“We often fear what we don’t understand….”

“We often fear what we do not understand; our best defense is knowledge.”
– Tuvok (Star Trek: Voyager)

“In time we hate that which we often fear.”  -William Shakespeare

 

As I look historically at childbirth in our country, I think the biggest question that screams in my head is, “Why did we START going to hospitals to have babies?” How did that become an ingrained part of our culture and response to birth?

Homebirth with a midwife 1900s

From the creation of man until the early 1900’s, homebirth was normal and expected. Like every other event in our lives, we sought the help of physicians and hospitals when there was something wrong. By 1930, almost half of all births were occurring in hospitals. By 1950’s, 95% of births in America occurred in hospital. Currently in the United States, only 1% of births occur in the home.

 

 

Hospital birth 1950s

There’s a lot of things that happened during this time – anesthesia for birth in the form of scopolamine (and now epidurals) became available, cesareans became routine (too routine if you ask some people today), forceps were used, germs were discovered to exist and antiseptic techniques (hand washing, etc) came into use, and while our knowledge of birth increased in the medical community it remained with elite circles as birth was not something that civilized people talked about.

Lucy’s checking into the hospital to give birth, husband Ricky in wheelchair because he is overwhelmed

In I Love Lucy, the first pregnancy to be represented on television, the word “pregnant” was not allowed to be said. The title of the episode is “Lucy is Encienta” – the Spanish word for pregnant. Therefore, more medical responses to complications increased, but the understanding of birth in the general population did not. We often fear what we do not understand, and most people did not understand (and still don’t understand) childbirth.

 

So in America today, most people fear childbirth.

In that time, doctors were taught about the pathologies that can happen during pregnancy. They learned how to take the sensations away with blocks and anesthesia, they learned how to do surgeries to save lives, they learned all about the things that can go wrong and how to respond to them – but they did not learn how to facilitate and help with “normal and healthy”. The medical model of care states that a normal birth can only be a retrospective diagnosis that happens after the fact – after everything is done and nothing has gone wrong. Not one day is spent learning about out of hospital births, midwifery care, ways to approach the spiritual and emotional event of giving birth. We often fear what we don’t understand, and they do not understand homebirth. They don’t understand the training homebirth midwives have to go through for certification/licensure. They don’t understand how intelligent and knowledgeable our average client is by the time they have researched childbirth and their options to the stage that they give us a call. They don’t understand what we are doing at home or how we are caring for people at home. They don’t understand why homebirth families are so passionate about the care they’ve received because it seems so scary to them. Understandably so – it is human nature to fear what we do not understand and homebirth goes way beyond most physicians education or experience.

So in America today, most physicians fear homebirths.

Dr Marsden Wagner

I once sat with the previous director for Maternal and Child Health for the World Health Organization, Dr Marsden Wagner, and we chatted about the state of obstetrics in America. He shared with me a story of speaking at a conference at the American College of Obstetricians and Gynecologists (ACOG – since changed to American Congress of Obstetricians and Gynecologists) and he was speaking favorably about midwifery care. He told me about the aggressively negative response midwifery received as they grumbled about how dangerous out of hospital births were. 250+ doctors arguing with the Director about homebirths, and Dr Wagner told me that he quieted them down and said, “Please raise your hand if you have ever attended or witnessed a homebirth.” Not a single hand went up in the room. NOT. ONE. HAND. Yet all of them felt STRONGLY in their opinion that homebirths were bad births. Dr Wagner shared this experience to demonstrate that ignorance is the great barrier between what should be a collaborative effort in the name of safety for moms and babies.

Our best defense is knowledge. The more women know about how their bodies work, what they are capable of, what their childbirth options are – the less they will fear it. I believe in my heart that the more doctors know about midwives and homebirths, the less they will fear it.  Teaching midwives about hospital births, teaching doctors about homebirth, gaining an understanding of the very real importance each options brings to the table can only serve to increase trust in each other and increase satisfaction and healthy outcomes for birthing families.Bridging this divide with knowledge and education. Bringing together the circle of mothers, fathers, doctors, midwives, nurses, birthing centers and hospitals – to work together in collaborative care to bring all pieces together – the only possible outcome is improvement of a very broken system.

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