Monday, June 20, 2011

No Ingles? C-Section for You!

This might raise more of a ruckus than anything I've ever said here.  I believe -- with good reason -- that English being your second language puts you at risk for a c-section in America.  Think about your friends or acquaintances for a minute.  Maybe you are from another country and gave birth in America.  Did you have a vaginal birth?

I have a couple of friends that work at a local hospital in the Dallas-Ft. Worth area with a c-section rate of 60%.  They have both told be they think the statistic is higher than that, however.  They have said there are days (and nights) where they don't see a single woman that has had a vaginal birth.  When I asked them why they think the numbers are so high, one of them said it's because that particular hospital has such an influx of Mexican women.  What?!  She went on to explain that when they don't speak the language (English), things just happen to them, the labor "spirals out of control," ending in surgery.

Surely in the United States of America they are getting the best health care in the world, right?  Frankly, I believe they are taken advantage of by a system -- doctors, nurses, hospitals -- that don't want to deal with them.  They know that these women and families are often scared, and frankly, trust the doctors to take care of them to do what is best for them.  I think they are being scammed.

It is not just Mexican women.  I know people from several other countries that have had the same experience in the DFW area.  I believe it is happening all over the United States.  One of the women I know who had a cesarean at the mentioned hospital said that in her Discharge Class, only 2 of the 15 women had had a vaginal birth.  She is Italian and will be VBACing this September at a different hospital with a VBAC-friendly doctor and she has hired a doula.  She will not be a victim this time around.

Very few women -- American or otherwise -- are truly aware of their choices when it comes to childbirth.  We place our faith and trust in the doctor's hands and become good little patients.  Less than 1/3 of women take a childbirth class when they are pregnant.  We make it unbelievably easy for the system to take advantage of us.  Plenty of American-born women have been a victim of the system and don't even realize it.  They just didn't take the time to educate themselves about labor and birth and were not active participants in their labors.  Birth was something that happened to them.

Women from other countries and cultures bring their own ideas of birth to the table which may or may not mirror our own.  The third step of the Mother-Friendly Childbirth Initiative is:  "A mother-friendly hospital, birth center, or home birth service provides culturally competent care -- that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother's ethnicity and religion."  That is rarely happening in this country!

Thoughtfully consider your place of birth regardless of where you are from.  Is your care provider respectful on all levels?  If English is your second language and you are having a baby in America, I hope that you will follow your intuition.  If you feel like your hospital or doctor is not respectful, don't ignore those red flags.  There are people who want to help you have a wonderful birth.  Seek out a midwife, a Bradley (TM) teacher, or a doula, for recommendations in your area.  It's only too late after the baby is here.

The diversity of this country is one of the many things that make is so interesting.  All women deserve to have a wonderful birth-day and not be a victim of a broken maternity system.  If you know someone in this situation, don't be afraid to speak out.  Help put her in touch with your midwife or doula. Language should never be a barrier to compassion or the beginning of motherhood.

13 comments:

~Fort Worth Doula said...

My first job as a doula was volunteering at a local hospital-provided program. It was truly the most traumatic, horrible birth story I could ever imagine. The mom was very young, spanish speaking only, and the dad wasn't much better. He understood a few words here and there. The short version of the story is that mom labored all day...(I have never seen someone so abused and taken advantage of in my life) they would NOT let her push in any position but rolled in a ball, on her back...legs in the air, shouting at her...when that didn't work, they attempted forceps (about 4 different interns, HUGE episiotomy) She went in for a c/section, (It was the doctor's first, I got to go because the dad was too scared) The new doc cut the baby's face BADLY during the surgery, and they would not give her her baby because they said SHE might injure the baby with the gash on his face. Mom wanted to breastfeed and they insisted on giving him formula. I did the best I could to advocate for her but NO ONE (but one NICU nurse) would help me. I know, without a doubt, 100% that she would have been treated differently had she been english-speaking. They knew that they could 'learn' on her because she wasn't going to sue if they screwed it all up. I think of that mama often. That was about 11 years ago.....

Sally T. said...

I believe it. Totally. I've been reading your blog for a little while but I wanted to comment. My husband is in a medical-related field, fluent in Spanish thanks to an LDS mission, and he says there is an attitude among many that you do what you want to do with non-English speakers. Tragic.

Krista Eger said...

I worked at the hospital for 4 years. First in St. George, UT, then in SLC. We had a lot of Latina patients in St. George and I feel like they were actually pretty respected at that hospital. There were a few nurses and doctors that spoke Spanish. We would probably have at least one every day. We didn't get quite as many in SLC. They were respected, but definitely treated differently. The saddest story was when a Hispanic mom that hemorrhaged and there was no one that spoke spanish to explain to her what was going on and the medical resident had to manually extract the clot from her uterus. It was really painful for the mom and I wanted to throw up mostly because she had no warning and I'm sure it was ten times worse because she was scared and didn't know what was going on. That was just an unfortunate situation though.
I think that the difference with the hospital here in Utah is that it is a non profit hospital. If a doctor does an unnecessary c-section it's because it's more convenient for him. Doesn't make it right, but the instance is a lot lower for sure.
A great way to prove this argument is to go to the census bureau website. Somewhere there has got to be a statistic on c-section and race. I know it's somewhere because the birth certificate clerks fill out statistical reports to the census and race and delivery type are big ones that they measure.

Krista Eger said...

http://www.census.gov/compendia/statab/2011/tables/11s0087.pdf
wow I can't believe I found this. I have been looking for this website forever and couldn't figure out how to get it, but this time I typed just the right thing into the google search!

Donna Ryan said...

I know I made the Mexican reference, even in the title, but I want to emphasize that they could be from anywhere else - Italy, Russia, Germany, China - you name it.

Krista, that chart was interesting. It's so hard to get really current data. The "data" I collected is mostly from observation. It'd be interesting to take a poll, wouldn't it? Is it politically correct to have this conversation?

Heather J to the ames said...

I know what you're saying to be 100% true. Oftentimes, as well, many Hispanic women who don't speak aren't legal. They basically have to birth in the hospital so they have proof their babies were born in this country. Also, many of them wouldn't protest anyway because they are under the assumption that America is the best country in the world and they are grateful as hell to be here. With that being said, they also think everything we do and the ways in which we do them, are better because we are better because our country is better. So if birth in the hospital hooked up to all the crap and getting cut open is what your white AMERICAN doctor says, Ok... s/he must know best. This is America, afterall.

Rain Clair said...

Mexico has a near 50 percent csection rate! Mexican women are actually much less likely to have a csection in the USA then in Mexico. Its a cultural thing and not some racist failing of the medical system of the USA.

Rain Clair said...

It should also be noted that Italy has a near 40 percent csection rate & China has a near 50 percent csection rate. Before jumping to extremely inflammatory & very incorrect assumptions like you all are you might want to check out the csection rates of other countries!

labortrials said...

And yet my doc here in MT was telling me that 'short, Mexican' women have better pelvises for birthing. (In comparison to me with my tall big boned nordic frame.) I don't find this post surprising, unfortunately. I did blog about my OB's claim, if anyone is interested: https://labortrials.wordpress.com/2011/06/09/hispanic-female-pelvises-are-better/. I think I'll print out that chart for him...

Rain Clair said...

@labortrials Hispanic women in the USA do have a lower csection rate then non-hispanic whites and African American women. I don't know if it has anything to do with their body type though. Interesting that they have the lowest csection rates in the USA when in their own country in many places over 70 percent have csections! We think our maternal healthcare is bad, but their's is HORRENDOUS!

Uniquely Normal Mom said...

I absolutely agree.

And NO, it's not just a Mexican thing.

I've worked with Nepali and Indian women, and the medical professionals ALWAYS talk to me and ignore the mom, who is giving birth. Always.

They take one look at her, assume she is some poor, young, impregnated girl and start asking me questions. They joke with me and basically ignore her. I saw many c-sections because of this as well.

I directed the hospital staff to the mother and father and will purposely not answer questions when asked, but that makes matters worse. Then, without asking or explaining, they just do what they want to do.

Meghan said...

Hi,
I'm not pregnant right now, but I'm trying to prepare for my next birth right as well as I can. In researching Fort Worth area hospitals, I have come across your blog several times. Can you give me references for mother and baby friendly hospitals in the area, or can you direct me to someone who can? I would appreciate learning from your experience very much.
Sincerely,
Meghan F

Donna Ryan said...

Meghan, the only hospital care providers that are mother-friendly and members of the Tarrant County Birth Network (www.tcbirthnetwork.org) are the UNT Midwives at Harris downtown and Carla Morrow at the hospital in Cleburne. Both do water births and are wonderful hospital options. Feel free to email me with any other questions: bannedfrombabyshowers@gmail.com.