What Women Aren't Told About Childbirth

By Manda Aufochs Gillespie and Mariya Strauss, AlterNet. Posted October 20, 2007.

Even in this age of cybervoyeurism and hyperinformation, the act of having a baby remains one of the few bodily activities about which many people choose to remain blissfully ignorant. This might best be described as the "but it won't happen to me" phenomenon. Understandably, women hope, despite all they may learn otherwise, that pregnancy, childbirth and parenting will go easier for them -- their baby will sleep, their feet won't swell to the size of melons and, of course, they will have an uncomplicated -- sweaty, perhaps, but not seriously painful -- labor.

Like most myths, there are the people for whom the fiction is the reality, but they are the exception. Chances are your baby will cry at night; your feet will swell; and unless you are willing to research in depth, shop around for care providers and advocate stubbornly for what you want, you probably won't have the labor you expect. This isn't just a benign statement about how we never get what we expect: A new survey of mothers reveals some disturbing things about hospital maternity care that may make pregnant women want to take a closer look at their options.

The survey Listening to Mothers II (LM 2) was released in 2006 and reports on U.S. women's childbearing experiences. Conducted for Childbirth Connection by Harris Interactive in partnership with Lamaze International and Boston University School of Public Health, it is the first comprehensive survey of women's childbearing experiences. The survey population is representative of U.S. mothers 18 to 45 who gave birth to a single infant in a hospital, with 1,573 actual participants.

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."

The majority of women ended up attached to IVs, catheters and fetal monitors. They had their membranes artificially ruptured and were given epidurals. Most of these women had little understanding of the side effects of these interventions, including cesarean and medical inductions. The report also shows that though women understood that they had the right to refuse medical interventions, few did, and many received interventions, such as episiotomies, without their consent.

Just as troubling is what is not being done. A "very tiny minority" of women received all of the care practices that promote natural birth. "With 4 million U.S. births annually, a single percentage point represents about 40,000 mothers and babies per year," the report authors say. Despite the relative health of women in the United States, many women are not getting the uncomplicated births they might expect.

But whose responsibility is it to make sure a baby's birth is a positive experience for the mother and her family? And what kind of birth do women want?

Achieving a more natural natural birth

Popular media outlets and advertisers would have women believe that labor and delivery happen in only one context: hospitals. When television shows, health magazines and films depict birth as a highly medicalized phenomenon that involves lots of screaming, a command to push and a baby before the next commercial break, it is no wonder that so few women in labor think to ask for more information when they are offered medical interventions. Or that so few are educated about natural childbirth.

Juli Walter teaches childbirth education classes on Chicago's northwest side. "Most of my students have an idea when they come to class that they would like to have a natural childbirth," says Walter. "However, they don't really have an understanding of what they need to have a natural birth." Though some make an effort to learn about birth from other mothers or books, most pregnant women don't have a grasp of the details of childbirth -- things like the physical and emotional stages of labor, the anatomical changes their bodies are experiencing, or the amount of pain they are likely to experience in labor and delivery.

Even among the women who say they want a natural birth, the term "natural" doesn't always mean the same thing. Many people believe that labor and birth are a natural human process, engineered by evolution with such sensitivity that any intervention -- like administering anesthesia or drugs to speed labor -- could cause it to malfunction. Under this model, most births are attended by midwives who act as lifeguards -- well-trained birth professionals who will be constantly present and intervene only if serious complications arise. This type of assistance during a birth, says doula and certified professional midwife (CPM) Mary Doyle, is "more about collaborating and being an ally to a pregnant woman, honoring her choices and letting her be in control of her experience rather than dictating what is going to happen."

Following this model of care for labor and birth, a woman might have her baby at home or in a midwife-staffed birthing center, both with the ability to transfer to a nearby hospital. Women have all sorts of reasons for wanting an alternative to hospitals: "For some women, it's the intimacy of birth that makes them want a birth center or to give birth at home," says Gayle Riedmann, a Certified Nurse-Midwife (CNM) who runs a midwifery practice in Oak Park, Ill. She is a board member of the Health and Medicine Policy Research Group (HMPRG), a group of health professionals and researchers that advocates for health-related policy improvements across the state.

See more stories tagged with: childbirth, labor, pregnancy, mothers, cesareans

Manda Aufochs Gillespie has served as editor of F Newsmagazine and Ink Literary Journal and was a regular contributing writer for the journal EcoCity Cleveland. Her work has been published in Conscious Choice , Cleveland Magazine, Communities Journal. Manda had her first baby at home with midwives in November 2006. Mariya Strauss' recent publications include literary reviews for Bookslut.com, feature articles and art reviews in F Newsmagazine. She recently edited a catalogue of essays published by the Video Data Bank. Mariya had her first baby in a hospital in September 2006.

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