We met last night and watched the documentary Born in the USA. We had a nice-sized group of women and had an enjoyable, informative talk after the film regarding the type of care women receive in various birth settings. The general consensus of the group was that midwifery care is far preferable to obstetric care due to the respect and autonomy women retain while under the care of a midwife. In the film an obstetrician is seen condescendingly telling a woman “that’s not a choice” the same way a mother might tell her three-year-old that it’s not a choice to hit his sister.
Use of Technology
The group also concluded that obstetricians employ the use of technology despite knowing that these interventions result in greater injury without improving outcomes. In one scene a group of obstetricians gather to discuss some cases. They laughingly talk about how one woman’s c-section may have been induced by the interventions she received. They state that breaking a woman’s water has never been shown to speed things up but that they all do it anyway. In another scene an obstetrician states that continuous fetal monitoring doesn’t improve outcomes for normal births but that it provides a record that may be used in a lawsuit. Obstetric tradition and fear of lawsuit are major factors as to why obstetricians intervene so readily.
Continuous fetal monitoring also makes it easier for nurses to watch multiple patients at once. The group discussed that in a home birth setting it’s common for there to be two or three midwives and assistants caring for one laboring woman. In a hospital setting it is common for one nurse to be watching two or three laboring women at the same time. That division of attention requires a nurse to rely more heavily on machines such as the electronic fetal monitor to alert her if there is any problem. In a home birth setting two or three pairs of watchful eyes are there to make sure everything is still normal and safe. An obstetrician who now works as the medical director of a birth center commented that even though he’d attended thousands of births he’d never stayed with one women throughout the course of an entire labor the way he sees the midwives at the birth center do routinely.
The group also determined that women in a home birth setting are much more likely to be supported and encouraged which results in safer, more joyful birth experiences. During the home birth shown in the film we saw the midwife giving lots of encouragement and (when needed) suggestions. The baby’s head was in an unfavorable position. Rather than reaching for technology to correct the “problem” the midwife instructed the mother to move around and use various positions to get the baby to adjust her head. It worked and the woman gave birth under her own power to a large and healthy baby.
The lack of support generally found in a hospital setting was glaringly obvious during one particular obstetrician-attended birth. The woman was at 3 cm and expressed that she wanted to have a natural birth. The obstetrician, arms crossed, said that that was fine but that if she stayed “this comfortable” then they’d need to give her pitocin. Later on the OB came in again, repeated that drugs are available and that pitocin is a good idea. The laboring woman decided to get pitocin and “something to help her sleep”. She got a shot of narcotics and some pitocin. The pitocin made her very uncomfortable (which is what the doctor wanted) and the woman decided to get an epidural. The doctor said that’s probably the best thing. She then commented to the camera that the woman and her husband were well-educated but that unfortunately sometimes things happen outside of their control. Later on the woman was given two more hours to finish dilating and ultimately had a c-section because the doctor said biology (not all the unnecessary interventions) had shown that she can’t give birth without surgery. This birth was particularly upsetting for us as a group because we saw this woman’s choices and desires being undermined at every step.
The treatment of babies after the birth was also startlingly different between hospitals and home. In the hospital births shown, babies were frequently separated from their mothers and left alone to cry, terrified, in warmers and isolettes while people around them either ignored them, walked away, or laughed at their distress. In the c-section birth described above the mother and her husband mentioned that the mother was the last person to get to hold her baby, which wasn’t for several hours after the birth. That is inexcusable, even in a surgical birth situation. In the home and birth center births, babies were immediately given to their mothers and they stayed there for a good long while with no pressure to take the baby away for measuring, weighing, cleaning, tests, and procedures.
The ultimate conclusion of the group was that normal, healthy women carrying normal, healthy babies would have safer, more respectful, and more enjoyable birth experiences outside of a hospital setting where they would receive undivided attention from competent midwives, encouragement, and support to give birth in the manner that best suits them.
Join us next time as we share inspiring birth stories. Bring your positive birth videos and birth stories to instill confidence that it is possible to have beautiful, safe, empowering natural births. We will watch another short film, a birth video called Psalm & Zoya which shows the unassisted home birth of twins.