Who Profits?

Anyone can admit that we are easily influenced and swayed by what seems to be a popular opinion. Most people would agree that it is much easier to be a PART of the masses than to be APART from them.

"What is popular is not always right,
and what is right is not always popular."

When it comes to parenting (specifically birthing and infant care) we are led to believe that our instincts are no longer necessary and that technology knows better than nature. But who profits from this philosophy? Certainly not mother and baby. Instead, there is a very large LITERAL profit to be made off of influencing you in your choices.

There is money to be made off of where you birth, how you birth and also, how you feed and treat your infant. The hospital makes a very large portion of their profit from the labor and delivery ward and let's face it, hospitals are businesses. They do NOT want to lose that money, even if it might mean safer outcomes can occur at home for low risk women. Obstetricians make thousands of dollars off your birth (and prenatal care) whereas homebirth midwives make around $4000 (for both the birth and prenatal care total). A cesarean can cost you more than $20,000 and only costs your OB 30 minutes of work (and a nice early bed time if you aren't "progressing" fast enough). Vaccinations, routine exams and procedures (episiotomy, circumcision, forcep delivery) all take just a moment to do/perform and net a nice profit.

Now, before you stop reading and get angry and tell me I hate OBs and that I think hospitals are evil, let me say, no. OBs are SPECIALISTS. They are INCREDIBLY skilled in saving what needs to be saved BUT for that, I think *most* of them have a difficult time knowing and trusting that birth is normal. If your focus of study is all that can go wrong with something, it's hard NOT to want to act in a precautionary manner. For this, I believe that most OBs truly have women's best interest at heart with certain things. However, there are a few scenarios that are indisputably self centered and dangerous, serving the woman absolutely no benefit.

To continue, it is ignorant to think that every ad or persuasion doesn't have an underlying hidden meaning. Formula companies for example want to make money. They do not care about you and your baby, they care only for the profit. At the beginning, when infant formulas were first introduced, they provided a way for the women who could truly not breastfeed or have a wet nurse a way to provide for their infant children. Again, just like the hospitals, this can be and was life saving for those infants. However, there was profit to be made, a feminist movement of choice and a desire to no longer have to feel tied down to your children...and they marketed that. Today they advertise with such sayings as "Just as good as breastmilk" or "Has all your baby needs!" Stop. Think. Who profits from promoting breastfeeding? The mother and child who nurse. Who profits from promoting formula feeding? The industry.

Am I going to lose sleep over another parents' choices? Nope. But as a parent who did things this way and that way before stepping back and evaluating the choices, I wish only to share the other side of the glass with you. I would never tell a woman what choice she should make, I can only share what I know and what I continue to learn, because I care.

To say that homebirthers are selfish or that it's dangerous, because that is what those who profit from your hospital birth tell you, well...that makes you sound not only uneducated, but silly.

Remember who profits from routine interventions in normal birth: it's not you...and it's certainly not the baby.

How to choose: Midwife or OB?

In America, most mom's don't even ask that question since the norm is to go see an OB (either private or group practice) and deliver in a hospital with all technology at hand. However, more and more women today are educating themselves on their birthing options and the previously normal trend of midwife attended birth is rising. Though still less than 1% of births take place at home, more women are opting for a nurse-midwife (a midwife who has RN training also called a Certified Nurse Midwife or CNM) for delivery in a hospital or birthing center.

Though the ideal place for normal, low-risk pregnancy and birth is home, having a midwife and birthing in a birth center will greatly help a woman achieve a less interventionist birth.

"Why would this be important to the outcome of birth? Isn't this just more a matter of preference?" many may ask. Well, technically, yes, either way you birth is ultimately a choice you have the free will to make. But, it DOES matter and it DOES play a large role in how your birthing experience can and will go. For many women, they want a natural birth simply to feel more connected to their body, more empowered. After all, there is nothing more womanly than birth and breast-feeding. But for some women, it's more than that. It is about the child, and they learn through research and thought just how negatively unnecessary intervention can be to their precious baby. It always makes me laugh to see women watch so carefully what they eat and drink during pregnancy just to pump themselves full of drugs hours before their baby is born.

For the women looking to achieve natural childbirth, the environment in which they deliver is very important. Not only the location, but who is there with them in attendance of their birth. When looking for a prenatal care provider there is a list of things you'll want to make sure are met.

• You want to look for someone who takes the time to listen and answer your questions and concerns without making you feel rushed or degraded. Don't forget, whether you're meeting with a midwife or OB, they work for YOU. You are paying them for their services and though they are there to offer their advice and suggestions, it is all up to YOU what happens.
• You want to hire a provider that connects with you. This is probably the most important thing you will do in your life (giving birth) and you don't want to share it with someone who looks at you as another number or as a meal-ticket. You want someone who is genuinely concerned with yours (and your child's) well-being, someone who understands that your wishes for a natural birth aren't silly and shouldn't be undermined.
  
• You will probably want a care provider who shares your similar views and interests regarding the area of birth. Perhaps your midwife or doctor has had natural births themselves and feels strongly about it, in turn, leading to more support for you. But, don't forget, midwives and doctors are people, and if you are delivering in the hospital, you get the hospital ride, meaning they could be one way during pregnancy, and another way in labor. Always be prepared. This is also why the previous "rule" is important.
• You'll want to ask for the provider's stats. And, if they are associated with a group or specific hospital, ask for those stats as well. It is important to know the trend your provider has. If you're planning a birth center birth, it may not be a good idea to do so with a midwife who's got a transfer rate of 45%. Likewise, if looking for a natural hospital birth, you don't want to hire an OB who has a high cesarean rate (anything over 10-15%). This information is important AND you are damned welcome to it. Any provider that won't disclose this information freely and gladly should make you nervous.
• You'll want to share early in pregnancy what your wishes and goals for your birth are. Don't wait until you are 35 weeks pregnant to say "Oh, by the way, I wanted to go natural.". At that time, your doctor has already built trust with you and probably has their own plans for the birth. Aside from that, it's sort of rude to tell your provider just weeks before birth that you want "this, this and that with no if's and's or but's". Just, be straight forward. When you first meet and share this information, you can also use their reaction and answers to it as a deciding factor in whether or not they are right for you.
• You should question any routine testing/intervention/practices your provider has. Some OB's will hand out a sheet of "what to expect" at different points in your pregnancy (for ex: when certain blood tests are done). Don't be afraid to question or deny a test or procedure, but if your doctor has a pre-printed list for patients, expect that they will probably fight you on your choice to refuse. This may mean that provider is not a good match for you, and you should keep searching. No matter the procedure, you have a legal right to refuse it. Also, your provider cannot legally drop you within 30 days without finding another one to take you on. Gestational Diabetes testing, ultrasounds, amniocentesis, quad-testing, and other procedures are not required, only suggested and ONLY on a case by case basis and if the mother is willing.
  
• You will also want to start saving, preferably before you get pregnant, but if it doesn't happen that way (for ex: if the pregnancy is a surprise) then you can start saving and budgeting early on in your pregnancy. The reason you want to save is not only for the purchases you'll make for baby, but also for your birth. You never know what may happen. Many women discover in the end of their pregnancy that they provider wasn't who they thought (this goes for OB's AND midwives). Women may go from planning a birth center birth to home, some go from home to unassisted, and sometimes late pregnancy complications arise and you could go from out of hospital birth plans to in hospital. Life is full of surprises, so it's no wonder that the journey to bring life into the world is full of surprises as well. Save enough money as you can comfortably, but try to shoot for a figure of a couple thousand.
  

If you follow some of these simple guidelines, not only should you end up with your desired birth, but you should have the confidence to know you made a good choice in care. Remember: your birth is important, and the provider you choose to attend it is a big part of your birthing experience.