"Anti Science Hippie Moms...."

A friend of mine posted on Facebook today asking for positive thoughts of comfort for her 17 yr old sister who was having a baby in a hospital with no doula or support people around her. She was concerned because of her own experience as a young woman birthing in the hospital with little choices offered and no one to help empower her. Her's was similar to mine, forced episiotomy, student OB's, a lot of interventions that were never quite explained and a lot of pain and suffering afterwards. A commenter on her post suggested that " I know the anti-science anti-doctor meme in the hippy community has some merit - however some docs are the reason baby and mom survived !" This is the last kind of comment a mother of 3, who has had 3 different births in 3 different settings and knows from experience what happens in a large portion of mother's experiences needs to hear from a "friend."

Please don't assume that people who support natural birth and dont advocate for healthy, low risk women to birth in hospitals don't do their homework, there is plenty of science that supports it. But yes, we are blessed when there are the couple of doctors who really do provide good support. But really, how long is the doctor there for? There are hours and hours for most first time moms with no support at hospitals and scientific studies show that when interrupted in labor by strangers, the physiological conditions that support a healthy biologically correct birth get disturbed and that does cause the complications that often require the help of the doctor to "save them" as she put it.

This article by Alice Dregger, so eloquently points out the misunderstanding fueled by the unethical treatment of women by doctors in the birthing business. 

Credit for pic and a great article can be found here.

" in the U.S., "obstetricians are the experts and the experts have come to see birth as dangerous and frightening." De Vries suggests that the organization of maternity care in this country -- "the limited choices that American women have for bringing their baby into the world, what women are not told about dangers of intervening in birth, and the misuse of science to support the new technologies of birth" -- actually constitutes an ethical problem, although we typically do not recognize it as one."
There are many people who also are under the misconception that midwives are not educated or do not have scientific studies to back up the "witchcraft" that they support. Yet time and time again, studies point to less intervention, less disruption, less meddling and better outcomes for both mothers and babies, long term.  The use of inductions , routine fetal monitoring, epidurals, and the inability to eat or move around freely has disrupted the normal processes of birth, increasing risks to the point that the Royal College of Obstetrics has made claim that there are too many babies born in hospitals.  

 Hospitals around the country are at the beginning phases of implementing a new paradigm into the birth culture of their institutions.  This is a wonderful starting point to shift the commonly held belief that birth is inherently risky and we NEED interventions to be safe. There are 30 other countries that have a better maternal mortality rate than the USA. Obviously, we can improve this. 

When a friend expresses her concern for a loved one, obviously, insulting them with stereotypes is not the nicest thing to do, but even more than that, carrying around this attitude and spreading it is dangerous. When it is already so hard to make decisions and swim through the information that you have to search for because it is not readily offered by your paid professionals in so many cases, the perception of your peers can influence the decisions that are made. If you are going to give advice to someone, please make sure it is accurate, you could be doing more harm than good. And if you made some of the decisions that have been proven to be not as safe as we think, and nothing bad happened to you, consider yourself lucky. This is the exception, not the rule, and it is very invalidating to be talked to like you don't have a reason to be concerned, when you are following your instincts and doing your homework. Being concerned when you have this knowledge is healthy. 

Childbirth Experiences Have a Lot to Do With Expectations

This is a paper I wrote for a sociology class in reference to this study http://www.ingentaconnect.com/content/routledg/cjri/2008/00000026/00000004/art00004

The expectations and experiences that mothers face can be related to the type of care and the culture that the expectant mother is exposed to. The study, “Childbirth expectations and experiences in Belgian and Dutch models of maternity care” conducted by Wendy Christianens, Mieke Verhaeghe and Piet Brake (Journal of Reproductive and Infant Psychology, Vol 26, No 4, Nov 2008, 309-322, Department of Sociology, Ghent University, Belgium) sought to confirm how a mother’s exposure to societal norms, previous experiences, other people’s stories and the way their care giver attend to the perceived needs and expectations account for the actual event’s experience and the level of satisfaction on the mother’s behalf. Belgium and Dutch women develop different patterns of expectations during their pregnancies and tend to have diverging birth experiences according to the care provided to them during their gestational and postpartum periods. The researchers expected that Dutch women would have a more positive outlook about childbirth than Belgium women, though there was no expectation of difference of experiences versus expectation between Belgium and Netherlands due to the socialization processes as a function of the maternity systems.

            The researchers used a variety previous data dating back  from 1982 to present to determine how to conduct the study and what variables they would use. There was a questionnaire made to be distributed to women in both Belgium and Dutch Maternity care systems. There was one questionnaire given at about 30 weeks gestation and another given at 2 weeks postpartum. These questionnaires were used to determine the expectations and outcomes of the mothers, planning on birthing in a hospital setting or in a home or birth center setting. The fixed factors were time, country and place of birth.

            In Dutch maternity care, it is common to have home births (30% of births), low medical intervention, and short hospital stays if the mothers do plan to attend hospitals. The Midwifery Model of care is used that is woman and baby centered, viewing birth as a normal, natural physiological process.

            Belgium is contrasting in the way that home births are uncommon and the medical model of care is highly practiced having a 98% hospital birth rate. The society there sees birth as risky and that hospital births will ensure a safe delivery. Birth has become a medical event in need of supervision by specialists and it is common to use interventions such as epidural pain relief and surgical birth.

            Data was collected within 4 groups of women. Women who planned their births in either the hospital or home in both Belgium and Dutch care systems. There were 5 hospitals and 27 midwifery practices with similar socio-economical factors. Midwives and Obstetricians asked their clients to participate. The main factors of eligibility were that they had to speak Dutch and be 18 years or older in age. The questionnaire was conducted in an anonymous manner.

            The Questionnaire was designed to learn if the subjects felt anxious about the upcoming birth and labeled the choices as unknown, uncontrollable and unavoidable. The language of “expectation” meant that women had to answer about what they thought would happen, not what they hoped would happen. The outcomes of the score would show people with a higher number were feeling more negative towards their expectations and experience and the lower score would show more optimism.

            Of the 827 questionnaires filled out during the prenatal stage, only 611 participated in the follow up questionnaire 2 weeks after birth, 265 were Belgium women and 346 were Dutch. Participating women were between the ages of 19 and 44, the mean being 31 years old. First time moms were 54% of the respondents and the study reported that more Belgium than Dutch women had a higher education with 77% of Belgian and 40.5% Dutch, though almost equal percentage (85%) of the women were employed. This raised a question for me personally about the way that higher education seems to be correlated with the increased use to medical intervention because of affordability or access to that kind of care.

            The results show that both countries had a expectation that was more negative than the actual experience even though the expectation were significantly different between the subject groups. The results concluded that “expectations and experiences are positively associated and the relation is rather strong. Expectations are a strong predictor of a woman’s experience of childbirth.” In the majority of cases the experience was better than the woman’s predictions. Some of the significant findings were that women planning on giving birth at home had the lower scores showing less anxiety about the process and also showed a higher level of satisfaction after the birth had happened.  This analysis conformed the hypothesis. What was also found in this study was that when replaced by the actual place of birth from the planned place of birth, the home birth subjects had a more positive experience than the hospital subject groups “showing that midwifery care is more satisfactory than care by doctors.” The findings were relevant to how policy is created when caring for pregnant women in a way that supports having a strategy to reduce negative experiences and is more encouraging of optimistic expectations. This would be a preventative approach that can be applied to maternity care systems worldwide.

            The researchers approach was a functionalist approach. The research was based on the idea of how the maternity system functions effect the satisfaction of the people who are receiving care through it. I found this study to be very pertinent to my main focus of education which is midwifery. The level of satisfaction that a mother experiences through her birth effects many parts of society. Her ability to raise a healthy human being is essential to the integrity of the future of our survival on this planet. If she is dissatisfied, that experience can lead to depression, detachment, breastfeeding problems, marital issues just to name a few. The baby could suffer from neurological damage from a traumatic birth,  not having a healthy mother or care giver, nutritional issues from not having built a strong breastfeeding relationship and social issues from lack of bonding due to birth trauma. These effects of birth on society are coming into a larger awareness as we are able to conduct more and more studies about the biology of birth and neurodevelopment and how our society benefits from cooperating with nature’s intended way of babies to be born. Additional research I would like to see on this subject is a longitudinal study of emotional and physical health of babies born in and out of hospitals, the rate of postpartum depression amongst women who have birthed in both settings and the incidence of long term emotional dysfunction (PTSD)from the women who viewed their birth in the higher negative range. 

Kaire Downin 2012