Obama Says Women Must Have a Natural Childbirth to Save Money?
Thursday, July 16, 2009 at 12:39AM
By Jill—Unnecesarean
Dick Morris, author of Catastrophe
Media Matters, a Web-based, not-for-profit, research and information center whose mission is to comprehensively monitor, analyze, and correct conservative misinformation in the U.S. media, posted a video of the O’Reilly-Morris interview and reported the following on its site on June 25, 2009:
In fact, the Obama administration has not advocated “cut[ting] back on cesarean sections.” Rather, the American Medical Association (AMA) proposed addressing “the overuse of certain services or procedures,” [emphasis added] including cesarean sections, in response to the administration’s stated goal of reducing the growth in health care spending.
The AMA and five other health care organizations issued the proposals in a June 1 letter to Obama to address the overuse of certain procedures. In its attachment to the letter, the AMA stated that the “AMA-convened” Physician Consortium for Performance Improvement (PCPI) recommended addressing “the overuse of certain services or procedures,” including “Induction of labor/Caesarean Sections.”
Read an excerpt from the AMA attachment, Efforts to Reduce Unnecessary Utilization, as well as a transcript of the interview on The O’Reilly Factor here.
The Morris “natural childbirth” interview preceded this week’s international media and blog furor over midwife Denis Walsh’s not-yet-published article,“Epidural Culture,” which was submitted to the journal Evidence Based Midwifery and is currently under peer review according to the Royal College of Midwives.
According to the BBC, Walsh claims that pain in labor is known to have positive physiological effects and triggers the release of endorphins to aid women in adjusting to the pain. Additionally, he calls pain in labor a rite of passage that help a woman adjust to the responsibilities of mothering. Walsh allegedly writes that epidurals have known risks, such as an increased need for synthetic hormones to augment labor and increased rates of instrumental deliveries. The BBC quotes Walsh expressing concern that the long-term effects of increasing epidural rates are unknown.
As of yet, there have been no media reports that “natural childbirth” will be required of women by the U.S. government to control health care cost, nor will cesareans be systematically denied to those in need. Furthermore, it appears that epidural anesthesia will remain available in U.K. hospitals in spite of the content of a not-yet-published article by one midwife.
Reader Comments (12)
I just saw on Twitter that Louise Marie Roth wrote about Dick Morris and his silly cesarean comment and more on Huffington Post on June 29. It's very thorough and, as usually happens on HuffPo to maternity care related stories, it got fewer comments than it deserved.
I'm not sure what to think about this. I don't agree with the medical side of the maternity care in our culture, and I wish that natural birth was explained and used more than it is. It has DEFINITE positives that medicated birth doesn't have.
And even though cutting down on cesareans would lower state and government costs by millions every year, I have never actually heard of anyone saying that natural birth is better because it is cheaper. If our government truly started pushing this, the ACOG would push right back, because they get the most money from medicated births and cesareans.
I wish that we had someone in the government that was helping employ natural birth practices, but I don't ever see it happening.
You know, not that I agree with any of the main players in this piece, but the cost of cesarean is not a completely taboo subject. I am developing a research project on maternity care that will look at cesarean as an outcome, and one of my goals is to do a cost analysis. If it costs more AND has worse health outcomes, it is obviously a wrong wrong wrong treatment choice. However, I have never heard of anyone suggesting simply lowering the cesarean rate. I think everyone's goal is to lower the unecessary cesarean rate. And, no one's goal is to simply slash costs. The goal is to slash unecessary costs.
Threatening a slippery slope right here is a little ridiculous, since we are careening in the opposite direction.
"As of yet, there have been no media reports that “natural childbirth” will be required of women by the U.S. government to control health care cost, nor will cesareans be systematically denied to those in need."
I vaguely remember reading an article a year ago or so. I don't remember who wrote it or where, but it was a first-hand account of an American citizen birthing in a European (Dutch?) hospital. In the telling of her story, she described how the use of epidurals in their birthing culture was looked down upon, and that epidural anesthesia was NOT routinely available (i.e. it took considerable planning and effort to have one in place should one choose to use it.) She implied that it was somehow repressive and unfair to deny a woman her "right" to epidurals, and her tone in general was rather critical of the culture for trying to "force" their belief system on all comers, IIRC.
(Gosh, I wish I could remember this better, ring any bells for anyone?)
I find it terribly interesting that modern women, esp. American women, tend to define such things as choices in a framework of belief system, instead of biological imperatives that one may or may not choose to heed (with resultant consequences.) The same is true for breastfeeding, circumcision, natural birth, etc etc. Granted, one's belief system may affect whether one chooses to heed that biological imperative, and far it be for us to say whether or not their choice is valid, but it cannot be be argued that the biological imperative IS the preferred state, and that we would do well to present that as the default option, with all other choices being considered frivolous and/or potentially harmful.
I still have a hard time understanding how stating the consequences for certain choices equals condemning that choice. Or for that matter, why trying to limit potentially harmful and costly choices equals loss of choice. Just because the option becomes less accessible, or loses official sanction, does not remove the choice. Unless what women want isn't choice, but validation?
Personally I think natural is better, but I've yet to experience it firsthand. Of the women whose stories I've read, quite a few who've experienced both prefer natural. Telling women that they have to go natural to save the system money, instead of presenting natural, unfettered, undrugged, untimed birth as a valid and attainable choice with positive health benefits for both mother and baby, will undoubtedly cause a backlash from women themselves. Instead of fighting for the option for physiological birth in institutions and at home, women will be fighting to preserve the medical model. What a reverse psychology mind-f&*k.
MomTFH, I don't think cost of cesareans is a taboo subject, either. I'm curious about all of the variables you'll look at in your cost analysis. Sounds interesting.
Kayce, I think by saying "natural birth," Dick Morris meant "vaginal birth." The accusation was that Democrats will cause necessary procedures, like cesareans, to be denied. As a result, women will have to have a vaginal birth even if they need a cesarean.
He pulled it out of his butt.
Emily, I don't remember the story to which you're referring but I do remember at the beginning of the year (?) when the NHS in the UK proposed charging for unnecessary epidurals to save costs and people were furious.
Emily said: "it cannot be be argued that the biological imperative IS the preferred state"
Sure it can. Unless you add on "from a health perspective" or "from an epidemiological standpoint," and I think even those could be challenged. I think I know what you're saying, though. "Choice!" gets sort of glorified in rhetoric. It's always interesting (in general) to watch people discuss personal freedom and choice between two crappy options and ignore the big picture, in which there may be five other options. That's not necessarily related to women's health; rather, just something I've noticed in online semi-intellectual ping pong matches.
Anon, that proves it. Denis Walsh is a double agent for RCOG.
Kidding, of course. I hadn't considered that threatening to ban epidurals or limit their availability (hypothetically) could create a free army of people advocating for a fully medicalized childbirth and all that goes along with it. While arguing for their right to epidural anesthesia in labor, they are simultaneously arguing for everything else that goes along with having to support a patient hooked up to an epidural. That's pretty interesting.
This only comment is about the talks of banning medicine or c-sections during childbirth. I am a mother of four and have had: 1 "natural-no meds" birth, 1 epidural birth, 1 epidural that didn't take birth, and 1 c-section as a vaginal birth would have split me in two.
And I can speak for some women who have actually given birth-not just a few who "think" they know what they're talking about. The natural-no meds birth almost killed me. I was ripped open, the doctor had to cut me and then I ripped a final time from the opening to the next opening. There was nothing left between the top of my "woman part" and the bottom of my other "human part" to put it nicely. I felt every tear and cut and felt like I was going to die. I elected "NO Medicines" during my birth, after all, women have been giving birth for centuries, right? I was in so much pain, that I couldn't relax and push the way I might have been able to, had I been medicated. I didn't enjoy the beauty of giving birth to my precious baby. All I could do is pass out from the loss of blood and the pain. When I came to, it was to the feeling of the Doctor sewing me up and I felt every stitch.
My recovery was that of which was previously unseen by the nurses or Doctors; it took three times as long for my lower half to heal. The first few weeks of my baby's life wasn't celebrated in my photos and videos and joy. I was lying up in a bed with pillows and ice between me and crying and begging for relief every time I urinated. It took at least 4 months until I could urinate without crying and grasping the sides of the wall. That's 4 months I could have enjoyed with my child.
The next pregnancy, I elected for an epidural. I was more afraid of the needle than I was remembering my previous birth. But I overcame and had an incredible Doctor see me through. This birth was smooth, enjoyable, very little PAIN, I was awake to see my baby and 3 hours after the birth and when the medicine wore off, I was up out of bed, tidying up my room. I felt amazing! I could do things with my baby.
My latest pregnancy was followed by a C-Section as I was informed that the tole the previous pregnancies and births took on my body was severe and that if I elected to a vaginal birth, I would be torn in two again. I chose the C-Section. It was not as wonderful as the vaginal birth, the hospital treated the C-Section like cattle going into the slaughter. They were incredibly HORRIBLE during this experience. But I suspect that might just my hospital and others handle the mothers more delicately.
The option of medicine should ALWAYS be available. 2 reasons: 1. The woman "Has the RIGHT to kill her baby if it's still growing in HER body. So, the woman only has the right to KILL her child (& with that prodcedure they'll offer pain medication), but NOT the right to have medicine if she CHOOSES to allow her child to LIVE? 2. Pharmaceutical companies pump out the commercials like they're selling candy bars. If medicine is going to be shoved down our throats when we visit our general MD for a head-ache, then, by-golly, if I am on my back with my legs in stirrups pushing out a human life after 9 months of sacrifices, then I should be allowed the right to have something to help with the pain. Cause no matter what those people who have never given birth painfully say--it does NOT feel GOOD and a little medicine can help the mother enjoy her most precious moment.
Mother of four: being "on my back with my legs in stirrups pushing out a human life" is very likely to have been a cause of your pain -- staying upright and choosing a care provider who doesn't routinely cut episiotomies (which contribute to massive tearing) can make such a difference. It makes me sad that women are given the whole medicalized package and then told they must have drugs to cope, instead of being encouraged to work with their bodies to give birth as God/Nature intended. :/