Differences in attitudes to childbirth???

Question

I've been noticing the differences in attitudes towards childbirth between the US and the UK. There are so many differences! All uncomplicated pregnancies and births are attended by midwives in the UK as a matter of course. In the US all care is provided by a OBGYN doctor and births seem to be more medicalised. In the US inductions seem far more common, especially between 37-40 weeks, whereas in the UK a healthy pregnancy would not normally be induced until after 42 weeks. I've also noticed that in the US even spontaneous labours are speeded up with the use of hormone drips and breaking of waters, seemingly far more often than in the UK. Attitudes to pain relief seem different also, with epidural anaesthesia seeming to be almost the norm in the US whereas in the UK it's usually a last resort. Home births seem far less common in the US also, why is this??

I just wondered if anyone else had noticed this. Why is it this way and which model of care do you think is preferable???

Tess192, I never slated the US. Read the question again. Calm down hun, good luck with your birth.

Answer 1

Oh, good question.

You might like the movie trailer here:

http://www.pregnantinamerica.com/

I'm in Canada, which is in between the US and UK on loads of things, childbirth included. I'm frustrated by the US similarities, assuaged by the UK ones, on this.

Two salient points:

1 The US has bizarrely high infant mortality rates.

2 Americans are pretty thoroughly schooled in the idea that theirs is the greatest country going.

It can't make it easy to question things. I lived there for a few years, and though the health care system was horrible. That with good insurance. I'm not saying Canada's is flawless, or that I haven't heard horror stories about the NHS; they've all got problems -- but it's the Americans who've been sold a very expensive bill of flawed goods. Well, different. Comparisons between Canada and the US usually bring up -- well, here, I'll let somebody else do the typing:

"Canada has achieved a wonderful thing, which is universal health-care coverage, but it has achieved it at a price, and that is quality of care. Canadians will argue until they're blue in the face that, in fact, the sacrifices in quality care are not that great. That is, I think, a lie. There are critical sacrifices that have been made and you can argue whether those sacrifices are worthwhile or not. I happen to think that they're not. And I would rather live in a system--and perhaps this is simply a difference with me--I would rather live in a system with the economic fear, knowing that in extreme cases I'm likely to get world-class care than the reverse."

http://www.washingtonmonthly.com/features/2000/0003.gladwellgopnik.html

The machines are very important there; it is frequently viewed as better to have absymal basic/preventative care, so long as you don't have to wait for an MRI. Different priorities, and ones that don't happen to go very well with childbirth.

More from the same article; sorry about the length:

"That suggests to me that the ideal health-care system for a man is very different from the ideal health-care system for a woman. In fact, what a man wants from a health-care system is a health-care system that is acutely oriented, not chronically oriented, that is much more interested in quality of care, much less interested in access. A man doesn't need access to care until he's very old. He wants a high end, super-specialized system that when he has something seriously wrong with him fixes it right away. A woman, on the other hand, wants a system that's low tech, that sacrifices quality for a kind of presence. She can go to the doctor three times a month if she wants to and get a personal relationship with that doctor.

The Canadian health-care system is a health-care system for women. The American health-care system is a health-care system that is perfectly situated for men. It's the male health-care system. This whole debate about what is better, the American system or the Canadian system, is essentially a variant on the gender war. As a man, I am infinitely better off in America than I am in Canada. Were I a woman, I would be much happier with the Canadian system, where I can go and see my ob/gyn for free, day in and day out if I wanted to, than I would be in America. I think once you think about those systems that way it sort of clarifies what's wrong with each. The Canadian system is not a good system for men.

There are two things that America developed that would not have been developed without Americans: trauma care. The idea of sending in a helicopter to pick up someone who was in a car accident and getting him back to a helipad at a hospital, rushing him downstairs and dealing with him right away. That comes out of the Vietnam War. That is an American invention, and it has saved thousands of lives. It has saved male lives."

That "it saves lives" is critical. Ask about home birth here, and you're told a story in which person X had their labour stall, and "needed" an "emergency" c-section, so wasn't it great that they were in a hospital that could do that? There's some mental block over the idea that not having been in the hospital in the first place would've meant no induction which led to the "emergency."

(Plus, in the States, you can just sue...! Sorry.)

I was/am freaked out by all the things Americans have to worry about -- why on earth, I wondered, do you have to put that you want to move around, that you want to eat and drink, in your birth plan? Then I realised I didn't have to worry about most of them in Canadian hospitals. But. It's still weird, and very unfortunate.

I've been wondering lately if people who like lousy birth options deserve lousy births. I realise that's a horrible thing to say; it doesn't keep it out of my mind, though. I read the slags on midwives and home birth from Americans who don't know the first thing about it, ones who really like the pregnancy-industrial complex and subscribe to every bit of obstetrical nonsense thrown their way, and think: "I wonder that you don't deserve that routine episiotomy..."

Answer 2

My opinion here is it depends allot on the individual, I have three kids, my first i was 20 and I was 41 wks when my waters were broken soon after I started to complain wanting pain relief.. I had a few things then an epidural.. worst labour could have slept when she was half way out, be rest assured if a specialist is required ie. complications there will be green coats all around before you can say boo. (that happened with her) The epidural was terrible and i was in so much pain afterwards. My second baby (all were in different hospitals) he was easier and quicker, I believe the pain relief was the reason my first was so long (14hrs), I only had one sook of gasinair with my second which made me sick he arrived only 4 hrs later, My 3rd who is 2 now was a walk in the park,, the midwife was gobsmacked i didn't want pain relief and id tell her i was having a contraction she would disagree, I told her I wanted to push she disagreed, I told her the baby is gonna ***, she gave me a internal she said you will be a few hours yet, i at that point held my partners hand the midwife took of her gloves and i raised my voice and started to sit upright !no its cumming look" she nearly fainted i was fine n my third almost hit the bottom of the bed. I didn't even stop for his shoulder's. I gasped n lay don and said to her "see I told you" but each birth the staff were great.

Answer 3

Honestly? I think it comes down to money. Healthcare is way different in the US than the UK. In the US most everyone has private insurance. Doctors can do all kinds of extras to get all kinds of money, whereas when its standardized, they know they'll only get a certain amount of money regardless of what they do. I too have noticed that c-sections and inductions are done more and more for the convenience of the doctors. I was in hospital last weekend with kidney stones. Since I'm pregnant, they sent me up to the labor and delivery ward. There were 3 girls that came in during the night and labored through the night. All 3 of them ended up with sections by 9am the next day. All of them in a row. I'm almost certain that it was cuz the doctor was ready to get home for his weekend. He rushed my discharge against the wishes of my urologist so he could get going.
I've heard good and bad about midwives and doctors. I think you just need to find the right person for your needs and comfort level. I will be giving birth in a hospital but will be hypnobirthing, which is considered "alternative." I'm rolling my eyes here. I don't think women in the US have a firm grasp on their rights and options. Just my two cents

Answer 4

Because women in the US have been scared into thinking pregnancy and childbirth are dangerous and need medical attention and that a women's body is not capable of doing this on its own. They treat pregnancy as an illness and childbirth as a surgical procedure.

my first child was born at home. I had a fabulous midwife attend the birth. She took great care of me, she became more than just a provider, she became a friend. (seven years later and she still invites me to her parties). She spent time with me, however much I needed, to talk about my concerns. All my friends and family got to attend the birth, it was a family event. when she came for the birth she came with eveything she needed including oxygen tanks in case someone needed it. It was a beautiful experiance compared to my second childs birth which took place in a hospital because my midwife didn't think I should deliver at home this time. It was a miserable experiance! I can't even begin to tell you how awful it was compared to the homebirth

In North Carolina, where I live, midwifery is illegal. In most states it is not but the midwives in those states have to work under the supervision of a doctor instead of their own judgment calls. Its crap, really. I think the only way to change this is to spread the word. So when I get the chance I tell anyone who will listen: HOMEBIRTH IS THE WAY TO GO!!!

P.S. last time I looked Japan had the lowest infant mortality rates in the WORLD. why? the same reasons you mentioned above, women go about having their babies the way nature intended and if (and only IF) they need medical attention do they see a doctor.

Answer 5

From what I understand I feel grateful that I gave birth in the UK. Someone said doctors are better equipped than midwives to deal with labour - what rubbish! I would rather have a midwife, someone who has done 4 years general nurse training then spent another 2 years specialising or one of the older ones who have delivered 1000's of babies than a stressed out doctor who is rushing to his next appointment. Many midwives are also mothers and who understand what your going through better than someone that has already been through it?

I was 10 days over my date and delivered a 8lb 12oz baby vaginally with no complications. If I had been in the states it seems I wouldn't have been giving the chance to get that far, induced and probably sectioned for no real reason.

I'm still a little sceptical of home births and don't think I would opt for one myself but I think its great that woman here have the right to choose.

And that's whats important here, for the woman to be in control to what is happening to her body as much as possible.

Answer 6

Good question. All I can think to answer is that with all the technology and medical advances, many families feel safer at a hospital since they're in a medical environment. Many women have preconcieved notions about midwife care such as it's outdated and harsh-why go through the pain when you can have meds to make it go away? All in all I think women in the US feel safer and more comfortable at a hospital just in case something goes wrong. I will be having our baby in a hospital b/c hubby's in the military and I like my doctor and the facilities...plus, the neighbors might not like all the noise I know I'd be making if we did a home birth. Even if a woman gave birth at home, she'd still need to go to the hospital later to make sure everything's okay. All the prenatal classes and tours are designed to get women comfortable with the birth process...as far as that goes, it's undoubtably safer in a hospital. As far as inducing goes, I don't think a good, licensed physician would induce without a good reason. Remember the due dates are an approximation-the baby could be further along than it looks! I'm 19 weeks tomorrow, and if we went by when I know the baby was conceived, s/he's be 21 weeks. There's no physical way the baby's only 19 weeks, but that's the dating they gave me for the baby's size...so that's where the discrepency with the weeks comes in. Hope that helps.

Answer 7

I totally agree with you. The UKs methods are far more effective than the US but in the US there are so many law suits going on that the doctors like to protect themselves by doing things the way they do. I would hate to give birth in the US if I couldn't do what I can over here in the UK but saying that, I haven't been in the US when any of this is going on and what we see and hear may not actually be what happens in labour rooms.

In reference to the answer above mine-we do give birth in hospitals surrounded by midwives and if something goes wrong then a doctor is called, we dont give birth in caves where no help is available!

Answer 8

There are huge differences between the US and the UK and personally I think the UK has a better idea. Midwives are a much better alternative and the US has too many drugs and inducing labors for convenience Birth should be much more natural-not like some kind of disease.

Answer 9

I never noticed this theory, but it is a very interesting one. I am a believer in natural birth, no doc's or pain relief but only in cases of emergencies. Woman has been giving birth for thousands of years it is a natural process and should not be speeded up for convienience how did they do it in the 17th century??? no paain killers then it seems. I really like your observations

Answer 10

US doctors are trained to minimize risk, not maximize care. They potentially have dozens of patients delivering on the same day. Intervention rates (epidurals, c-sections, epesiotomies) exceed 80% in the USA. It is all for the doctor's concern over time management, avoiding lawsuits and profit.

There used to be terrible, untrained, midwives in the USA which gave the profession a bad name. The doula industry is starting to change this in the USA.

We recently had a daughter delivered by a widwife in the hospital (in the USA). It was a much nicer experience than going through a doctor. She had a physician as her backup and we were already in the hospital in case anything went wrong.

In general, Americans know very little about their medical options. What they learn about delivering a baby comes from watching television soap operas.