Monday, January 21, 2008
Here's A Shocker
According to Fit Pregnancy magazine, Kansas City Missouri (my city) finds itself number 44 among cities ranked for the "Best place to have a baby." Find all the particulars on this website. http://www.fitpregnancy.com/bestcities2007/main07 Check it out to see if your American city is on the list. Now this is in no way scientific, its more for novelty. However it does draw attention to some important issues and it does use real numbers gathered from government agencies, private foundations, professional associations and public databases. Of course I'm not surprised that things are so dismal for my city. Fit Pregnancy cites very low breastfeeding rates (both initiation and duration), low access to midwifery care (just 2.6% statewide vs 7.3%nationwide- also low in my opinion), high smoking rates (12%), and low access to daycare. (It also sites our high crime rate and low access to healthy foods). Whew, where do I begin? While I have lots to say about crime and access to quality food (especially in the urban core) my focus is mainly on low breastfeeding rates, and low access to midwifery care. It strikes me that women choosing homebirth almost automatically use midwives and breastfeed. Among women who follow the typical course of perinatal care (OB care and complete or supplemental artificial breastmilk feeding) the skirting of midwifery care and good lactation education and support is almost complete. (Be honest, how many conversations did you have with your OB about breastfeeding?) Here in Missouri, lay midwives are illegal, but even CNMs aren't exactly welcomed with open arms. Doulas are still an anomaly in most places (downright unwelcome in some). Most hospitals around here don't get the importance of hiring LCs and most L&D nurses would just as soon stick a bottle in your kid's mouth than to blow 20 minutes teaching you how to latch. Kansas City's limited options means pregnant women and newborns have limited access to the very things that help ensure positive health outcomes.