Tuesday, April 5, 2011

What does it really cost me to give birth at a hospital?

I'm not saying that hospital births are all bad things, but if you're aiming for a completely natural experience, it's the last place you'll want to look.

What is the natural experience? Well, that varies from each woman. Some women mean it to be a vaginal delivery, some women mean it to be drug free. For the purposes of my reference of the term "Natural Birth" on this blog, I will define it as a drug free, vaginal birth.

The biggest issue with hospitals is often their policies. These policies are written by men and women who are often in offices and rarely, if ever in the actual field of medicine that applies to you. This is especially nerve wracking with birth.

It's typically hospital policy to do the following:
1. Insert and IV
2. Run fluids and/or antibiotics (especially to Group B Strep positive mothers)
3. Insert a urine catheter
4. Labor in bed on the back (which is the worst possible position for delivery)
5. Withhold food and fluids, allowing only ice chips
6. Frequent vaginal checks by multiple people
7. Continual fetal monitoring (external or internal)
8. A strict timeline in which labor must be completed before it is considered stalled and in need of intervention

Hospital births cost approximately thirteen thousand dollars, more in some areas and depending upon the level of interventions placed upon the mother. A home birth or birth center birth would typically cost anywhere within the realm of two to four thousand, including complete prenatal care, delivery and postpartum care as well as breast feeding support. The $13,000 price tag for the hospital birth? That's just for delivery.

If you don't wish for these certain interventions to be placed, you may consider a birth plan. Upon review with your doctor certain items may be negotiated away. Other items however, typically the IV are often considered absolutes with the hospital and can not be prevented.

Many women, including myself, have gone into hospitals for an induced labor and ended up with an emergency c-section. Often because the baby began to show signs of distress, the cord was wrapped around the neck, the mothers pelvis was too small, etc. These are all reasons mothers have been given for the necessity of their c-section, the truth is however that the actual instance of a genuine emergency c-section is more rare than the general public has begun to believe in the recent decades.

The World Health Organization (or WHO) states that a nations c-section rate should never exceed 15%. In 2007 the American c-section rate was over 30%. That's more than double the recommended rate.

The women of America are no different than the women of China, Africa or England, but for some reason our rates are the highest, along with a high ranking* of maternal and fetal fatality in the developed nations. The United States has higher maternal fatality rates than Sierra Leon, the Congo and Somalia.

The last three countries I just listed were some of the lowest in the world* and the most under developed and impoverished.

How does this happen? Since the 80's the U.S. rate of c-section has never dropped, in spite of increases in medical technology. An estimated 40% of induced labors will end in c-section.

The birth process is a natural, instinctual function of the human body. Women are made to deliver babies vaginally, very few can not and for what reasons they can't can be explained with 100% medical legitimacy. When we interfere with the natural process, by augmenting labor, we disrupt the bodies route toward laboring appropriately.

The natural process follows its own path, of a series of contractions, releases of hormones and stimulation of natural devices to aide in labor progression by helping increase the mothers own hormone levels. When we add artificial hormones and medications to trigger these processes on for us, we cause a far reaching ripple affect of less than desirable consequences.

American women believe that birth is painful! And a majority of the time we hear this from a woman who has had a medicated or augmented labor. Birth is painful, but it is not so agonizing that a woman can not overcome it, were that the case we would have destroyed our own evolutions by preventing our kind from reproducing. Induced labor pain is considered inexorability more than that of a natural labor pain.When we introduce pain medications into labor, it stalls out the progress, which introduces the opportunity to aide it with another medication. While we are unable to feel the pain of the augmented labor, our babies are being put under tremendous stress within as the body does or rest or has inadequate time to rest between contractions and having to deal with contractions that are much stronger than what the body would do naturally. This is a majority of the triggers of "fetal distress" which immediately lead to c-section.

Placing a mother on her back is preventing gravity to aide in our births. Only when birth entered the hospitals did it become common place to place mom on her back, with a sheet over her legs to introduce modesty and civility to an animal behavior. We are still mammals, highly functioning, capable of thought and speech but basically animals. Before this new tight upper lip method approached birth, women often labored in a squatting position, pulling on ropes above or leaning against their partners. Inducing the labor of a woman who's body is not ready puts the baby in a less than desirable location. When baby is still very high up and labor is started without the help of gravity, this presents the perfect opportunity for a cord to slip through the vagina ahead of the baby, or around the neck, torso or other limb. This cord presentation reduces blood flow to the baby and also triggers fetal distress.

Babies are meant to float into position with their cords behind them, when the uterus is ready and the cervix is ripened. Cord emergencies of a true nature are not as common as they've become when presenting during c-section births of augmented labors.

So your baby is born, through whatever methods necessary but you're having difficulty bonding. It's normal, you're told, give it time, they say. Again, I revert to the animal argument. Upon birth of the baby, the mother's brain releases a complex combination of hormones which is commonly called the love cocktail. This was an evolutionary imperative that we developed to insure protection and absolute devotion to our helpless young. The maternal bonding instinct is present in many animals, none more than in us. When labor is augmented or birth is avoided completely via a cesarean route, we fail to flip the switch on that wonderful box of love hormones just waiting to be released. The alarming rates of cesarean in this country are beginning to be linked with increasing rates of postpartum depression (also known as PPD).

PPD is a condition that no one should ever be ashamed of or fear getting help for. The feelings experienced under PPD are normal of the condition and can be treated, sometimes, without medication. You should seek immediate help from your caregiver if you are feeling symptoms of PPD, or "the baby blues."

In the end, all that truly matters is a healthy baby and a happy mother right? And each woman has the right to choose her birth. But I implore you to educate yourself if you find your hands holding a belly and your hearts filled with all the nervous joy and fear that all new parents experience. There is no single more important thing in the world that we should research. Know your choices, know the risks and make the informed decision.

Stay tuned to learn more about home birth options!

* Worst in the developed nations according to 2008 findings introduced in a study found in The Lancet
*MMR Global ranking report findings

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