Friday, May 21, 2010

On the business of birthing babies *

What do you think of when you hear "natural childbirth."  It conjures of images of a granola-eating hippie who thinks medicine is for the birds and who would rather have the birth of their dreams than a safe birth.  A lot of people liken it to "natural dentistry" and who would do that?  Well, having had both - I can tell you that they are nothing alike.

I'm a huge proponent of natural childbirth.  For me, that means giving birth without the use of drugs and with as little intervention as possible.  This means the woman is allowed to eat and drink, she does not have a mandatory IV, she is not strapped into a bed by monitor belts, she is not induced unless medically necessary, and above all else, she is allowed to take time to give birth to her baby in a safe, quiet and nurturing environment.  A woman's body is designed for childbirth.  It's not like having her appendix out.  Her body was made for this.  Provided with a safe, nurturing environment, and a skilled childbirth attendant, I feel that 9 out of 10 women can give birth to perfect babies on their own.

Now, natural childbirth is not for everyone.  There are definitely situations where a birth should take place in a hospital for medical reason (high-risk women/babies).  Other women just feel safer in a hospital.  Or some women have a great fear of childbirth or pain.  For theses, women a hospital birth with or without anesthesia makes total sense.

But for the majority of women, I feel that natural childbirth is what's best for the mother, the baby, and even the partner. If you are at all interested in childbirth or are having a baby, I highly recommend The Thinking Woman's Guide to a Better Birth by Henci Goer or Ina May's Guide to Childbirth by Ina May Gaskin.   They are fascinating.  I particularly like The Thinking Woman's Guide because it references many, many scientific studies and really gets at facts in addition to philosophy.

There's a reason the US has a higher maternal and fetal death rate than every other Westernized country.

  • We fiddle with the process designed by nature to birth babies correctly and safely.  
  • Lower income women have less access to prenatal care.  
  • Women in this country are no longer exposed to childbirth as a natural, everyday occurrence.  We are taught that childbirth is scary from friends, relatives, and the media.  
  • Society reinforces the medical "god complex" of doctors and medical providers.  No one questions their doctor, even though he or she is human and can make mistakes or have outdated training.  
  • OB/GYN's are by definition surgical specialists in obstetrical procedures.  OB/GYNs are trained specifically for non-normal births to"get the baby out."  They are not trained to "let the baby come out" which it normally does just fine on it's own.

I'm not dogging OB/GYNs.  What they are trained for (emergencies, surgery, non-normal births), they do very well.  However, few if any receive training for a normal, non-interventional birth.

How many of you think an episiotomy (cutting the perineum to enlarge the vaginal opening) is necessary or the baby can't come out?  At the birth center where I had my baby, in all of their thousands of births, they had only ever done ONE episiotomy.  And what gets me, is that many times, a episiotomy may be done without the mother's consent.  Compared to allowing a natural tear, routine episiotomy increases the risk of more serious tears, increases pain and healing time, and make intercourse more painful.  Personally, I think it should be a crime.  But I'm REALLY passionate about this issue.

Yes, childbirth can be dangerous.  But when hand washing and sulfa drugs entered the scene in the early 1900's the maternal/fetal death rated plummeted.  And most women were still having babies at home.  When birth first moved from the home to the hospital in the 1930's, the maternal and fetal death rates shot up again and it continues to be higher than home/birth center births.  Even when you compare only low-risk women in similar circumstances.  Because we fiddle with it!

I'm frustrated by the lousy reputation that natural childbirth gets.  Every scientific study that I've been able to find demonstrates that for a low-risk woman having a low-risk pregnancy, natural childbirth with a midwife is safer and preferable to a high-intervention birth for both the mother and baby.  But even with scientific studies, the American Medical Association (AMA) and American Congress of Obstetricians and Gynecologists (ACOG) issue statement after statement condemning giving birth at home or in a birthing center.  Hospitals are withdrawing physician backup for midwives.  The AMA and ACOG are also lobbying state legislatures to outlaw any births other than those in a hospital assisted by doctors.  To me this issue stinks of money and arrogance.   Doctors don't want to lose money or patients when they've got the market cornered. So they're labeling midwives as witch doctors.

If America was founded on freedom, shouldn't women have the freedom to choose the safest birth they can?  Even if that means without a doctor present?

*If you have any questions on the facts I've listed, just let me know.  Since this is a blog, I'm not listing sources, but I'd be happy to provide references if your interested.  Most, though, are from Henci Goer's book.

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