HW 42

Looking Back on the Past One-Hundred Years of Childbirth

There are certainly many aspects of society which at first glance don't seem unusual. However, the closer one looks, the more they realize just how unusual most things are. Specifically, birth. In a world where everyone is constantly trying to stand out birth is the one thing where literally every person experienced some form more or less of a similar entrance. The only thing that separates people is exactly the technique that was used to bring them into this galaxy. Through this distinction one begins to realize how "normal" has shifted quite a bit, and through this discovery one begins to question what they consider to be normal.

The turn of the 20^th century brought on a tremendous change in the way the United States approached birth. Just six years before 1900 in 1894 the first cesarean section was performed in Boston. The change of birth seemed to be parallel to many industrial and transportation changes as well. Since cars and better roads were in progress it was much easier for people to get to the hospital. By 1900 physicians were participating in nearly half of the countries births, mainly women of middle and upper class. Surprisingly enough only five percent of women actually gave birth in a hospital, yet there was a huge pull for a hospital birth since the pain seemed to decrease in this environment verses having a home birth. For a women of lower class a midwife oversaw her birth instead of a doctor. It wasn’t until 1914 that twilight sleep was brought into hospitals in the United States, yet in just five years (1921) the rate of hospital births rose to thirty to fifty percent for the entire country. By 1938 the twilight sleep had taken over all of the deliveries and just one year later in 1939 nearly seventy-five percent of births occurred in hospitals. By the 1950’s eighty-eight percent of births occurred in the hospitals and ten years later in 1960, ninety-seven percent of births occurred in hospitals. By 2006 the cesarean section had become the most regularly performed surgery in the hospital. Today more than one in five births are induced and nearly 32% of births are cesarean sections. Shocking how in just a little over one hundred years so much “progress” could be made to a key component of life that was doing fine before all of the alterations. (Adapted from The History of Midwifery and Childbirth - A Time Line)

It appears as though the hospital is one big gimmick. When looking at different structures one often feels a certain emotion, looking at a restaurant makes one hungry, or looking at a funeral home makes one scared or sad but the sound of sirens or the structure of a hospital doesn’t normally make one feel robbed, nervous or angry. When most think of hospitals of course there is a sense of unknown but most of the time it is a sense of hope or relief that the people within this structure will do whatever it takes to keep a person alive and well. So it becomes quite complicated and even a bit confusing when a different side of the hospital is shown, a side that is not normally shown or even talked about because this sense of emotion isn’t wonderful or something to celebrate, it becomes a situation where the best thing to do is, “get the hell out of the hospital.” The problem with birth in the United States is that very few doctors have ever actually witnessed a “normal” birth, in their mind a “normal” birth probably involves some pitocin, an epidural and a cesarean section. It is safe to say that “normal” has shifted into something so unnatural and so meaningless. Strangely enough the United States has the second worst newborn rate in the WORLD. Sure the doctors are relieving the pain of the mothers for a moment or two but the pain of the unborn child is sacrificed, and “No pain-no game” is completely contradicted in the delivery room for the doctor ends up playing the game more so then the mother. Her moment of pure ecstasy is pushed right out of her as the drugs get pushed into her, and instead of “giving into the pain” she is forced to avoid it. The question of why this has to happen is then asked, is it because cesarean sections are doctor friendly, or because “…it’s done, it’s surgery… one, two, three.”? The strong sensations a woman feels while delivering don’t have to be interpreted as pain and this sense of fear is based truly around the fact that women are convinced they don’t know how to give birth. In consolation though these emotions are expected considering how birth has changed, the sense of beauty and sacredness is gone, and now all that is felt is emptiness. (The Business of Being Born)

Yet maybe women truly are in so much pain that they would rather get through it with the help of a needle or a knife, and could care less for the ecstasy…“As Dorothy Thomashower, a New Yorker who gave birth unnaturally in the early 1950s put it, “Practically all of us got some anesthesia. It depended on how hysterical you were. It was based on the personality of the woman. It wasn’t until women were burning their bras and letting their hair grow under their arms that they really all went for natural childbirth. Why? For one thing, anger is a powerful motivator. Women in the 1950s were not rebelling. If they wanted to tweak the medical routine-say, be coherent during delivery-they did so with their doctor’s blessing. That would all change in the 1970s, when their daughters were marching for civil rights, joining feminist rallies, and demanding a patients bill of rights.” (127-128) This however brings the question that even with all of the fighting against the system why the statistics of the birth world today are even higher than they were in 1950. One would think that this fight would lower them dramatically; curiosity of this sparks the idea that this group of fighters was too small to make a significant change yet amongst them though the change was large. “Birthing guru Dr. Grantly Dick-Read once effused: “Happy childbirth is the most vital factor for building a progressive, purposeful and considerate world. Let us help them to realize birth should be natural…and we will have healthier children with controlled nervous and mental function.”” (Page 111) It almost seems as though if the vast majority of society were to participate in a truly natural birth a world of utopia would be born as well. If babies are coming into the world on drugs and with the mindset of anxiety then that would explain the reasoning behind the amount of people who use drugs and are mentally unstable. (Get Me Out: a History of Childbirth from the Garden of Eden to the Sperm Bank)

It seems so bizarre that an act a woman’s body is made for is so questionable and worried about. When a woman has a successful natural birth she is praised for her efforts and individuality. When in reality most woman should and could have the same experience since all woman are made up of the same parts…

(Click on Image to Enlarge)

Even fifty years ago society was still in awe that someone could undergo this type of experience and come out alive. This state of awe has practically stayed at the same level today, a women who decides to participate in a natural birth without intervention of drugs is looked at as so unordinary when really she is just going by what nature expects. Nature has become something that humans are constantly trying to defy and go against because there is a sense that everything could be done better. It makes one wonder though about all of the other animals that also give birth successfully, how do they avoid the criticism of the rest of their tribe. Considering humans find themselves superior to all of the other species residing along side them maybe when it comes to birth humans are way behind every other creature that recreates… (Bornfree! Laura Shanley's Unassisted Childbirth Page)

Something to consider is the constant need for the United States to be ahead of the game, the faster the babies get out the sooner they will be working and paying taxes to the government. Yet the side affects of this fast moving pace will most certainly have consequences and the ones paying the price are all of the Americans who choose to live by these standards. A woman who gave birth once in Malawai (Central Africa) and once in the United States had smooth pregnancies in both countries, however the way she was treated during and after was significantly different. “In 1969, I gave birth to my first baby in Malawi, Central Africa…My son was born without complication in a small hospital with very minimal intervention. My American doctor had told me to get help if I needed to use the toilet, and I ran for the nurse after a short while. When she arrived, she asked if I were okay, and then I said I was but that I was supposed to get assistance, she said, “All you did was have a baby.” Perhaps this sounds rude, but it was of course true…An hour later, my hospitals roommate’s family arrived with a big platter of hot curry, and I sat on her bed and shared it with her. The whole atmosphere was very joyous…we were both delighted with our achievements…Two years later, I was in New York State…I ended up in a Maternity Hospital, run by woman doctors. I had to do a bit of lying during my labor. I didn’t want my pubic hair shaved, so I told one nurse that the doctor said I didn’t have to, and I had to fight not to have an episiotomy…The relaxed attitude was gone; even in my case it was clearly a medical procedure, although nothing like what woman go through now in America.” (1-2) There is a change in her tone where she makes almost a complete turn into cruelty, it’s as if she is coming in to be beaten verses in Africa where she was coming into the hospital for a experience that she had control over. In Africa there was no sense of unequal power or fighting, just a simplistic day full of natural ways. (Childbirth across Cultures: Ideas and Practices of Pregnancy, Childbirth and the Postpartum)

In contrast however a midwife gave her ideas on the state the United States is in now, in terms of the birth world. “The hospital's view is that they want a healthy baby and mom emerging from the birth process. The hospital wants to avoid lawsuits as they are very expensive to settle or to take to court (which rarely occurs due to the vast expense)… As long as medical studies come out saying that outcomes are improved when labor follows a timely curve, I don't see practice in the hospital changing much. Most women, if left to their own devices can have a natural birth. However, we do live in a society where we expect easy, fast results. Labor hurts a lot and many women in today's world can't take the pain. They then get interventions such as early epidurals, etc. that immobilizes them into the bed, leading to other interventions that eventually can lead to having operative delivery. One must never forget, however, pregnancy and birth is always dangerous for women. Many things can go wrong. Just look in any old cemetery and see all the young women who died given birth. The trick is knowing when you must intervene. Frequently, they are the one's saying "Cut me!" At least in the population I serve--poor and working class immigrant women. Of course, I always reassure them that they can do it.” One would anticipate and expect her to be very anti-hospital considering the position she serves. However, she seemed very neutral and in no way had the urge to bash the hospital. She was honest that birth is going to be painful and some women can with stand the pain while others need the man made techniques of relief. Yet she is true to making sure that whatever the women truly needs she will get and she isn’t going to suggest anything unnecessary just to get things to move a bit faster.

As Foucault said, "I would like to write the history of this prison, with all the political investments of the body that it gathers together in its closed architecture. Why? Simply because I am interested in the past? No, if one means by that writing a history of the past in terms of the present. Yes, if one means writing the history of the present." History is crucial to a better understanding of a subject, if one takes information of the past it will allow them to make better choices for the future. By examining the many aspects of birth, as a country there is a better shot of changing the way birth is treated. Although not everyone will decide to throw the drugs away and be firm about saying NO to cesarean sections there is hope that some will, and with that hope comes the courage that the joy and the ecstasy will become a reality for the vast majority.

Citations:

1. Feldhusen, Adrian E. "The History of Midwifery and Childbirth - A Time Line."Midwifery Today - Pregnancy, Birth, Homebirth and Midwife Information. 2000. Web. 31 Mar. 2011.

2. The Business of Being Born. Dir. Abby Epstein. 2008. Film.

3. Epstein, Randi Hutter. Get Me Out: a History of Childbirth from the Garden of Eden to the Sperm Bank. New York: Norton, 2010. Print.

4. "Unassisted Childbirth in the 1950's." Bornfree! Laura Shanley's Unassisted Childbirth Page. Web. 31 Mar. 2011. .

Selin, Helaine, and Pamela Kendall. Stone. Childbirth across Cultures: Ideas and Practices of Pregnancy, Childbirth and the Postpartum. Dordrecht: Springer Verlag, 2009. Print.

5. Foucault, Michel. Discipline & Punish - The Birth of the Prison. New York, 1979. Print.