A trend to reverse....

[CTRedSoxMom]

In The United State's the American College of Obstetricians and Gynecologists estimate that there are 42,333 OB/GYN's currently practicing medicine nationwide. That is a large number, no one can deny that.
Then lets look at the number of Midwives that are actively delivering babies and practicing medicine, which I really have never heard a midwife actually use the term "practicing medicine" for the care and support that they provide, but that is a whole other blog for another day. Roughly there are about 8,000 midwives delivering babies in The United States.
That brings the OB/GYN to Midwife ratio to around 5.25 to 1. Which is a HUGE difference.
Bringing me to the serious problem with our maternity care system as opposed to all the other maternity care systems of industrialized nations.

Lets take a trip to Sweden. The country that in 2004 had the lowest infant mortality rate, and right next door in Denmark, where 1/3 of births take place at home, the maternal death rate is the lowest in the world. And what do we see that is a factor in these two countries that The United States does not have in common? Midwives deliver the majority of women, and the OB/GYN's are left to manage the care of the small percent of high risk patients.

That is a huge difference from how maternity care is handled here, which also leaves us with the 2nd worst maternal and infant death rates.
Hmmm... we are a country that demands the best in everything. From cars and homes, to medical care and insurance coverage. So why are we accepting sub standard care and continuing with the impression that the care we get, because it is more invasive and costs more is better than these other nations that are having much better birth outcomes?

I will leave that seed planted in your head.

[emslala]

Jul. 15, 2009 at 11:56 PM

Why? Brainwashing from those who have to pay for malpractice insurance in a severely lawsuit-happy country!!

Thank you for posting!! Voted UP!!  <3 <3

[eema.gray]

Jul. 15, 2009 at 11:58 PM I really think we'd see much better care for every pregnant women if we could transition to a system more like in the countries you mentioned. The vast majority of women are low risk and can get all the care they need from a capable midwife. The women who ARE high risk would probably receive better care than they do now because their OB's wouldn't be overworked attending to low risk women who really don't need a surgical specialist.
If I have migraines, I don't go straight to a neurosurgeon! I go to my family practice doctor first and work with him. If his solutions don't work, THEN I go to a specialist. We really need to adopt the same model for pregnancy care.

[Julie411me]

Jul. 16, 2009 at 12:45 AM

Well, get used to it.  We are becoming a mediocre country.  And fast.

[mtnmama111]

Jul. 16, 2009 at 3:58 AM

I have pondered upon this myself, many a time...birth is way overmedicalized (in America)... they (hospitals) discount basically completely a mother's experience/knowledge/ability and try to *run* things instead of letting a baby come when and as it and it's mother want...

[Momma_Halo]

Jul. 16, 2009 at 11:15 AM

I blame a lot of it due to culture issues. Before women were not allowed to work and midwives were largely women.

Also if you research midwives you will find for a VERY long time it was outlawed for women to practice because it was seen as witchcraft... in America alone it was widely frowned upon to practice such things and only men to deliver the babies and do medical care. (For those ready to defend and yell at me I am not attacking Christianity just fundamental people in the past)

Europe seemed to bounce back from their mistake fairly fast where as America is slowly rebuilding the midwife practice. But things are already cemented into American women's minds from the time we go to school to adulthood. We are told that we NEED our doctors and that we shouldn't question things. We are also told we are lucky to have our doctors do this and to prove the point they show us places like Africa and so forth and their issues.

Yes they have issues but they forget to show us their is not just ONE way to do this. Like yes I believe in going to the doctor, having myself vaccinated and so forth. But I don't go to the doctor every chance I get. I am usually snuggled up on the couch with herbal tea's and food that builds your immunity when I am sick. Same thing with my son. He loves Chamomile.

And I am rambling.

[megatriguena]

Jul. 16, 2009 at 12:42 PM

I really hate when people quote the highest infant death rate statistic.  We live in a country where a 23 weeker that would be left in the birthing room to die in any other country is brought into the NICU.  We also live in a country where although everyone can get emergency medicaid, its a process that usually takes at least 2mth leaving my more motivated patients with subpar care and the absolute lazy ones with no prenatal care at all.  How I feel about the ethics of this is one thing but there are a lot of things that go into the highest infant death rate amongest developed nations, the most powerful factor I think is the affect that universal access to health care allows places like sweden to pull ahead.   As a family medicine physician who practices" obstetrics, I take great offense at the suggestion that these countries perform better bc of the magical addition of the nurse midwives. Do I think that more wide spread use of the nurse midwife would reduce costs and still result in good care?  Absolutely. Obstetrics is not rocket science as it is not a medical condition as some practioners believe.  But blaming poor outcomes on the way that Ob Gyns practice instead of the system that they practice in is incorrect and mean spirited.

[Mandie2006]

Jul. 16, 2009 at 1:09 PM

Funny, I was just thinking about this the other day. It's amazing how years and years and years ago, women delivered their babies at home... and a lot of the time with the help of a midwife. I'm not saying that the mothers/children didn't have complications, because I'm sure there were.... but basically they just let nature run its course.

I personally have never been able to have a normal delivery, I have so many complications myself and a bicornuate uterus on top of everything else... but still, I've often thought that doctors are just making things too crazy and are stepping in too much. A woman's body knows how to handle a pregnancy, labor, and delivery. And after looking at all of my hospital bills - total about $1500, I have to think, geez - years ago labor and delivery was FREE pretty much! But now we have to pay for every little thing.

I'm all for midwives... I think they are fantastic, and personally I would have rather used such care - but like I said, that wasn't the option for me. A midwife's care is more personal... instead of being handled as a "job." Just my opinion though. Other countries know what's up... our country is just in it for the money! And an ob/gyn makes a LOT of money....

[reflect1light]

Jul. 16, 2009 at 2:02 PM

thank you :)

[FlagMomNick]

Jul. 16, 2009 at 2:12 PM

I personally would rather have the care of a midwife, but it isn't an option because of ins..  So I have to endure all of the invasive equipment, procedures & interference that a midwife would not inflict on a woman in labor. I have ripped out an IV during every labor by accident. I did not need an IV! I also want to deliver sitting up because gravity works, therefore I am an inconvenient & uncooperative patint because I think that the attending is there for me & not the other way around.

[mommashaybay]

Jul. 16, 2009 at 2:23 PM

i think that some women forget that you can tell your ob NO...i do not want that iv...NO  i do not want to be laying down when i deliver...NO i do not want to be induced unless it is a medical emergency...your pregnancy does not have to full of invasive care if you do not want it to be...also, maybe some women should interview a few ob's before choosing one and found out their stance on things like induction, c sections and birthing positions...