Thursday, October 06, 2011

Dear Dr. Lisa, Thank you for helping!

After viewing the segment on waterbirth with Barbara Harper yesterday on the daytime talk show The Doctors, I just want to say thank you to Dr. Lisa!

The Doctors asked Barbara on their show to talk about waterbirth. After all, she is the expert and travels world-wide to educate professionals as well as parents about the gentleness and benefits and the precautions surrounding waterbirth.  She has written books.  She has created DVDs.  She has an evidence-based website with all of the evidence-based research data.  As Barbara said in a text message to me on 10/5/11 about the show: "They edited it so much and moved things around.  The taping was far worse and longer.  I actually think it was good for our side.  The truth prevails!!"

And Dr. Lisa made a great point (and I am paraphrasing): please read ACOG's opinions and then go to Barbara's website to see the research evidence from medical journals and then let the parents make the decision.  Brilliant.

It was clearly evident by her excessive body language and voice inflection/argumentative tone, that Dr. Lisa felt very threatened by Barbara's presence and the evidence which Barbara brought to the show....or tried to even over the posturing and yelling of Dr. Lisa.  This is, in fact, typical behavior when a person feels as if their territory has been invaded.

However, and let me be historically accurate, it was the midwife or sage femme who began assisting mothers with birth...back in the day...when we all wore fig leaves and lived in caves.  It was the midwife/sage femme who continued to care for the family when other children came along.  Physicians became insanely valuable during difficult births and because they are trained surgeons, when a cesarean became necessary.  However seeing that becoming a mainstay in maternity care meant more financial stability, some physicians formed a trade union called ACOG - the American College of Obstetricians and Gynecologists - and began a movement to move in on and ultimately deter midwifery care.  And more damning is that in a June 2011 story on MSN, this statement appeared:

The rest are based on anecdotal evidence or expert opinion, which is subject to personal biases, they reported.

So if ACOG and obstetricians in general are operating on less than 33% evidence, is it any wonder why Dr. Lisa had to resort to carnival stunts by showing a dirty aquarium with a baby doll sunk in the water?  She simply does not know the evidence.

Oh, wait, this isn't the first time that they have formed a movement against wellness in maternity care.  In the early 1980's, physicians/hospitals co-opted childbirth education from the community to the hospital ("The Politics of Co-optation: strategies for childbirth educators" by Dr. Eugene Declerq. Birth 1983 Fall 167-172) .  As epidurals, inductions and the rising cesarean rate became evident, obstetricians often tell their expectant patients that childbirth education is not necessary.  In other words, don't go.  Hospitals loose revenue, and reduce childbirth education down to a one day, 4 hour class or worse yet, no classes offered at all.  And too, an informed patient/client asks questions, which take time and may cause a deviation away from the set and managed practice guidelines.

In her 2004 book, The Medical Delivery Business, author Barbara Bridgman Perkins states that academia and industry (aka the pharmaceutical company) worked together to develop management of labor - not only an expectant mother's labor but the labor work force in a hospital.  An Upjohn-funded study in Britain concluded that labor induction could save hospitals money by enhancing staffing and efficiencies in their labor and delivery units.

More inductions --> more interventions --> more cesareans = more $$.  And according to Perkins, bowing to (1994) contemporary practice, ACOG softened its stance against elective induction for logistic reasons.

"Production costs" do not allow for nature to be involved.  Long labors cost man-hours, with no added benefit (revenue from induction, interventions such as continuous EFM, epidurals, cesareans).  The one-workday labor is a major incentive for managed care.  Nature not invited.

Dr. Lisa may have very well ignited (or fanned the flames) of re-forming maternity care by reformation.  Similar to what the International Childbirth Education Association published in 1972, Doris Haire's The Cultural Warping of Childbirth (where she documented the inadequate evidence supporting much of the routine technological intervention practiced in birth during the late 60's and 70's).  Sound familiar?

There should be a second edition of The Cultural Warping of Childbirth published.  The re-forming of care, the true identification of best practice, and putting the well-being of mothers and babies above increasing revenue should be paramount.  There needs to be a ROBUST conversation about the state of maternity care.

The question is: can we come TOGETHER to actually have that ROBUST conversation?

I believe the answer is YES!

So yes, thank you Dr. Lisa for reminding us about all of these things! 

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