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Monday Reading: Health Care Reform and More

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As a contributor to the high-traffic Common Ground series on RH Reality Check, Amy Romano explores attainable goals in making hospital birth better and providing access to the midwifery model of care for all American women in Improving Maternity Care: A Mother and Child Reunion.


On Science and Sensibility, Amy Romano notes the similarity in theme between her Common Ground article and the recent publicizing of midwife Denis Walsh’s alleged theories (co-opted as link bait for several major British and Aussie publications) on epidurals and maternal bonding that recently ignited the cliché web furor about birth, motherhood and parenting. She writes in Denis Walsh, mommy wars, and coming together On Common Ground:


I believe that mothers and babies experience physiological and emotional benefits when the woman has an unmedicated vaginal birth. But in our culture, women are not given a fair shake to achieve unmedicated vaginal births, and are fed messages that they shouldn’t care how they give birth as long as there’s a healthy baby. Even when care is top-notch, some women will still need epidurals or cesareans. Do we really want to tell these women that they might not be able to parent effectively?


I squealed with delight (is that weird?) when I read of my favorite blogging OB-GYN student’s proposed research focus. Mom’s Tinfoil Hat summed it up this weekend:


What I want to know is why there is a disconnect between evidence based clinical research and practice. Also, it seems that the same practices that are proven in literature but ignored in practice are the woman centered, autonomy encouraging practices, and the practices that disfigure and deprive women are the ones that persevere.

So, now I am going to do a study on attitudes on and barriers to incorporating certain practices into clinical obstetrics. I think I am going to compare those four practices: episiotomy, denial of food and water, continuous labor support by a doula, and upright positions in second stage. I want to examine perceptions of their evidence, confidence in the support of their effect on outcomes, and general attitudes toward each of the practices and evidence based medicine in general.


If you have a few hours to kill, the entire 1018 page “America’s Affordable Health Care Choices Act of 2009” is online.


Kevin pulled together a few quotes from articles about malpractice and liability in Fixing malpractice is a vital part of health reform.


Odd, but interesting: Duncan Cross blogged ’save my Body from the Surgeons’.


Reality Rounds reminds busy nurses to pee. That goes for all of us. Life is busy. Pee as frequently as needed.


Have a great week!


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Reader Comments (5)

I am so happy other people are giddy and/or squealing over my research topic. I'm not the only dork who thinks this is really, really cool.

July 20, 2009 | Unregistered CommenterMomTFH

Jill, you are my favorite blogger on the continent (tee hee). Thanks for the link, and links!

July 20, 2009 | Unregistered CommenterReality Rounds

Do we really want to tell these women that they might not be able to parent effectively?-Amy Romano

Yes. Yes we do. For the same reason we (hope to) cover subjects like emergency care after rape with our daughters. Women should be given the information they need to cope with some of the feelings that come up after a traumatic birth. Some women are in too much pain, or are too out of it to give much attention to their children. Some feel that their children are the cause of their suffering, and don't want to have much to do with them. Some women are angry with their husbands for not intervening and focus on that aspect. Some are angry with their attendants. Some are too shellshocked to deal with the added burden of a baby. There are other scenarios out there. My point is that if women knew beforehand that these feelings are NORMAL after a "bad" birth, it allows for easier healing. When women accept that they are not alone, are able to vent in a safe place without judgement, and are supported and understood instead of being written a prescription, they will be more able to deal with these types of situations. And that will lead to better parenting.

July 20, 2009 | Unregistered CommenterAnon

Unfortunately, if you read the new healthcare bill it will be highly UNLIKELY that women will have more control over their own birth--in fact, it will be the opposite. It will be some health czar deciding what is necessary and what is unnecessary.

In my last birth I finally had the experience I wanted under my own control. Sad that it had to be my 4th birth to attain that. One of those reasons is the massive lawsuits surrounding childbirth and the physicians need to push every medical intervention necessary.

I can't fathom how the new requirements in the bill will possibly help our plight to have better childbirth experiences. I see them as heading more towards the 50's where everyone has to have the same birth experience in the fasted mode possible.

July 21, 2009 | Unregistered CommenterDawn

Dawn, under the current system, women like me are denied having their pregnancies covered all the time. I was told my pregnancy was a preexisting condition by my insurance company because I didn't test negative for pregnancy for two months before asking for maternity coverage.

I am not sure what providing health care coverage to the 30% of our citizens who have no insurance, and the countless more who are underinsured (like I apparently was) will do to make things worse. Every country with better infant and maternal health care outcomes than the United States (and there are dozens) has universal coverage or a single payer system.

These countries often have access to midwifery care or obstetrical care, and homebirth is even covered. What kind of options do you think would be ruled out?

July 21, 2009 | Unregistered CommenterMomTFH
This blog is all done!
Thanks for wanting to comment. This is an archive of a blog that once was. Take care! Jill