I’ve been watching videos of unassisted home births. It’s such a wonderful occurrence compared to hospital births, which (from what I’ve seen) seems nothing short of brutal!
The homebirth mothers were so calm … and pain seemed minimal even without pain killers … admittedly, they were exhausted from labor… but to see their faces af the end holding the baby, while still attached to the cord, was just amazing!! It brought tears to my eyes!!
When I watched one of a mother giving birth in hospital, the mother had all these IVs and monitors attached to her … and when the baby was born, they cut the cord, held it up to show the mother, and then whisked it off so quickly to clean, measure, and weigh it …
… the mother just waited and waited to hold it! What a contrast.
Consider these quotes regarding hospital/home births:
“Within hours of admission, colonies of hospital strains of bacteria develop in the patient’s skin, respiratory tract, and genitourinary tract.”
Sheila Kitzinger, British childbirth expert, states that planned home birth with an experienced lay midwife has a perinatal death rate of 3-4 babies per 1,000 births (51). Hospital births, by contrast, carry a perinatal mortality rate of 9-10/1,000. [Perinatal death rates include fetal deaths on and after 28 weeks gestation, whereas neonatal mortality rates only include deaths occurring in the first 28 days after birth (Jones 96,98)].
Joseph C. Pearce states in his landmark book Evolution’s End that homebirthed babies have a six to one better chance of survival than a hospital-birthed child.
Dr. Lewis Mehl did a study comparing home and hospital birth with mothers from California and Wisconsin with matched populations of 2,092 mothers for each group. Midwives and family doctors attended the homebirths; OBGYNs and family doctors attended hospital births. Within the hospital group, the fetal distress rate was 6 times higher. Maternal hemorrhage was 3 times higher. Limp, unresponsive newborns arrived 3 times more often. Neonatal infections were 4 times as common. There were 30 permanent birth injuries caused by doctors (Jones 99).
Dr. Mehl did another study comparing 1,046 home births with 1,046 hospital births. The groups were matched for age, risk factors, etc. There was no difference in infant mortality. None! However the hospital births caused more fetal distress, lacerations to the mother, neonatal infections and so on. There was a higher rate of forceps and C-section delivery and nine times as many episiotomies (Jones 110).
Women who give birth in a hospital are much more likely to experience postpartum depression or even post traumatic stress disorder. Kitzinger states that the more interventions a woman experiences, the more likely she is to be depressed, with C-sections obviously carrying the greatest risk of depression (193). She quotes 5 or 6 studies documenting the effects of this “institutional violence.”
Aidan McFarlane, a British physician, notes that while 68% of hospital mothers experience postpartum depression , only 16% of home birth mothers do (Jones 24).
Aspects of hospital birth that may strongly contribute to the incidence of postpartum depression in our country are the way the moment of birth is handled and the routine separation of baby and mother. In a study which appeared in the New England Journal of Medicine in 1972, Marshall Klaus, the “bonding” expert, found that holding the baby close released “dormant intelligences” in the mother and caused “precise shifts of brain functioning and permanent behavior changes” (Pearce 115). In other words, bonding is not just an emotional thing that only mothers think happens. It is a biochemical process that forever changes the mother, so that she knows more instinctively how to relate to her baby. In the hospital, baby cannot see mom with all the bright lights and is often inspected and observed for several hours before mother can hold it for any length of time. This is not to say love can’t make up for this loss, but motherhood might come easier if we had those natural body changes to help us. Then babies are still routinely kept in the nursery, if not most of the time, at least part of the time. The routine separation of mom and infant makes baby frightened and mom depressed (Pearce 124).
As if the above quotes are not powerful enough, read this comment on childbirth by Carolyn Steiger (extracted from Becoming a Midwife, now out of print).
I once heard a woman who had recently given birth at a hospital describe her experience as “Natural Childbirth”. Her labor had been induced with pitocin, her membranes were ruptured artificially, a fetal monitor had been strapped on, she remained in bed the entire time, she was in the lithotomy position for second stage and she received pain medication throughout labor!
Things have gotten out of hand. The cesarean rate is so high that any vaginal birth is now considered to be “natural”. Certainly, “natural” is not always best from our point of view. Nature sometimes is destructive, whether in the form of a tornado or a pelvis that is literally too small for a baby to pass through, and sometimes we are thankful for ways to bypass nature. But we shouldn’t kid ourselves about what reality is.
Consider this analogy:
Would you feel that you had engaged in natural sexual intercourse and love-making if you had only performed it at a hospital, with a little gown on, after an enema and many hours without food? Add to this an I.V. in your arm, a spotlight focused on your genitals, and strangers entering and leaving the room without warning. People are telling you how to do it, when to do it, how fast or slow to do it, and everyone around you is dedicated to helping you perform noiselessly. They are also insisting you do it in the position most convenient for them so they are better able to look at your genitals and put their hands inside your body. To help male readers further envision this scene, imagine that you are having trouble “delivering”: the doctor could help you by making just a little cut!
Remember, too, that you are expected to perform according to the Steiger curve – too long or to short a time until you accomplish your mission and intervention will be necessary!
It would be absurd to call this “natural” sex. Calling birth “natural” under these same conditions is also absurd. But some physicians who clearly see the effects of psychological and emotional factors, environment, and stress on sexual potency and function are disdainful of people who suggest the same might be true of a laboring woman.
If people were forced to make love under these conditions, we would be shocked and offended. We should be equally offended when it happens to a woman in labor unnecessarily. Women now expect these indignities and numb themselves in preparation. Even as midwives we become numb. We can become accustomed to the indignities and powerlessness pregnant women endure. We may become casual about intruding on a human experience that is inherently no less intimate, private, personal, special, or affected by environment than making love.
Refraining from intervention and acting respectful should arise, not from a calculated bedside manner aimed to please the client, but from a true reverence for the process, love and respect for the people involved, and gratitude for the privilege of being present. Only then can we turn away from making birth an unnatural act.