Today in the United States, the majority of women give birth in hospitals. Many of these women go through an array of medical procedures such as Pitocin injections, epidurals, episiotomies, and C-sections. These procedures are very risky, and many times one procedure will necessitate the use of the next. In a society where hospital births are considered the norm, many women may be surprised to learn that there are options available to them, such as the Certified Nurse Midwife, which can be much more beneficial to both mother and child during the birthing experience.

The majority of people assume that a hospital birth is completely safe. In fact, many times the mother and child are at higher risks of morbidity and mortality from hospital procedures (Block). Even women with healthy pregnancies may be exposed to many unnecessary medical interventions during their labor and delivery in a hospital.

I consider this research to be very valuable because of the way I came into the world. When my mother was five and a half months pregnant, she was admitted to the hospital with abdominal pain. It was not an issue related to the pregnancy, and the doctors assumed it was a bladder infection or ruptured appendix. My mother went into surgery a few days later to have her appendix removed. Afterwards, the doctors realized that nothing was actually wrong with her appendix. After the surgery, she was moved to the maternity ward. She was being given fluids through an iv, a standard practice in hospitals. The nurses and doctors forgot to monitor her fluid output from her catheter. My father found her swollen and blue, drowning internally in her hospital bed.

Because she nearly died, the doctors put my mother, with me still inside of her, into a coma. This lasted for about three weeks, during which my father was persuaded to abort me. To my eternal gratitude, he refused. After she came out of the coma, I was “born” by emergency c-section and moved to a different hospital on my birthday, September twenty-ninth.

When I was born in 1989, the survival rate for premature babies, or preemies, born under thirty weeks was very low. Surfactant, a drug that helps protect the tissue of the lungs in preemies, was still in the experimental stage, and was offered to my parents as a last resort. Since it was the only option, they agreed; though at this point they were wary of the hospital’s competence. The drug helped to save my life, and I was released from the Neonatal Intensive Care Unit three months later, on December tenth, two weeks earlier than my mother’s original due date. A few weeks later, my parents received a bill from the hospital for twenty percent of what the ordeal had cost the hospital. It was over one million dollars. My parents were forced to declare bankruptcy.

My story is just one of the millions like it. Hospitals are not perfect, and when mistakes are made, it can be the difference between life and death. However, the majority of women seem to trust anyone in a lab coat much more than their own intuition when it comes to labor. When this misconception becomes the dominant thought process, the only person who benefits are the hospitals and doctors, not necessarily mothers or babies.

Pitocin is given to about 90% of laboring women in hospitals (Block). It is a synthetic form of oxytocin, the natural love and bonding hormone in humans. Pitocin induces false contractions to begin or speed up the birthing process. However, these pseudo-contractions are much more painful than natural contractions; which gradually increase in severity, and are usually not overwhelming. This extreme pain from the pseudo-contractions causes many women to request an epidural. An epidural then paralyzes the lower half of the woman’s body, the muscles she needs to guide the baby out of the birth canal, but since she no longer has feeling or control over these muscles, labor becomes very difficult; as a result, many times a cesarean section will be strongly encouraged by obstetricians and nurses. After a C-section, a woman spends at least two weeks in the hospital, and a few months on bed rest to recover from such a major surgery. This is the standard experience of childbirth in our country, and it is time women start to question it.

Women have been giving birth since the beginning of time. Obviously, the female body is equipped to perform this function. However, the medical industry and popular culture have been telling women for years that their bodies are too weak, birth too painful, and that they could not possibly handle the full experience of natural labor and delivery (Block). These ridiculous scare tactics have worked, and many women see birth as a terrifying, painful, and traumatic experience. The media’s depiction of childbirth also reinforces this conception of birth as trauma, showing laboring women at the pinnacle of physical pain, screaming, crying, and demanding drugs. As a result, many women believe that medical interventions during labor are necessary and vital to the safety of their babies, and they do not question the hospitalized system of childbirth.

This system is troubling for a few reasons. For one, the chances of life-threatening side effects and risks from procedures such as epidurals and cesarean sections are often downplayed to women who are in labor or expecting. This is unfair to the mothers who have no information or support, and it certainly does not constitute informed consent. Equally as troubling, the long-term effects of drugs given to pregnant women are unknown by medical professionals (The Business of Being Born). The hospital is a business, and that is exactly how it is run. It is a place for emergencies and life-threatening situations. The question we as women need to be asking; is childbirth a life-threatening trauma that requires medical salvation? The answer is that ninety percent of the time, it is not (Block).

One of the best examples of how hospitals have taken their own faulty route in the realm of childbirth is the physical position women are put in when they are in labor. Women are made to lie on their backs with their legs lifted in the air, most of the time either held up by nurses or put in stirrups. The vagina and uterus are at a slight angle in the woman’s body, so lying a woman on her back creates a kind of uphill battle for the child, and also makes the pelvis smaller (The Business of Being Born). This position is literally the worst for childbirth, but the women are required to stay in this position because it gives the doctor the best view (Cook 62). When the mother is pushing during labor in this position, the baby is struggling to move upwards and out rather than just down, as it would be in a standing or other vertical birth position. What then occurs is that the obstetrician or nurse will say that the birth is “stalled”, a medical term that can basically cover any type of delay that is taking too much time, which in a hospital does not require much, and the woman is then rushed off for an emergency cesarean.

This emphasis on what is easiest for the doctors to work with caused one filmmaker, Steve Buonaugurio, to apply the term “McDonaldization” to hospital births. “McDonaldization” is the application of fast-food principles such as time, efficiency, and control, to other areas of American society, in this instance, childbirth (Pregnant in America). This may seem like a silly analogy to make, but when hospital protocol and policies are examined more closely, the shocking truth is that mothers and babies are not the main concern, or the ones who ultimately benefit from obstetric intervention. In this society, doctors in particular are always aware of the possibility of being sued or held accountable if anything goes wrong with a patient. When it comes to childbirth, obstetricians want to perform every possible intervention so that later on, if something goes wrong, they can say that they “did everything they could” (The Business of Being Born). An obstetrician, therefore, is not at all likely to sit and wait patiently for up to forty hours while a woman has a natural delivery. Hospitals are businesses, and they are run and operated as such. If a woman in labor at a hospital expects preferential treatment or consideration, she will be greatly disappointed.

It would be unfair to argue that medical advancements in obstetrics are without their benefits. For many women with complications in pregnancy, a medical intervention could be the difference between life and death of the child and mother. Medical interventions have saved many lives, no doubt. However, The problem arises when women with healthy pregnancies and a low risk of complications are still being put through these interventions for no reason, other than hospital protocol. As it was so eloquently put in a documentary, “because Obstetricians search for pathology, they often see pathology where it doesn’t exist” (The Business of Being Born).

The good news is, there is another option for giving birth in the United States. That option is the Certified Nurse Midwife. Many midwives work in Birthing Centers. These centers are a great alternative to a hospital birth, and emphasize a calming, supportive, personalized birth experience (Cook). For women who are looking for an alternative setting for childbirth, birthing centers provide a safe setting for healthy women to have a drug-free, natural birth experience.

To see what these birth centers were really like, I visited a birthing center in Allen, TX. As soon as I parked, I was already impressed. The “Baccus-Brown” House stood before me. It was painted a charming canary yellow, and in the yard was a garden and gazebo. Later, I learned that the house was built in 1908 and is one of Allen’s historic residences (Giles). The outside of the house gives a comfortable and inviting feeling. The interior of the Center is just as appealing. The house was open and bright, and the hardwood floors gave it a cozy yet refined feeling.

After meeting with Amy, a Certified Nurse Midwife (CNM), I was given a tour of the house. I saw the kitchen first, and learned that a woman in labor is allowed to bring her own food to the house, and is allowed to eat and drink during labor. This seemed like a great change from the hospital policy of ice chips only. The main reason hospitals do this is because they are preparing the woman in labor for a potential cesarean section. The birthing center offers women options during their birth experience, and the midwives do not limit what a woman can do while she is in labor. The process of natural birth can be long, so anything that the woman feels is necessary, such as walking and moving around, eating, or taking a shower, may help her labor to progress faster naturally (Cook).

Finally, I was shown the two birthing and delivery rooms.  The rooms are comfortable, homey, and look much more inviting than a sterile, fluorescent hospital room. The rooms have a large queen-size bed, rocking chairs, bathrooms equipped with a shower, and birthing tubs similar to a jacuzzi. The dressers and drawers conceal some necessary medical equipment that a midwife may need to use during labor, including gauze and oxygen.

About 70-80% of women, or the majority, will have normal and healthy pregnancies (Block). Still, not many women take advantage of their options when it comes to childbirth. Amy, the Midwife I met with, explained that many women choose midwives for their birth plan during their second pregnancies, after having a traumatic or negative experience at the hospital (Giles). Many women may feel that they had drugs and procedures forced on them by medical professionals, even if they had originally planned to have little to no interventions. Midwives, on the other hand, trust the woman that is in labor because they have formed a relationship with one another over the course of the woman’s pregnancy. They let nature take its course and simply oversee that everything is progressing naturally.

Some women may be thinking: this is all well and good, unless something goes wrong, and medical intervention is needed. In the case of an emergency during labor at a birthing center, the woman is simply taken from the Birthing Center to the hospital. Allen Birthing Center, for instance, said they rarely have to transfer women to the hospital (about 5 percent of the time), but when they do, it only takes about 3 minutes to get there (Giles). That is what the hospital is for: emergencies. If a woman in labor is transferred, a midwife from the birthing center will follow her to the hospital to make sure that the laboring woman is protected from any unnecessary interventions given by the obstetricians. This gives the woman an extra support system, especially if complications occur.

Breech births occur when the baby begins to emerge in a different position, such as buttocks or feet down, instead of leading with his head. There is a common misconception about breech birth: that these turned babies cannot be delivered vaginally. This is false. Women are capable of delivering babies in breech positions, as long as they have a professional there assisting them, and can move around freely to help guide the baby out of the birth canal. However, most of the time breech babies simply need to be moved to the correct position. This is called an external cephalic version, and is accomplished by the midwife by placing her hands on the baby through the mother’s stomach and applying gentle but firm pressure to turn the infant. When compared to the risks of a cesarean section, the hospital’s current default problem solver, external version of a breech fetus can help the mother stay with her plan of natural vaginal birth, and is also healthier for the baby than the drugs and risks associated with a c-section. Studies have also concluded that “Improved access to both external cephalic version and support for vaginal breech birth is needed to honor women’s informed choices and avoid adverse short- and long-term effects of cesareans in mothers and babies” (Sakala 3).

Cesarean sections are at an all-time high in the United States at about one-third of all births (Pregnant in America). This number is shocking, and does not reflect a positive trend. In the 1970s, the World Health Organization recommended that the C-section rate not rise above fifteen percent. Doctors have obviously ignored this warning in favor of faster deliveries and more control over the situation. Childbirth is not about what is easiest for doctors. It is about women bringing new life into the world through a process that is natural and beautiful. Women should not be putting their trust in surgeons and hospitals, but rather in themselves, and in their own bodies. Birth can be empowering and enlightening if we allow it to be, and if we stop meddling in a normal process. It has been said by supporters of natural birth that women are changed through the birth process, and that the cocktail of hormones that the body releases naturally during birth makes the mother feel happy and euphoric during and after childbirth, which also helps to cement the bond between mother and child (The Business of Being Born).

Postpartum depression is a growing problem among many new mothers in hospitals. After giving birth, a woman may feel depressed or disconnected from her child and family members. This depression can hinder familial relations during a time where closeness and bonding is essential to form long lasting attachments between the parents and the child. However, this affliction did not exist at the beginning of the twentieth century, when ninety-five percent of women were giving birth at home (The Business of Being Born). The conclusion is that hospital experiences are causing women to feel this way in the time directly following their birth. Studies have shown that “the most frequently reported risk factors for posttraumatic stress disorder resulting from childbirth were high levels of obstetric intervention, perception of inadequate support during labor, cesarean birth, (…) and loss of control in labor” (Eugene 217). Women who are put through these traumatic interventions are likely to feel that they have become powerless over themselves and their bodies. This is a stark comparison to the empowerment and sense of accomplishment a mother will feel after having a natural birth experience. More women need to connect these dots, and do the necessary research that will illuminate the inherent flaws in the hospital system of childbirth. More awareness will lead to happier and more competent parents for the newborn child.

Since the first and second wave feminist movements, women have demanded equality and freedom of choice in almost every sphere of modern society. However, when it comes to childbirth, a universally female experience, it seems that women are losing confidence and knowledge of what their bodies are truly capable of. I am not saying that a woman who chooses painkillers or interventions during birth is doing something wrong; it is all about choice. I believe that if more women knew what labor could be like in a setting such as a birthing center: a calming and bonding process between mother and child with no drugs or surgeries, hence faster healing time after birth as well, then maybe women could let go of their fear of birth and embrace it as a joyous experience that has the ability to empower them.

 

 

Works Cited

Block, Jennifer. Pushed: The Painful Truth about Childbirth and Modern Maternity Care. Cambridge, Mass.: Da Capo Lifelong, 2007. Print.

Cook, Kalena, and Margaret Christensen. Birthing a Better Way: 12 Secrets for Natural Childbirth. Denton, Tex.: University of North Texas Press, 2010. Print.

Giles, Amelia. Personal Interview. 15 May 2011.

MacDorman, Marian F., Eugene Declercq, and T. J. Mathews. “United States Home  Births Increase 20 Percent From 2004 To 2008.” Birth: Issues In Perinatal Care 38.3 (2011): 185-190. Academic Search Complete. Web. 30 Apr. 2012.

Pregnant in America: A Nation’s Miscarriage. Dir. Steve Buonaugurio. Perf. Mandy Buonaugurio, Steve Buonaugurio, and Gordon Grobelny. Bella Media Productions, 2008. DVD.

Sakala, Carol. “Expanded And Improved Federal Data On U.S. Maternity Care Practice.”      Birth: Issues In Perinatal Care 38.4 (2011): 357-359. Academic Search Complete.      Web. 30 Apr. 2012.

The Business of Being Born. Dir. Abby Epstein. Perf. Mary Helen Ayres, Julia Barnett      Tracy, and Sylvie Blaustein. Barranca Productions, 2008. DVD.