Saturday, June 11, 2011


Recently, on The Unnecesarean, there was a post about how 94% of US births had "complicating conditions" in 2008.

Now, as some astute commenters pointed out, complicating conditions does not mean exactly the same thing as complications. Complicating conditions does include things like hemorrhage, episiotomy, etc. - things going wrong and injuries - but it also includes things like the patient being of "advanced maternal age," very minor first degree tears that don't need repair, etc. Basically, any deviation from "mother in her 20s, hasn't had too many kids, spontaneous physiological delivery over intact perineum" gets put into the "complicating conditions" box.

Now that that's clarified, I'd like to look at the two major opposing viewpoints in the comments.

(1). A lot of these aren't real "complications." I mean, a woman over 35 who otherwise has a perfect birth gets put in the "complicated" box just because of her age. Many, many of these "complicating conditions" are either nothing but the hospital's definitions, or they are caused by the hospital. How ridiculous is it that the hospital treats 95% of births as complicated, when birth left to its own devices might be uncomplicated, if not 95% of the time, probably at least a good 80% of the time! (That is a totally made up but vaguely-ballpark stat.)


(2). Look how complicated and dangerous birth is! How ridiculous it is to "trust birth" when something goes wrong 94% of the time. This is proof of how inherently unsafe birth is, and of how much would be going wrong if most births didn't take place in hospitals with modern medicine.

Neither of those are direct quotes, and #2 is certainly exaggerated beyond what that commenter would probably actually say, but I think that both of these little "summaries" describe pretty accurately how the extreme camps feel.

I just think this is an interesting example of how two people can look at the same fact and draw wildly different conclusions about it. One group looks at "94% rate of complicating conditions" and concludes that hospitals make normal birth scarier than it has to be to justify their control of it. The other group looks at that 94% and says, look how scary birth is, hospitals need to be in control of it!

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