This is just appalling. I think I will need to create another blog category called “bizarro”. Apparently one Dr. Alinson, of Orange County, California used a cauterizer to etch the name of a patient on her uterus during a hysterectomy so as not to get it confused with others. The patient wanted pictures of the operation because she suffered burns on her legs during the procedure (also bizarre). I am literally at a loss for words. Needless to say, he is being sued.
I usually don’t write too much about international stories as there is so much going on right here in the ol’ US of A, but this story really hit a nerve as it sheds some light on our own midwifery history.
Taiwan used to have a rich and thriving midwifery profession since at least the late 19th century and probably much before that. It is estimated that midwives delivered 400,000 babies annually up until the 1960’s. With the advent of economic prosperity in the 1970’s and the introduction of socialized health care in 1995, many proverbial nails have been put in the midwifery coffin, so much so that the state is planning to cancel the midwifery licensing exam all together as only 7 people in the entire country signed up to take it this year. Where there used to be 20 midwifery schools, now only one remains. Of the 300 registered midwives, only about 1/2 are practicing- delivering maybe a dozen babies a year. It’s very sad.
Kaiser Permanante, a large hospital chain, recently introduced a new nurse-midwifery program to their Hawaii hospital. The nurse-midwives work in a team with doctors where the midwives are assigned to women who are expected to have a normal, uncomplicated birth. The doctors are available should any unforeseen situation arise. So far, the birthing women love the new arrangement and the doctors are ‘ecstatic’. WOW! That’s just great! It’s just another example of how changes in approach and attitude can work wonders in the favor of birthing women, midwives and doctors. It didn’t hurt that the head of obstetrics at KP saw the integration of midwives as “a big dream I had from years ago.” He was partially trained by midwives while in residency, and midwives have been an integral part of the team at several hospitals he worked at.
The title says it all. Today, Medscape released a paper ‘Science and Sensibility’ outlining the recent studies related to the safety of home birth vs. hospital birth while discussing the barriers that home birth practitioners, and women who want home births are facing.
Recently, women are choosing or are interested in home births at a greater rate than in the past several decades. The paper discusses ‘planned home birth’, which refers “to the care of selected pregnant women by qualified practitioners within a system that provides for hospitalization when necessary.”
Woah! I’m going to have to create a new category called “bizarre, but believable”.
The just came out with a paper saying that the ‘fathers of obstetrics’, William Hunter and William Smellie were actually serial murders. Until now, history describes them as anatomists who gave us the first ‘scientific’ basis for obstetrics and midwifery. They lived over 250 years ago and are still highly regarded as pioneers in the field of obstetrics. Smellie designed and developed forceps and other obstetrical instruments and they ‘wrote the book’ on anatomy of childbirth.
In California, what is supposed to be among the most ‘progressive’ of our 50 states, is banning certified nurse-midwives at at Camarillo Hospital– driven ‘by concerns of patient safety’. WHAT?
I guess they haven’t read the studies, or paid any attention to their own statistics. They cite the reason as ‘ doctors worry most about midwives who specialize in home births and rely on hospitals for backup when complications arise.’ But meanwhile, the midwives in question only do hospital birth. The change leaves only two hospitals in the county, St. John’s in Oxnard and Community Memorial Hospital in Ventura, where midwives deliver babies.
I think I have to get this book. It’s called Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank By Randi Hutter Epstein. The author was recently interviewed on “Fresh Air” from NPR and I had a chance today to read the excerpt (linked above) and listen to the interview. Although her bit about Eve was a little too matter of fact for me (did that really happen- the whole rib, and apple thing?) it seems like an interesting and intriguing book worth a read for all interested in birth. We need to know the history because if we don’t know where we’ve been, then we don’t know where we’re going-right?
As I continue to read through the evidenced-based maternity report, I am more and more convinced that moving towards midwifery based care and free-standing birthing centers could be the answer to many of our country’s healthcare woes. Charges for childbirth vary considerably depending on the type and place of birth. “The average hospital charge in 2005 ranged from about $7,000 for an uncomplicated vaginal birth to about $16,000 for a complicated cesarean section, yet out-of-hospital birth centers were about one-quarter of the charges of uncomplicated vaginal birth in hospitals ($1,624 in 2003, when the national average charge for uncomplicated vaginal birth in hospitals was $6,239) three-quarters of the expense concentrated in the hospital stay.”