Guilt in Childbirth, and the need for Balance

Belly

A recent popular publication posted an interview with a retired doctor who believes that natural birth is evil, promotes guilt, and was invented by a doctor in the 1950”s.  This woman tends to vehemently promote medicalized birth, and is presently selling a book she wrote.  I don’t have a problem with promoting your work, but when you make statements like “Dr. Grantly Dick-Reed invented Natural Childbirth”, and that natural childbirth is a bad way to go, it borders on insanity. (I won’t reference this person’s name, or book, because it just feeds the troll, as the saying goes. But, if you really want to know, contact me.)

I agree that women should not feel guilty about needing medications, interventions, and surgeries.  There are many times that we say thank goodness for the technology, or medication.  It should never be about perfect birth, but healthy birth.  It is ridiculous that we have “Birth wars”, with extreme opinions on one side or the other. We should be striving for a healthy balance.

But let’s start with this woman’s opinion that Dr. Grantly Dick- Reed invented Natural Childbirth.  Natural, physiological childbirth is the way nature designed children to be born. If we hadn’t, then the human race would not be in existence.  Dr. Grantly Dick-Reed , Dr. Robert Bradley, and Dr. Lamaze simply saw the negative effects of the OVER USE of technology in birth, and the need to return to a more physiological way of having babies.

Birth is not an all or nothing thing. When a woman works to stay healthy and low risk, then she has a very good chance of having a totally natural birth, and not NEEDING any interventions. When you spend time studying the research on the subject, you see that number comes out to around 80% of women being able to have natural births.  With 20% (or less) needing some sort of interventions, and 15% or less requiring a cesarean.  Please note that the statistics in the US are the opposite – 80 – 90% of women receive multiple medically unnecessary interventions, and 32.2% are receiving cesareans (Double the rate recommended by the World Health Organization.)

Why would you want to lower the Cesarean rate? Because while cesareans are safer than they used to be, they do pose serious health risks. They are major abdominal surgery.  Mothers and babies are 2 – 3 times more likely to die, and the mother’s future fertility, health, and the babies’ future health are negatively impacted.

New research documents the fact that we need to change the way women are educated about birth.  We need to change the approach taken by the medical establishment.  Ideally we live in a world where we should have the best of all possible outcomes, but we don’t.  The reason for this is lack of balance in maternity care.  We know what good maternity care looks like, but it is not what is practiced in the US.

Good maternity care is such that it improves outcomes, by lowering maternal and infant morbidity and mortality.  But the US has the highest rates of infant and maternal mortality of any industrialized country around the world. We have started to make strides, but it has been too slow.  And now we have a medical establishment fighting back to maintain that status quo.

It takes an average of 17 years for good research to be put into action, and applied in the real world.  So even though we know 50% of the cesareans performed are medically unnecessary, and do not improve outcomes; or that other interventions, such as Pitocin, carry serious risks, no changes are made.  We have a whole culture that believes the more intervention you throw at birth, the better.

This is not about guilt, it’s about health.  No woman should ever feel guilty about needing interventions during birth.  But the care providers should feel guilty about the way women are treated and cared for in the US.  That is where the guilt should lie.  Until we have a maternity care system that produces the best outcomes (i.e. fewer women and babies dying and being harmed) then the medical care providers should be ashamed of themselves.

References:

Dick-Read, G.; Childbirth Without Fear: The Principles and Practice of Natural Childbirth ; Pinter & Martin Ltd; 2 edition (May 16, 2013)

Bradley, R.; Husband-Coached Childbirth (Fifth Edition): The Bradley Method of Natural Childbirth; Bantam; 5th edition (May 20, 2008).

The Birth Wars Debate: http://www.jenniferblock.com/homebirth_debate.html

Haas, AV; Healthy Babies! Healthy Moms! A Practical Guide to Preventing Problems during Pregnancy, Labor, and Birth , 2016.

Listening to Mothers III Survey and Report (2013) Childbirth Connection http://www.childbirthconnection.org/article.asp?ck=10450

Wagner, M.; Born in the USA ;University of California Press, Berkley & Los Angeles California; 2006.

Amy V. Haas, BCCE©2016