Over Medicalisation of Birth – What’s the Problem?

Photography:Alexa Doula Photography

By Nickita Stark

Birth. The mind conjures images of women screaming in agony, the sound of dramatic midwives shouting at women to ‘PUSH’, beepy machines, white coats, stirrups, women pushing ‘uphill’ on their backs, episiotomies and tears. We are told during pregnancy not to smoke, not to drink, not to dye our hair, most pain killers are out of bounds, no sushi or unpasteurised milk. However, the second we go into labour we are pumped full of drugs, told to give birth in hospital as our bodies are no longer trusted to do their job unsupervised. We are connected to machines and experience uncomfortable vaginal exams. We are put on a time scale acceptable for the hospital, experience trauma as a standard and we have become conditioned to think it’s normal?

So why on earth has a physiological process been handed over to a medical team? Is birth inherently dangerous? As an experienced birth worker, I would say a profound no!

It saddens me to see countless women handing over their births to the medical profession. Hospital births have become standard and we have lost trust in our bodies. We have lost touch with our instinctive wisdom. Why do we fear childbirth so much? When did this happen and how? I must stress, we are very lucky to have medical intervention when we need it. For the most part, midwives are doing an exceptional job. I am not discussing the hard working birth workers here, only the ‘system’ in which they work. I have the utmost respect for birth workers, be it independent or NHS. They are mostly wonderful, caring individuals who just want to help. This article is not about these individuals, but the failing maternity system.

I recall over the years, while discussing homebirth, people asking, “What if something goes wrong? women used to die in childbirth”. To answer the former, we first need to understand why things ‘go right’ in birth. The best way to answer this is to compare birth with sex. Babies are created in love and born in love (well that’s the ideal scenario). We must bear in mind that the same hormones we release during sex are also the hormones we release during birth – oxytocin, the ‘love hormone’ being the most important.

So imagine you are making love to your partner, you are in a blissful, beautiful and euphoric state. You are in the moment, it is private and such a wonderful experience. Now picture some bloke in a white coat slams open your door, turns on the lights, storms in followed by a couple of women wearing scrubs and masks and start observing you while saying, “You can probably do this yourself, but we are here just in case you can’t. I’m just going to take your blood pressure and fiddle about a bit with your genitals. Don’t worry, I do this all the time, it’s normal.” Do you think you would be able to return to bliss after that rude and arrogant display? Unlikely. Birth is no different.

Oxytocin is released when we are calm and feel safe. If we release adrenaline, it will significantly compromise oxytocin flow. Our bodies will not labour as intended if our adrenaline levels are telling us we have to fight or fly.

All the blood needed in our uterus will simply leg it to our extremities. Guess what stimulates adrenaline? Bright lights, feelings of being observed, strangers and being prodded! Where does all of the above take place? Is it any wonder why so many women arrive at hospital and their labour slows or completely stops? This is where you will hear that vile phrase ‘failure to progress’. This is just basic birth physiology! So why is this not hard wired into our brains instead of fear and trauma associated with birth?

It is not uncommon to be told “women used to die in childbirth”. In the late 19th century, women feared ‘childbed fever’. We had no understanding of bacteria or hand washing until Semmelweis discovered women were dying at the hands of doctors. They would perform surgery then deliver babies without washing their hands. He ordered his staff to wash their hands without understanding why it was working, but maternal death rates significantly dropped. After evidence emerged about bacteria, childbed fever virtually disappeared. Being that poverty is one of the leading causes of maternal death, it is not surprising that as poverty rates decreased over the years, so did maternal and infant deaths. Issues such as overcrowding and malnourishment were no longer a common risk factor for women.

After the second world war, there was a mass shift from home to hospital without any evidence whatsoever that it improved safety. It became a status symbol to give birth in hospital. So rather than just the ‘high risk’ women giving birth in hospital, it became common practice for all women. We lost community midwives and more importantly, we lost continuity of care. This is probably one of the biggest travesties in obstetrics.

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