No medical care, and therefore zero medical errors: live until 62, die of something trivial.
Average Cuban life expectancy: 78
High priced and highly available medical care doesn't always buy the outcomes one would expect.
Source: https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...
http://www.slate.com/articles/news_and_politics/explainer/20...
i would like to see a survey of the actual number of invasive medical procedures done per capita today compared with say 1950 and 1900.
That includes what are today routine things like being put under for wisdom teeth extraction, joint repair and replacement work, reconstructive surgeries, cosmetic surgeries, skin cancer removal, etc.
Routine preventive medical care with no fee-for-service perversions creating incentives to over-treat, perhaps more errors, but each of lower consequence: live to 95.
I'm not saying that pregnancies shouldn't benefit from advancements in disease detection to prevent potentially fatal outcomes. It's not a black or white situation.
Inducing labor to prevent a fatal outcome during birth and inducing labor because you want to be at a party/whatever the next week aren't the same.
No but it increases a patient's comfort. I'm going to assume you've never given birth because it's exceptionally painful and can last over 30 hours (especially if it's the first baby). Pain management is huge in medicine and many people are willing to take risks.
FYI being able to properly manage the pain actually can save lives though those statistics are far harder to get. For instance extreme pain during child birth causes some mothers to pass out which, if the baby is in the birth canal, can be incredibly dangerous. I've seen this. It's very scary.
> scheduling c-sections don't reduce mortality rates.
Absolutely false. The vast, vast majority of the time you're scheduling a c-section because the mother has a complication that could put her or her baby at risk for a normal birth (previous c-sections for instance; extremely dangerous to try a v-back for many women).
Maybe there are some doctors who schedule it just because but that's an exceptional case, statistically.
Naturally, I asked him to leave, and the birth was attended by some quite reasonable nurses. The only way to survive American health "care" is to know your facts and advocate for your own interests. The average physician in this country is mostly interested in billing you and moving on.
I never said it wasn't real I simply said it's in a minority of cases because it is. I've met dozens of OBGYNs who all think needless c-sections are simply unethical and who would never do them. But just as your experience mine is yet another anecdote.
c-sections in general are not a majority of births. Needless ones should be a subset of that (though because of the way reporting is done it's hard to determine which ones are and are not needless).
Hospital Name City State Rate
-----------------------------------------------------------
Hackensack Medical Center Hackensack NJ 41.8%
HackensackUMC Mountainside Montclair NJ 29.8%
Holy Name Medical Center Teaneck NJ 16.1%
Morristown Medical Center Morristown NJ 30.1%
Obviously, if a hospital is specializing in C-sections, it will handle cases where the likelihood of having a sectino is much higher.
(Similarly, hospitals are very dangerous places if you compare the death rate in a hospital to the death rate at any other place where people stay. Of course it's mostly not because hospitals kill people, it's mostly because people go to hospital when they are sick.)
This is purely a hypothesis, however.
See: https://www.statnews.com/2015/12/01/cesarean-section-childbi...
In actuality, measuring the C-section rate is one way to measure the quality of a hospital. Of course, the morbidity of the population must be taken into account, but it is worth noting that a C-section is a surgical intervention with much higher associated costs and pay.
* Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to help ensure an adequate blood flow to your baby. If there is a sudden drop in blood pressure, you may need to be treated with IV fluids, medications, and oxygen.
* Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries and episiotomies.
Try doing a hit of fentanyl via IV and see what your blood pressure is.
I hate the way the medical community makes words like 'may', 'could' so intentionally vague. Could mean 90% chance, could mean 1%, depending on the context. It's like speaking a doublespeak.
Obviously c-sections that are not planned are needed
Um, what? So let's walk through a scenario here. A woman has an issue where she had to have an emergency c-section in a previous birth. So far you're okay with that, right?
Okay now this woman is having a second child. Conducting a v-back can be dangerous (it's at least a higher increase of complications from a vaginal delivery especially if the previous c-section had to be more invasive than normal). So the doctor schedules it, typically at about week 38 to avoid natural delivery kicking in.
So you are saying that, in my scenario, the scheduled c-section is "elective" and not "medically necessary"?
That's a really wrong viewpoint. Kinda dangerous really.
> Women have given birth for a long time without medical intervention, using competent mid-wives[.]
My dad works in international development and has spent a better part of his career working on programs in Bangladesh to get people to use hospitals instead of mid-wives. Now rich people in the United States are using mid-wives instead of hospitals. It's pure insanity.
Would your dad be able to share his thoughts on this?
While your assertion is technically correct, this singular take is a misleading characterization of the source you linked. Per your source:
> Perinatal mortality was higher with planned out-of-hospital birth than with planned in-hospital birth, but the absolute risk of death was low in both settings.
More specifically
> adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54
I'm not sure this necessarily follows your original description of "pure insanity."
And that's with the status quo of only the healthiest pregnancies being candidates for home birth. It'll only go downhill as it becomes more prevalent.
> Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P=0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth. Planned out-of-hospital birth was also strongly associated with unassisted vaginal delivery (93.8%, vs. 71.9% with planned in-hospital births; P<0.001) and with decreased odds for obstetrical procedures
Also, 1st world homes are significantly sanitized when compared to other homes.
Can you explain what part in particular about this is insane? My wife is 9 months pregnant and our hospital has midwives on staff. Having a midwife doesn't preclude going to a hospital.
Giving epidurals is pain management, and managing pain helps the mother do what she is being coached to do (and manages adverse stress reactions that the body has as a result of pain), so I'd be surprised if it didn't reduce mortality, though the effect is probably small.
Scheduled C-sections are often because of early-identified risk factors of vaginal delivery; they certainly do reduce mortality rates.
And they were dying in droves: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm (Figure 2); http://www.cdc.gov/mmwr/preview/mmwrhtml/00054602.htm (Figure 1).
Maternal mortality decreased from 700-800 deaths per 100k live births at the turn of the century to less than 30 in 1967, and 5-10 by 1996. Hospitalized births is one of the, if not the most astonishing triumph of modern medicine. It's bigger than the advances in cancer treatment and HIV put together.