To Midwifery Today -- Your Online Birth Center

Is Hospital Birth Better?

Subj: Re: Educating the Public
Date: Wed, May 31, 1995 2:56 PM EDT

I believe that what routinely happens to women (and their babies) birthing in hospitals with OBs borders on abuse. What else could you call forcing a healthy laboring woman and her baby to lie still for hours in a position which makes her labor far more painful and endangers the health of her baby, all for the sake of hooking her up to a machine which has only been shown to further increase her risk of complications? That is just the beginning.

Women who venture to ask are routinely told by their doctors that they only do episiotomies if they are really necessary. Turns out they are "necessary" almost every time. This is a lie, and cutting women unnecessarily is abusive.

Women are led to believe that they can have a wonderful home-like birth in hospital birthing suites with OBs, when the reality is that childbirth without intervention is virtually non-existent there unless a midwife is in attendance.

Treatment of newborns might surprise a few people, too. It did me. My first child was born 3 1/2 years ago in Cedars Sinai Hospital in Los Angeles. My husband insisted on accompanying his newborn son to the nursery while he was bathed and checked over. First they pumped out his stomach - the colostrum from his first nursing experience went down the drain (and no, there was no meconium staining, this was just routine procedure). Next they stuck a tube up his butt, then injected him with vit K and stuck his heel and squeezed a while for his PKU test. All this time he was uncovered, flailing about on a tabletop and screaming. Finally, it was time for his first bath. The nurse held him under running water, all the while scrubbing his skin with a stiff brush. He cried so hard that he stopped breathing three times, for which he was briskly slapped on the feet and buttocks and yelled at to take a breath. When my husband was near tears and finally protested, the nurse said, "I do this 20 to 30 times a day. It really doesn't hurt them." What do YOU think? What would most new mothers think if they could see this?

I could go on and on, and these are just examples of what happens ROUTINELY when there are NO complications. Does this not amount to an assault on women and babies at two of the most vulnerable times of their lives? I have not even begun to speak about the millions of women whose babies were stressed into distress or presumed distress by these practices. Their babies were born surgically. After believing that your baby was about to die, how could you not feel thankful that medical technology was able to save it? How could you not come to believe that birth is a painful and dangerous proposition?

You may quite rightly wonder why women who endure, by their own accounts, horrible experiences at the hands of doctors and hospitals would not only return time and again to them. You wonder why women continue to believe that in a hospital with an OB is the safest place to birth babies, and disbelieve anyone who might try to convince them otherwise. Women are affected by many things in their decisions, so I don't presume that there's any simple reason. There are, however aspects of our culture which predispose women to choose unwisely.

In the United States and in a number of other countries, children are conditioned through, among other things, compulsory schooling to believe that authority figures have the right and responsibility to exert control over them. We are told that children do not know what is best for them, nor do their parents, for that matter. For the first 18 years or more of our lives, we are told what to do, what we will learn, how we will learn it, where and with whom we shall spend our days, etc. In addition we are constantly judged and ranked according to how successfully we can comply. This cannot help but have an effect on how we respond to authority.

The medical model IS an authoritarian one. In it, a doctor assumes responsibility for your care, and relieves you for the most part of your responsibility for yourself. The doctor is the expert, the authority. The doctor is best able to decide what is best for you. If you question the doctor's expertise, you are a problem patient. Doctors tell us that hospitals are the safest places to birth our babies. They tell us that it's the completely unexpected complications that are the killers. They tell us you never know what might go wrong. They tell us midwives who do homebirths should be prosecuted for risking our lives. They tell us not to worry, they have wonderful, safe drugs these days to ease our pain and c-sections to save our babies. They measure and test and monitor us. They leave us thinking that they know how we're doing and we don't.

Women have their babies in hospitals because they are terrified not to. We have fewer babies, later in our lives and can ill afford to lose one. We are convinced by the time we are adults that we cannot possibly know what is best for us, that we do not know how to birth babies, and that if we do not surrender authority to doctors who do, we are being reckless and irresponsible. We hear over and over again about strong women who "fail" the childbirth test. We learn not to trust our bodies. We are essentially blackmailed into thinking that if we do not accept the medical model, horror stories and all, something TRAGIC will happen to our babies, and it will be OUR FAULT. My original analogy was to battered women. They stay in part because they come to believe that they are somehow at fault, and because they cannot see a safe way out of their situation. They also stay because they believe that their abusers MEAN WELL. Do you see the similarities?

As to why women do not believe you when you show them studies...... Well, I suppose that part of the answer is that you are not an authority figure. The midwifery model IS NOT an authoritarian one. Also, I think that most women find it hard to believe that doctors would outright lie to them. When faced with deciding who is telling the truth and who is lying, they can't help but believe the "experts" because they are conditioned to do so.

I think that women are often intimidated by the purity of home birth, and fear that they somehow could not measure up. I think that often when we say, "see, these women have done it and so can you," that this is seen as a judgement of them, that we are suggesting that anything less is a failure.

I've gone on long enough, but I have one last anecdote to share. Before my first birth, I took the hospital tour. The nurse giving the tour explained that we might not have a nurse with us all the time while we were in labor. She then pointed to the monitor (EFM) and said in all seriousness, "Never fear, BIG SISTER WILL BE WATCHING YOU."

Laura Derrick

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