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  1. #31
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    Quote Originally Posted by Lila123 View Post
    I really question the author of this study. To make a comment that all OBs "...had a tendency to see all births as risky until the baby was delivered." is such a generalisation and factually unsupported. The study could not have proven this as it's a subjective statement.

    Furthermore, some of us choose to see an OB, not because we are "high-risk", but because we feel more comfortable with having continuity of care by one doctor that is a highly trained professional, or even because we just want to go to a private hospital. There could be many reasons.

    The author then goes on to suggest ''There is also strong incentive for surgeons to 'schedule in' women for induced births to make their workload and patient flow easier.'' Most OBs accept their job as being 24/7 and cannot possibly "schedule" all their patients to be induced, so therefore what is the incentive really to induce some of your patients, you will still have a large proportion of patients that go into labour spontaneously and naturally. Can hardly see how you could really manipulate your workload that much to make a real difference.

    I can only go by my experience and that of many, many of my friends and colleagues that have birthed in private hospitals and the majority of us had vaginal births. My OB for example does not perform elective C-sections (I know because I have asked). In my last pregnancy, when I was over my due date, she said I would have to wait at least 5-10 days before she would induce me. During my labour, when I was finding it really difficult and begged for the vacuum, she wouldn't use it. I really don't think she is unique in this respect. I believe most OBs prefer not to do c-sections unless they have to, due to the higher rate of complications that potentially can occur, there is more risk & liability for them. I guess I just think it is a bit of misnomer to think all OBs prefer intervention. Either way, it's all about choice and personal experience.

    I don't think the author of the study is suggesting that Obs *like* doing c/s, just that women under obs care will be more likely to have one- which they are. The author suggests this is due to seeing birth as 'risky', as opposed to the midwifery model which sees it as 'normal'. I would also argue litigation plays a big part, not sure how it all wOrks but I imagine a private Ob will be sued personally, whereas a public Ob might have the hosp sued instead. So private obs are more likely to e that little bit more cautious.

    The article also did not claim women see obs coz they are high risk- the opposite in fact. If you are high risk you SHOULD be seeing an Ob, and intervention will possibly be NEEDED. Like you said many women go private so get the private hosp experience and continuity of care. If this was offered in the public system by midwives I have no doubt more women would choose this option. Unfortunately apt of these women are low risk and walk out of hosp having had interventions that were not needed.

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  3. #32
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    Default Private hospital births: 'horror' figures

    Quote Originally Posted by wannawannabe View Post
    It's stuff like this that makes me ambivalent about starting work as a midwife.

    Yes we know that research shows that induction/epidurals lead to higher intervention. Whatever.

    Why can't people respect that everyone has a right to make a decision for they want/need and whether thats a natural waterbirth at home or an elective caesarean section in a private hospital - who cares!!! Does how Sally from down the road birthed her baby actually effect you whatsoever?

    Its the same with breastfeeding/bottle feeding. Who cares as long as the baby is fed, mum is happy and decisions were made based on information and noone was pressured/felt pressured into doing anything.

    I wish people could just get along (this goes for midwives/ob's) and instead of seeing as each other as hippy freaks or scalpel happy, respect each others professions and the right of the woman to chose either for her pregnancy care.

    Vent over.
    Exactly this!!

    Oh and maybe just maybe private hospitals have higher such higher intervention rates is bc that is where is where you go if you can afford it, as the public system is not as elective cs friendly.

    And even if someone is low risk they should not be forced to go without an ob, if that's what they want.
    All my experiences with midwives have been a nightmare - I may be biased!

  4. #33
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    Default Private hospital births: 'horror' figures

    Quote Originally Posted by wannawannabe View Post
    It's stuff like this that makes me ambivalent about starting work as a midwife.

    Yes we know that research shows that induction/epidurals lead to higher intervention. Whatever.

    Why can't people respect that everyone has a right to make a decision for they want/need and whether thats a natural waterbirth at home or an elective caesarean section in a private hospital - who cares!!! Does how Sally from down the road birthed her baby actually effect you whatsoever?

    Its the same with breastfeeding/bottle feeding. Who cares as long as the baby is fed, mum is happy and decisions were made based on information and noone was pressured/felt pressured into doing anything.

    I wish people could just get along (this goes for midwives/ob's) and instead of seeing as each other as hippy freaks or scalpel happy, respect each others professions and the right of the woman to chose either for her pregnancy care.

    Vent over.
    Exactly this!!

    Oh and maybe just maybe private hospitals have higher intervention rates is bc that is where is where you go if you can afford it, as the public system is not as elective cs friendly.

    And even if someone is low risk they should not be forced to go without an ob, if that's what they want.
    All my experiences with midwives have been a nightmare - I may be biased!

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    Quote Originally Posted by sparklebug View Post
    Exactly this!!

    Oh and maybe just maybe private hospitals have higher intervention rates is bc that is where is where you go if you can afford it, as the public system is not as elective cs friendly.

    And even if someone is low risk they should not be forced to go without an ob, if that's what they want.
    All my experiences with midwives have been a nightmare - I may be biased!
    Best care and best experience is different for each people.

    I just went camping through the Canadian Rockies and had a blast. I know plenty of people who's idea of camping is 3 star hotels and would have stayed at the hotels along the way. Doesn't mean my trip was the better way of doing it nor does it mean there's was. It was what suited us best.
    Last edited by wannawannabe; 10-09-2012 at 16:58.

  6. #35
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    It says that 35% don't have any intervention in public hospitals. That is pretty high as well.

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  8. #36
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    Yes, it is. I think that's why some public hospitals are now looking at one midwife, one woman style care.

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    'We have no idea if the women in this study were choosing interventions … because the researcher did not ask women that" -

    This is telling as well. Also- the term "elective c/section" - it is a stupid term. I had an "elective c/section" -that was needed for a valid medical reason, and if I hadn't hat it I had a 35% chance of neonatal death. To me that isn't elective at all, it had to be done, there was no question.

    Terminology really needs to change, sometimes elective really is elective for not much reason whatsoever, but sometimes elective is a must. .

    I do believe one thing though - I believe that all women should be able to birth however they want, even if it is a c/section, even if it is a freebirth. At the end of the day - it will never go really well unless you are 100% happy with the way you are giving birth.

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    Default Private hospital births: 'horror' figures

    Quote Originally Posted by sparklebug View Post
    Exactly this!!

    Oh and maybe just maybe private hospitals have higher such higher intervention rates is bc that is where is where you go if you can afford it, as the public system is not as elective cs friendly.

    And even if someone is low risk they should not be forced to go without an ob, if that's what they want.
    All my experiences with midwives have been a nightmare - I may be biased!
    Maybe they do go private to elect a c-section, but how does that explain significantly higher rates of induction, episiotomy, instrument delivery?

    And episiotomy for cultural reasons, never heard of it, but don't think it would increase the rates significantly, plus they would still be able to get one in a public hospital.

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    Default Private hospital births: 'horror' figures

    Quote Originally Posted by nat11 View Post
    It's comparing apples to oranges in my opinion. There are so many variables at play here that it will always be a biased result. For a start (and this is through the observations of the women in my community and our 2 local hospitals) one is more reactive and the other is preventative (which does require a bit more intervention at times), the two are socioeconomically different (many of the wealthier career women go private because 1. They can afford to, 2. They are sometimes older and therefore higher risk, other people want to be able to have a better choice (e.g partner in the military or FIFO and want a social induction or c section so that they can be there). There are so many more variables to consider here.

    There are also those (like me) who believe that continuity of care you get when seeing a private OB is of the utmost importance due to a previous experience where a lack of continuity of care in the public system was solely to blame for a missed diagnosis which would in normal circumstances require intervention for safety of mother and child. Sure I got a drug free natural birth in the public system (because by the time they realised they needed to intervene it was too late due to an extremely fast labour) but that certainly was not the best thing for DS and I. In fact a friend of mine lost her baby during birth in a very similar situation to mine. For me, I choose safety over low intervention rates.
    You can have continuity of care without having an ob.

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    headoverfeet is offline The truth will set you free, but first it will **** you off. -Gloria Steinem
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    Default Private hospital births: 'horror' figures

    My private hospital birth was pretty intervention free I was augmented (I had my waters broken) but I had an audience of 4 midwives because they told me they rarely get to see a natural birth! Says a lot


 

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