Once again, the Childbirth Connection website comes to the rescue. You can download the first
Listening to Mothers survey report, which was carried out in 2002 and covered women giving birth in 2000-2002. In it you will find that most women thought that the natural process should not be interfered with unless necessary. Nonetheless, most women were subjected to numerous practices and procedures for which there is no evidence of benefits with frequent or routine use, but there is evidence of harm. Most women were also ill-informed about the adverse effects of epidurals, which would make it impossible for them to make an informed choice on whether to have one.
Listening to Mothers 2006 reports on women giving birth in 2005. Nine percent of women reported feeling pressured by their care provider to agree to a cesarean, 11% felt pressured to agree to an induction, and 7% to agree to an epidural. This time, the survey asked questions about the adverse effects of cesarean surgery. Most women either did not know the answer or gave an incorrect answer.
As to what I think about the system, the picture I see is a bleak one. One can only conclude that something has gone horribly wrong in a system where nearly 1 in 3 women overall and 1 in 4 low-risk first-time mothers give birth by major abdominal surgery with all that entails in risk, pain, and consequences for future reproductive health. No reasonable person can think that this percentage of women need surgery in order to be healthy women giving birth to healthy babies. And, as Listening to Mothers documented, the cesarean surgery epidemic is the tip of the iceberg. Few women having hospital delivery escape without being inappropriately subjected to at least one and usually several procedures, drugs, or restrictions with potential for harm.
Moreover, there is no internal mechanism for putting things right. The system does not hold care providers or institutions accountable for management practices that are unsafe, ineffective, or generally both. Care providers are not held accountable for providing inadequate, no, or misinformation to women. Nor are they held accountable for unethical practices such as using coercion or threats to achieve compliance or for human rights violations such denial of VBAC, which forces women to agree to surgery in order to obtain medical care. And, as the recent NIH conference showed, those who should be in the forefront of trying to improve care practices have completely abrogated their responsibilities to advocate for what best preserves the health and well-being of mothers and babies.
To blame the victim for this debacle simply adds insult to injury.
-- Henci By: Henci Goer