The birth of her baby will impact a woman for the rest of her life; this occasion will affect what kind of mother she will be, the kind of lover she is and ultimately determine how she perceives herself. If her birth experience left her feeling strong and able she will be empowered and confident; birth matters. Ask any woman her birth story and you’ll see the flood of emotions come back to her. ACOG defines delivery as the extraction of a fetus.
The state of maternity care in the United States renders us third highest of developed nations for maternal mortality rate. In a nation where we flaunt our technology this statistic is shameful. Our cesarean rate is 32% when the World Health Organization recommends no higher than 15%. Hospitals emphasize standardized care across the board for this personal life event. Putting a woman in a hospital, treating her as if she has an illness, completely undervaluing her power and ability to birth her own baby is not the appropriate approach to birth. Maternity care should protect mothers from complications rather than creating them. Far too often care providers are managing birthing women in the most time efficient, convenient manner; cost being a huge influence of how they provide care and further influence coming from insurance companies and new technology that is released before its full impact can be determined. Indeed, we are seeing today the effects of the epidural and still seeing more negative outcomes than positives as a result of standardized continuous fetal monitoring. These fetal monitors interfere with the ability to labor comfortably; whatever happened to women being attended individually and monitored by their personal birth attendant? This can’t be done in a hospital when the demand is for more patients, nurses stop by for scheduled readings and care providers step in to “deliver” the baby or if the machines determine a problem. In other developed nations such as Holland, home is the place of choice for birth, yet here the first thing we do is call a trained surgeon and pick a hospital. At home we can’t control labor and birth like we can in a hospital but that’s just the thing—like Mother Nature, birth is not meant to be controlled. In a hospital, a woman must be firm in her request for staff to ‘sit and wait’ because it’s so common for them to speed things along, manage her pain “the easy way” and turn the bed for the next patient. Those who are aware of their options have to exert great effort for what they want, negotiate to prevent what they don’t want and constantly repeat their desires. If health care providers were to protect the mother’s space, being there when needed to assist as she birthed, patiently sitting on their hands when not needed, birth could become the sacred, peaceful event it was meant to be.
Today, the media has instilled into women fear surrounding birth. From the introduction of hospitals, came a veil, separating fathers for a time, and stripping birth from its normal role within the family when girls once saw birth many times prior to their own experience. In this harsh environment complications were born where we sought to make things easier. Doulas are said to create a buffer for this harsh environment as well as provide continuous emotional and physical support for the mother and even for the father allowing him to participate at a level that he feels comfortable. Prepared childbirth aims to give women understanding of the physiological process of birth, understanding the hormones, emotions, variations of 'normal' and their options. There are various methods of prepared childbirth that equip women with means of coping and accepting their labor in a positive, relaxing way. The goal of prepared childbirth is to take away fear and instill confidence; doulas facilitate this preparation. Unfortunately only 36% of women will take a childbirth education course and only 3% will use a doula. Fear of birth results in negative outcomes, while acceptance is attributed to positive birth outcomes.
In most cultures midwives provide the primary care for expectant mothers and obstetricians are there in case of complications. This is not to say that all ob’s are medicalized but that is their training—in managing complications prenatally and in labor & delivery. In the 1920’s when birth moved into the hospital, doctors slandered midwives to gain more patients and attract attention to their “nice, shiny facilities”; there became a rift between these two birth professionals. Across the United States midwives face animosity from obstetricians and hospitals when in fact, their goals should be the same—a healthy mother & baby and a satisfying birth experience. The birth experience will influence bonding between mother and baby as well as overall maternal health, therefore, this aspect cannot be ignored. The problem remains in the great divide between obstetricians in midwives. It is immensely important that we bridge that divide as well as heed to the “do no harm” creed in obstetrics care. It would be prudent of us to follow suit of those cultures where birth is attended by a midwife and medical interventions and ob’s come in play as necessary. Birth is a natural life event, an important part of the Journey of Life, and should be treated as such; it’s not a money-making endeavor.
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