For millions of years, humans have been procreating and multiplying throughout the earth without the use of drugs and medical interventions, at least until modern times. The Industrial Revolution created the need for a cleaner childbirthing environment, since urban and lower class women typically lived in dirty, cramped spaces, unfit for delivering babies. This is when hospitals became the new alternative clinical setting for laboring and birthing in our country, and thus began the medical approach to childbirth. Today, it is basically the same in most developed countries all around the world. The Stanford Encyclopedia of Philosophy describes the situation well:
“Pregnancy and childbirth have become increasingly medicalized in most parts of the world since the early twentieth century. That is, they are increasingly processes that—in fact and as a social ideal—are managed and overseen by medical professionals, typically involve a high degree of technological medical intervention and contact with clinics and hospitals, and are assessed by medical experts who are the authorities on their progress.”
How and why did this come to be? And is it really even healthy or necessary? We now live in an age, where people in most developed countries enjoy a quality of life that would allow for childbirth to occur at home, or at least in a more home-like setting, with little to no medical intervention. It seems that if our health care professionals in the medical industry today really had an interest in community health, the prevalence of medicalized hospital labor and delivery, i.e. medical interventions, would be waning, not increasing. But the truth is that the medical industry has financial interests involved, so the intervention-based standard of care in most hospitals continues on, almost unchanged. Despite plenty of evidence that homebirth is just as safe, if not safer than hospital birthing, the industry as a whole is just not supportive of the idea of women taking charge of their birthing experiences and having their babies at home if they so choose.
Fortunately, there has been a sort of grassroots home birthing movement building for some time now, steeped in the ancient tradition of midwifery, which has steadfastly stood up for the rights of women to birth naturally in a comfortable, positive, and supportive setting, and most importantly, without fear. In the seventies, home birth activist and spiritual midwifery pioneer Ina May Gaskin founded a hippie commune and midwifery center called The Farm, in southwestern Tennessee, with exactly those goals in mind. Ever since, Ina May has been unapologetically criticizing the practices of conventional American maternal care and the problems of infant and maternal mortality, which she has said is both insufficiently and erroneously reported; and is much more easily preventable than our medical institutions seem to want to recognize. In a 2008 article on the subject, she boldly proclaims:
“Like most people raised here, I accepted without question the story that modern medical advances have brought the maternal death ratio (the number of deaths directly related to pregnancy or birth per 100,000 live births) to such a low point that the problem of preventable maternal death could be considered solved. Only after I had been a midwife for more than 25 years was I finally shocked out of my own complacency about the safety of becoming a mother in my country compared with others.”
It is a complicated issue, with many different factors, but in the last few decades the statistics consistently show that the maternal mortality rate in the U.S. is not only higher than in any other industrialized nation in the world, but the number of deaths associated with childbirth are continuing to increase. It is partly a matter of economics and access to care, but another large factor at play in this problem is the approach to maternal care overall. Women simply aren’t empowered by medically-facilitated, fear based techniques employed in the hospital setting. Midwives are not usually provided with standard care, and labor and delivery nurses mostly just monitor patients and administer drugs. And while having a doula present to help advocate for the mother and ensure that her birth plan is followed is a great idea in theory, hospital policies can be so aggressively enforced that first time parents can be made to feel completely powerless in the birthing process at your average hospital.
In my own experience, my wife and I began parenthood by birthing premature twins five days after finding out we were having two at once, and in a hospital setting we were unfamiliar with, after months of planning to birth naturally at a freestanding birth center. Though we were able to birth naturally, and without much intervention, we were made to do so in the overly bright and stressful setting of an operating room, under threat of having a C-section if the babies didn’t come quickly enough. After the first child was birthed rather effortlessly, his twin brother was coming out breach, and instead of giving my wife opportunity to move about and labor, the doctor simply reached inside and pulled our second son out by his feet. Not only was she forced to labor on her back and without stirrups (even though they were offered), but hospital staff insisted that she remain covered by constantly throwing towels over her, even though it was her instinct to remove her clothes as she was feeling claustrophobic. It was a traumatic experience to say the least, and though there were risks involved with our pregnancy and we were glad to have medical technology available to us, the standard practices of hospital maternal care made us feel disrespected and considered as less than human.
The fact of the matter is that much of what we’ve grown accustomed to thinking about childbirth in our country is completely wrong. First of all, pregnancy is not a medical condition and birthing a child does not have to be overseen by a doctor. Having trained nurses and doctors and medical technologies available in case of an emergency can be the difference between life and death in some instances. But it isn’t necessary, or preferable, for prenatal and maternal care to be managed entirely by our standardized, cold, sterile, and impersonal health care system. If environmental sanitation and hygiene are a concern, consider how many sick and diseased patients are in and out of a hospital on a daily basis. Clearly, the average home is probably a much safer, cleaner, and certainly more comfortable environment than any medical facility. So let’s make our childbirthing choices based on what seems most appropriate, healthy and comforting for the mother, rather than what we think is expected of us or what is forced upon us by the domination of the medical industry.