I've come across a very interesting blog called Man-Nurse Diaries. He's a student neuro-trauma nurse in Chicago and a father of four children, all born at home. He recently posted an eye-opening account of a woman who almost bled to death from a cesarean. He points out how today's medical community seriously downplay the risks of this major abdominal surgery while overplaying the risks of VBAC and vaginal breech delivery. It's a must-read.
In another recent post he writes about the homebirth debate. My favorite part is where he discusses the ridiculousness of the current obstetric system in the US where healthy, low-risk women see specialists (obstetricians) for pregnancy and birth. Here's a great quote:
" It seems inefficient to train physicians for years to achieve a high level of emergency obstetric skill, in order to attend births which generally don't require any of those skills. I think this artificially raises the intervention rate on normal births (as a doc said the other day at work, when all you have is a hammer, everything looks like a nail), as well as ill side effects of those interventions. Not only would it lower the intervention rate and probably make birth safer if we handed normal births over to midwives, but it would be a better division of labor and resources. Critical care physicians don't spent 95% of their time seeing healthy adult patients in a family practice clinic. Medicine has already divided critical care from family practice in order to become more efficient and provide more appropriate care. So I don't see why critically-skilled obstetricians devote their time to the 95% of births which are normal and uncomplicated. And no insurance company would pay for you to go see an intensivist if you're healthy and just have the common cold. If insurance companies weren't paying all women to get high-tech obstetric care, my insurance premiums would probably be lower.
Dividing labor (pun intended) between emergency/high-risk obstetrics and midwifery would also produce a better integration between the two, which would be better for those of us (like my wife) who do home birth. There's no reason on earth why most women can't birth at home. There's also no reason why women who choose to birth at home should be treated like second-class patients if they do require emergency obstetric skill. I'm sure if I ever have to transport my wife, even if it's to a hospital I work at, we'll be treated like we have three heads. It's a shame. But I don't think good, patient-friendly integration will ever happen if obstetricians (and their hospitals) are fighting with midwives for the same market. "
Very good points indeed!