Natural Selection, what if?

As I was reading a thread today about Vitamin K, I came across a comment from someone who said that, basically, if a baby has low Vitamin K levels, nature has a reason. The poster claims that things that killed babies 100 years ago were no longer a problem due to the availability of antibiotics. Her argument is incredibly ignorant. It led me to wonder, "What if we let natural selection occur?". We see some who are totally supportive of letting nature rule the roost and I can't help but wonder. Do they understand the implications of natural selection?? The old days, what were they like before our medical advances??

Way back around the turn of the century, 100 out of 1000 infants would die. 10% of infants were dying. That number is exorbitant. Now, we're at 6 out of 1000. That is .6%. With there being 4 million live births every year, if we went back 114 years in medical advances, we would have over 400,000 infants dying. FOUR HUNDRED THOUSAND. We lose, roughly 2400 infants a year. TWENTY FOUR HUNDRED. Our infant mortality rate would increase over 99%. That is JUST under age 1. I haven't even touched on childhood rates (but fyi, they're pretty big too). Our rates then were on par with Somalia these days.

When we look at Stillbirths, in 1922, rates were 39.4 vs 2.95 now. That's a 92.5% improvement. We were where Nigeria is now.

In 1907, the mortality rates for children between 1 and 4 were 1418.8 out of 100,000. In 2011, that rate was 26.2. This means mortality rates for this age group have declined by 98%. Your child had a 1.4% chance of death. Those rates are on par with current day Thailand and Grenada.

In 1907, Ages 5-14 had a mortality rate of  307.5. In 2011, that rate is 13.1. This rate has declined by 95%. .3% of children within this demographic would pass away.

So, if we look at this, around 1900/1907, between birth and age 14, we would lose 11,726.3 children, 11.7% of children would die. Now, we are looking at 99.3 deaths out of 100,000 between birth and age 14. We lose .09 percent of our children yearly now. Most of the deaths we have now are within that first year with 2/3rds of them being within the first month of life. If we want to get more technical, we can remove the 2.45 motor vehicle related deaths since there were no cars around 1900. This would bring our rate down to 96.85/100,000. However, if we keep our 99.3 rates, we'll have noticed over a 99% improvement in mortality rates.

Around 1900, our maternal mortality rates were around 1 in 100. Today, it's 21 out of 100,000. There has been over a 97% decrease in maternal deaths. Congo now has the mortality rates we had back then.

In 1914, Average life expectancy for males was 52 while for us women, it was 56.8. Oddly enough, in Nigeria, the average life expectancy is where men were 100 years ago. For us women, that is a current day Congo. Woohoo.

Can anyone tell me why the good old days sound so good?? Our ancestors lived in, basically, third world conditions. Many lost their children, many women lost their lives. What in the world is so good about nature??? We now know if it's not combated, people die. I know, had I lived 100 years ago, I would not have 4 of my living children, if I had even lived to have all of them.

 

More Than A Number

     As everyone in the homebirth debate knows, MANA released their their incredibly cherry picked numbers last month leading to tons of discussion about numbers for intrapartum mortality, c-sections, hemorrhage, early neonatal mortality, late neonatal mortality, etc. Great, we know that only 20-30% of your midwives are honest about outcomes. Homebirth is STILL riskier than hospitals! Big shocker!

However, there is so much that is needed in this discussion. People look at a number and say "Oh, that's small, it's insignificant and means nothing". This mortality rate is 2.06 per thousand. This means that 2 babies out of 1,000 are dying that shouldn't be. I can guarantee this number is realistically higher than what has been shared. That's not exactly where I'm going here, but I digress, higher chance of death every way you look at it. If I recall, a recent study said that there are more brain damaged babies as well. We have all of that to look at. So, keep it in mind. 

With all the discussion, we hear about absolute risk and statistical risk as though its small and insignificant. One huge thing is missing here. I think people are tending to forget that every number we see is someone's baby. I can look and see that although my child is "one of those statistics" (although not really because I know we weren't included in any MANAstats), she is more than a number. People see a number and that's it. There are no cares about WHO that number represents or what happened to that baby that caused it's demise. These are babies, not numbers. If you haven't been touched by loss, maybe you don't understand the impact that it has on all of those who loved that baby. As I see these higher mortality and morbidity numbers thrown around as not meaning anything, I see it as people telling us our babies really don't matter and their deaths are insignificant. That couldn't be any farther from the truth. Our extended families are fairly large (around 82 people) and our daughter's death impacted all of these people, moreso our more immediate families, but impacted nonetheless. If you add in friends, that's one loss that affects at least 150 people of varying ages and degrees. These babies, they're important to many people. I'm still close with many of the girls from my June 08 board and as birthday's start hitting, they all start feeling it. She's important and she matters. Seeing her as just a number dismisses the importance of her and what happened to her. There are many more just like her. 

Our babies are not a number, they are babies with names and families, who had tiny toes and fingers and sweet features that we had to memorize, whose lives were lost when they shouldn't of been. 

 

In Defense of Mothers and Babies, A response to In Defense of Midwives

Shannon Mitchell recently created a blog post titled In Defense of Midwifery. I read this with my jaw dropped. This, it just, it needs it's own post.

I want to address a few things here:

Shannon, you bring up knowing stories of midwives who have been arrested, investigated, have a "bad outcome" that makes the state take notice or parents being upset over the outcome. You nonchalantly say "It happens, it's inevitable, all midwives face it at some point". What you call a bad outcome is an incredibly dehumanizing term. Let's call it what it is- a DEATH or DISABILITY. Most of the time, at home, these outcomes ARE avoidable. If you have all of these midwives being arrested or investigated, there's a reason. It's not persecution of poor little midwives. It's someone caring about the "bad outcomes" the community cares to not address. If the community had a choice, our babies deaths/injuries would be swept under the rug and never addressed.

Shannon, you say this goes beyond various denialist mindsets such as, "it could never happen to me", "there must be more to the story", and "what was really going on". Actually, no, this does NOT go beyond denialist mindsets. If a midwife is educated and trained and knows not to take risks, it very well may never happen to her. Most of the time, there IS more to the story. Looking at the role your midwife buddy may of played in a death or disability is necessary. It's important to question, esp in the midwifery community.

Shannon, you are worried that if Rowan Bailey is charged that a precedent may be set and other midwives could be found guilty of murder. The issue here is that Rowan screwed up. The law states that murder is the unlawful killing of a human by another human with malicious aforethought. One of the definitions of malice is "Reckless indifference to an unjustifiably high risk to human life". So, yes, she has committed murder. Let's be honest, most homebirth deaths are due to a reckless indifference to human life.  A precedent needs set to protect mothers and babies. If the community won't handle this, then the law needs to.

Shannon, you say that one day it will be a fellow midwife looking into a grieving mother's eyes helping her comprehend her loss saying you hope there isn't a DA behind her calling that midwife a murderer. As that grieving mother whose midwife attempted to manipulate her multiple times, I'm of the opinion that midwives have absolutely no business trying to help us comprehend our losses. Midwives have shown us that they are all about themselves as this blog posts blatantly expresses. If there is a DA behind the parents, then yes, that midwife messed up. The DA doesn't get involved if a death is from congenital anomalies! If this death was preventable, oh yeah, they need to be involved!

Shannon, you tell fellow midwives to get off their asses, pull their heads out of the sand, and realize ramifications of this stuff on midwives. Here is where I will agree with you. Yes, the community needs to get off it's lazy ass and start really looking at their fellow midwives actions and see how their "sisters" are harming them. You are sticking up for a murderer and encouraging others to stick up for them as well. You are completely minimizing the actions of these midwives. You are telling every single grieving mother that her baby is unimportant, that only the midwife she had matters.

Lastly, Shannon, you tell fellow midwives to imagine having to tell someone they love and respect that they are being charged with murder in the death of a baby. How about you having to call your friends and family and tell them that your baby is dead? Or how about having to tell people that your decision is why your baby is dead. I have had to look people in the eye and admit that my choice to have a homebirth with a CPM is why my daughter isn't here. I have to look at that person in the mirror every day. I would of never of made the same decisions if I knew the outcome would be this.

Lucky for Shannon, a CPM by the name of Jessica Weed ran to her rescue in the comments about how midwives need to stand in solidarity. Why?? Jessica herself managed to get herself arrested for child abuse because she chose to take on a breech delivery where the baby ended up with bleeding on the brain and behind the retinas on top of mom ending up with an infection due to retained placenta. Wood also asked parents not to disclose her involvement in the delivery.  I certainly don't question why someone like Weed would promote the solidarity ideals!