DOCSLIB.ORG

Birthing Outside the System: Trauma and Autonomy in Maternity Care

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Birthing Outside the System: Trauma and Autonomy in Maternity Care Birthing outside the system: trauma and autonomy in maternity care Martine Helene Hollander Birthing outside the system: trauma and autonomy in maternity care Proefschrift ter verkrijging van de graad van doctor aan de Radboud Universiteit Nijmegen op gezag van de rector magnificus prof. dr. J.H.J.M. van Krieken, volgens besluit van het college van decanen in het openbaar te verdedigen op dinsdag 19 maart 2019 om 14.30 uur precies door ISBN 978-94-028-1373-9 Design/lay-out Martine Helene Hollander Promotie In Zicht, Arnhem geboren op 11 januari 1975 te Leiderdorp Print Ipskamp Printing, Enschede © M.H. Hollander, 2019 All rights are reserved. No part of this book may be reproduced, distributed, stored in a retrieval system, or transmitted in any form or by any means, without prior written permission of the author. Promotoren Contents Prof. dr. F.P.H.A. Vandenbussche Prof. dr. J.A.M. van der Post (Amsterdam UMC) Chapter 1 General introduction 7 Copromotoren Chapter 2 Women refusing standard obstetric care: maternal-fetal conflict 19 Dr. J. van Dillen or doctor-patient conflict? Legal and ethical considerations Dr. E. de Miranda (Amsterdam UMC) Chapter 3 Women’s motivations for choosing a high risk birth setting 31 Manuscriptcommissie against medical advice in the Netherlands: a qualitative analysis Prof. dr. A.E.M. Speckens Chapter 4 Fulfilling a need. Holistic midwifery in the Netherlands: 59 Prof. dr. S.A. Scherjon (Universitair Medisch Centrum Groningen) a qualitative analysis Dr. A. de Jonge (Amsterdam UMC) Chapter 5 ‘She convinced me’- Partner involvement in choosing a high 91 risk birth setting against medical advice in the Netherlands: a qualitative analysis. Chapter 6 Less or more? Maternal requests that go against medical advice. 121 Chapter 7 When the hospital is no longer an option: A multiple case 143 study of defining moments for women choosing home birth in high-risk pregnancies in the Netherlands. Chapter 8 Preventing traumatic childbirth experiences: 2192 women’s 177 perceptions and views Chapter 9 Psychosocial predictors of postpartum posttraumatic stress 197 disorder in women with a traumatic childbirth experience. Chapter 10 Women who desire less care than recommended during 221 childbirth: results of three years dedicated clinic. Chapter 11 General discussion and conclusions 237 Chapter 12 Developments since the start of this project 255 Chapter 13 Summary | Samenvatting 261 Chapter 14 List of abbreviations and terminology 277 List of publications 279 List of co-authors 283 PhD portfolio 285 Dankwoord 291 Curriculum vitae 295 1 General introduction 8 | Chapter 1 General introduction | 9 General introduction Jeske is expecting her first child. She has had a difficult childhood, and not many friends 1 or family. The pregnancy is complicated by severe pelvic pain and she has difficulty walking. Around the due date, labor starts suddenly and one contraction quickly follows another. She calls her midwifery practice, and a locum midwife, whom she has never seen before, comes to her house. After several hours and only two centimeters of dilation, she asks her midwife for pain relief and she is transported to the hospital for an epidural. Jeske feels that the anesthetist is in a hurry. “I was forced to sit cross-legged and couldn’t move. Meanwhile it was one contraction after another.” Pain relief is suboptimal, and Jeske is surrounded by unknown people. She remembers being told to lay on her back without much explanation, and an electrode is placed on the baby’s head. When she reaches complete dilation, she is told to start pushing, even though she feels no urge. She is left pushing with a nurse for 45 minutes, after which an obstetrician enters. All she remembers of this is him saying: ‘I am here to help you.’ The next things she remembers is that he “pushes the ventouse in”, without much in the way of explanation. She has no idea what to do, but tries to push. It is in vain. She is taken to the operating room for an emergency cesarean section. At the follow-up appointment six weeks later, Jeske has recovered well physically, but nobody asks her how she feels about the birth. She has recurring nightmares, and has been experiencing vaginism ever since, which was never an issue for her before. (‘Jeske’, which is not her actual name, has read her story as presented here and has given permission for it to be used.) Jeske’s story is an example of how maternity care, conducted according to guidelines and protocols and carried out by maternity care providers with the very best intentions, can result in trauma for the women involved. This trauma may cause some women to decide to avoid future medical care, or decline certain parts of recommended care for their next pregnancy and birth. These phenomena gained national attention in the Netherlands in 2013, when three community midwives were tried by the medical disciplinary committee for delivering assistance during home births in high risk pregnancies1. Home births in high risk pregnancies were not unheard of in the Netherlands, even prior to this court case. Also in 2013, the Amsterdam UMC, AMC had started a designated clinic for women who planned to go against medical advice in their choices surrounding birth, including those planning a home birth in a high risk 1 https://zoek.officielebekendmakingen.nl/stcrt-2014-18656.html 10 | Chapter 1 General introduction | 11 pregnancy2,3,4,5. However, the court case referenced here was the first time Magnitude of the problem: what is known? midwives were prosecuted for attending home births in high risk pregnancies, since this was considered an undesirable development by both the Health Care It is currently unknown exactly how many women choose to have an unassisted 1 Inspection, who initiated the court case, and many maternity care providers in childbirth in the Netherlands each year, although this number has been the country. All three midwives were reprimanded, and one was struck off, estimated to be around 2006, which makes up approximately 0.12% of all births. although the latter verdict was overturned on appeal and converted to a There are no data at all on the number of Dutch women choosing home birth in one-year’s license suspension. The reasoning by the court of appeals in this case a high risk pregnancy. Why women would make these choices has also never was that second best care, for instance a midwife attending a high risk home before been investigated in the Netherlands. However, several studies from birth, was preferable to no care at all, providing the woman in question had other countries have been published on the motivations of women to choose been adequately counseled. The reprimands and suspension were, among other high risk birth options, which are summarized in a recent scoping review of 15 reasons, due to the fact that insufficient case notes were made by the midwives studies by Holten and De Miranda.7 The themes found in this review were: to prove that they had recommended hospital care and that the women in this resisting the biomedical model of birth by trusting intuition, challenging the case had been adequately counseled about the risks they were taking. The ruling dominant discourse on risk by considering the hospital as a dangerous place, of the court of appeals was cause for concern for many community midwives in feeling that true autonomous choice is only possible at home, perceiving birth as the Netherlands, because it was made clear that conflicting interests could occur an intimate or religious experience, and taking responsibility as a reflection of in situations where women ‘demand’ care outside protocols and midwives don’t true control over decision-making. The studies used for this review all originated feel comfortable providing such ‘second best care’, for which they may feel in countries where home birth is not institutionalized: Finland, Sweden, the unequipped, unqualified and which can make them feel emotionally vulnerable. United States, Australia, or is a marginal phenomenon: Canada. Unfortunately, This ruling stressed the urgency of further research into the phenomenon of no studies had yet been done in countries with an integrated home birth system, women disregarding medical advice and giving birth at home in a high risk such as New Zealand, the United Kingdom, or the Netherlands, with its pregnancy, or choosing unassisted childbirth (UC), and led to the inception of maternity care system known for a physiological approach to childbirth and the this thesis. general acceptance among both public and professionals of home birth as a regular option for healthy women with a low risk pregnancy. Because of this physiological approach, it may seem all the more surprising that the phenomenon of ‘birthing outside the system’ also occurs in the Netherlands. However, the apparent increase in women who choose to go against medical advice in their birth choices could be seen in the context of other developments of the last decade. In 2008, the Netherlands saw the publication of the first PERISTAT (Perinatal Statistics) report, in which perinatal health indicators of 29 European countries were compared8. The perinatal mortality rates of the Netherlands were relatively high in comparison to other high income countries. This prompted the Ministry of Health to appoint a Steering Group Pregnancy and Childbirth (Stuurgroep Zwangerschap en Geboorte), which produced a report making suggestions for increasing safety around pregnancy and 2 https://www.amc.nl/web/ik-heb-een-afspraak-1/mijn-afspraak-in-het-amc/poli-ondersteuning- maatwerk-zwangerschap-geboorte-pom-polikliniek.htm 3 https://www.trouw.nl/home/goed-gesprek-helpt-bij-weigermoeder-die-per-se-thuis-wil-bevallen~ ab1f0831/ 4 http://www.maia-verloskundigen.nl/geldersevallei/_sitefiles/file/De%20Graaf%202014%20 6 Verbeek A.
Load more

Recommended publications
  • Impact of Whole Systems Traditional Chinese Medicine on in Vitro Fertilization Outcomes
    HHS Public Access Author manuscript Author Manuscript Author ManuscriptReprod Author ManuscriptBiomed Online. Author Manuscript Author manuscript; available in PMC 2016 June 01. Published in final edited form as: Reprod Biomed Online. 2015 June ; 30(6): 602–612. doi:10.1016/j.rbmo.2015.02.005. Impact of Whole Systems Traditional Chinese Medicine on In Vitro Fertilization Outcomes Lee E. Hullender Rubina, Michael S. Opsahlb, Klaus Wiemerb, Scott D. Mistc, and Aaron B. Caugheyc aOregon College of Oriental Medicine, Oregon Health and Science University, 75 NW Couch St, Portland Oregon, 97210, USA bNorthwest Center for Reproductive Sciences, Kirkland, Washington; Poma Fertility, Kirkland, Washingon, USA cOregon Health and Science University, Portland, Oregon, USA Abstract Patients undergoing IVF patients may receive either acupuncture or whole-systems traditional Chinese medicine (WS-TCM) as an adjuvant IVF treatment. WS-TCM is a complex intervention that can include acupuncture, Chinese herbal medicine, dietary, lifestyle recommendations, or both. In this retrospective cohort study, 1231 IVF patient records were reviewed to assess the effect of adjuvant WS-TCM on IVF outcomes compared among three groups: IVF with no additional treatment; IVF and elective acupuncture on day of embryo transfer; or IVF and elective WS-TCM. The primary outcome was live birth. Of 1069 non-donor cycles, WS-TCM was associated with greater odds of live birth compared with IVF alone (adjusted odds ratio [AOR] 2.09; 95% confidence interval [CI] 1.36 to 3.21), or embryo transfer with acupuncture only (AOR 1.62; 95% CI 1.04 to 2.52). Of 162 donor cycles, WS-TCM was associated with increased live births compared with all groups (odds Ratio [OR] 3.72; 95% CI 1.05 to 13.24, unadjusted] or embryo transfer with acupuncture only (OR 4.09; 95% CI: 1.02 to 16.38, unadjusted).
    [Show full text]
  • Statement on Unassisted Birth Attended by a Doula
    Statement On Unassisted Birth Attended by a Doula _______________________________________________________ Definition Unassisted childbirth – the process of intentionally giving birth without the assistance of a medical or professional birth attendant – is a decision made by a very small percentage of parents. DONA International certified and member doulas provide physical, informational and emotional support. Any type of medical or clinical assistance is outside the scope of practice agreed upon by DONA International certified and member doulas. DONA International opines herein on the considerations a doula must make when accepting clients planning an unassisted birth. Introduction Unassisted childbirth (UC) refers to the process of intentionally giving birth without the assistance of a medical or professional birth attendant. UC is also sometimes referred to as free birth, DIY (do-it-yourself) birth, unhindered birth and couples birth. In response to the recent growth in interest over UC, several national medical societies, including the Society of Obstetricians and Gynaecologists of Canadai, the American College of Obstetricians and Gynecologistsii, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologistsiii, have issued strongly worded public statements warning against the practice. Professional midwives' associations, including the Royal College of Midwivesiv and the American College of Nurse-Midwivesv also caution against UC. Those who promote UCvi claim the practice offers mothers-to-be a natural way of welcoming their child into the world, free from drugs, machinery and medical intervention. They also note that UC allows a woman to listen to her body's signals rather than coaching from an outsider. The women who are choosing UC may do so because they do not feel supported and respected in the obstetrical care facilities available in their areas, or they are unable to afford or obtain home midwifery or physician support, which is more in line with their philosophies.
    [Show full text]
  • Birthing Outside the System: Trauma and Autonomy in Maternity Care
    PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/201204 Please be advised that this information was generated on 2021-10-07 and may be subject to change. Birthing outside the system: system: the Birthing outside Uitnodiging voor het bijwonen van de openbare verdediging van mijn proefschrift Birthing outside the system: trauma and autonomy in maternity care op dinsdag 19 maart 2019 om 14:30 uur in de Aula van de Radboud Universiteit trauma and autonomy in maternity care in maternity autonomy and trauma Comeniuslaan 2, Nijmegen. U bent van harte welkom bij deze plechtigheid en de aansluitende receptie. Martine Hollander [email protected] | Martine Helene Hollander Martine Helene Birthing outside the system: trauma and autonomy in maternity care Paranimfen Lianne Holten [email protected] Martine Helene Hollander Claire Stramrood [email protected] Birthing outside the system: trauma and autonomy in maternity care Martine Helene Hollander 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 1 ISBN 978-94-028-1373-9 Design/lay-out Promotie In Zicht, Arnhem Print Ipskamp Printing, Enschede © M.H. Hollander, 2019 All rights are reserved. No part of this book may be reproduced, distributed, stored in a retrieval system, or transmitted in any form or by any means, without prior written permission of the author. 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 2 Birthing outside the system: trauma and autonomy in maternity care Proefschrift ter verkrijging van de graad van doctor aan de Radboud Universiteit Nijmegen op gezag van de rector magnificus prof.
    [Show full text]
  • Experiences of Women Who Have Planned Unassisted Home Births: a Systematic Review Protocol
    SYSTEMATIC REVIEW PROTOCOL Experiences of women who have planned unassisted home births: a systematic review protocol 1 1 2,3 Danielle Macdonald Josephine Etowa Melissa Helwig 1School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada, 2W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, Canada, and 3Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence Review question/objective: The objective of this review is to identify, appraise and synthesize the qualitative evidence on the experiences of women in high resource countries who have planned unassisted home births. This qualitative review aims to answer the following question: what are the experiences of women who have planned unassisted home births? Keywords Freebirth; unassisted birth; unassisted home birth JBI Database System Rev Implement Rep 2019; 17(1):16–21. Introduction urging of physicians for reasons such as safety and 11 here are many decisions that women and family hygiene. This new, innovative medical model of birthing in hospitals slowly became normative after T members face as they prepare for the birth of a 12 new child. Place of birth and the type of healthcare World War II. As women and families came to provider for perinatal care are two common consid- associate hospital birth with safety, their interest and erations for women and families. For many women, trust in home births dwindled. In countries like a hospital is the preferred location for labor and Canada and the United States, in the 1970–80 s delivery, attended by a physician.1 Increasingly, in the home birth movement emerged in response to high resource countries,2,3 women and families are the misuse of obstetrical interventions, less than ideal birthing experiences and lack of choice for non- choosing to have midwifery care and home births 12 attended by midwives.4 normative ways of birthing.
    [Show full text]
  • Home Birth in Saskatchewan
    Home Birth in Saskatchewan Childbirth is a life-changing experience. Many expectant parents may want to take some time to research, explore, and think about their choices for childbirth and the type of birth experience they want to have. There are personal, cultural, religious, medical, economic, and other reasons why some women may prefer one birth setting over another. Both home and hospital births are valid, well-researched options. When considering a home (out of hospital) birth, some women may consider an unassisted home delivery, also known as a “freebirth”. This is when women choose to birth at home without a licensed prenatal care provider (i.e., family physician, registered midwife, or obstetrician). Instead, they give birth by themselves or with other unlicensed birth attendants, such as doulas, friends, or their partners. All women want to have a positive birth experience and a healthy baby. It is possible for women to plan for the childbirth experience they want, while still working with a licensed prenatal care provider. It takes open and honest communication between women, partners, and healthcare providers. This resource is designed for pregnant women who are thinking about having a home delivery unassisted by a licensed prenatal care provider. It highlights the importance of having a licensed prenatal care provider present. This resource also outlines the potential risks of having an unassisted home delivery. Women can use this information to make informed decisions about their childbirth. It is important for women to know that if they birth at home without a licensed prenatal care provider, both they and their babies are at an increased risk of poor health outcomes.
    [Show full text]
  • Freebirth, Unassisted Pregnancy and Unassisted Birth • Aims.Org.Uk
    Page 1 of 6 Freebirth, Unassisted Pregnancy and Unassisted Birth • aims.org.uk Freebirth, Unassisted Pregnancy and Unassisted Birth What are freebirth and unassisted childbirth? There is no specific definition of freebirth, but broadly speaking, a woman freebirths when she intentionally gives birth to her baby without a midwife or doctor present. Some women prefer to use the term ‘unassisted childbirth’ or UC to describe this. This is different from the situation where a mother births without medical support unintentionally, either because a midwife refuses to attend a homebirth or because she births before her midwife can get there. The latter is classed as Born Before Arrival (BBA). Freebirthing is an entirely legal thing to do, but freebirthers often report stigma and condemnation for giving birth this way. The legal position is explained in this factsheet from the charity Birthrights www.birthrights.org.uk/factsheets/unassisted-birth Freebirth is an umbrella term for a variety of pregnancy and birthing journeys. What is unassisted pregnancy? Freebirthers may choose to have some, all, or no antenatal care. ‘Unassisted pregnancy’ is the term most frequently used to describe the situation when a woman decides to have no antenatal care from a midwife or doctor at all. Women are not obliged to inform any health services about their pregnancies, as antenatal care is offered and not compulsory. Most freebirthing women do register their pregnancies with a midwife or GP. However, a small number of women will decide not to. An unassisted pregnancy is an active, legitimate and legal decision to not pursue antenatal care, and it should be respected as such.
    [Show full text]
  • Unassisted Birth Among the Piro of Amazonian Peru
    JASO 3111 (2000): 31-43 WOMEN'S STRENGTH: UNASSISTED BIRTH AMONG THE PIRO OF AMAZONIAN PERU LUISA EL VI RA BELAUNDE OF all the exploits attributed to indigenous women by colonists in the Amazon, the alleged ability to give birth unaided might be closer to reality than fantasy. Amongst several indigenous groups, women do give birth unassisted or with very little help, in spite of growing pressure from medical institutions to introduce mod­ em midwifery ~n the area. The widespread practice of unassisted birth, however, has largely escaped social analysis and is usually mentioned solely as a matter of factual description. For instance, in his ethnography of the Colombian Cubeo, Goldman (1963: 167) states: 'I have seen a pregnant woman leave for her manioc garden and return later in the afternoon with a new-born baby'. A similar account is found in Cardenas's study of the Peruvian Shipibo: 'When the moment of the delivery approaches, the woman looks for an isolated spot-generally she goes into the forest-and she gives birth without help or witnesses. This form of self­ reliant delivery is a sign of feminine pride and decorum' (1989: 215, my transla­ tion). Both ethnographic studies report that assistance for the delivery is provided in advance only in the case of first-time mothers or if complications are expected at birth following a difficult pregnancy. We are told that women usually prefer to I am particularly grateful to the people of Diamante for their hospitality and help. A pre­ vious version of this paper was presented at the University of F1orianapolis, Brazil, and the University of Manchester, UK.
    [Show full text]
  • Disenfranchised Grief in Postpartum Women: a Heuristic Inquiry Into Women's Lived Experience of Loss of the Dreamed-Of Birth
    University of Pennsylvania ScholarlyCommons Doctorate in Social Work (DSW) Dissertations School of Social Policy and Practice Fall 10-9-2015 Disenfranchised Grief In Postpartum Women: A Heuristic Inquiry Into Women's Lived Experience Of Loss Of The Dreamed-of Birth Rumyana P. Kudeva University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations_sp2 Part of the Maternal and Child Health Commons, Maternal, Child Health and Neonatal Nursing Commons, Other Mental and Social Health Commons, Social Work Commons, and the Women's Studies Commons Recommended Citation Kudeva, Rumyana P., "Disenfranchised Grief In Postpartum Women: A Heuristic Inquiry Into Women's Lived Experience Of Loss Of The Dreamed-of Birth" (2015). Doctorate in Social Work (DSW) Dissertations. 72. https://repository.upenn.edu/edissertations_sp2/72 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations_sp2/72 For more information, please contact [email protected]. Disenfranchised Grief In Postpartum Women: A Heuristic Inquiry Into Women's Lived Experience Of Loss Of The Dreamed-of Birth Abstract Abstract DISENFRANCHISED GRIEF IN POSTPARTUM WOMEN: A HEURISTIC INQUIRY INTO WOMEN’S LIVED EXPERIENCE OF LOSS OF THE DREAMED-OF BIRTH Rumyana P. Kudeva, MSW, LCSW Jeffrey Applegate, PhD The childbearing year is of upmost significance in a woman’s life, carrying inherent possibilities of empowerment and self-actualization. Most women create a vision of their “dreamed-of birth” that represents their beliefs about birth and their role in the process. However women’s expectations about birth are often subverted by the authoritative knowledge and practices of the Western maternity care system or by the unpredictable nature of the birth itself.
    [Show full text]
  • An Examination of Risk Perception Amongst Obstetricians and Certified Rp Ofessional Midwives in Missouri Allison R
    Washington University in St. Louis Washington University Open Scholarship Undergraduate Theses—Unrestricted Spring 4-21-2013 Risking It: An Examination of Risk Perception Amongst Obstetricians and Certified rP ofessional Midwives in Missouri Allison R. Horan Washington University in St. Louis Follow this and additional works at: https://openscholarship.wustl.edu/undergrad_open Part of the Medicine and Health Commons, and the Social and Cultural Anthropology Commons Recommended Citation Horan, Allison R., "Risking It: An Examination of Risk Perception Amongst Obstetricians and Certified Professional Midwives in Missouri" (2013). Undergraduate Theses—Unrestricted. 6. https://openscholarship.wustl.edu/undergrad_open/6 This Dissertation/Thesis is brought to you for free and open access by Washington University Open Scholarship. It has been accepted for inclusion in Undergraduate Theses—Unrestricted by an authorized administrator of Washington University Open Scholarship. For more information, please contact [email protected]. Risking It An Examination of Risk Perception Amongst Obstetricians and Certified Professional Midwives in Missouri Allison Horan Washington University in Saint Louis Department of Anthropology Senior Honors Thesis Dr. Carolyn Sargent, advisor Dr. Lewis Wall, reader Dr. Barbara Baumgartner, reader ABSTRACT The concept of risk is pervasive in contemporary discussions of childbirth –both amongst professionals and consumers. While risk is often presented as an objective entity, in reality it is an elusive concept to define, particularly within the context of maternity care. Since the nineteenth century, obstetricians and midwives have conceptualized the risks of birth differently. This thesis examines how two groups of practitioners in Missouri, obstetricians (OBs) and certified professional midwives (CPMs), perceive risk in pregnancy and childbirth.
    [Show full text]
  • The Rules of Maternity, 84 Tenn
    Penn State Law eLibrary Journal Articles Faculty Works 2017 The Rules of aM ternity Dara Purvis Penn State Law Follow this and additional works at: http://elibrary.law.psu.edu/fac_works Part of the Family Law Commons, Health Law and Policy Commons, and the Law and Gender Commons Recommended Citation Dara Purvis, The Rules of Maternity, 84 Tenn. L. Rev. 367 (2017). This Article is brought to you for free and open access by the Faculty Works at Penn State Law eLibrary. It has been accepted for inclusion in Journal Articles by an authorized administrator of Penn State Law eLibrary. For more information, please contact [email protected]. THE RULES OF MATERNITY DARA E. PURVIs* INTRODUCTION. ...................................... ..... 368 I. AUTONOMY WITHIN MOTHERHOOD ................... 371 II. RULE 1: YOUR BODY IS YOUR CHILD'S VESSEL .. ........... 377 A. Drug Use During Pregnancy ................ ...... 379 B. Risks during Pregnancy as Torts ............. ..... 387 C. Self-harm as Child Abuse... .................... 390 D. Keeping the Vessel Alive.................. ....... 391 III. RULE 2: DOCTOR KNOWS BEST ... ...................... 394 IV. RULE 3: MOTHERS MUST ALWAYS PROTECT ....... ........ 402 A. Failureto Protect ......................... ..... 402 B. Failure to ProtectBoth Yourself and Your Child............. 405 C. Failure to Protect and Immigration ................ 409 V. RULE 4: GOOD MOTHERHOOD IS A NARROW ROAD .................. 410 A. The Importance and Danger of Breastfeeding.................. 410 B. Munchausen Syndrome by Proxy/Medical Abuse............ 419 C. Helicopter Versus Free Range Mothering.... ........ 426 VI. RULE 5: ONLY SOME WOMEN NEED APPLY ...... ......... 430 A. PotentialMothers in Prison ................ ...... 431 B. PotentialMothers on Probation .......................... 432 C. PotentialMothers on Welfare............................ 434 D. Free Range Redux- Not if You're Poor.....
    [Show full text]
  • Births Prompt Alarm
    news-apr5_Layout 1 16/03/11 10:48 AM Page 648 News the wheat from the chaff when it comes “everything that seems simple may not Safety Commission’s National Electronic to online advice, videos give people be to everybody.” Injury Surveillance System reveals a who are considering self-treatment a While Canadians are less likely than litany of botched attempts to remove leg better sense of what they’re getting their American counterparts to “rifle casts with paint thinner, moles with nail into, says Zaugg. “You don’t need a lot their own medicine cabinets” rather clippers, dry skin with razors and teeth of medical knowledge to perform cer- than see a doctor for financial reasons, with screwdrivers, among other do-it- tain procedures. In almost all cases, the Goldman says wait times in Canada are yourself medicine failures (www.cpsc main risks you run are infection or cut- motivation enough for some people to .gov /cgibin/NEISSQuery /ExportFile .aspx ting into something you shouldn’t, but shirk professional care. ?FileName=/download/nss20027.tsv). that doesn’t mean the knowledge “A woman I know was scheduled Most common are the “people who should be inaccessible for anyone who for an appointment at an orthopedic have a lump on their skin and are certain wants to put the time and effort into clinic to have surgical pins removed they have an abscess, so they squeeze learning. I think everything a doctor from her foot. She arrived on time for it,” putting themselves at risk of “partic- learns, your average intelligent person her appointment at eight in the morn- ularly serious” blood-borne infections, can learn without a degree.” ing, and was kept waiting until four in says Goldman.
    [Show full text]
  • Factors Associated with Health Care Access for Ohio Mothers Who Chose Home Birth
    Factors Associated with Health Care Access for Ohio Mothers who Chose Home Birth THESIS Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of The Ohio State University By Martha Catherine Nieset Graduate Program in Rural Sociology The Ohio State University 2013 Master's Examination Committee: Professor Joseph Donnermeyer, Advisor Professor Cathy Rakowski Copyrighted by Martha Catherine Nieset 2013 Abstract Every year in Ohio and throughout the United States women of childbearing age are increasingly making the decision to forgo the hospital setting and give birth at home. The evidence has shown that women’s decisions to birth at home are highly influenced by their desire for greater control over their birth process in order to avoid unnecessary, technology-intensive interventions in the normal birth process. The body of research has demonstrated similar safety ratings for both the mother and child in planned low-risk home and hospital births attended by skilled providers. Compared with low-risk hospital births, outcomes of intended home births have consistently shown considerably lower rates of medical intervention in episiotomy, electronic fetal monitoring, caesarean section, and vacuum extraction with home birth care providers receiving higher client satisfaction ratings than their in-hospital counterparts. Currently over half of U.S. states regulate home birth midwife practice (most commonly the Certified Professional Midwife, CPM) through some form of licensure or statute. Ohio currently does not regulate the practice, leaving women seeking a midwife for a home birth without a legally recognized care provider. Recognizing home birth as an option, tracking down a home birth midwife, and going through an entire pregnancy planning a home birth are not highly visible options for the majority of women in part because of the uncertainty ii around home midwifery practice and the potential for it to be construed as “practicing medicine without a license” and prosecuted as such.
    [Show full text]