“The Business of Being Born”, British-Style
Recently, the New York Times reported on a study unveiled in Great Britain, which revealed an interesting find in the field of childbirth. According to the study conducted by Britain’s National Institute for Health and Care Excellence, it is safer for women with no complications during their pregnancies to give birth under the supervision of midwives, rather than ob-gyns. (Women with no pregnancy complications are defined as those who have not had high-risk pregnancies in the past, are expected to carry the fetus to full-term, and for whom the baby is presenting head-first). The study found that obstetricians are more likely to use unnecessary medical interventions among low-risk pregnancies — including spinal anesthesia, cesarean section, forceps delivery, and episiotomies — which pose greater threats of infection and surgical accidents.
Of course, this is not new news within the natural pregnancy movement. Ricki Lake’s famous documentary, The Business of Being Born, made this argument years ago. Restricted by looming warnings of malpractice, obstetricians – surgeons by training – are more likely to impose medical interventions on delivering moms. This means ordering C-sections and performing episiotomies in cases where these may not always be needed. Midwives, however, rely on mother’s advocacy and self-awareness to guide decisions in the delivery room. They will defer to doctors when a complication surfaces that could pose a risk to Mom or Baby.
The Times notes that in the US, only 9% of the 3.9 million births that occurred last year were attended by midwives. This has not always been the case, however. At the turn of the century, midwives attended approximately half of all births. However, notable shifts in medical knowledge, which stigmatized childbirth as a pathology to mother and child, and positioned midwives as lacking in education/training and a resource for the lower classes, contributed to the decline of midwives and home births (read more here). Eventually, years later, the rise of the nurse-midwife helped to ease the public’s mind about the training and licensing for midwives. The nurse-midwives brought great changes to the birthing field, including the inclusion of fathers in the delivery room, a push for breastfeeding, and the allowance of babies and mothers to remain in the same room post-birth. Fast forward fifty years to now, when 75% of certified nurse midwives work in physician practices or hospitals, and either interact with or are under the supervision of doctors. Strict standard and licensing requirements for midwives have long assured expecting parents of their capabilities in the delivery room, and now it seems, they may even be a safer option? Perhaps the implications of the British study will have a ripple effect on the American healthcare system to push for greater autonomy among midwives.
By Jenny Nigro, online intern
Photo source: Wikimedia Commons