Monday, October 11, 2010

Want an Unmedicated Birth -- Or Even Just a Vaginal Birth? Hire a Midwife and a Doula

I have recently had a bad run -- lots of cesareans and epidural births.  I've thought about them a lot over the last several days and weeks, and there are some significant numbers that I want to share.

Up to now, my stats have been about 79% of people that take my class give birth without medication.  14% have a cesarean, and about 7% have an epidural, the majority of the time to avoid a c-section.

These last few months have been the worst statistics I've had in over seven years of teaching.  It's hard for me to put this out there, but I've gone back about 4 months to include a couple of classes and several DVD couples.  There are some interesting things to note, and I hope this improves future outcomes.

In the last 4 months, I've had 23 couples give birth.
10 had unmedicated vaginal births.
5 had epidurals (but still had a vaginal birth).
8 had c-sections. 

Let's break this down, starting with the 10 unmedicated vaginal births.  (This is what everyone was shooting for.)
6 hired midwives (mix of CNMs and CPMs).
4 hired an OB.
6 hired a doula.

Of the 5 epidural births:
3 had a midwife.
2 had an OB.    
Only one of these women hired a doula.  
It should be noted that a few of these women started with OBs and switched to midwives.   Length of labor and/or pushing would have certainly resulted in c-sections had they stayed with their original OBs and hospitals.

Of the 8 c-sections:
2 had a midwife.
6 had an OB.
Only 2 of these women hired a doula, and only one had her doula present.
Obviously, these c-sections happened for a variety of reasons, some valid, some not-so-much.  Can't ignore that 80% were with OBs.  Honestly question if they would have happened with a midwife.

Summary:  If you want an unmedicated birth, your birth team is crucial.  All the education in the world won't matter if you have a doctor who is determined that you or your baby "need" a c-section.  As for a doula, the statistics speak for themselves.  A woman who has the support of another woman in labor will almost always have a better outcome, or at least feel better about doing all that she could do to prevent having an epidural or a c-section. 

If you are birthing in a hospital, you need to hire a midwife instead of an OB and you need a doula by your side.  End of story.


Cassie said...

110% agreed.

Allison said...

I have lived this part:

"All the education in the world won't matter if you have a doctor who is determined that you or your baby 'need' a c-section."

So sad, so sad. Good for you for putting this out there as a great big eye opener about the reality of the North Texas 50% cesaerean birth rate. Your class is excellent, and being educated about normal birth is essential, but hiring a birth team that is IN THE HABIT of treating birth as "normal" and beautiful is the only way to have your baby without a fight.

Regina said...

I am forever changed, and will always use a midwife! So happy, proud, and blessed to have narrowly escaped the C-section with my first, and to be one of your 10 non medicated births for my second!

Anonymous said...

AGREED! A good support team is invaluable!

Donna Ryan said...

Two unmedicated births this week! Yea!

Kali said...