Who do you want on your birth team?

Here's one Q & A exchange — the last one, in fact — from an interview Tara Parker-Pope, who writes the "Well" blog for the New York Times, conducted last year with Randi Hutter Epstein, physician, mother of four and author of the 2010 book on childbirth, Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank.

Q (TPP)  Should the care of women during childbirth be reserved for other women?

A (RHE)  I look at it as a doctor-patient relationship history, more than a man-woman kind of thing. When you hear women say, “I’d much rather give birth with a midwife than a doctor,’’ I think, “Why?” I love my ob-gyn. It’s sad people think you’ll have a nicer person if you avoid the medical system. That’s the feeling you get when you talk to women. I think if women had better relationships with their doctors, I think that would help. They would be more informed. They would believe the information their doctors tell them.

I agree with some of what Dr. Epstein is saying. I loved both my ob-gyns, too. I believe, though, that to choose a midwife for a birth attendant instead of a doctor is to opt for, or at least to attempt to have, a qualitatively different experience.

It isn't just a hope to deal with a nice person. It's embarking on a whole different journey.

What do you think? I would love to hear from you.

Home-birth share small but rising

A study released this week on home birth in America shows a substantial increase in the still very small numbers of women who are choosing to have home births.

The study, released online in Birth: Issues in Perinatal Care, shows that of the 4.2 million births in the United States in 2008, 28,357 were home births. That is 2/3 of one percent of the total, but it represents a 20 percent increase, from 0.56 percent in 2004.

Non-Hispanic white women accounted for most of the growth, with an increase of 28 percent between 2004 and 2008. More than 1 percent of those women now have their births at home.

The study was based on United States birth-certificate data.

Take time for women’s health

This week is National Women's Health Week, the U.S. Department of Health and Human Services' observance of the importance of women doing the things they need to do to stay healthy. The theme this year is "It's Your Time."

Today was National Women's Checkup Day, on which women are urged to make appointments with their health-care providers and to find out what screenings and immunizations they need.

The general message from Uncle Sam to the women of America is the usual good stuff: Eat a nutritious diet, get plenty of sleep and exercise, wear your seatbelt, don't smoke.

This is a great idea, setting one week aside for women, who often are too busy taking care of others to take care of themselves, to concentrate on doing what they need to do to maintain their own health.

What are you doing for yourself this week? I would love to hear from you.

“The Clock Is Ticking”

The Girl Effect, the Nike Foundation's initiative to highlight the critical role women play in the well being of their societies, has a new video, "The Clock Is Ticking," that argues that education can make a huge difference for young women in developing counries.

Four good trends for the world’s women

"Women have long delivered for society, and, slowly, society is at last delivering for women. This is a moment to celebrate—and accelerate," The Lancet editor-in-chief Richard Horton wrote in a commentary that accompanied the publication of a new survey on global maternal mortality the British journal published on Monday.

Four factors associated with maternal mortality are moving in a good direction in many areas of the world, according to the study published this week, which was discussed in the previous post here on Birth Story.

First, the global total fertility rate (TFR), which reflects births per woman, has come down considerably, from 3.7 children in 1980, to 2.6 in 2008. That is a good thing, as the TFR is closely associated with maternal mortality.

Secondly, per capita income is also up, especially in Asia and Latin America. When families have more money, women get more nourishing food, and are more likely to get access to medical care.

Women are also more likely to get some education than they were 30 years ago, which bodes well for a society in which mothers can give birth in a safe environment. Women 25 to 44 years of age in sub-Saharan Africa had 1.5 years of school in 1980, but now have 4.4 years of school on average.

And lastly, women are more likely to have skilled birth attendants in 2008 than they were thirty years ago. "Some large countries such as India have witnessed quite rapid increases in skilled birth attendance in recent years," the study reports.