby’s best interest at heart. They do it FOR the baby, not in spite of the baby. Yes they want to feel empowered and blissed out, but the lack of trauma and the satisfaction a mother gets after a natural birth all benefits the baby too. A mother’s health and well being has a HUGE impact on the baby. So why should we ignore the interest and well-being of the mother?

In the wake of this tragedy and surrounding media coverage, some feel the need to point out that there is a difference between home birth and free birth. Dr. Meredith Nash of The Baby Bump Project says homebirth and freebirth are not the same.

The media has failed to differentiate between freebirth or unassisted birth (no midwife or doctor) and homebirth (a birth at home, usually with a midwife or homebirth doctor). For the most part, for low-risk births that are attended properly, homebirth has been proven to be a safe alternative to hospital birth. Freebirthing is significantly more risky (sorry, I’m a supporter but also a realist). It is essential to make this differentiation. Now that homebirth is on the precipice of being banned given that independent midwives are likely going to be denied indemnity insurance from next year, the suggestion that all women who homebirth are crazy radicals or that homebirth represents the majority of birthing women in Australia (only about 2%) is ridiculous. If anything, midwives and their ability to attend homebirths will be the saving grace of the Australian maternity system. Rather than convincing the small proportion of women who avoid a medicalized birth, why not support these women in their choices by making homebirth safe and easy?

Summer Minor, who blogs at Wired for Noise and gave birth to her daughter at home a little over a week ago, references the recent Nederlands study that says home birth is as safe as hospital birth. “A new study is out from the Netherlands that gives us home birthing mothers a nice little pat on the back. Despite the labels of ‘dangerous’ and ‘unsafe’ by some, once again it’s been found to be just as safe as giving birth in a hospital.” From the BBC:

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births.

I think that Shanley said it best when she said, “In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home.” We all must do our research and make the choices that we feel are the best for ourselves and our babies and then, find peace with our decisions.

I offer Janet Fraser and her family my deepest sympathy. My thoughts are with them.

Cross-posted on BlogHer.

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As I found myself watching and live Tweeting the 20/20 episode on Extreme Motherhood on ABC Friday night, I felt disappointed that once again mainstream media had let me down. It didn’t come as a complete surprise, but I really had hoped for better from them.

The show, for those of you who were occupying your time with better things (wise choice), consisted of segments on Orgasmic Birth, fake babies - women who buy Reborn dolls and treat them very much like real babies (um, yes, it was more than a little freaky), long-term (extended) breastfeeding - including a mention of 2 1/2 yr old twins still nursing (uh, what’s extreme about that?) as well as a few older children, serial surrogates, and home birth. The majority of the time seemed to be spent on the fake babies and the serial surrogates, with lesser amounts devoted to the rest. The least amount of time (and what I felt should have received the most) went to home birth.

The home birth segment had very brief interviews with Ricki Lake and Abbie Epstein (producers of Business of Being Born) and Laura Shanley (author of Unassisted Childbirth). There were no interviews with any midwives. There was no talk of the training midwives go through or the preparation that women who choose unassisted birth generally undertake. It all seemed very much focused on fear rather than offering up real information. The AMA says blah, blah, blah - nothing we haven’t heard before.

One of my main issues with the show was that it was not objective journalism at all. The correspondents spewed a lot of shock value comments instead of asking intelligent, thought-provoking questions. Maybe I’m naive to expect better from them.

Overall, I have to say I’m sorry I wasted my time watching it. I felt it was very exploitative. 20/20 gets a big ol’ Twitter Fail Whale from me. I don’t feel the show gave much, if any, useful information, except maybe some women will seek out Business of Being Born or Orgasmic Birth (which has a lot more to it than the name implies) after watching 20/20.

For those of you who are looking for some real information, you might be interested in reading my thoughts (and others’ thoughts) on orgasmic birth - Giving Birth can be good, ecstatic and even orgasmic or long-term breastfeeding Breastfeeding until age 3, 4 or 5 - more common than you think? - including a list of moms who have breastfed older children. I’ve also written about planning for a home birth and my home birth story.

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Update: The show has been pushed back. The new tentative air date is Jan. 2 now.

Just a quick note to let you all (but especially the birth junkies) know that ABC’s 20/20 is doing a segment on Orgasmic Birth this Friday, Dec. 12.

Have no idea what I’m talking about? OB-GYN Dr. Christiane Northrup, midwife Ina May Gaskin, and childbirth educator Debra Pascali-Bonaro all agree that under the right circumstances, i.e. when a woman is relaxed (and in my opinion very comfortable with her body), and due to the huge hormonal changes that occur in the body during labor, a kind of birth ecstasy is possible.

To learn more about the 20/20’s Orgasmic Birth, check out Labor Orgasms called ‘Best-Kept Secret’ - Moms, Experts Say Relaxation is Key to Pleasurable Childbirth. Then be sure to tune into 20/20 on Friday. I’ve already got my DVR set to record it.

What do you think? Is a segment on ecstatic birth “a bit too much information” as one woman on Twitter called it or, in a largely-medicalized, fear-based birthing society, just the kind of information women need?

Additional resources:
Orgasmic Birth, the film
Orgasmic Childbirth: The Fun Doesn’t End at Conception! by Laura Shanley
Pioneering midwife touts ‘orgasmic birth’ on MSNBC

Edited to add: I want to point out that it does not appear they are not saying all women will have an orgasm or that an orgasm should even be the goal. I think the point is moreso that birth can be a good experience.

For women who hope to create a similarly happy ending for their labor, Pascali-Bonaro hopes they realize that it’s possible, but the goal is not necessarily an actual orgasm.

“I hope women watching and men watching don’t feel that what we’re saying is, every woman should have an orgasmic birth,” she said. “Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience.”

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Just a few frightening strange odds and ends from around the world:

• Baby formula in China tainted with melamine has resulted in the death of two children and more than 1,200 others have fallen ill with hundreds hospitalized. Melamine is a trimer of cyanamide.

  Melamine has also been found in yogurt in China.

  All the more reason I’m glad I was/am able to breastfeed my children and know exactly what they were ingesting. PhDinParenting feels similarly. Makes me think I should buy my own cow though, like my sister-in-law and family have done. If only we had the land for it (and chickens, ‘cuz by golly, I still want me some chickens).

• Dr. Phil apparently wants to make a mockery of home birth and is asking for negative home birth stories. The home birth community, rightly so in my opinion, has been in an uproar over this.From Dr. Phil’s site:
  DO YOU REGRET HAVING A HOME BIRTH?

  Did you have a child at your home?

  Did you want to have a soothing experience where you were in control and could bond with your child?

  Did it not go the way you planned?

  Do you regret having a home birth?

  Do you regret using a midwife instead of going to a hospital?

  Did you have your second child the traditional way in a hospital?

  If you or someone you know regrets having a home birth please tell us your story below.

  Be sure to be specific and include details!

  A response from the home birth community: Many of us are instead using this form to a) tell our horrible hospital stories, b) tell our great home birth stories, or c) just plain let Dr. Phil and his staff how bad we think this show concept is.

  Based on the number of emails I’ve received about this, I figure everyone under the sun is probably aware of it by now, but just in case that’s not the case, I’m passing it on. I still need to weigh in over there myself.
  

• The Corn Refiners Association has created several ads about high fructose corn syrup - watch them here - to prove that it’s “natural” and “OK in moderation.” I don’t know what your take on HFCS is (I’m against it), but if you check your labels, you’ll find it in just about everything. (Have you seen King Corn yet? Check it out.) Jody was shocked to come home with a loaf of bread the other day only to discover that it, too, had HFCS in it! For the record, the bread we usually buy from Costco does not have it.

  Anyway, there’s a great article over on BlogHer debunking the ads and sharing more information. And at 5 Minutes for Going Green, Beth writes that HFCS is the “Wolf in Sheep’s Clothing” and brings up the environmental concerns as well.

What do you think about all of this? Kind of a lot to digest in one post, eh?

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While I’m on vacation until Aug. 9 (and quite possibly for the day or two after I get back), I’m featuring several guest bloggers. Today’s guest post comes from Sonja from Girl with Greencard. Sonja shares the birth story of her son Noah who was born just weeks ago.

The longest birth story ever

The plan:

Midwife-attended, natural home birth, potentially in the water.

The Husband and I made this choice for many reasons, but mainly because a normal pregnancy is not a disease and does not need to be medically managed. We wanted to have control over the parts of the birth process you can have control over, like avoiding routine interventions, knowing all the attendants, being comfortable in our surroundings, and making choices ourselves rather than having doctors or nurses make choices for us. On top of that, I was radically and irrationally afraid of being admitted to the hospital. I haven’t been to a hospital in the last 15 years or so without becoming lightheaded – and that was just when I visited others!

The preparations:

Find a midwife.

Take Bradley class.

Take many a supplement.

Buy lots of plastic sheeting and cheapo towels and set up birthing tub (sans water, of course).

Prenatal care and due dateapalooza:

After we had found a midwife and decided on the home birth, I saw both her and a midwife at Kaiser for prenatal appointments. Generally speaking, the appointments at Kaiser were awful (low iron! too much weight gain! scary big baby stories!) and the appointments with The Good Midwife (TGM) were great. I was low-risk, happy, healthy, and progressing normally. From the get-go, I had two different due dates: June 17^th from Kaiser and June 19^th from TGM. Then, Kaiser did the 2^nd trimester ultrasound, and on the print-out it said that my due date was June 23^rd.

Forward to week 35 of my pregnancy, when the baby dropped (I carried my belly between my knees all of a sudden), and TGM told me that first babies usually arrive four weeks after they drop. So now I considered my “due date” to be between June 12^th and June 23^rd.

Waiting…:

I didn’t have a baby on June 12^th. Nor on the 13^th, the 14^th, or even on the 23^rd. TGM went to a conference in Canada (leaving me in the capable hands of a very sweet stand-in). She was due back on July 1^st, which was also my “due date + 8” (first time moms on average deliver 8 days past their due date) from June 23^rd. I dealt with some crampiness and mucousiness while she was gone, but I had decided that I would have the baby on July 1^st (because at that point I had STILL not gotten it into my blonde head that this was NOT UP TO ME). Starting on Thursday (June 26^th), the crampiness progressed into nightly occurrences of pre-labor (or false labor), which was exciting, but robbed both me and The Husband of sleep. And… it didn’t progress into anything serious at all.

I didn’t have a baby on July 1^st. Nor on July 2^nd. I was getting a little desperate. Okay. A lot desperate.

Finally! Labor! Wooohooo!

Thursday night, July 3^rd, I could tell my contractions were different. The Husband and I decided that FINALLY! I was in labor, and called TGM to giver her a heads-up. I took the birthday cake out of the freezer. In between my contractions we talked about how our baby had just waited so he could have parades and fireworks for his birthday every year. Needless to say, we were excited. Of course, being obedient Bradley students, we went to sleep. That is, The Husband went to sleep. I realized that real contractions are a heck of a lot more painful lying in bed that in pretty much any other position, so I walked around and dropped to my knees a lot.

Towards the morning, I felt increasingly annoyed with the contractions and got in the birth tub. This of course slowed the contractions waaaaay down, but I managed to wedge myself in so I could take a floating nap, which was great.

TGM arrived around daybreak. I was only 3 cm dilated and incredibly discouraged. She recommended resting and distracting ourselves during the day and felt sure that my contractions would pick up again at night.

The next night went much like the night before. When TGM arrived at the house early the next morning, I was 3 cm dilated and clearly not in labor. Also ready to jump off a cliff – angry, annoyed, and just way too pregnant to deal with still being pregnant.

Hospital:

That Saturday was a long day. Saturday night was the first night in over a week that went by without so much as a single little cramp from ye olde uterus. Sunday morning, I had a really hard time peeing. By 9am, I couldn’t really pee at all even though I had been drinking water and juice like crazy. I figured that this was just a new nuisance of being extremely pregnant – baby is putting pressure on my bladder (because BOY did I have to go!) and simultaneously sitting on the exit. It wasn’t until I dissolved into tears trying to pee at church around 11am that it dawned on me that something was not right (I’m real bright sometimes, what can I say!). We went home. I called TGM who phone diagnosed me with a UTI (a diagnosis that proved accurate though I shrugged it off as preposterous because it didn’t feel like a UTI) and sent me to urgent care.

Of course, when we got to the Kaiser hospital, we were re-routed from urgent care to labor and delivery.

I was asked to pee in a cup (HAHAHA!) and actually managed to squeeze out a few drops. I had to exchange my clothes for the breezy gown and was hooked up to a fetal monitor. A surly midwife scolded me for not having come in for a biophysical profile at 41 weeks. And this, my dears, is when I found out that Kaiser only adjusts the due date based on the 2^nd trimester ultrasound if it is more than two weeks different from the due date based on LMP (which I think is sound medically – I just wish I had asked that question back in January!). In other words, June 23^rd had never actually been my due date, which now put me at almost 43 weeks pregnant. I felt like a giant fool. But not for long, because of the commotion – baby’s heart rate dropped! Dramatically! To the 50s! Nurses rushed into the room, The Husband was pushed out of the way, and an oxygen mask was pressed on my face. As soon as the monitor had been adjusted, baby’s heart rate was fine again, but this “random decel” turned into another Big Deal, though I am convinced that it only happened because the monitor moved on my giant belly.

An ultrasound determined that I had next to no amniotic fluid left (not good) and an exam revealed that my bag of waters had ruptured – unbeknownst to me. It had quite possibly (and likely) been ruptured for three or four days (really not good).

So here I was – with premature rupture of membranes, too little amniotic fluid, a “random decel” of baby’s heart rate, a UTI, and 2 weeks 5 days past my due date. Oh, and without any contractions. We agreed to induction, happy that they were offering it rather than arguing for a c-section right away.

Intervention carnival:

Before I knew it, I had an IV with fluids and antibiotics. My bladder was catheterized (oh, sweet relief!), fetal monitoring was done internally (sorry baby!), and I got an infusion of amniotic fluid. Once everything was situated, they hooked me up to Pitocin.

Fast-forward about 12 hours. I was stalled at 7 cm but felt veeeery pushy with each contraction. Baby’s head was tilted (not good) and his heart rate continued to have “random decels” (Pitocin side effect). TGM had come to the hospital to support us, and at this point, she recommended I get an epidural to give me the chance to continue dilating without having to try not to push, to relax me so that perhaps baby’s head would move into a more favorable position, and to allow me to get some rest. I went for it, and it really helped. I dilated to 9 cm while I took a little nap. Baby’s head turned. I got a second wind. But… I had to keep the oxygen mask on at all times to prevent baby’s heart rate from dropping (and take slow, deep breaths). Baby had turned posterior (no wonder - I had to labor on my back!) and I stalled at 9 cm with my cervix stuck between baby’s head and my pubic bone.

We decided that at that point, a c-section would be the best option to get the baby out safely.

Noah was born at 10:15am on Monday, July 7^th. He was covered in meconium, but had APGARs of 8 and 9. His daddy fought the nurses for skin to skin contact while they were cleaning and suctioning him and then stayed with Noah until they had sewn me back up. I was able to hold and even nurse Noah in recovery – before I could even wiggle my toes (or actually really feel my boobs).

The aftermath

Healing from a c-section is no picnic. Getting into and out of bed was nearly impossible for the first few days – even in the hospital. At 16 days post-surgery, I still cannot carry Noah and the diaper bag at the same time. I don’t stand a chance lifting the stroller into or out of the trunk of the car. Sneezing, coughing, and blowing my nose are extremely painful – I feel as though those things rip me apart at my incision.

Healing emotionally

I’m actually doing pretty well emotionally. I certainly have learned a lot.

One of the reasons why I chose a home birth was my fear of hospitals. I didn’t want to have to assert myself and to fight for the natural birth I wanted. In many ways, home birth was the path of least resistance for me. Not only did the hospital turn out to be very accommodating of all of my special little requests, but I never felt judged for my decisions (like refusing the eye treatment and Hep B vaccine for Noah). My wishes were actually respected (I told the first nurse I did not want pain medication offered to me and nobody ever mentioned it after that.)! I felt well taken care of the entire time I was in the hospital, and I realized how strong I was. I was able to get what I wanted without having to drop-kick anybody (or even arguing for it).

I know that I did everything I could to have a natural delivery. I feel that all interventions were medically necessary. Sure, the Pitocin led to the random decels in baby’s heart rate which ultimately led to the c-section, but I did need the Pit to get me to go into labor. The stalling at 9cm and baby’s poor position could have been avoided (or remedied) had I been able to move around while in labor, but again – with the issues I came in with, laboring on the bed was my only option.

And so I learned that the hospital is not an evil place (though choose your hospital wisely if you’re planning to birth there), that I am stronger than I thought (I sort of want to cross-stitch “12 hours on pit with not pain meds” into a pillow), and that even though it can sometimes appear as though they are, medical professionals are NOT the enemy (but… do your research! I’m always amazed at people making decisions based on little to no background info. One of the nurses actually asked me if I was a nurse because of how much I knew about labor and birth.).

And to end the longest birth story ever told (which is fitting since it felt like the longest pregnancy known to womankind), here are some photos:

Girlwithgreencard is the pseudonym of Sonja. She is a retired elementary school teacher and new SAHM living the high life of smog, terrible traffic, and crazy hot summers in Southern California. She has a green card because she came to the States from Germany eight years ago to get married to this guy she fell madly in love with. Sonja likes the smell of rain and her baby’s blissed-out smile when he comes off her boob. She very much dislikes crumply sheets and people talking on cell phones in public restrooms.

Sonja chronicles her daily life at Girl with Greencard and shows off her crafting endeavors at Girl with Fabric.

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If you disagree with the AMA and AGOG’s proposed legislation to outlaw home birth and support a woman’s right to choose, please sign the Keep Home Birth Legal petition and pass it on.

Edited to add: One woman put her response to the AMA and ACOG in a song. Take a listen.

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Whether or not you’ve had a home birth or would choose one for yourself in the future, I think most women would agree that they should have the right to choose where they give birth. Just as every woman is unique, every baby is unique and every birth experience is unique. What works best for one woman will not work best for the next. Some women feel the most comfortable giving birth in a hospital with an OB. Some feel comfortable birthing with a family practitioner or midwife in a birthing center. Others feel comfortable birthing with a midwife at home. All of these are options are safe choices, so why is the American Medical Association (AMA) trying to outlaw home birth?

Are they scared that Ricki Lake is raising awareness that women have options with her movie The Business of Being Born? They specifically cite Ricki’s and other celebrities’ home births in the media. “There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as ‘Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film.’” Ricki responds to the AMA here, and, over on the Huffington Post, Ricki, Abby Epstein and Jennifer Block have posted Docs to Women: Pay No Attention to Ricki Lake’s Home Birth. Are they scared that women might question the establishment and demand better care for themselves and their babies? Are they scared that they might (gasp) lose money? Are they scared that women might take back birth?

I’ve done a lot of research over the past few years regarding home birth and, of course, came to the conclusion that it was a good choice for me and my family. I’ve also written extensively about my research regarding home birth and my own home birth story as well. I would never say that it is the right choice for every woman, but it do believe it’s a woman’s right to know what her options are, do her research and decide what is best for her and her baby. I do not believe it is the AMA’s right or the ACOG’s (American College of Obstetricians and Gynecologists) right to tell a woman where she has to give birth. As Steff Hedenkamp from The Big Push for Midwives states, “a law dictating where a woman must give birth would be a clear violation of fundamental rights to privacy and other freedoms currently protected by the U.S. Constitution.”

So what now? What can we as women, or men who support women’s right to choose, do? You can sign the Keep Home Birth Legal petition and I also encourage you to spread the word about this. Feel free to grab the button (which links back to this post) and put it in your sidebar or blog about this on your own blog. Get the word out there that the AMA is trying to take away our rights. Home birth is a choice. Let’s keep it that way.

I’ve been trying to get the code for the ‘Home birth is a choice’ button to work, but to no avail. If you’d like to add the button to your sidebar please email me - amygeekgrl AT gmail DOT com - and I’ll send it to you directly.

And if you feel like a debate today, check out the lively discussion on this topic going on over at BlogHer.

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An article in the New York Times this weekend reported that some women are being forced to pay higher health insurance premiums or are being denied insurance coverage all together if they’ve had a Caesarean section in their past. Peggy Robertson of Centennial, Colo., was turned down for individual health coverage by Golden Rule Insurance Company because she had given birth by c-section. No matter that she was in perfect health. “Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it.”

This could be a serious problem and affect countless women given the c-section rate in this country. It is believed that the current c-section rate in the United States is at a record high of more than 30% (that is nearly 1 in 3 babies is born via cesarean section) despite the World Health Organization’s recommendation that says “the best outcomes for mothers and babies appear to occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good (Althabe and Belizan 2006).”

Tina Cassidy from The Birth Book Blog believes the situation with the insurance company all comes down to money.

As always, it is money dictating the rules of health care. Of course, money (malpractice fears) is one of the reasons why the c-section rate in the US at 1 out of every 3 births. Honestly, it is surprising that it took insurance companies this long to wake up to the fact that they are paying either way — for the c-sections that don’t get done when they should, those that get done poorly (regardless of whether they were necessary) or when a woman is denied access to a vaginal birth after cesarean, which is happening more and more…

Perhaps it does all come down to money, but if that really were the case, then why wouldn’t my insurance company reimburse me a measly $2000 (relatively speaking) to cover my prenatal care, home birth, and postnatal care that I had with a midwife for my son’s birth in 2006? They refused to pay me one single penny, yet had I given birth in a hospital, they would’ve covered the entire thing (tens of thousands of dollars since I would’ve had a c-section due to my son being a surprise breech) less my one-time $10 copay. Logically, I figured that they’d rather pay for the lesser of the two, but logic apparently has no place when dealing with insurance companies. Maybe Tina is right on with her assessment. After all, why would they want to reimburse me and pay $2000 when they can get away with paying nothing at all?

Sharon Holley at The Traveling Midwife feels this is a great example for why we need national health coverage and also pondered what this could mean for the future of midwives and had other questions as well.

If insurance companies are going to start denying coverage for previous cesarean sections then what is to stop them from denying coverage for any type of previous surgery? Will this help bring midwives more respect as we have better c-section rates and still maintain excellent outcomes nationwide? Currently midwives are always battling with insurance companies to reimburse for care. Even Medicare and Medicaid does not pay 100% for services when compared to same services that are provided by physicians. Will this push women to question the need for a cesarean at the time of delivery?

Heather at A Mama’s Blog who has had both a c-section and a VBAC (vaginal birth after cesarean) and has written about in the past about her c-section experience and what a c-section is really like believes the insurance situation should be alarming for all women in their child-bearing years.

Even if you have no intention what-so-ever of having a c-section, in the rare case that you did need a medically necessary one, you can be denied insurance coverage now, because the procedure has been over performed.

Doctors and hospitals must start allowing VBACs, and return to delivering breech babies, in order to lower the ever rising c-section rate. If nothing else, c-sections should be reserved for true emergency situations. Something has to change - now more than ever, our very health depends on it.

Louise at Colorado Health Insurance Insider writes about her experience in the insurance business and says:

I’ve written before about how caesareans should only be covered by health insurance if they are medically necessary - “elective” c-sections should always be patient-pay, regardless of what health insurance carrier the patient has. It mystifies me as to why someone would willingly choose a c-section instead of a vaginal birth, considering the increased risks, much longer recovery time, and permanent scar. But at the same time, a lot of doctors are also guilty of over-using medical intervention for convenience in obstetric care. Part of the problem is the ridiculous malpractice system we have in this country.

Louise goes on to add:

For women who are trying to secure individual health insurance policies, a prior c-section can be a headache. They should be able to find at least one company willing to offer coverage, but it may not be their first choice, and it may come with a higher price tag. Just one more reason why a c-section should be a last resort, and should never be performed without a medical reason.

Jennifer Block at Pushed Birth feels a policy like this is adding insult to injury.

The losers in all this, of course, are women and their families: going through unnecessary primary cesareans, then being discouraged or flat out denied normal, physiological birth for their next pregnancy, on top of that being denied health insurance because the repeat cesarean their providers are insisting upon would cost the insurer more money, and having babies at higher risk of being born too early, not to mention the risks of repeated major abdominal surgery for mom. And we call this maternity “care”?

Carolyn McConnell of Rock the Cradle - The Politics of Motherhood agrees and points out the results of a 2005 survey where one quarter of the women polled “reported feeling pressured by a medical professional to have a C-section.”

And then they pay for it, in a high rate of infection of the incision, extended recovery and pain in comparison to vaginal birth, risks of injury to the baby, greater difficulty initiating breastfeeding, and greater risks of breathing problems in the baby—and finally in a loss of insurance coverage.

So, what now? On one hand I think it’s good that insurance companies are finally realizing the cost they having to bear as a result of a c-section rate that is inexcusably high and perhaps this will encourage more women to become better informed about c-sections before they go to the hospital. Maybe this will also put some pressure on the OBs that are performing unnecessary c-sections. On the other hand, I don’t feel it’s fair to women to raise their premiums or deny them coverage based on something that many of them may have been pressured into in the first place. And in the case that it was a medically-necessary c-section, then what? Another thing that is disturbing to me in all of this is that many hospitals have banned VBACs, so even if a woman wants to have a vaginal birth after a c-section, her options are often very limited.

I don’t know what the answer is, but I do know something needs to change in this country and the c-section rate must be lowered. Women, and their babies, deserve better care than this.

What do you think?

Additional resources:

• Childbirth Connection - What Every Pregnant Woman Needs to Know About Cesarean Section
• International Cesarean Awareness Network
• VBAC

Cross-posted at BlogHer

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Hello. :) I’m Amy, also known around the internets as amygeekgrl. Welcome to my groovy green blog party, part of the Ultimate Blog Party hosted by 5 Minutes for Mom! I’m so glad you stopped by. :) Come in, have a seat and let me offer you something to eat.

Can I tempt you with some homemade granola or perhaps an oat-nut scone topped with strawberry jam or maybe you’re in the mood for a Grilled Panini with Provolone and Basil or a brownie baked with love? I have a fair bit to choose from here, as I enjoy cooking and baking a great deal. :) I just wish I had more time to do more of both.

Now that you’ve got something to munch on, let me tell you a little bit about myself. First and foremost, I’m a mom. I stay at home with my two amazing children - Ava (3 3/4 years old) and Julian (15 months). My husband Jody and I try to raise them with the philosophy of attachment parenting in mind, though we really just follow our instincts and do what feels right for our family.

I have a lot of passions that I like to write about on my blog. Some of them include home birth (my son was a footling breech and born at home), breastfeeding (I’ve shared my experiences of nursing while pregnant and tandem nursing), and informed healthcare decisions (why we delay/selectively vaccinate). I also write a lot about the environment (picking up trash in our neighborhood, composting, and recycling) and do a weekly Green Tip of the Week column with suggestions to make life a bit more eco-friendly. Some would call me a hippie or granola or crunchy, hence my blog title. ;)

One of my favorite quotes is “You must be the change you wish to see in the world” by Gandhi. I try to live by that philosophy both on my blog and in my life.

I also write about maternal health as a contributing editor on BlogHer, write reviews for Green Mom Finds and will soon be joining the team of Blissfully Domestic as the Eco-Diva.

I like to do giveaways here at Crunchy Domestic Goddess. In the past I’ve given away t-shirts, natural cleaners, reusable bags, books, toys, and even a digital camera. I currently have a giveaway going on right now for a bottle of Shaklee Basic H2 natural cleaner. It’s good stuff! The deadline to enter is March 13. Hope you’ll check it out and enter to win!

In addition to my blog, I also have two online stores - Attached At The Hip, featuring AP advocacy wear and more and home to the I make milk. What’s your superpower? shirt, and Cute As A Bug, featuring cute and original designs for babies, kids and adults. I enjoy photography (and love taking part in Best Shot Monday), reading, and hiking.

Ya know, this is my kind of party, very environmentally friendly - no paper or plastic waste and little carbon emissions! :) I hope you enjoyed your visit and will come back again.
Please feel free to sign up for my RSS feed or follow me on Twitter (amygeekgrl)! And, of course, be sure to leave me a comment so I can try to come check out your party too. :)

Now it’s time for the kids and I to get our party groove on, but feel free to visit the rest of the other party people linked up at 5 Minutes for Mom.

Edited to add: I’ve donated a prize - an I make milk. What’s your superpower? short-sleeved t-shirt - to the Ultimate Blog Party. It is prize #141 on the prize list.

There are so many great prizes to choose from in this year’s Ultimate Blog Party, but my top fvie choices are: Bead Dangle Photo Tile Necklace by Elemental Memories, Marketing for Entrepreneurs by Lis Garrett, Burt’s Bees Naturally Ageless skin care line by Geggie, Go BPA Free Sippy Sampler Kit by The Soft Landing and Rocking Horse by A Rocking Horse To Love. If my top five picks are already taken, then I’d also love any of the following (in order of preference) #11, 12, 15, 2, 3, 14, 32, 34, 37, 70, 72, 79, 87, and 5 or anything related to a toddler or preschooler. :)

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BlogHer has unveiled a new topic area: Body Image and is encouraging everyone to write a Letter to Our Body.

Hello dear body o’ mine,

It’s been a while since we talked so I thought I’d take this opportunity to chat with you for a bit.

First of all, thank you for sticking with me all of these years. You’ve done some amazing things over the past 32 years and put up with some crap from me and yet, despite that I don’t often acknowledge your greatness, you keep on keepin’ on.

You proved yourself awfully resilient from an early age when you endured three eye muscle surgeries (for strabismus) before you/I were even 2 years old. You rose to the challenge when, at age 6, I stepped on a piece of wood while in a lake, and was on crutches for a few weeks while you healed yourself. You stayed remarkably healthy and strong throughout my middle school years when a bag of Funyons and a candy bar was often considered a “cooler” lunch than a sandwich and apple. And you kept on truckin’ throughout high school when I got us up before school for 7 a.m. band/flag corps practice, then went to school, then had drill team practice after school, then did homework and often worked until 10 p.m. at K-mart. You are a machine for getting by on so little sleep and still functioning well enough to get good grades throughout high school.

Then there were the college years, where I was often an emotional wreck, ate crappy cafeteria food, pulled all-nighters cramming for exams, not to mention the experimentation with drinking and smoking (cigs, cloves and other). I know there wasn’t a huge amount of either of the two, regardless thank you for responding so well the majority of the time, and keeping me on the straight and narrow even though I have a serious family history of addiction. You don’t know how thankful I am for not falling victim to it.

After college I began to wise up a bit and understand that you deserved better. I started drinking water instead of soda and even went the vegetarian route a few times. However, I admit exercise was not then and is still not one of my biggest priorities. You deserve better from me in that regard.

When I got pregnant for the first time, I believed in you to help me through a natural childbirth. And while I did the best I could with the cards dealt me (HELLP syndrome), I ended up having to be hooked up to machines and on drugs (magnesium sulfate) that I never knew existed. Even though I was seriously sleep deprived and bed-ridden and drugged, you stayed strong for both me and my baby girl. Thank you from the bottom of my heart for that.

After Ava’s birth, you recovered from anemia and, as Ava grew older, I started to pay closer attention to the foods we ingested, both for her health and for yours. Instead of frozen dinners, I opted for more whole, organic foods. I think this helped you, my body, a great deal when I got pregnant with my second child.

Knowing that I wanted a home birth this time around, I was willing to do just about any and everything to keep you in the best shape possible so that I could to achieve that, which meant eating more protein throughout my pregnancy, going for acupuncture, and drinking some nasty concoctions of Chinese herbs. All of it paid off when I went into labor on my own without any symptoms of HELLP.

You proved yourself to be a birthing warrior when you gave birth vaginally to a 9 1/2 lb. surprise footling breech baby boy in our bedroom at home. No drugs, no machines, just pure hormones, endorphins, love and determination. You were amazing. Again, thank you for doing exactly what you needed to do to have a healthy baby.

These past nearly four years of motherhood have caused some wear and tear on you, this I know. Sleep deprivation can be hard on a body, as can breastfeeding hunched over with poor posture. I will do my best to honor your cues as to when you need sleep and to be mindful of my posture. I know I need to take care of you to be able to take care of my family.

I hope to have a long run with you, dear body, and I pledge to continue to nourish you with good foods, save the occasional sweet treat. I gotta be honest, I think you do love your chocolate. ;) I pledge to exercise more. I can’t promise anything fancy, but I can do more frequent walks and at least that is something. I also will try to take some time to honor you on a regular basis and appreciate you for the wonderful life you give me.

You are an incredible thing, my body. You are strong, resilient, healthy and amazing, and I thank and love you.

Sincerely,

Amy
(Crunchy Domestic Goddess)

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