Pre-natal care post crash

[Chickengirl]

(anyone would think I'm obsessed by pregnancy, babies and birth  )

Chances are that people will still be having sex after TSHTF 

so people will still be having babies.

And we all know that recieving decent prenatal care makes a HUGE difference to the health and wellbeing of both mum and bub before, during and after birth.

And as the majority of us in here are of the female persuasion (although I really welcome any input from the fellas, they need to know this shit too), it'll be US that other women turn to for advice etc about pregnancy, birth, babies etc. Remember the stories of the wisewomen? The didn't just do herbal lore, they were often vet, doctor and midwife to the local community.

Now obviously some things most of us take for granted will likely be unavailable - ultrasounds, blood testing, amnio etc etc all rely on a functioning health system that can afford to carry out that level of testing. Women may not have ready access to that in the future.

So what is going to happen with prenatal care post crash? Have you thought about it?

[tobyjones]

Babies will continue to be born as they have been for ages.  Our infant mortality rate will probably go up from the current .6-1.4% to a more third worldish 10% or so.  I am not sure how much value  prenatal  care has in the absence of modern high tech medicine.  First and second trimester medicine mainly involves education and screening.  If the future ends up being a little on the bleak side then Prenatal care will be more education and less screening (how it should be now anyways IMHO)  Genetic testing will be replaced by "lets see if this one lives" (not meant to be as insensitive as that sounds)

If you don't have a Neonatal  Intensive Care bed on standby when the ultrasound identifies a heart defect or Gastroschisis (abdominal contents on the wrong side of the abdominal wall)  what is the point of doing the ultrasound.  For third trimester medicine like screening mothers for pre-eclampsia, diabetes, Help syndrome, Group B Strep may be possible but more difficult/less precise.  Treatment may or may not be available.

Many more babies will die, Many more mothers will die.  A few children will die after living for a short while with what was once a treatable condition.
Birth plans may need to be changed to include biting a rag in place of epidural.

On the upside I think that birth will become de-institutionalized and we will have more home births and people will become more connected with the miricle of birth (and death)

[kathleen]

We will also see fertility treatment disappear so many of the complications stemming from older, not so healthy moms having babies will be gone. The multiple gestation premies will also be a thing of the past, as well. Enhanced hygiene did so much to lower puerperal fever; if we don't revert back to unsanitary wards with doctors reusing filthy instruments and yanking on placentas to get them out, we should never return to the incredible maternal mortality of the distant past. We need to retain knowledge and this is why midwives/healers will be so important.
This assumes a well fed populace, lacking only modern medical technology and I know that is a lot to assume.

[justanouveaufarmer]

If the future ends up being a little on the bleak side...

   yeah, it just might.

On the border of our farm is a little family graveyard from the 1800's.  There are 3 adults buried there and 8-10 tiny graves.  A lot of them are unmarked.  Some just say Infant and the dates of birth and death.  Others are just a rough little slab of stone with no markings, as if the family was too grief stricken (or poor) to do more.  One headstone is for a two year old boy.  I often wonder how he died. 

On a nearby homestead there's a mother, father, and all 8 children buried just up the hill from the crumbled remains of their old 2 room cabin.  The whole family died of cholera.

It's a fact of nature that everything dies.  Your roses die, your animals die, and you die.  Sometimes your babies die. 

We have this colossal sense of entitlement that if someone dies it's a huge mistake in the fabric of the universe that shouldn't have happened.  That's going to be one of the first things to go.  We won't be crying over our hairdresser making a mistake on our celeb-look-alike hairdo.  Maybe we'll go back to grieving over (and cherishing) the things that matter.

[Ranger]

I really don't think it will revert back to primative times. It will probably be too expensive to have fertility treatments, but I do not feel all we have done and learned medically will just vanish. We are not going to just stop trying.  There will probably be small local care clinics that can be run on different forms of energy besides oil......maybe more doctors who do house calls.

[madison]

Hey, great thread!  I also love pregnancy, birth and infants  

Anyone who has doula training will be well appreciated.  If tshtf in some catastrophic way, then having someone knowledgeable will be invaluable.  You can get certifed as a doula (birth or postpartum or both) by various organizations.  I did mine with DONA (Doula's of North America).  I think the training cost around $800?  I loved it.  It was soooo helpful when I was pregnant a few years after that experience!

It will be a sad fact that infant and maternal mortality will increase.  Malnutrition can create weaker moms and babies, as can stress, and overwork.  All things we may be looking at soon, if we aren't already. 

So many women don't have any clue about breastfeeding.... that is really scary to me.  That is going to be a huge tragedy, and so sad because it's avoidable. 

I'd also like a stethescope.  And a homebirth kit put by just in case some day.  And I'd love to get re-certified as a doula some day.  I have kept all my books and notes.

One book I would recommend everyone find is "Homebirth" by Sheila Kitzinger.  It's awesome!

Another thing to know might be what plants are nutritious to eat during pregnancy that aren't the typical things we find at the grocery store.  What has folic acid?  What plants are hight in protein? 

[kathleen]

Hey, great thread!  I also love pregnancy, birth and infants  

Anyone who has doula training will be well appreciated.  If tshtf in some catastrophic way, then having someone knowledgeable will be invaluable.  You can get certifed as a doula (birth or postpartum or both) by various organizations.  I did mine with DONA (Doula's of North America).  I think the training cost around $800?  I loved it.  It was soooo helpful when I was pregnant a few years after that experience!

It will be a sad fact that infant and maternal mortality will increase.  Malnutrition can create weaker moms and babies, as can stress, and overwork.  All things we may be looking at soon, if we aren't already. 

So many women don't have any clue about breastfeeding.... that is really scary to me.  That is going to be a huge tragedy, and so sad because it's avoidable. 

I'd also like a stethescope.  And a homebirth kit put by just in case some day.  And I'd love to get re-certified as a doula some day.  I have kept all my books and notes.

One book I would recommend everyone find is "Homebirth" by Sheila Kitzinger.  It's awesome!

Another thing to know might be what plants are nutritious to eat during pregnancy that aren't the typical things we find at the grocery store.  What has folic acid?  What plants are hight in protein? 

I read a while back that much of the infant mortality in the 1700 and 1800's was from failure to thrive/weight loss issues. The social trend at that time was to get a wet nurse if at all possible, even for marginally well off folks. The wet nurse would take on as many as 10 babies and, of course, couldn't produce enough milk to keep them all healthy and thriving. So much of human misery has stemmed from going against nature. 

[turnipgirl]

I think the big thing that will help is prober hygiene during the birth- because strep(at least that what I think it is- it's been a while) in the birth canal is like 1 in 3 women I'd make sure that every woman did a 10 day round of antibiotics prior to the due date.  That right there should help alot.

[heathenmom]

I think the big thing that will help is prober hygiene during the birth- because strep(at least that what I think it is- it's been a while) in the birth canal is like 1 in 3 women I'd make sure that every woman did a 10 day round of antibiotics prior to the due date.  That right there should help alot.

Eek!    Everybody has GBS (Group B strep).  Everybody.  If you have an overgrowth, it can cause infection.  In a very small percentage of mothers with a problem, it can cause infection in her baby.  In a very small percentage of THOSE babies, it can cause death.  Subjecting all mothers and babies to the issues caused by overuse of abx to treat a very, very small percentage of babies, while done with the best of intentions, is not the way to go imh (and completely non-medical) o.

Again, imo, the vast majority of women and babies would do quite well with far fewer tests and far better nutrition. 

[thumbclaw]

Ditto heathenmom.  GBS is a red herring to make sure you stay in the hospital system.

Actually, prenatal care is one of the things furthest from my worries.  We are animals, we birth.  And now, thank god, we know to wash our hands when helping other people birth. 

Sure, there will be lots of cases where a baby would have could have maybe survived in a high-tech system and dies in the low-tech.  But the upside is we'll stop treating pregnancy like a disease

Thank god midwifery has started making a comeback here in the US, so there will be lots of women trained and ready to train others to pass on that knowledge.

[heathenmom]

Yes.

[Chickengirl]

Actually, prenatal care is one of the things furthest from my worries.  We are animals, we birth.  And now, thank god, we know to wash our hands when helping other people birth. 

well, yes, and no 

Most women these days know diddly squat about birth and pregnancy (I mod a pregnancy forum, and am active on a couple of others - trust me, the lack of knowledge is extraordinary).

They rely on doctors to tell them what to do, what they can and can't eat, what tests they should have (all of them, it seems, needed or not  ) etc etc. They do more research in the model of car seat they buy than pregnancy and birth. And most of what the doctors have to say tends to revolve around "tradition", and not evidence based care. Routine testing and procedures aren't about health care, they are about arse covering. Testing when the health of the woman indicates there might be a problem? That's a different kettle of fish 

Prenatal care is more than "have this test, pee in that cup". I get great prenatal care from my midwife, and the only "test" I have is a scan at about 20-22 weeks, and some BP measurements. If I showed symptoms that indicated more testing, I'd have them. No peeing in a cup so far

But I get great nutritional info, advice on excersice and movement, on what is happening with my body and baby, my midwife listens to bub, and to the placenta (so she knows where it is and roughly how much bloody is moving through it before I ever get to a scan ), we talk about risks to me and bub with birthing, she provides advice and info about moving into labour and birth, what to expect in the first few weeks afterwards, advice on contraception afterwards, preparing for breastfeeding, and a lot of emotional support with moving into "parent of a newborn" mode again. And it's not only me that gets it, but my partner and our kids too.

That kind of prenatal care is going to be super important. They already know that providing this kind of one on one care increases the outcomes for mums and bubs, especially "at risk" mums (poor, bad health, undernourished, crappy circumstances - all of which are likely to be pretty common, right)

Knowing about the extra nutritional needs of a pregnant/lactating woman is a good idea. So is knowing about how pregnancy affects the body (and the mind  ) - the physical abilities of a pregnant woman are different to a non pregnant woman.

Knowing how to effectively help a women birth is always handy too - patting on the hand and saying "there there, it's all for a good cause" is NOT going to cut it 

Effective remedies for minor complaints, an understanding of what happens when a woman is miscarrying, how to spot signs that things are not progressing as normal (during pregnancy and birth) etc etc - these are all skills that at least one person in the family should know.

turnipgirl - routine meds for something a woman may or may not have is never a good idea - especially since we can never know exactly when a bub is going to be born. The biggest infection risk for a pregnant woman is someone doing an internal examination before or during labour/birth. Knowing how to read the signs of where a woman is in her labour, and listening to her, means not having to do routine internals and massively reducing that risk  Strep B isn't something that is tested routinely over here i think, although I homebirth, so skip most of the "procedures" lol.

[thumbclaw]

of course modern women know diddly squat.  that's how TPTB want the masses.  but you and i both know that it's an unnatural state to be so disconnected from your pregnancy and your baby.  it's not like i learned a whole bunch of stuff about my body.  i just stopped paying attention to modern medicine and found most of what i needed to know was already there.  didn't need books or classes to know how to push a baby. 

and... i'm a scientist LOL.  i'm one of them hahaha.

for #1 i had an extreme medical birth for what was completely normal presentation.  that's a FAIL for modern society.  i HOPE that's one of the first things to go.  Even without a damn crash.... 

[MEA]

What frightens me that that we'll go from people who know nothing about delivering babies, to people who think they know something....

I knew once (got the fig, from WHO) about how many who died in childbirth died from a birth attendent pushing down (or sitting on) or jumping on them to try to  move al labor along.

[thumbclaw]

thank god for selection.

jk

this is why *trained* midwives will be uber important