Endnotes - Spontaneous Creation: 101 Reasons Not to Have Your Baby in a Hospital

ENDNOTES

Spontaneous Creation:

101 Reasons Not to Have Your Baby in a Hospital, Vol. 1

A Book about Natural Childbirth and the Birth of

Wisdom and Power in Childbearing Women

by Jock Doubleday

PREFACE

This is the story of how we begin to remember. (Paul Simon, "Under African Skies," Graceland CD)

Trembling, he plucked one, wiped the dust away to see the berry's true color. . . . Gritting his courage, Covenant put the berry in his mouth. . . . The world spun wildly, then sprang straight. Cool juice filled Covenant's mouth with a savor of peach made tangy by salt and lime. At once, new energy burst through him. Deliciousness cleansed his throat of dirt and thirst and blood. All his nerves thrilled to a savor he had not tasted for ten long years: the quintessential nectar of the Land. (Stephen R. Donaldson, The Wounded Land, 135-137)

For persons who wonder how someone who is not a doctor can write with authority about childbirth, I quote John Robbins in his 1996 work, Reclaiming Our Health: "Some people wonder how I can presume to write with authority about these subjects, when I am not a doctor. Many of us have been taught that doctors, by virtue of their medical training, constitute a special class of human being, almost a priesthood. The truth is that if I had been trained as they have been, and if I were subject to the same financial pressures they are, I might be preoccupied with technology and drugs, oblivious to their drawbacks and risks, and dismissive of alternative approaches, just as many physicians today are. If I had spent six or eight years of my life being trained to practice orthodox medicine, and had sacrificed greatly in order to do this, as most of our doctors have, I would hardly be in a position to consider the subject without personal bias. It is precisely because I am not a doctor that I can more easily stand outside the fray, and hopefully bring a measure of objectivity to the discussion." (Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing, 7) I would say in addition that the true experts in childbirth are, without any doubt, women. The greater part of this book is based upon information from female authors, female midwives, and women's birth stories.

John Robbins brings doctors down to earth: "We struggle today, as a culture, to get over the idea that M.D. stands for "Medical Deity." It wouldn't hurt us to remember that in Israel in 1973, doctors went on strike for a month, and the death rate dropped 50 percent. There had not been a month with so few deaths since the previous doctors' strike, 20 years before. A few years later, in Bogota, Colombia, a two-month-long physician strike resulted in a 35 percent drop in the death rate. And when Los Angeles county doctors went on a work slowdown to protest soaring malpractice insurance premiums, the death rate dropped 18 percent. But when the slowdown ended, and the medical industry got back in gear, the death rate jumped right back up to where it had been before." (Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing, 7)

Spontaneous creation Sheila Kitzinger writes that "labor is essentially a spontaneous physiological process." ("The Rhythmic Second Stage," The Birth Center Newsletter (Summer 1978) 101 Tufnell Park Road, London, N7, England, in Nan Koehler, Artemis Speaks: V.B.A.C. Stories & Natural Childbirth Information, 291)

Alan Watts writes: "The Chinese phrase which is ordinarily translated as "nature" is tzu-jan, literally "of itself so," and thus a better equivalent might be 'spontaneity.'" (Nature, Man, and Woman, 10)

Philosophically, the idea of spontaneous creation is that "something can come from nothing," an idea that both quantum physics and many religions posit. See "Cosmogony" at www.evolution.mbdojo.com/cosmogony.htm for a twist on the quantum physics version of this idea. See "How the universe can come from nothing," at www.braungardt.com/Physics/Vacuum%20Fluctuation.htm for a list of quotes on the quantum physics view of "something from nothing." For a fascinating expose on the theory of the Big Bang, see "The true state of the universe," at www.holoscience.com/news.php?article=0auycyew. See "Author's Statement," at www.unifiedreality.com/statement.html for a discussion of how Eastern religions view the idea of "something from nothing."

spontaneous organization, "like some dark and passing shadow within matter, spaces the notes of a meadowlark's song in the interior of a mottled egg." (Loren Eiseley, The Immense Journey, 26)

Homeostasis stabilizes your in utero infant's temperature when you take a five-mile walk in 100° heat Diane E. Depken writes: "Normal thermoregulation processes in humans would not cause [infant-adverse] temperature increases during exercise." ("Exercise Physiology in Pregnancy," The Encyclopedia of Childbirth, 133)

homeostasis brings your pleasure-inducing endorphins back down from their 30-times-normal levels and slowly shrinks your uterus back to its original size. (Jimenez, S. "Supportive pain management strategies," in Childbirth Education: Practice, Research, and Theory, F.H. Nichols and S.S. Humenick, eds., Philadelphia: Saunders, 1988)

"the distinction between what is biological and . . . social [in childbirth] has no ontological status." (Brigitte Jordan, Birth in Four Cultures: A Crosscultural Investigation of Childbirth in Yucatan, Holland, Sweden and the United States, 1)

"It is sometimes argued that modern women have lost the 'art' of giving birth and that culture and beliefs have so over-ridden women's natural responses that they require direction and assistance to birth normally. This overlooks basic innate drives to reproduce, and reproduce successfully, common to all species, and the ability of endogenous endorphins to create the necessary introverted and uninhibited states that form the basis for instinctive behaviours. Successful birth is far too important in nature for its achievement to be left to chance or luck: inbuilt mechanisms guide the process towards a successful conclusion, and these can be accessed provided a woman is willing to explore her hidden capabilities, and if she is provided with an environment conducive to this exploration." (Andrea Robertson, Empowering Women: Teaching Active Birth in the 90s, 101)

Andrea Robertson writes: "It is true that many women allow cultural values, fashion and personal beliefs to inhibit their innate abilities. It is also true that the current medicalisation of birth encourages women to forsake their own resources and embrace technology and external guidance during labour. The folly of this approach is only now being revealed through rigorous scientific studies. Meanwhile, many women have discovered, to their cost in physical and emotional terms, the inherent risks of tinkering with nature." (Empowering Women: Teaching Active Birth in the 90s, 101)

"The whole room actually turned pink . . . It was the dead of winter – still pitch dark outside, so it wasn't sunrise. The doctor noticed it too and he's straight as an arrow. . . . He didn't understand it . . . this rose colored light absolutely filling the room." (Mother's testimonial, in Nancy Caldwell Sorel, Ever Since Eve: Personal Reflections on Childbirth, 1)

"In their child-bearing on some green mountain-side, sometimes not even sheltered from the rain, they face their essential womanhood . . ." (Margaret Mead, Male and Female: A Study of the Sexes in a Changing World, 29)

Homo sapiens, or creatures very like Homo sapiens (those of the genus Homo), have survived the snowstorms of no fewer than 20 ice ages in the last 2.5 million years. There is some controversy as to the time of the dawning of the human race. Rick Gore writes that "around seven million years ago, at least one offshoot of the Africa apes began walking on two legs. As that bipedal ape [possibly Ardipithecus kadabba, or her ancestor] evolved into what would become us, other mammals came and went. Most had to adapt to yet another global climate change about 2.5 million years ago, triggered in part by the formation of the Isthmus of Panama. Its formation blocked east-west ocean circulation and encouraged the Gulf Stream to grow stronger. As the Gulf Stream pumped more warm water closer to the North Pole, precipitation increased. Heavy snows became glaciers two miles thick, which advanced and retreated in a series of more than 20 ice ages." (Rick Gore, "The rise of mammals: adapting, evolving, surviving," National Geographic, April 2003, p. 31)

Her bipedalism was and still is a novelty in the mammalian world. The first reptilian biped is believed to have been the little-known bolosaur (www.sciam.com).

"Often a woman will say, 'Thank God I was in the hospital when I gave birth. There were complications, but the doctor saved my baby's life.' What she may not understand is that the interference by the doctor and the nursing staff, from the moment she entered the hospital, may have actually caused the 'complications' in the first place." (Laura Kaplan Shanley, Unassisted Childbirth, 11)

"Are you anti-technology? Are you anti-science?" (Larry King (playing himself) to spiritualist "Palmer Joss" (Matthew McConaughey) in the movie Contact, based on the novel of the same name by Carl Sagan)

"The question that I'm asking is: Are we happier as a human race? Is the world a fundamentally better place because of science and technology? We shop at home, we surf the Web. But at the same time, we feel emptier, lonelier, and more cut off from each other than at any other time in human history. . . . We're becoming a synthesized society. . . . I'm not against technology. I'm against the men who deify it at the expense of human truth." ("Palmer Joss" (Matthew McConaughey) to Larry King (playing himself) in the movie Contact, based on the novel of the same name by Carl Sagan)

"Many doctors [believe] that we can improve everything, even natural childbirth in a healthy woman. This philosophy is the philosophy of people who think it deplorable that they had not been consulted at the creation of Eve, because they would have done a better job." (G.J. Kloosterman, M.D., "The Midwife: Her Task and Responsibility in a Technologic World," in David Stewart, The Five Standards for Safe Childbearing, 229)

In 1990, China's hospital childbirth rate had already reached 51 percent. By the year 2000, it had risen to an astonishing 76 percent. (http://english.peopledaily.com.cn/200209/30/eng20020930_104171.shtml)

Marsden Wagner writes: "During a WHO visit to China, I realized that the developing world was – and is – in serious jeopardy of unquestioningly importing the orthodox obstetrical model." ("Confessions of a Dissident," in Davis-Floyd, Robbie E. and Sargent, Carolyn F., Eds. Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives, 373)

"Our attempts to wipe out all traditional practices in one blow and start over, either by sending the nonlocal medical personnel or by forcing women into a hospital environment, can only . . . hasten the disintegration of a people's cultural heritage. In the end, we will be responsible for the alienation of a people from itself, as is the case in many areas of Western culture. And these cultural heritages are far too precious to lose." (Grantly Dick-Read in Judith Goldsmith, Childbirth Wisdom From the World's Oldest Societies, 205)

Some cultures resist Western culture's techno-fetish more strongly than others. Margaret Mead writes: "The Samoans have made one of the most effective adjustments to the impact of Western civilization of any known people. From the European's technology they took cloth and knives, lanterns and kerosene, soap and starch and sewing-machines, paper and pen and ink, but they have kept their bare feet, their cool short sarongs, their houses built of native materials fastened together with coconut-fibre cord. When the hurricanes come, the metal roofing sheets on the white men's house fly off and sometimes kill people, the house itself is wrecked, but the Samoan house collapses gracefully before the storm, later to be rebuilt of the same posts. They accepted Protestant Christianity, but gently remoulded some of its sterner tenets. Why repent so bitterly, says the Samoan preacher, 'when God is just waiting to forgive you all the time'?" (Margaret Mead, Male and Female, 124)

"In the pursuit of Tao, every day something is dropped.

Less and less is done until non-action is achieved.

When nothing is done, nothing is left undone.

The world is ruled by letting things take their course.

It cannot be ruled by interfering."

(Lao Tzu (spelled Lau Tsu in this commentatry) The Tao Te Ching, translators Gia-Fu Feng and Jane English)

"We have forgotten the part we came here to play. We have lost the key to our own house. . . . Together we embark on a quest for our own enchantment. It will take us to a place where what is feminine is sacred . . . There we can become who we are meant to be and live the life we are meant to live." (Marianne Williamson, A Woman's Worth, 5-6)

"Fully 75 percent of hospital-birthing women have their babies taken from them before breastfeeding has begun." (Suzanne Arms, www.birthingthefuture.com/AllAboutBirth/birthMythFact.php)

Tragically, the vast majority of Americans born since 1970 have made a primary bond with a material object instead of with a human being. Nature could not have anticipated this state of affairs and has no remedy for it. Joseph Chilton Pearce writes: "At the height of this stress, the infant is isolated, which very plainly means abandoned. There, in proximity to only material things (the baby blanket), he must manage again to achieve some stress reduction in order to survive; the need of physical skin stimulus to facilitate this reduction finds only that baby blanket, a nonhuman source of stress reduction. What is the great learning? What is being built into the very fibers of that mind-brain-body system as the initial experiences of life? Encounters with people are causes of severe, unbroken, unrelenting stress, and that stress finds its only reduction through contact with material objects." (Magical Child, 63)

Unbonded persons feel that they have no safe place to stand. Joseph Chilton Pearce writes: "Bonding seals a primary knowing that is the basis for rational thought. We are never conscious of being bonded; we are conscious only of our acute disease when we are not bonded or when we are bonded to compulsion and material things. The unbonded person (and bonding to objects is to be very much unbonded in a functional sense) will spend his life in a search for what bonding was designed to give: the matrix. The intelligence can never unfold as designed because it never gets beyond this primal need. All intellectual activity, no matter how developed, will be used in a search for that matrix, which will take on such guises as authenticity, making it in this world, getting somewhere." (Magical Child, 63)

"The unbonded female might become neurotic and be unable to bond to her [own] child properly, but the unbonded male goes very subtly mad. Unless rooted to the mother matrix, his other matrices cannot form, and his machinery loses its balancing mechanism, its governor. He runs amok. What the unbonded male does is spend his life turning back on that matrix, trying to force from it that which is lacking. And what is lacking is his source of personal power, his possibility, and his safe space. Lacking these, he turns and uses his strength to rape. He rapes either crudely or with sophistication, that is, bodily, or intellectually, raping the earth matrix with technology. . . . The rapist himself does not understand the real hunger that drives him." (Joseph Chilton Pearce, Magical Child, 258; see also www.birthpsychology.com/violence/index.html)

"Technology is now displacing philosophical and religious values as the dominant force in shaping the world, and therefore in determining human fate." (René Dubos, Mirage of Health, 270)

"Gaia is a tough bitch" (Lynn Margulis, "Gaia Is a Tough Bitch," www.edge.org/documents/ThirdCulture/n-Ch.7.html)

INTRODUCTION

The midwifery philosophy says that the birth of your child will probably go well, that nature will succeed in giving you a healthy baby as it has succeeded for millennia in the perpetuation of our species. The midwifery philosophy says that childbirth is a natural event. The medical philosophy says that nature may fail in the birth of your child. It says that prudent expectant mothers should enlist the help of medical professionals in case any of various emergencies arise. The medical philosophy says that childbirth is a medical event. Andrea Robertson writes: "The single most important decision that prospective parents will make, in terms of the outcome of the birth and the potential future health of their child, concerns the choice of caregiver for pregnancy, labour and birth. Research has clearly shown that the attitudes, philosophy and practices of the main caregiver present during labour and birth will shape the management of the event and have a huge impact on the quality of the experience for each parent, and also for the baby. Research has shown, for example, that a midwife, with a training and philosophy centred on birth as a normal bodily process, approaches assisting a woman in labour differently from a doctor, who tends to view birth from his training in the medical model of treating illness. A midwife is more likely to assume that the labour is going well unless it is demonstrably not the case, whereas a doctor is more likely to assume there will be a problem, and demand proactive intervention [like vaginal exams, electronic fetal monitoring, etc.], just in case problems occur later." (Empowering Women: Teaching Active Birth in the 90s, 63-64)

In Europe, 75 percent of birthing women use midwives as their principal birth attendants.

(Midwives' Alliance of North America, www.mana.org and Citizens for Midwifery, www.cfmidwifery.org)

Dr. Charles S. Mahan writes that "midwifery has, like public health, been the firm foundation of the health care pyramid for mothers and babies in most countries, except for ours. This lets the reader with even an average imagination see some of the folly of building a hierarchy of care as an inverted pyramid – with the majority of pregnant women receiving care from specialists even though most of the women are experiencing a normal physiologic event. Such is life in the U.S. health care non-system." (Foreword to Judith Pence Rooks' Midwifery & Childbirth in America, xvii)

Lester Dessez Hazell writes: "The obstetrician spends about eight years getting an education that fits him admirably for dealing with the 5 or so percent of women who present real obstetrical problems . . ." (Commonsense Childbirth, 52)

In America, only three percent of women use home birth midwives as their principal birth attendants. (Midwives' Alliance of North America, www.mana.org and Citizens for Midwifery, www.cfmidwifery.org)

Doris Haire writes: "As an officer of the International Childbirth Education Association I have visited hundreds of maternity hospitals throughout the world . . . [C]ertain patterns of care soon became evident. For one, in those countries which enjoy an incidence of infant mortality and birth trauma significantly lower than that of the United States, highly trained professional midwives are an important source of obstetrical care . . . In these countries the expertise of the physician is called upon only when the expectant mother is ill during pregnancy or when labor or birth is anticipated to be, or found to be, abnormal." (The Cultural Warping of Childbirth, 3)

The United States ranks 28th poorest in the world in infant mortality . . . (www.unicef.org/sowc96/swc96t1x.htm)

Judith Pence Rooks writes: "Virtually every year the U.S. Public Health Service announces that our infant mortality rate has decreased. The announcements fail to mention that, although lower than before, our infant mortality rate is higher than rates in almost all countries whose level of wealth, development, and medical sophistication is similar to that of the United States. The gap between our infant mortality rate and the rates in most of those countries is getting wider . . ." (Midwifery & Childbirth in America, 1-2)

In strictly monetary terms, it has been estimated that America might save 20 billion dollars annually in health care costs by demedicalizing childbirth. (Frank A. Oski, M.D., professor and director, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore; see Midwives' Alliance of North America, www.mana.org and Citizens for Midwifery, www.cfmidwifery.org)

Judith Pence Rooks informs us that countries whose standard of care is midwifery provide care that is less sophisticated technologically than ours, spend far less money in the process, and achieve better results. (Midwifery & Childbirth in America, 1)

Charles S. Mahan writes: "We spend more money per capita on health care than any other nation and yet end up in the bottom half of international rankings for most measures of health care outcomes." (Foreword to Judith Pence Rooks' Midwifery & Childbirth in America, xviii)

Symptomatic genital herpes If you have symptoms from herpes, you are "symptomatic." If you have no symptoms, you are "asymptomatic." Anne Frye writes: "Women who are asymptomatic . . . rarely have infected babies, presumably because of the low infectivity of the virus [Gilstrap, L. and S. Faro, Infections in Pregnancy, 148] and maternal transfer of antibodies." (Understanding Diagnostic Tests in the Childbearing Year, 503)

Primary genital herpes carries a 40 percent risk of neonatal infection. Anne Frye writes: "The overall risk of neonatal infection from exposure to primary lesions present during labor is about 40%." (Understanding Diagnostic Tests in the Childbearing Year, 502)

Recurrent genital herpes carries a five percent risk of neonatal infection. Anne Frye writes: "Recurrent genital herpes: This is defined as a prior history of genital outbreaks accompanied by a positive antibody titer to HSV-2. Infants of mothers experiencing secondary genital outbreaks may acquire passive immunity before birth, which plays a role in lessening the severity of neonatal infection. Babies that come in contact with such lesions at the time of labor have a 5% risk of infection." (Understanding Diagnostic Tests in the Childbearing Year, 503)

Dr. Marie Eagleton writes: "Following research on some 40,000 pregnancies it was demonstrated that those most at risk of passing herpes onto their infants at birth, were not those already infected with the disease prior to pregnancy (where transmission rates from mother to baby are low), but rather those woman who become infected during pregnancy by contact with a sexual partner who is often undiagnosed. These findings indicate the importance of diagnosing this disease in pregnancy and the need for diagnostic protocols to identify which couples are at risk of infection." ("Recent advances in herpes technology could revolutionise treatment," www.diagnology.com)

When herpes is passed from mother to infant, it causes infant death in 50 percent of cases, and almost half of the survivors suffer serious neurological damage Anne Frye writes: "The overall risk of neonatal infection from exposure to primary lesions present during labor is about 40%. Without antiviral drugs, about half of these babies die, and 35 to 40% suffer severe neurologic sequelae, retardation and apnea." (Understanding Diagnostic Tests in the Childbearing Year, 502)

infant infection may occur . . . after birth through day-to-day mother-infant contact Anne Frye writes: "After birth, the baby can acquire herpes via contact with lesions on the breasts or lips of an infected person; babies born to seronegative mothers are most at risk from such exposures." (Understanding Diagnostic Tests in the Childbearing Year, 501)

"The majority (82-87%) of neonatal infections occur during delivery, but some also occur in utero or postnatally." (Columbia-Presbyterian Medical Center, "Screening for Genital Herpes Simplex," Guide to Clinical Preventive Services, Second Edition, Infectious Diseases, 1997)

because infant infection may occur before the birth (that is, in utero) or even after birth through day-to-day mother-infant contact, cesarean section should not be looked upon as a certain or complete solution. (See Anne Frye's important work on this subject, in her book, Understanding Diagnostic Tests in the Childbearing Year, 498-508)

If your in utero infant is in a position known as persistent transverse lie . . . cesarean delivery may be warranted. (Ina May Gaskin, Spiritual Midwifery, 319)

Most transverse-lie babies turn spontaneously before birth. Murray Enkin, et al. write: "Less than 20 per cent of transverse lies observed after 37 weeks' gestation persist to delivery." (A Guide to Effective Care in Pregnancy & Childbirth, 146)

Soft tissue obstruction, in which a fibroid or other growth blocks the birth canal, is a possible indication for cesarean section. Barbara Ursenbach Lamb writes: "Even extensive fibroid growth should not automatically indicate cesarean section, as many women give birth vaginally in spite of fibroids." ("Uterine fibroids," in The Encyclopedia of Childbearing, 413; see also Beth Shearer, "Cesarean Birth: Indications and Consequences," in The Encyclopedia of Childbearing, 56)

Cohen and Estner write: "We have worked with several women with pelvic adhesions or fibroids who have gone on to deliver vaginally. There have been no problems, even when the fibroids were in the lower segment and were described as "extensive." . . . With the increasing use of sonography, more fibroids are being discovered (or uncovered); we are certain that before sonography many women had perfectly normal deliveries in spite of fibroids." (Silent Knife, 105)

Regarding fibroid tumor prevention, Andrew Weil writes: "Fibroid tumors feed on estrogen. The higher your blood levels of estrogen, the faster they grow. You can slow their growth by cutting sources of artificial estrogen from your diet (commercially raised meat and poultry), by losing weight (high body fat is correlated with higher levels of circulating estrogen), by doing aerobic exercise regularly (it lowers blood estrogen levels), and by minimizing or eliminating consumption of alcohol (which stimulates the production of estrogen)" ("Ask Dr. Weil," Natural Health, January 1996); Julia Tolliver Maranan, assistant editor at Natural Health, writes: "Certain foods can lower estrogen levels in your body[;] fibroids shrink when patients increased their intake of whole foods and healthy fats," (Natural Health, December 2002, p. 79))

Both the size and the proximity of the fibroid are factors. Christiane Northrup writes: "Fibroids can result in miscarriage or even infertility, particularly if they've distorted the uterine cavity enough. Whether there are problems seems to depend on the location of the fibroid within the uterus and how close it is to the developing baby and placenta." (Women's Bodies, Women's Wisdom, 189)

Proper nutrition – a diet rich in fruits, vegetables, and other whole foods – may decrease the size of fibroids and their attendant risks. Christiane Northrup writes: "A woman who changes from a highly refined, nutrient-poor diet (high in prepackaged foods, cookies, white bread, french fries, candy, and pasta) to a diet rich in fruits, vegetables, and other whole foods will often experience decreased bleeding, lessened bloating, and even a decrease in the size of her fibroids. . . The vast majority of women who treat fibroids through diet get rid of their pain and heavy bleeding within three to six months." (Women's Bodies, Women's Wisdom, 201-202)

Adelle Davis writes: "Labor is easier when the prenatal diet has been good. The Toronto doctors found that women whose diets had been poor had difficult labor, whereas fewer women who had eaten more adequately had difficulty (24 per cent compared with 3 per cent). Yet the women on the poorer diet gave birth to twice as many premature infants, who were naturally smaller than full-term babies. More of the poorly fed women suffered hemorrhages during labor, and three times as many contracted infections of the uterus. Twice as many suffered from breast infections, and three times as many had breast abscesses. The Harvard group also found that, in spite of the fact that the babies were much smaller, labor was more difficult and the complications far more severe when women had eaten a poor diet during their pregnancy. . . . [F]or women who had had one or more children, the hours of labor were found to have decreased almost to half when the diets had been good. The women having more adequate diets suffered fewer hemorrhages and lacerations, and their uterine contractions were stronger. The poorly fed women convalesced more slowly, and three times as many suffered from such major complications as severe hemorrhages; infections of the uterus and urinary tract; phlebitis; high blood pressure; and inflammations, infections, and abscesses of the breast as did the better-fed women." (Let's Have Healthy Children, 7)

A condition possibly warranting cesarean delivery is placenta previa, which occurs when the placenta implants too low in the uterus and partially or entirely covers the cervix. (Ina May Gaskin, Spiritual Midwifery, 417)

Murray Enkin et al. write that second-half-of-pregnancy painless vaginal bleeding indicates placenta previa in 98% of cases. But as placentas often migrate, women found with low-lying placentas should be rechecked at 30-32 weeks. (A Guide to Effective Care in Pregnancy & Childbirth, 137)

Placenta abruptio, which occurs when the placenta dislodges too early from the uterine wall, also results in possibly life-threatening hemorrhage. Placenta abruptio is a needless tragedy, because it can be prevented with adequate protein intake before and during pregnancy: "[P]lacental detachment . . . often does occur in the parous patient with poor nutrition." (Grantly Dick-Read, Childbirth Without Fear: The Principles and Practice of Natural Childbirth, 85)

cesarean section increases the risk of experiencing placenta previa in a subsequent pregnancy (Ziadeh, S., et al., "Placental praevia and accreta: an analysis of two years' experience," J Ob Gyn 19 (1998):584-586; see also www.aims.org.uk/reswin99.htm)

Pre-eclampsia, or toxemia . . . is both preventable and reversible with proper prenatal nutrition. (Ina May Gaskin, Spiritual Midwifery, 415)

Lynn M. Griesemer writes: "Toxemia is completely preventable through a proper diet. Good protein, salt and fluid intake are essential." (Unassisted Homebirth: An Act of Love, 224)

David Stewart writes: "The principle means of prevention of toxemia is through diet. . . . If detected early enough, the effective treatment for it can also be through diet." ("How to choose a safe birth attendant, in David Stewart, The Five Standards for Safe Childbearing, 441)

Ina May Gaskin writes: "The results we have had with the 1723 pregnancies under our care tend to support Dr. Tom Brewer's contention that toxemia is a disease of malnutrition, especially when the mother's diet is very low in protein. Seven cases out of more than 1700 pregnancies is a very low rate of toxemia by anyone's estimation. While Brewer advocates that pregnant women eat plenty of meat, fish, eggs and dairy products to prevent toxemia, it would appear from the very low rate of toxemia among the women of The Farm, all of whom were complete vegetarians [vegans] during the period of their childbearing, that a diet [with adequate vegetable] protein works just as well as one based in animal protein for the prevention of toxemia" (Spiritual Midwifery, 415). See also Carter, J.P., et al., "Pre-eclampsia and reproductive performance in a community of vegans," Southern Medical Journal 80(6) (1987).

Joseph Keon writes: "The diet of a pregnant mother has always been highly controversial. Conventional wisdom built upon nutritional myths has led mothers and many well-meaning physicians to believe that pregnancy requires lots of meat and dairy products to support the development of the child. Fortunately, this is only a myth. There is no more reason for a pregnant woman to consume animal products than for a woman who is not pregnant. With the exception of vitamin B12, a mother-to-be can derive all the necessary nutrients to support both herself and her baby by eating plenty of whole grains, legumes, vegetables, fruits, nuts, and seeds." (Whole Health, 156)

Judith Goldsmith writes: "In a number of traditional cultures, women avoid eating meat during pregnancy, or lessen the amount of meat in their diet, especially in the later months. Their main protein comes instead from such nonmeat combinations as beans and rice, or corn and beans. A primarily vegetarian diet is often the rule for tribal women, pregnant or not, and separate "kitchens" for men and women are not unusual in traditional societies. Many tribal women provided the main staples for themselves and their children from their gardens, while men were the hunters and eaters of flesh. . . . Milk is also absent from many tribal diets. Cattle keeping is a fairly recent development in the evolution of humanity, and there are still many tribal groups that do not practice it. Furthermore, in some places milk is specifically avoided during pregnancy, even though available. In Burma, pregnant women normally do not drink milk because they 'do not like the smell.' . . . Another food absent from traditional diets is sweets." (Childbirth Wisdom from the World's Oldest Societies, 8)

Judith Goldsmith continues: "Meat . . . is stressed in Western countries as an important part of the prenatal diet, yet, as we have noted, it is often only a small part of tribal diets. . . . Dairy products, too, are often absent from traditional diets. . . . Rather than concentrating on new pieces of hardware for the operating room . . . doctors could have a much stricter insistence on the inadvisability of sweets and fats as part of the diet during pregnancy; of overeating in general during this time; and of the pitfalls of smoking, drugs, coffee and alcohol, all of which interfere with a woman's general health. All these substances are absent from tribal prenatal diets, and, as we have seen, the health of tribal mothers during and after childbirth, as well as the health of their children, definitely seems excellent." (Childbirth Wisdom from the World's Oldest Societies, 139, 141)

Robert S. Mendelsohn writes: "If your doctor tells you to hold your weight gain to 15-20 pounds, he will probably insist that this is important because it will make your delivery easier. He may also tell you that it will forestall the possibility that you will develop toxemia, one of the most dangerous and sometimes fatal complications of pregnancy. These sound like persuasive reasons to control your weight, and you obviously would be wise to heed them if they were true. You needn't, because all of the available evidence indicates that in terms of ease of delivery and the threat of toxemia the truth is the other way around. If you are malnourished, your uterus may not function properly and labor will be prolonged or even stop. . . . Evidence has been accumulated for half a century that it is improper maternal nutrition, not excess weight, that causes toxemia in pregnancy. Because the proper nutritional elements are not present in your diet, your liver malfunctions, and your body's responses produce the symptoms that are associated with toxemia." (How to Raise a Healthy Child . . . in Spite of Your Doctor, 32-33)

Grantly Dick-Read writes: "There is no doubt that . . . the general nutrition of the mother and her dietary and other habits during pregnancy are all important. . . . An investigation in London, before the Second World War, by the People's League of Health (The Peckham Experiment) and a similar investigation, on a smaller scale, carried out at Toronto General Hospital in 1941 demonstrated that there was a quite dramatic reduction, not only in foetal and perinatal loss, but also in the morbidity of the mother in that group of patients who were given a carefully balanced diet throughout their pregnancy." (Childbirth Without Fear, 85)

Susun Weed writes: "[P]reeclampsia . . . is a form of acute malnutrition." ("Herbs & nutrition in pregnancy," The Herbalist, newsletter of the Canadian Society for Herbal Research, March 1989)

eclampsia, a little-understood condition that can result in maternal convulsions and coma and in 10 percent of cases results in maternal mortality. (Ina May Gaskin, Spiritual Midwifery, 415)

eclampsia is preventable with proper prenatal nutrition (Ina May Gaskin, Spiritual Midwifery, 415; see also nutrition-related quotes under "pre-eclampsia," above)

proper prenatal nutrition Robert S. Mendelsohn writes: "Because they have been denied the nourishment they needed to develop properly, some degree of mental retardation is found in half of the low-birth-weight babies, and their incidence of epilepsy, cerebral palsy, and learning or behavioral problems is three times that of babies of normal weight. That's a good reason for you to eat a well-balanced, nourishing diet, avoid starving yourself or your baby . . ." (How to Raise a Healthy Child . . . in Spite of Your Doctor, 33-34; see also Anne Frye, "Nutrition for Two: Preventing Cesarean," Tricks of the Trade, Volume 1, 47)

Jinjee Talifero writes of her healthy diet during pregnancy:

"During my pregnancy I ate:

~ an abundance of fresh organic fruits
~ about 4 glasses of fresh-squeezed organic orange juice a day
~ green juice about twice a week (using a variety of one or more of the following [organic] ingredients: celery, kale, chard, spinach, broccoli, parsley, carrots, and beets flavored with either lemon, apple, ginger, onion or garlic).
~ delicious tabouli salad two to four times a week: one bunch of parsley, one bunch of cilantro, a bunch of green onions, and 4 tomatoes chopped up with a dressing of a mashed avocado, lemon, honey, olive oil, and salt. Instead of the traditional cracked or bulghur wheat we use ground almonds. We take a handful or two of almonds (not soaked) and put them in the blender, grinding them into a fine flour. Then we add this flour into the tabouli salad.
~ salad of organic lettuce or baby greens with avocado/lemon or tahini/lemon dressing once or twice a week, but not regularly (maybe on average once every week or two). Sometimes with other vegetables added.
~ my staple recipe that I had once or twice almost every day was an avocado and a tomato chopped up in a bowl with lemon and salt. Sometimes I'd wrap the mixture in a kale leaf.
~ around every second day on average I would have some kind of nut or seed milk; either tahini milk, sunflower seed milk, or almond milk. I would add the soaked nuts/seeds (almonds soaked for 4-8 hours, sunflower seeds soaked for 2-6 hours) or raw organic tahini (ground sesame seeds) from the health-food store to the blender (about two tablespoons of tahini or 1/2 to a whole cup of nuts/seeds) with a blender full of water, a tablespoon of honey, a dash of organic cold pressed extra virgin olive oil, and a pinch or two of unrefined/celtic sea salt).
~ other foods I would sometimes eat were guacamole, salsa, Earthseed Multigrain (manna) sprouted seed bread (available at health-food stores in the refrigerated breads section), fruit smoothies, blended salads, sunflower seed patées, whole vegetables including corn, celery, bell peppers, carrots, cucumbers, and jicama, whole fruits including durians (the stinky fruit) and young coconuts (durian and young coconuts are both good fatty fruits available at Asian markets), berries, apples, bananas, melons, cherimoyas, satsumas, and guava pineapples.

"Fruits and vegetables have all the vitamins and minerals you and your baby need. They have all the fats, carbohydrates and protein you and your baby need. Nuts and oils (hemp seed oil, olive oil, and flax oil, all organic and all cold-pressed) have all the omega fatty acids that you and your growing baby need. There are many who say that the nuts and oils aren't even necessary but that fruits and vegetables are enough, even during pregnancy and nursing. I believe this may be true. Storm prefers to be cautious and include the nuts and oils. Perhaps they are the secret of his long-term success with the raw-vegan diet.

"According to the new book "Rawsome" by Brigitte Mars, the following are all sources of Vitamin B12 (also called Cyanocobalamin or Cobalamin). I also received a list like this from Charles Partito the owner of the Ejuva Cleanse company a few months ago saying that it was based on new scientific test results performed on foods.
   Alfalfa leaves
   Bananas
   Comfrey leaves
   Concord grapes and raisins
   Ginseng
   Hops
   Mustard greens
   Plums and prunes
   Seaweeds (Kelp and Nori)
   Sprouts
   Sunflower seeds
   Wheatgrass

"My feeling is that overall it doesn't matter whether you are 90% or 100% raw or whether you take supplements or not. There are far more obvious issues that most of us need to address such as making sure we don't consume any major toxins such as cigarettes, alcohol, drugs, coffee, sugar, MSG, artificial sweeteners, and processed and packaged foods that contain chemicals and preservatives. There are other factors that are definitely important to health such as a joyful spirit, a positive mind, and a body that gets enough exercise, sleep, fresh air and water. After we handle these areas that drastically affect our health and the health of our babies we can then be clear enough to better be able to discern how to get to the next level of health and decide on issues such as whether to be 99% or 100% raw or whether to take supplements or not.

"The toxins named above are able to penetrate the placental barrier and affect the development of your baby. They can cause damage to the nervous system including the brain.

"Your emotions also affect your baby within. It seems that children often take on the mood of their mother during pregnancy as their general disposition." ("Ecstatic Birth: Raw Pregnancy & Childbirth" www.thegardendiet.com/ebooks/birth/)

Polyhydramnios is often associated with diabetes and toxemia (Ina May Gaskin, Spiritual Midwifery, 419)

Formerly referred to as hydramnios, polyhydramnios is a condition usually resulting from in utero infant death or disability. A viable fetus drinks up to a quart of amniotic fluid a day.

Margaret F. Myles writes: "In polyhydramnios the amount of fluid in the amniotic sac exceeds the normal quantity of 500 to 1,500 ml but is not as a rule clinically apparent until the amount is over 3,000 ml. During a period of 10 years in the Simpson Maternity Pavillion five patients had over 12 litres of fluid, the maximum being 15.6 litres. Polyhydramnios occurs in about 1 in 200 pregnancies. The cause is unknown, but the condition is associated with monozygotic (uniovular) twins and with pathological conditions, both fetal and maternal. . . . About 25 per cent of pregnant diabetic women have marked polyhydramnios; a number having it in lesser degree." (Textbook for Midwives, 145)

Polyhydramnios is often associated with diabetes and toxemia, both conditions of which can be prevented, controlled or eliminated with proper nutrition. (See nutrition-related quotes under "pre-eclampsia," above.)

Diabetes is a condition that may warrant hospital obstetric care. A summary of June 14, 1999 Associated Press article on diabetes: To date, there are 16 million diabetics in America, over 14 million of them type 2. Type 2 diabetes had long been thought to be a disease that affected only adults, but it is now being diagnosed in startlingly high numbers of children. In the last three years, type 2 diabetes has tripled in that age group. Obesity is its main indicator. Obesity [the direct result of SAD (the Standard American Diet) and a TV-watching (sedentary) lifestyle] now occurs in 14 percent of America's children, up from 8 percent in 1976. (David Royse, "Doctors See More Diabetes in Kids," Associated Press, June 14, 1999)

Diabetes . . . is preventable with dietary and exercise management. (See nutrition-related quotes under "pre-eclampsia," above.)

gestational diabetes . . . is wholly without foundation as an indicator of hospital obstetric care. Sheila Kitzinger writes: "Gestational diabetes. This has been called 'a diagnosis looking for a disease.' . . . Your urine is tested for sugar whenever you see the doctor or midwife. Nearly all women at some time during pregnancy produce sugar in their urine, indicating that they may have raised blood sugar levels, which contribute to a baby's growth. Very occasionally the presence of sugar in the urine can be a sign of diabetes but most of these women are not diabetics. It is merely a biochemical variation, not an illness." (The Complete Book of Pregnancy and Childbirth, 142)

Michel Odent writes: "Countless tests are routinely offered to all pregnant women, at different stages of their pregnancy. Simple physiological adaptive reactions are presented as diseases and named with bizarre terms. For example a transitory modification of the metabolism of carbohydrates is called 'gestational diabetes'. An increased blood volume, which is a good sign of placental activity, is misinterpreted as anaemia because the blood is more diluted than usual, and the concentration of substances such as haemoglobin is therefore lower. It is obvious that repeated prenatal consultations often have spectacular negative effects on the emotional state of pregnant women, planting seeds of doubt. I call that a Nocebo effect." (The Farmer and the Obstetrician, 62)

Henci Goer tells us that "doctors engaged in rituals to ward off the supposed dangers of GD [gestational diabetes] refuse to see that what they are doing is not only useless but harmful . . . The fact is that only those who were true diabetics prior to pregnancy or those few whose pregnancies have tipped them into a true diabetic state benefit from special care. Beyond that, women who are overweight should try to achieve normal weight before pregnancy, because maternal weight bears the strongest relationship with infant birth weight and glucose tolerance." (Obstetric Myths Versus Research Realities, 161)

Routine prenatal care Most obstetricians will not offer prenatal care to mothers-to-be who plan to give birth at home. This may be a blessing in disguise. Midwives in general offer better (more thorough, more accurate, more helpful) prenatal care for less money. Using blood iron as a "test subject," Dr. Michel Odent contrasts science-challenged hospital obstetrician prenatal care with science-backed midwifery care: "Many practitioners [physicians] think that iron deficiency in pregnancy can be detected via the haemoglobin concentration. When a woman has a result in the region of 9.0 or 9.5 at the end of her pregnancy, more often than not she is told that she is anaemic and she is given iron tablets. She understands that there is something wrong in her body that needs to be corrected. If, on the other hand, the practitioner is anxious to protect her emotional state, is interested in placental physiology and reads the medical literature, [the pregnant woman] will be given good news. She will be told that, according to . . . statistics, results in the region of 9.0 are associated with the best possible birth outcomes. It will be explained to her that the blood volume of a pregnant woman is supposed to increase dramatically, and that the haemoglobin concentration indicates the degree of blood dilution. She will understand that the results of her tests are suggestive of effective placental activity and that her body is responding correctly to the instructions it is given [by her placenta]. . . . Once more there is a tendency [on the part of medical practitioners] to confuse a transitory physiological response (blood dilution) and disease (anaemia)." (The Farmer and the Obstetrician, 132-133)

Rh-negative blood with a positive antibody screen For an in-depth discussion of Rh, see http://gentlebirth.org/Midwife/genpcare.html.

If you have Rh-negative blood with a positive antibody screen, hospital obstetric care may be indicated. Routine prenatal care, both midwifery and obstetric, includes a blood test to determine your risk. Fortunately, proper diet and an herbal regimen can render this condition harmless Concerning what Dr. John Christopher calls "one of the greatest sacred cows of all time – the RH factor," Christopher writes that "The RH factor is a hereditary susceptibility [emphasis mine] to toxicity of the bloodstream: it is not necessarily a lifelong burden inherited by generation after generation, but a temporary toxic condition of the bloodstream which can be remedied by first cleaning up the bowel and then the bloodstream.

"[T]he RH vaccine . . . is actually a potent anti-RH antibody (an immunization through the use of a toxic substance) in the form of the 7S fraction of gamma globulin, a two-armed molecule. . . . the RH factor is a substance in the red blood cells of most persons (85%). Red blood cells that contain the RH factor agglutinate (clump) if they come into contact with an antibody called anti-RH. The antibody is a substance produced by the body in response to a specific foreign material, or antigen. . .. The blood factors A, B, and RH are antigens. . . . an antibody that is formed in RH negative individuals will attack and destroy red cells of persons who are RH positive in response to an antigenic challenge by the RH factor. This reaction can produce serious illness or death. Persons who have the RH factor are known as RH positive. Those lacking it are RH negative. Karl Landsteiner and Alexander Wiener, who discovered the factor in rhesus monkeys in 1940, named it RH for the monkey. . . .

"Anti-RH does not occur naturally in the blood. But, if an RH negative person receives a transfusion of RH positive blood, anti-RH may build up in his blood plasma. By the time the anti-body has been produced, the donor blood is, in most cases, so diluted that no serious reaction takes place. But if the patient receives later transfusions of RH positive blood, the anti-RH will attack the RH positive red blood cells and cause agglutination. . . .

"The RH factor is inherited. The child of an RH negative mother and an RH positive father may be RH positive. Before birth, some of [an RH positive] baby's blood cells may enter the mother's blood (through the placental barrier). Then the mother may build up anti-RH. Most of the antibody does not form until after the baby is born, however, so it seldom causes any problems with the first child. But if the mother becomes pregnant with another RH positive baby, she now has a ready-made supply of anti-RH. The flow of large amounts of her anti-RH into the child's blood can cause clumping and destruction of the infant's red blood cells. This condition is called erythroblastosis fetalis, or RH disease. RH disease can result in severe anemia, brain damage, and even death. When the RH disease does occur, doctors treat the condition by replacing the baby's blood with fresh blood. In most cases, this procedure eliminates any long term effect of the disease. In several early examples in RH literature, the mother contributed to the toxicity of her child through breast milk, since breast milk is like a blood transfusion. . . .

"We owe it to the future generations [to practice] proper nutrition: cleansing, wholesome foods, clean water, sunlight, fresh air, relaxation and exercise, herbal foods where necessary to rebuild debilitated areas of the body. We must depart from the traditional medicinal arsenal of drugs . . . It is much simpler to prevent the tragedies brought about by the RH factor, which is nothing more than a toxic bloodstream, than to command . . . technicians to be on standby to correct our ignorant and lazy misjudgments. . . .

"We begin the detoxification procedure by first cleaning up the bowel so that the nutrients can be absorbed, and wastes do not back up in the system. For this we use . . . Barberry bark . . . cascara sagrada, cayenne, ginger, lobelia, red raspberry leaves, turkey rhubarb root, fennel, and goldenseal root. This combination will restore vitality to the intestines. . . .

"Both parents should begin these detoxification procedures before conception. During pregnancy, the mother should drink plenty of red raspberry leaf tea; approximately one quart a day. . . . People could do much to correct high risk pregnancies . . . if only they would take the time to learn about how to care for the body." (Dr. Christopher Newsletter and Continuing Education Service 2(5); you can obtain a hard copy of Dr. Christopher's article from Ingri Cassel at vaclib@coldreams.com)

For an in-depth discussion of Rh, see http://gentlebirth.org/Midwife/genpcare.html.

proper diet and an herbal regimen can render this condition harmless Dr. Christopher tells the story of a woman who had had three children, all with RH negative factor problems: "(Each of the three children had to have their blood drained out and different blood filled in). All had a difficult time pulling through the ordeal and staying alive. Any mother having this condition RH factor, and having three children, . . . if she is an average woman, would say "no more"! But . . . she wanted a large family. The first thing we had her do was go on the "basics"; for instance, to use the lower bowel formula and clean out the bowels, and drink a gallon of steam distilled water each day to keep flushing the system. She drank no less than a quart of red raspberry leaf tea, using two capsules of Dr. Christopher's Red Clover Combination blood purifier formula [red clover blossoms, chaparral, licorice root, pke root, peach bark, Oregon grape root, stillingia, cascara sagrada, sarsparilla, prickly ash bark, burdock root and buckthorn bark] and followed the "Dr. Christopher's Three Day Cleanse and Mucusless Diet." This woman's program was watched carefully during the entire nine months and the progress was excellent. When the next baby came it was with no RH factor problem (no [infant] blood pumped out and replaced). This woman and her husband became parents of two more babies born a few years later, and both of them were free of this RH negative factor." (Dr. Christopher Newsletter and Continuing Education Service 2(5), obtain hard copy from Ingri Cassel at vaclib@coldreams.com)

DES in fact promoted miscarriage (Deirdre Colby Sato, "DES: Diethylstilbestrol," in The Encyclopedia of Childbearing, 99-101; see also Sandra Steingraber, Having Faith, 61; see also Beverley Lawrence Beech, "Drugs in labour: What effects do they have 20 years hence?" Midwifery Today 50, Summer 1999, www.midwiferytoday.com/articles/drugsinlabour.asp; see also Kay Weiss, "Vaginal cancer: an iatrogenic disease?" International Journal of Health Services 5(2) (1975):235)

Joseph Dumit and Robbie Davis-Floyd write: "Estrogen had been know as a cancer-causing agent as early as 1932. But in 1947, on almost no evidence, the FDA approved DES for pregnant women who had had multiple miscarriages. In 1952 and 1953 the use of DES at all in pregnant women was vigorously challenged by three articles in the American Journal of Obstetrics and Gynecology. Through controlled studies, the authors showed that DES was not effective at altering miscarriage rates and quite possibly even worse than placebos . . . ("Living with the "Truths" of DES," in Cyborg Babies, Robbie E. Davis-Floyd and Joseph Dumit, eds., 220)

DES . . . was further found to be a vaginal and cervical carcinogen (cancer agent), both for women who took the hormone and for their daughters. Mary Daly writes: "Between 1943 and 1970, DES was widely prescribed in the United States to prevent miscarriage. Estimates of the numbers of women who received this drug range from 500,000 to possibly 2,000,000. . . . It is now widely known that DES causes precancerous conditions and cancer in daughters of the women who took this drug during their pregnancies. Indeed, an estimated 90 percent of the young women exposed to DES have adenosis, the development of abnormal vaginal and cervical cells, a condition which may lead to cancer. It is not yet known to what extent these abnormal cells will be affected by pregnancy and menopause. Both the known effects of DES and the probability of further complications have been widely publicized. Thus pregnant women who were brainwashed into taking this drug to ensure having offspring are now chastised by the knowledge that they were unwittingly instrumental in the damaging of their daughters. . . . "Although vaginal cancer is daughters exposed to DES in utero provided the clinical evidence to secure a Food and Drug Administration ban on DES as an additive to cattle feed, the FDA approved a new use of DES as a "morning-after pill" contraceptive even though the contraceptive contains 833,000 times the amount of DES banned for human consumption in beef." (Gyn/Ecology: The Metaethics of Radical Feminism, 245-247)

None of the over 75 nonsteroidal estrogen pharmaceuticals currently sold in the U.S. has ever been shown by scientific research to be safe for childbearing women or their babies. DES mothers' incomplete cervixes provided the raison d'etre for a whole new generation of obstetricians and justified and still justifies the use of obstetrical machines, tools and – you guess it, additional untested pharmaceuticals. Some obstetricians, the true heroes of the clan, work within and against the system – for example, allowing and attending VBACs, in full knowledge of the risk they are taking of being fired for not fulfilling their hospitals' cesarean quotas. (See Nancy Wainer Cohen, Open Season, 158.) The rest are literally victims of dysfunction education, reading textbooks based on "studies" that are funded, skewed, or simply written by pharmaceutical companies.

If your baby's umbilical cord precedes her body or head into the birth canal, she will cut off her own blood-transported oxygen supply as she enters the canal. (Beth Shearer, "Cesarean Birth: Indications and Consequences," in The Encyclopedia of Childbearing, 56)

there is no reason to surrender yourself prematurely to high-tech care Complications may occur in any birth, but for women who have not already been diagnosed with a crisis-care condition (that is, for the great majority of women), starting birth at home is the statistically documented safest option.

David Stewart writes that "the principle danger of the hospital is the presence of immediate technology. Planning a home birth is the best way to protect one's self from the misapplication of technology, even if one ultimately transfers to the hospital to complete the birth." ("Home: The Traditional Safe Place for Birth," in David Stewart, The Five Standards for Safe Childbearing, 286)

Asking obstetricians to use their hard-earned and highly specialized skills to manage routine births is like asking firemen to spend their days rescuing cats from trees. Marsden Wagner, former director of the World Health Organization's Women and Children's Health Division, gives us another analogy: ". . . having a highly trained surgeon obstetrician assist at your birth is about as sensible as hiring a pediatric surgeon as a baby sitter for your healthy two year old . . . Like the obstetric surgeon who gives the normal woman a shot to hurry her labor, the pediatric surgeon baby sitting your normal child will focus on medical management: when your robust two year old gets tired and fussy, the pediatric surgeon will give him or her a shot to hurry the child to sleep. The result? In the one case the medicalization of birth (remember, birth is not an illness) with a lot of unnecessary risky interventions and very expensive medical care, and in the other case the medicalization of childhood (being two years old is also not an illness) with unnecessary risky interventions and very expensive baby sitting." ("Technology in birth: First do no harm," http://midwiferytoday.com/articles/technologyinbirth.htm)

"Obstetricians are not trained to approach birth as a normal process and have little or no training in providing the pregnancy support and counseling and labor support that inherently keeps birth safe and normal. The average obstetric training includes one day on nutrition and no training on labor support. Numerous studies show that physicians, especially specialists such as neonatologists and perinatologists, are best used as back-up technical support for primary care community-based health workers, notably midwives." (Suzanne Arms, www.birthingthefuture.com/AllAboutBirth/birthMythFact.php)

David Stewart writes: "Doctors are specialists in abnormality. Unless they have special training in non-interventive obstetrics and/or midwifery, they should not deal with normal birth at all, even for prenatal care. With few exceptions, they simply don't have the qualifications for normal practice. . . . A board-certified obstetrician specializing in high risk is no more qualified to handle normal, healthy women than a skilled midwife would be to perform a cesarean. . . . Midwives should be the primary caregivers for all mothers, regardless of risk, calling upon specialists when needed." ("The Proper Relationship Between Doctors, Hospitals, and Normality," in David Stewart, The Five Standards for Safe Childbearing, 75)

women as potential consumers of hospital obstetric services are the agents of change. Ivan Illich writes that medical professional power "can only be delegitimized by popular agreement . . ." (Limits to Medicine, 6-7)

For a discussion on obstetricians' unwillingness to lower cesarean rates after presentation of scientific evidence, see, for example, Porreco, R.P. "Meeting the challenge of the rising cesarean birth rate," Obstet Gynecol 1990;75(1):133-36; Lomas, J. et al., "Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians," New England Journal of Medicine 1989;321(19):1306-11; Soliman, S.R. and R.F. Burrows. "Cesarean section: analysis of the experience before and after the National Consensus Conference on Aspects of Cesarean Birth," Can Med Assoc J 1993;148(8):1315-20; Dillon, W.P. et al., "Obstetric care and cesarean birth rates: a program to monitor quality of care," Obstet Gynecol 1992;80(5):731-37.

Robert S. Mendelsohn writes: "Doctors aren't culprits. Like their patients, they are victims of the system. They are the first to be impaired by medical education's preoccupation with intervention rather than prevention, its infatuation with drugs and technology, and the indefensible rituals, mores, and egotistical attitudes that are burned into the brain of every student who survives the rigid and often irrelevant curriculum and training. They emerge with their heads so stuffed with institutionalized foolishness that there is no room left for common sense." (How to Raise a Healthy Child . . . in Spite of Your Doctor, ix)

Henci Goer writes that "science and logic can have no effect unless obstetricians first change their beliefs, which is unlikely because those beliefs are the underpinnings of obstetrics." (The Thinking Woman's Guide to Better Birth, 5)

Obstetricians should be heroes. But today they rarely can be heroes. Obstetrician Michel Odent writes: "We just need to look at some statistics to realise why obstetricians of the industrialised era cannot be reliable experts in unusual, strange or pathological situations. Let us take the United States as our example, since it has constantly preceded other countries in the trend towards industrialised childbirth. In the U.S., the number of obstetricians is in the region of 36,000, for a number of births a year that is in the region of 3,600,000. This implies that a typical obstetrician is in charge of about 100 births a year. Most modern obstetricians are therefore primary care givers rather than doctors specialised in pathological or unusual situations. They have a dangerous lack of experience. For example a typical American obstetrician has the experience of about one twin birth a year. He (she) needs five years of practice to confronted with one shoulder dystocia (when the baby is stuck at the level of the shoulders). He (she) needs ten years of practice to see one real placenta praevia (the baby cannot get out because the placenta is in the way) and a whole career to see one real eclampsia. On the day when she (he) has to do a caesarean for a transverse presentation, she must adapt her technique after referring to her text books, because it is a rare situation she probably has never met. . . . The prerequisite for the replacement of medically controlled childbirth by a biodynamic attitude is a dramatic reduction in the number of obstetricians. The highly trained experts of the future will not have the time to control every birth. They will be at the service of women and midwives. They will appear on demand." (The Farmer and the Obstetrician, 112)

MAIN TEXT

1. You want to live.

The important thing for parents to realize is that if their physician says that "hospitals are safer than home birth or birth in a birth center" this is a purely subjective opinion based on his or her own limited experience and the traditions of the profession. It is not based on science. To back up their claims, doctors favoring hospitals usually cite the anecdotal cases of the "baby who did not breathe" or the "mother who would have bled to death had she not been in the hospital," etc. The point is that however valid these claims may be in the individual cases involved, the statistical evidence does not support them in general. (David Stewart, "The Limits of Science in Childbirth," in David Stewart, The Five Standards for Safe Childbearing, 49)

See also Tew, M. Where to Be Born? New Society, p 120-121, January 20, 1977; Bradshaw, J. Babes in the Ward, London: Undercurrents, January 1977; Watkin, B. "Back to home deliveries?" Nursing Mirror Midwives Journal, p. 42, February 3, 1977; Mehl, L., "Statistical outcomes of home birth in the U.S.: The current status," in Stewart, D. and L. Stewart (eds.) Safe Alternatives in Childbirth, fourth edition, pp. 73-100, Marble Hill, MO: NAPSAC, 1994; Young, D. and C. Mahan, Unnecessary Cesareans: Ways to Avoid Them, Minneapolis, MN: International Childbirth Education Association, 1989; Tew, Marjorie. Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998; Mehl, L., "Scientific Research on Childbirth Alternatives: What it Tells Us About Hospital Birth," in Steward, D. and L. Stewart (eds.), Twenty-First Century Obstetrics Now! Marble Hill, MO: NAPSAC International, 1977.

David Stewart writes: "Those biased in favor of hospitals may say there is not enough data to scientifically prove home is a safe alternative, but the fact is that all available data favor the home and incriminate the hospital for most births. According to the World Health Organization (WHO) there is no scientific data anywhere in the world, past or present, that prove hospitals are a safe alternative for most women." (David Stewart, "The Limits of Science in Childbirth," in David Stewart, The Five Standards for Safe Childbearing, 55; see Tew, M., Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998; Wagner, M., "Why Midwifery is the Safest Form of Maternity Care," Amicus Brief, World Health Organization, Geneva, March 1991, reprinted in NAPSAC News (1991):16:2, 1)

Women in America are told that the hospital is the safest place to give birth and that the way the hospital delivers is the safest way to deliver. That is untrue. (Naomi Wolf, Misconceptions, 153)

Thou art much too fair

To be death's conquest and make worms thine heir.

(William Shakespeare, "Sonnet VI")

The current official maternal mortality rate in America is 7.6 deaths per 100,000 live births (Thomas H. Strong, Jr., Expecting Trouble: The Myth of Prenatal Care in America, 16)

Judith Pence Rooks gives us figures from the first part of the century: "Early in this century, levels of both infant and maternal mortality in the United States were as high as they are in many developing countries now (Maine, 1991). Maternal mortality plateaued at a high level (600 to 700 deaths per 100,000 births) between 1900 and the mid-1930s and then began a steep decline coincident with the availability of antibiotics, blood transfusions, and drugs to treat pregnancy-induced hypertension (Maine, 1991; Loudon, 1992; AbouZahr & Royston, 1991). The most important contributing factor was the sudden availability of antibiotics. Sulfonamide drugs were being used for obstetric infections by the late 1930s. Penicillin became available to the civilian population at the end of World War II. The number of infection-related maternal deaths fell from 3,719 in 1937 to 392 in 1954 (Maine, 1991). Similar drops in maternal mortality occurred throughout the Western industrialized world. The U.S., the Netherlands, and Britain experienced dramatic reductions in maternal mortality starting in the mid-1930s but had very different forms of maternity care: In the United States obstetricians delivered most of the babies in hospitals. In the Netherlands professional midwives delivered most of the babies in homes. Britain had both home and hospital births and used midwives, general practitioners, and specialist obstetricians. These differences had no apparent effect on the rate of maternal mortality (Maine, 1991)." (Midwifery & Childbirth in America, 30-31)

Judith Pence Rooks writes: "The greatest gains in the safety of childbearing came from medical discoveries and inventions made during the first half of this century – blood transfusions, antibiotics, and medicine to treat pregnancy-induced hypertension." (Midwifery & Childbirth in America, 2)

David Stewart writes: "Science has never proven that hospitals are the safest place for most mothers to give birth [and] science has never proven that obstetricians are the safest birth attendants . . ." ("The Limits of Science in Childbirth," in David Stewart, The Five Standards for Safe Childbearing, 55)

David Stewart writes: "[T]he safest alternative in childbirth is one based on health and good nutrition, without drugs, with a midwife, and outside of a hospital, preferable in one's home." ("How New Ideas Become Accepted," in David Stewart, The Five Standards for Safe Childbearing, 17)

Deaths due to cesarean section are underreported by as much as 50 percent on hospital maternal death certificates. No one knows the true rate of maternal death in U.S. hospitals, but it is significantly higher than the reported 7.6 deaths per 100,000 live births. (The Thinking Woman's Guide to a Better Birth, 23; see also Joseph Chilton Pearce, Evolution's End, 117)

The exact numbers are difficult to pin down because many deaths attributed to pregnancy and its complications go unreported. See Berg, C.J., Atrash, H.K., Koonin, L.M. et al., "Pregnancy-related mortality in the United States, 1987-1990," Obstetrics and Gynecology 1996, 88:161-167. Marsden Wagner writes: "[D]eaths associated with caesarean section are seriously under-reported. In one United States study [Rubin, G., H.B. Peterson, R.W., Rochat, B.J. McCarthy & J.S. Terry, "Maternal Death After Cesarean Section in Georgia," Am J Obstet & Gynec, 139:681-685, 1981], five of the sixteen maternal deaths after caesarean section (nearly a third) had not been reported . . . Nine of these sixteen deaths were found to be due to the caesarean section per se. These nine deaths produced a caesarean-per-se-attributed maternal mortality rate (9 per 15,188 caesarean sections or 59.3 per 100,000 caesarean sections) which was six times higher than the maternal mortality rate for all vaginal births." (Pursuing the Birth Machine, 184). Henci Goer reports: "Death certificates seriously undercount deaths due to cesarean section." ("How to Read the Medical Literature (for Fun and Profit)," MAWS Annual Conference, October 23, 1999, Seattle, Washington.) Henci Goer writes: "Studies have found that data culled from vital statistics undercount cesarean death rates by 40 to 50 percent." (The Thinking Woman's Guide to a Better Birth, 23; see also Joseph Chilton Pearce, Evolution's End, 117)

Nancy Wainer Cohen and Lois J. Estner write: "Maternal mortality statistics are difficult to assess because maternal death is notoriously underreported (or covered up!). The Ob./Gyn. News for July 1980 describes a study of cesarean sections performed in Georgia in 1975, where eleven deaths were determined by routine surveillance of death certificates. Upon further investigation, five more cesarean-associated deaths were identified. By obtaining additional information from the medical examiner's reports, the hospital records, the police reports, and the women's physicians and families, researchers attributed nine of the total sixteen deaths to the surgery itself. The reported cause of death in those nine cases was pulmonary embolism in six women, and complications of anesthesia in three. . . ." (Silent Knife, 29)

Cohen and Estner continue: "Maternal death is defined as one related to pregnancy and/or the process of childbirth. An article in the Winter 1981 issue of NAPSAC News warns that "the time span of consideration" for maternal death often extends only to the sixth week following a live birth, so that the death of a mother after this time span is not attributed to pregnancy- [or hospital birth-] related causes even when it should be. Additionally, many maternal deaths that occur close to the time of birth are not recorded as maternal mortalities because the woman with severe complications has been moved from maternity to another wing of the hospital and is no longer considered a maternity patient. The NAPSAC article cites a study of childbirth-related deaths that found a significant number of maternal deaths to be due to complications of cesarean delivery. Yet the death certificates of many of these women made no mention whatever of the cesarean surgery or even the fact that they had been recently pregnant. This article suggests that maternal deaths in the United States may be double the rates reported." (Silent Knife, 29-30)

Nancy Wainer Cohen and Lois J. Estner write: "Although we tend to think of cesarean section as a life-saving rather than a life-threatening procedure, the maternal mortality rate for cesarean patients is not insignificant. Evrard and Gold, in their eleven-year study of maternal death associated with cesarean section in Rhode Island [Evrard, John R. & Edwin M. Gold, "Cesarean section and maternal mortality in Rhode Island: Incidence and risk factors 1965-1975," Ob Gyn 50(5) (1977)], found that "the risk of death from cesarean section was 26 times greater than with vaginal delivery" (emphasis ours). A recently completed analysis of maternal deaths in Georgia showed a mortality ratio of 59.3 / 100,000 births by cesarean section as compared with 9.7 / 100,000 vaginal births [National Institutes of Child Health and Human Development, Draft Report of the Task Force on Cesarean Childbirth (Bethesda, Maryland: NIH, September 1980)]. A California study showed the risk of maternal death associated with cesarean section to be two to three times greater than that for vaginal delivery [Pettiti, Diana B., et al., "In-hospital maternal mortality in the U.S.: Time trends and relation to method of delivery," Ob Gyn 59(1) (1982)]. All of these studies took into account the conditions that necessitated the cesarean and only included deaths that were due to the surgery itself." (Silent Knife: Cesarean Prevention & Vaginal Birth After Cesarean, 29)

The current U.S. infant mortality rate is 6.9 deaths per 1,000 live births. ("Infant Mortality Statistics from the 2000 Period Linked Birth/Infant Death Data Set," NVSR 50(12) 27 pp. (PHS) 2002-2120, www.cdc.gov/nchs/releases/02facts/infantmort.htm)

The United States ranks 28th poorest in the world in infant mortality, even though it far exceeds the first 27 countries in per-capita maternity and newborn care spending.

obstetricians "preferred to fill their practices with the wealthy, the healthy, the well nourished, and those with well-endowed insurance policies. . . . The history of midwifery [is one in which] midwives handled the lower income, less educated, less sheltered, poorly nourished, and even chronically ill mothers. It is a myth to believe that doctors have historically dealt with the high risk and midwives with the low." (David Stewart, "Skillful midwifery: the highest and safest standard," in David Stewart, The Five Standards for Safe Childbearing, 189; see also Tew, M. and S.M.I. Damstra-Wijmenga, "Safest birth attendants: recent Dutch evidence, Journal of Midwifery (Br.), 7, (1991):55-63; Tew, Marjorie, Safer Childbirth? A Critical History of Maternity Care (London: Free Association Books, 1998)

In her article, "Family centered maternity care: past, present, and future," Celeste Phillips writes: "By 1936, approximately one-third of all live births occurred in hospitals, half of all births were delivered by physicians in homes, and midwives accounted for twelve percent of all births (American Journal of Public Health 1983) [Yankauer, A., "The valley of the shadow of birth," American Journal of Public Health (6) (1983):635-638; not to be confused with another article with the same title published in 1951: Smith, Clement A., "The valley of the shadow of birth," American Journal of Diseases of Children 82 (1951):171-201]. With popular magazines and leading women of the time encouraging expectant mothers to seek hospitalization for birth, the change to hospital birth was relentless.

"By 1945, approximately eighty percent of women delivered in hospitals in surgical settings under general anesthesia, attended by physicians, and subjected to ritualistic nursing interventions. Physicians wrote most obstetric nursing texts. In fact, Dr. De Lee authored a nursing text that was popular in nursing schools for more than twenty years. For nursing education, he emphasized that, "Labor and its complications have the highest pathologic dignity and require the care and attention of the most skillful surgeon and the most efficient nurses." Throughout his text, Dr. De Lee emphasized the importance of aseptic technique and nursing's control over the environment for birth (De Lee 1927) [De Lee, J.B., Obstetrics for nurses, Philadelphia: W.B. Saunders Co., 1927]. In actual hospital practice, nurses chose a subspecialty area in which to work which included normal newborn nursery, labor and delivery, or postpartum.

"In 1948, Woman's Day, a popular women's magazine, published an article titled, "Whose Baby Is It?" (Ripperger 1948). In this article, the author explained the advantages of rooming-in and criticized current hospital practices that emphasized "routines" and made mothers and babies live by the hospital clock. The author claimed that "the hospital takes over and you conform" and encouraged readers to ask for rooming-in because "the baby belongs to you and not to the hospital."

"By 1952, only 4.5 percent of all births in America were attended at home by midwives (American Journal of Public Health 1983).

"While many women had acceptable birth experiences, many others bitterly reported to magazines about "cruelty in maternity wards." In May 1958, the Ladies' Home Journal published letters from American women in an article titled, "Journal Mothers Report on Cruelty in Maternity Wards" (Shultz 1958). Women reported being strapped down on delivery tables or being left alone for long periods of time while in labor. One woman wrote: "Our biggest enemy is smugness and indifference."

"The medicalization of childbirth was so successful [i.e., complete] that consumers and professionals in the forties and fifties who suggested there could be a better way to birth were seen as revolutionary.

"In the 1960s, the FCMC [Family Centered Maternity Care] social movement gained momentum when consumer organizations formed and advocated for family-centered maternity care. The first of such groups to organize was the International Childbirth Education Association (ICEA), founded in 1960. Since its inception, the ICEA has subscribed to the motto, "Freedom of choice based on knowledge of alternatives."

"Led by the Maternity Center Association (MCA) in New York City, "freestanding birth centers" soon emerged (Pearse 1987) [Pearse, W., "Parturition: places and priorities," American Journal of Public Health 7(8) (1987):923-924] in the 1970s. These centers offered essentially low-risk childbearing women and their families a low intervention style of maternity care.

"Then in 1978, a consortium of professional organizations including those representing obstetricians, pediatricians, nurses, and certified nurse-midwives published a document entitled Family-Centered Maternity/Newborn Care in Hospitals. The booklet called on all hospitals to change attitudes and practices related to the care of pregnant women and their families and spelled out specific ways to accomplish these changes (Pearse 1987) [Pearse, W., "Parturition: places and priorities," American Journal of Public Health 7(8) (1987):923-924]. In the fall of 1979, the Cybele Society was founded to research and promote family-centered maternity care. This organization was established as a forum for a wide range of maternity care providers, including obstetricians, pediatricians, nurses, midwives, anesthesiologists, family practitioners, and hospital administrators.

"The first wave of the family-centered maternity care social movement was over. A hard-fought battle had been won. Advances included allowing fathers to be present in delivery rooms and liberalizing visitation. But most women were still separated from their babies after birth and were moved through the assembly line of labor to delivery to recovery and then to postpartum. Electronic fetal monitoring was accepted into widespread use and the cesarean birth rate increased from 5.5 per 100 births in 1970 to 14.7 percent in 1978 (Taffel et al. 1987). Questions began to arise about the association between widespread use of electronic fetal monitoring and the increasing cesarean birth rate.

"As competition for the childbearing population increased in the 1980s, most hospitals altered the physical and facility design of their maternity units. Many hospitals consolidated the old multitransfer surgical design of separate labor, delivery, recovery, and postpartum units into multi-transfer labor-delivery-recovery (LDR) rooms and postpartum units with separate well-baby nurseries. Some hospitals changed their physical facility to one room for labor-delivery-postpartum and well-newborn care (LDRP rooms) and did not build central nurseries. Instead, these hospitals designed small "baby holding or respite areas" where babies could be watched when away from their mothers' rooms for short periods of time.

"Hospitals that did not build central nurseries designed their nursing practices to facilitate nonseparation of mothers and babies. In so doing, postpartum and nursery nurses were cross-trained to function as mother-baby or couplet nurses. (Celeste R. Phillips, "Family centered maternity care: past, present, and future," December 1999, www.icea.org/1299samp.htm)

References: Apple, R. 1987. Mothers and medicine: A social history of infant feeding, 1890-1950, 3, 4, 94, 18. Madison: University of Wisconsin Press; Bowlby, J. 1953. Child care and the growth of love; Kuhn, J. 1984. Updating family-centered maternity care: Application of a conceptual analysis of support. Health Care for Women International 5: 1-3, 94-101; Leavitt, J. W. 1989. Joseph B. De Lee and the practice of preventative obstetrics. Obstetrical and Gynecological Survey 44, no. 9: 682-683; Midmer, D. 1992. Does family-centered maternity care empower women? The development of the woman-centered childbirth model. Family Medicine 24, no. 3: 216-221; Phillips, C. R. 1996. Family-centered maternity and newborn care: A basic text, 4th ed. St. Louis: C. V. Mosby Co.; Ripperger, H. 1948. Whose baby is it? Woman's Day 42-43, 86-87, 121-124.

Shultz, G. 1958. Cruelty in maternity wards. Ladies' Home Journal 44-45, 152-155; Speert, H. 1980. Obstetrics and gynecology in America - A history. Chicago: American College of Obstetricians and Gynecologists; Stolte, K., and S. Myers. 1987. Nurses' responses to changes in maternity care, Part 1. Family-centered changes and short hospitalization. Birth 14, no. 2: 82-86; Taffel, S. M., et al. 1987. Trends in the United States cesarean section rate and reasons for the 1980-1985 Rise. American Journal of Public Health 77: 955-956; Tegtmeier, D., and S. Elsea. 1984. Wellness throughout the maternity cycle. Nursing Clinics of North America 19, no. 2: 219-227; Thoms, H. 1950. Training for childbirth: A program of natural childbirth with rooming-in. New York: McGraw-Hill Book Company; Wertz, R. W., and D. C. Wertz. 1989. Lying-in: A history of childbirth in America. Expanded edition. New Haven and London: Yale University Press; Wiedenbach, E. 1959. Family-centered maternity nursing. New York: J. P. Putnam's Sons; Wooden, H., and E. Engel. 1965. Infection control in family-centered maternity care. Obstetrics and Gynecology 25(2):232-234.

(With over forty years of experience in maternal and child health care, Celeste Phillips, EdD, RN, is a nationally known educator, lecturer, and consultant on obstetrics and women's health care. Dr. Phillips received AWHONN's (then NAACOG) Distinguished Professional Service Award in 1988 and has received AJN's Book of the Year award. She also developed the Mother-Baby Resource Guide for AWHONN and numerous articles on contemporary obstetric nursing. She has been invited as keynote speaker for many national professional associations. Dr. Phillips specializes in assisting hospitals assess their needs and then achieve a consensus course of action. Through programmed site visits, board-level presentations, and focused retreats, she provides an unusual service in raising management's and physician staff's consciousness about their future obstetric and women's health care needs, creating new visions for perinatal care and how it should be delivered in the future. Dr. Phillips was elected to serve on the AWHONN Board of Directors for 1998-2000. She is currently a member of the International Childbirth Education Association Board of Consultants.)

If you give birth in the hospital with an obstetrician, rather than at home with a midwife, you are between 2.9 and 6 times more likely to die. The average risk, while somewhere between the two numbers above, is hard to pin down because it depends on the figures one starts with, and these figures are in question. But it's absolutely certain that the vast majority of women are at least twice as likely to die if their babies are delivered in the hospital. (David Stewart, "Mothering perinatal healthcare statistics and sources," Mothering, Fall 1993)

Nancy Wainer Cohen and Lois J. Estner write: "The NIH Task Force [National Institutes of Child Health and Human Development, Draft Report of the Task Force on Cesarean Childbirth (Bethesda, Maryland: NIH, September 1980)] determined that "cesarean delivery carries about four times the risk of maternal mortality of a vaginal delivery" and that "cesarean delivery for previous cesarean carries two times the risk of maternal mortality of all vaginal deliveries." We believe these figures to be conservative." (Silent Knife, 30)

Interestingly, according to a study by the American College of Obstetricians and Gynecologists ("National study of maternity care: survey of obstetric practice and associated services in hospitals in the United States," 1970) maternal death rates are highest in large hospitals with large obstetrical units (2000 or more births per year). They are also high in medical school hospitals and teaching hospitals affiliated with medical schools. (See Yvonne Brackbill, et al., Birth Trap, 2)

Diana Scully talks about "teaching hospitals, where the poor become "training material" for residents . . ." (Men Who Control Women's Health, 2)

Judith Pence Rooks, in her discussion of the Maternity Center Association's work with poor inner-city families in New York, shows us that U.S. obstetric maternal mortality figures have long been higher than midwives': "During its twenty-six years of operation from 1932 to 1958, midwives of the Lobenstine/MCA program attended 7,999 births, most in the mother's home (Varney, 1978). The maternal mortality rate for MCA births was 0.9 per 1,000 live births; the national average during the same period was 10.4 per 1,000 – more than ten times higher (Roberts, 1995b)." (Midwifery & Childbirth in America, 39)

Rooks continues: "In 1955 the American Journal of Obstetrics and Gynecology published an article that reported the outcomes of the care provided to 5,765 pregnant women during the Maternity Center Association's first twenty years of operation (1931-1951). MCA nurse-midwives had delivered 87 percent of the women in their own homes. Their maternal mortality ratio of 8.8 per 10,000 live births was far lower than the national ratio, which was 31.7 per 10,000 at the midpoint of that period (1941). MCA obtained these good outcomes despite a high incidence of poor nutrition, poor home conditions, low income, unmarried mothers, and high parity [large number of babies per mother] among the women served by the nurse-midwives (Laird, 1955)." (Midwifery & Childbirth in America, 46)

Rooks gives us similar results from the Frontier Nursing Service, a program started by Mary Breckinridge in 1925 to help poor mothers in rural Kentucky: "The Frontier Nursing Service kept careful statistics and evaluated its progress after every thousand births. All maternal and infant outcome statistics for FNS's first thirty years of operation (1925-1954) were better than for the country as a whole, despite extreme poverty in the area and a high proportion of pregnancies carried by women at the extremes of the childbearing age span and by women of very high parity. The biggest differences were in the maternal mortality rate (9.1 per 10,000 births for FNS, compared with 34 per 10,000 for the United States as a whole) and low birth weight (3.8 percent for FNS, compared with 7.6 percent for the country) (Browne & Isaacs, 1976)." (Midwifery & Childbirth in America, 47)

Rooks gives us the results of the success of the above programs: "These positive findings [from the MCA and FNS programs] encouraged the development of other nurse-midwifery services, including a demonstration project that was started in Madera County, California, in 1960. Although midwifery was illegal in California, a special law allowed nurse-midwives (referred to as "nurse obstetrical assistants") to practice in a state-supported project designed to alleviate chronic physician shortages in a rural hospital that served the entire population of Madera County. Although the project documented improved pregnancy outcomes associated with the introduction of nurse-midwifery care, the special law was rescinded and the project was terminated in 1963." (Midwifery & Childbirth in America, 47)

Rooks gives us further figures from the first part of the century: "The proportion of U.S. births attended by midwives declined from about 50 percent in 1900 to 12.5 percent in 1935 (Devitt, 1979; Jacobson, 1956). By 1932 approximately 80 percent of all midwives practicing in the United States were traditional birth attendants living in the rural south (Devitt, 1979; Jacobson, 1956). Whenever and wherever midwifery declined, the incidence of maternal mortality and infant deaths from birth injuries increased. In the 1920s midwifery declined and maternal mortality rose in Newark and Cleveland, whereas an increase in midwifery in Pittsburgh was accompanied by a decrease in the ratio. Midwives delivered 10 percent of babies born in the District of Columbia in 1915, and the maternal mortality ratio was 6.6 per 1,000 live births. By 1923 the midwives' share of D.C. births had fallen to 4 percent and the maternal mortality ratio had risen to 10.1. When Massachusetts made midwifery illegal in 1907 the state's maternal mortality ratio was 4.7; it rose to 5.6 in 1913 and 7.4 in 1920. Throughout the nation, infant deaths from birth injuries rose by 44 percent between 1918 and 1925, as the overall practice of midwifery declined (Devitt, 1979). . . . Early in this century, levels of both infant and maternal mortality in the United States were as high as they are in many developing countries now (Maine, 1991). Maternal mortality plateaued at a high level (600 to 700 deaths per 100,000 births) between 1900 and the mid-1930s and then began a steep decline coincident with the availability of antibiotics, blood transfusions, and drugs to treat pregnancy-induced hypertension (Maine, 1991; Loudon, 1992; AbouZahr & Royston, 1991). The most important contributing factor was the sudden availability of antibiotics. Sulfonamide drugs were being used for obstetric infections by the late 1930s. Penicillin became available to the civilian population at the end of World War II. The number of infection-related maternal deaths fell from 3,719 in 1937 to 392 in 1954 (Maine, 1991). Similar drops in maternal mortality occurred throughout the Western industrialized world. The U.S., the Netherlands, and Britain experienced dramatic reductions in maternal mortality starting in the mid-1930s but had very different forms of maternity care: In the United States obstetricians delivered most of the babies in hospitals. In the Netherlands professional midwives delivered most of the babies in homes. Britain had both home an hospital births and used midwives, general practitioners, and specialist obstetricians. These differences had no apparent effect on the rate of maternal mortality (Maine, 1991)." (Midwifery & Childbirth in America, 30-31)

In 1930, the U.S. maternal mortality ratio was 670 maternal deaths per 100,000 live births. The ratio declined substantially during the 1940s and 1950s, and continued to decline until 1982. Maternal mortality ratios remained higher for black women than for white women. Ratios for black women generally fluctuated between 18 and 22 per 100,000 births and for white women between 5 and 6 per 100,000 live births. The overall annual U.S. maternal mortality ratio remained steady at 7.5 maternal deaths per 100,000 live births from 1982 to 1996. Maternal deaths are defined as those deaths that occurr during a pregnancy or within 42 days of the end of a pregnancy and for which the cause of death is listed as a complication of pregnancy, childbirth, or the puerperium (International Classification of Diseases, Ninth Revision, codes 630 – 676). The United States has not reached an irreducible minimum in maternal mortality; WHO estimates demonstrate that 20 countries have reduced maternal mortality levels to below those of the United States. ("World Health Organization revised 1990 estimates of maternal mortality: a new approach by WHO and UNICEF," Geneva, Switzerland: World Health Organization, 1996, report no. WHO/FRH/MSM/96.11). In this WHO report, maternal mortality ratios are based solely on vital statistics data and are underestimates because of misclassification. (CDC, "Morbidity and Mortality Weekly Report," 47(34) September 4, 1998)

Judith Goldsmith writes: "Maternal mortality in childbirth is reported for only five groups, protracted labors in only two. Out of the nearly five hundred culture groups represented in the research for this book, this is a very low percentage. Furthermore, the dates of these reports are all fairly recent, and therefore disease and economic problems brought on by Western contact may be factors." (Childbirth Wisdom from the World's Oldest Societies, 193)

Judith Goldsmith continues: "Can modern women have easy natural births? Some people have argued against this, claiming that something in the physical makeup of tribal women made them able to give birth more easily. . . . However, ease in childbirth is certainly not limited to non-European women. Alé Hrdlicka, the physician and student of tribal people who traveled extensively through North America in the early part of [the 20th] century, noted that women of European descent living under conditions similar to tribal women were equally able to enjoy a natural childbirth. . . . Conversely, tribal women who have begun to live a more Westernized lifestyle have much more trouble in childbirth than women of the same tribal group who live in the traditional way. Sanya Djo Onabamiro, writing of west Africa, stated: 'It has long been observed that among the educated young women of the new generations of West Africans who . . . live a sedentary and generally lazy life during their period of pregnancy . . . the rate of maternal mortality is much higher than that of the illiterate, active women . . . who have to support themselves . . .' It would seem, therefore, that easier natural childbirth is made possible by the attitudes, ways of life, and other intrinsic practices of the materially minimal lifestyle, and not by the physical (racial) characteristics of non-Western women." (Childbirth Wisdom from the World's Oldest Societies, 179-180)

The essence of the technorinos' argument is that nature (i.e., "genes"), not culture (i.e., technology), is at fault when a woman dies from childbirth complications. These advocates of technological birth believe that human physiology is inherently flawed and that childbirth is especially high risk. Fortunately for women and babies, this argument is without substantial merit.

Andrew Weil writes: "Doctors believe that health requires outside intervention of one sort or another, while proponents of natural hygiene maintain that health results from living in harmony with natural law. In ancient Greece, doctors worked under the patronage of Asklepios, the god of medicine, but healers served Asklepios's daughter, the radiant Hygeia, goddess of health. Medical writer and philosopher René Dubos has written: 'For the worshippers of Hygeia, health is the natural order of things, a positive attribute to which men are entitled if they govern their lives wisely. According to them, the most important function of medicine is to discover and teach the natural laws which will ensure a man a healthy mind in a healthy body. [T]he followers of Asklepios believe that the chief role of the physician is to treat disease, to restore health by correcting any imperfections caused by accidents of birth or life.'" (Spontaneous Healing, 4)

Women labeled "high risk" by modern-day medical standards somehow become low risk when attended by midwives (Zander, L., et al., "The role of the primary health care team in the management of pregnancy," in Kitzinger, S. and J. Davis, eds., The Place of Birth (Oxford: Oxford University Press, 1978):118-134; Confidential Enquiries into Maternal Deaths in England and Wales, 1970-1972, Dept. of Health and Social Security, London: H.M.S.O., 1975; Goodlin, R., "Intrapartum fetal monitoring: is it worth while?" in Kaminetzky and Iffy, eds., New Techniques and Concepts in Maternal and Fetal Medicine (New York: Van Nostrand, 1979); Mehl, Lewis, "Scientific research on childbirth alternatives," in David and Lee Stewart, eds., The Five Standards of Safe Childbearing (Marble Hill, MO: Napsac Reproductions, 1977); Madrona, M. and L. Mehl, "The future of midwifery in the United States," NAPSAC News 18(3-4) (1993):1-29; Tew, M. and S.M.I. Damstra-Wijmenga, "Safest birth attendants: recent Dutch evidence, Journal of Midwifery (Br.) 7 (1991):55-63; Tew, Marjorie, Safer Childbirth? A Critical History of Maternity Care (London: Free Association Books, 1998); Wagner, M., "Appropriate technology for birth," World Health Organization, The Lancet (August 24, 1985):436-437; Tew, M., "The practices of birth attendants and the safety of birth," Journal of Midwifery (Br.) 1 November 1985):1-8; Tew, M., "We have the technology," Nursing Times (Br.) 81(47) (November 20, 1985):22-24; Tew, M., "Do obstetric intranatal interventions make birth safer?" Brit Jour Ob Gyn 93 (July 1986):659-674; David Stewart, "Skillful midwifery: the highest and safest standard," in David Stewart, The Five Standards for Safe Childbearing, 188-189; Mehl, L. "Research on alternatives: what it tells us about hospitals," in Steward, D. and L. Stewart, eds., Twenty-First Century Obstetrics Now! 1 (1977):171-207; Huntingford, P., "Obstetric practice: past, present, future," in Kitzinger, S. and J. Davis, The Place of Birth (Oxford: Oxford University Press, 1978):229-250)

Marjorie Tew writes: "While it is now more readily conceded that obstetric management cannot make low-risk births safer, there is still not a shred of evidence to support the other universally accepted belief . . . that obstetric management is especially able to make safer those births predicted on obstetricians' ever-widening criteria to be at high risk." (Safer Childbirth? A Critical History of Maternity Care, xii; see also Turnbull, D., et al., "Randomised controlled trial of efficacy of midwife managed care," Lancet 348 (1996):213-218)

David Stewart writes: "Question: Why do midwives have better outcomes than doctors? Typical answers . . . given by doctors: (1) "Doctors deal with the high risk, while midwives deal with the low risk." . . . "This is a totally false excuse. When the perinatal outcomes of doctors and midwives are compared within the same demographics and levels of risk for each, the midwives obtain better results in every instance, whether the populations be high risk or low. [Levy, B. et al., "Reducing neonatal mortality rate with nurse-midwives," Am J Ob Gyn, 109:50-58, 1971; Montgomery, T. "A case for nurse-midwives," Am J Ob Gyn, 105:3, 1969; Mehl, L. "Research on alternatives: what it tells us about hospitals," in Steward, D. and L. Stewart, eds, Twenty-First Century Obstetrics Now! Marble Hill, MO: NAPSAC International, 1977, vol. 1, 171-207; Zander, L., et al. "The role of the primary health care team in the management of pregnancy," in Kitzinger, S. and J. Davis, The Place of Birth, Oxford: Oxford University Press, 1978, pp 118-134; Huntingford, P., Obstetric Practice: Past, Present, Future, in Kitzinger, S. and J. Davis, The Place of Birth, Oxford: Oxford University Press, 1978, pp 229-250; Confidential Enquiries into Maternal Deaths in England and Wales, 1970-1972, Dept. of Health and Social Security, London: H.M.S.O., 1975; Goodlin, R., "Intrapartum fetal monitoring: is it worth while? in Kaminetzky and Iffy, eds, New Techniques and Concepts in Maternal and Fetal Medicine, New York: Van Nostrand, 1979; Madrona, M and L. Mehl, "The future of midwifery in the United States," NAPSAC News, vol. 18, No. 3-4, pp 1-29, 1993; Tew, M. and S.M.I. Damstra-Wijmenga. "Safest birth attendants: recent Dutch evidence, Journal of Midwifery (Br.), vol. 7, pp 55-63, 1991; Tew, Marjorie. Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998; Wagner, M. "Appropriate technology for birth," World Health Organization, The Lancet, August 24, 1985, pp 436-437; Tew, M. "The practices of birth attendants and the safety of birth," Journal of Midwifery (Br.), vol. 1, pp 1-8, November 1985; Tew, M., "We have the technology," Nursing Times (Br.) vol. 81, No. 47, pp22-24, November 20, 1985; Tew, M., "Do obstetric intranatal interventions make birth safer? Brit Jour Ob Gyn, Vol. 93, pp. 659-674, July 1986] . . . [I]mpoverished mothers, even when on government medical assistance programs, are routinely refused care by doctors who prefer to fill their practices with the wealthy, the healthy, the well nourished, and those with well-endowed insurance policies. . . . The history of midwifery . . . is one where midwives handled the lower income, less educated, less sheltered, poorly nourished, and even chronically ill mothers. It is a myth to believe that doctors have historically dealt with the high risk and midwives with the low. In most of the data reported here the opposite was true." [Tew, M. and S.M.I. Damstra-Wijmenga. "Safest birth attendants: recent Dutch evidence, Journal of Midwifery (Br.), vol. 7, pp 55-63, 1991; Tew, Marjorie. Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998] (David Stewart, "Skillful Midwifery: The Highest and Safest Standard," in David Stewart, The Five Standards for Safe Childbearing, 188-189)

David Stewart writes: "Question: Why do midwives have better outcomes than doctors? Typical answers . . . given by doctors: (2) "Doctors handle a greater proportion of complicated cases in their practices than do midwives." . . . "This one is true. Doctors do encounter more complications and problems in childbirth than midwives encounter. But this is not the whole story. The truth is that the majority of the complications of pregnancy and labor encountered by physicians are, in actuality, caused by physicians (iatrogenic) and/or by hospitals (nosocomial). . . . Doctors are quite correct in claiming to encounter frequent problems in childbirth, but what they fail to recognize and accept is that they are the principal cause of such problems." [Tew, Marjorie. Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998; "False Hypertension Linked With Cesareans"] Many pregnant women may undergo unnecessary cesarean sections because they have "white-coat hypertension" – high blood pressure that happens only when they are around doctors, a study reported in the Journal of the American Medical Association suggests. [See Steven Reinberg, "DASH Diet Can Control Stage 1 Hypertension," http://womenshealth.medscape.com/reuters/prof/2000/09/09.19/20000919clin015.html] Almost one-third of pregnant women have such false high blood pressure. Believing it is real hypertension, doctors usually treat it with blood pressure lowering drugs, which can compromise a woman's ability to have normal contractions and in the study led to apparently unnecessary cesareans, said research author Dr. Gianni Beliomo of Assisi Hospital in Italy. Researchers studied 144 pregnant women who had high blood pressure during the final third of their pregnancies and found that 42 had white-coat hypertension. The women's blood pressure was normal when it was not being measured by a health professional, as shown by portable monitors the women wore for 24 hours. Nineteen of these 42 women ultimately underwent cesareans (45 percent), a rate similar to the 42 cesareans (41 percent) among the 102 women with true hypertension. But only 13 cesarean deliveries (12 percent) were done among a comparison group of 103 women with normal blood pressure." ("Skillful Midwifery: The Highest and Safest Standard," in David Stewart, The Five Standards for Safe Childbearing, 188, 190)

David Stewart writes: "Question: Why do midwives have better outcomes than doctors? Typical answers . . . given by doctors: (4) "Doctors keep more complete and accurate records; midwives don't report all of their mortalities, even though they are supposed to do so." . . . "By all indications, midwives are very conscientious in reporting their birth statistics. There are no published documents indicating that they do not. On the other hand, there are a number of publications showing that doctors in hospitals do under-report their mortalities and commit other errors in the reporting of birth statistics. ["Underreporting of neonatal deaths, Georgia, U.S.CDC, U.S.PHS," Morbidity and Mortality Weekly Report, 28:253-254, 1979; Gittlesohn, A. and J. Sennig, "Studies on reliability of vital statistics and health records," Am J Public Health, 69:680-689, 1979; McCarthy, B. et al., "The underregistration of neonatal deaths, Georgia, 1974-77," Am J Public Health, 70:977-982, 1980; Patterson, J. "Assessing the quality of vital statistics," (editorial), Am J Public Health, 70:944-946, 1980; "ACOG offers family physicians larger share of OB practice if they join in fight against midwives," Ob Gyn News, June 1, 1980 and Family Practice News, June 15, 1980 and NAPSAC News 5:3:6, 1980; Doornboos, J.P.R. et al., "The reliability of perinatal mortality statistics in the Netherlands," Am Jour Obs & Gyn, vol. 156, pp. 1183-1187, 1987] ("Skillful Midwifery: The Highest and Safest Standard," in David Stewart, The Five Standards for Safe Childbearing, 188, 190)

See also Mehl, L., "Research on alternatives: what it tells us about hospitals," in Steward, D. and L. Stewart, eds., Twenty-First Century Obstetrics Now! Marble Hill, MO: NAPSAC International 1 (1977):171-207; Zander, L., et al., "The role of the primary health care team in the management of pregnancy," in Kitzinger, S. and J. Davis, The Place of Birth (Oxford: Oxford University Press, 1978):118-134; Huntingford, P., "Obstetric practice: past, present, future," in Kitzinger, S. and J. Davis, The Place of Birth (Oxford: Oxford University Press, 1978):229-250; Confidential Enquiries into Maternal Deaths in England and Wales, 1970-1972, Dept. of Health and Social Security (London: H.M.S.O., 1975); Goodlin, R., "Intrapartum fetal monitoring: is it worth while?" in Kaminetzky and Iffy, eds., New Techniques and Concepts in Maternal and Fetal Medicine (New York: Van Nostrand, 1979); Madrona, M and L. Mehl, "The future of midwifery in the United States," NAPSAC News 18(3-4) (1993):1-29; Tew, M. and S.M.I. Damstra-Wijmenga, "Safest birth attendants: recent Dutch evidence," Journal of Midwifery (Br.) 7 (1991):55-63; Tew, Marjorie, Safer Childbirth? A Critical History of Maternity Care (London: Free Association Books, 1998); Wagner, M., "Appropriate technology for birth," World Health Organization, The Lancet (August 24, 1985):436-437; Tew, M., "The practices of birth attendants and the safety of birth," Journal of Midwifery (Br.) 1 (November 1985):1-8; Tew, M., "Do obstetric intranatal interventions make birth safer?" Brit Jour Ob Gyn 93 (July 1986):659-674; David Stewart, "Skillful midwifery: the highest and safest standard," in David Stewart, The Five Standards for Safe Childbearing, 188-189.

"High risk deliveries are by definition hospital deliveries. Hospital deliveries are by definition high risk deliveries." (Judith Pence Rooks, Midwifery & Childbirth in America, 280; see also Cunningham, et al., 1993).

David Stewart writes: "Placing 90-100% of mothers in hospitals in an attempt to save the small percent of mothers and babies genuinely falling into the high-risk categories through natural causes increases the risk for the many." ("The Limits of Science in Childbirth," in David Stewart, The Five Standards for Safe Childbearing, 49; see Tew, M. Where to Be Born? New Society, pp 120-121, January 20, 1977; Bradshaw, J. Babes in the Ward, London: Undercurrents, January 1977; Watkin, B. "Back to home deliveries?" Nursing Mirror Midwives Journal, p. 42, February 3, 1977; Young, D. and C. Mahan, Unnecessary Cesareans: Ways to Avoid Them, Minneapolis, MN: International Childbirth Education Association, 1989; Tew, M., Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998)

"Doctors do encounter more complications and problems in childbirth than midwives encounter. But this is not the whole story. The truth is that the majority of the complications of pregnancy and labor encountered by physicians are, in actuality, caused by physicians (iatrogenic) and/or by hospitals (nosocomial). . . . Doctors are quite correct in claiming to encounter frequent problems in childbirth, but what they fail to recognize and accept is that they are the principal cause of such problems." (David Stewart, "Skillful midwifery: the highest and safest standard," in David Stewart, The Five Standards for Safe Childbearing, 190; see also Tew, Marjorie. Safer Childbirth? A Critical History of Maternity Care (London: Free Association Books, 1998); "False hypertension linked with cesareans," Midwifery Today E-News 1(44) (October 29, 1999); www.naturalchildbirth.org/natural/resources/risk/risk13.htm)

Ivan Illich writes: "The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for 'physician,' and genesis, meaning 'origin.'" (Limits to Medicine, 3)

Ivan Illich writes: "In rich countries medical colonization has reached sickening proportions; poor countries are quickly following suit. (The siren of one ambulance can destroy Samaritan attitudes in a whole Chilean town.) This process, which I shall call the "medicalization of life," deserves articulate political recognition." (Medical Nemesis, 8)

Ivan Illich writes: "[W]hat has turned health care into a sick-making enterprise is the very intensity of an engineering endeavor that has translated human survival from the performance of organisms into the result of technical manipulation." (Limits to Medicine, 7)

Ivan Illich writes: "The pain, dysfunction, disability, and anguish resulting from technical medical intervention now rival the morbidity due to traffic and industrial accidents and even war-related activities, and make the impact of medicine one of the most rapidly spreading epidemics of our time. Among murderous institutional torts, only modern malnutrition injures more people than iatrogenic disease in its various manifestations." (Limits to Medicine, 26)

Ivan Illich writes: "[P]eople believe that hospitalization increases their chances of surviving a crisis. With some clear-cut exceptions . . . more often than not, they are wrong. (Limits to Medicine, 104-5)

Ivan Illich writes: "The threat which current medicine represents to the health of populations is analogous to . . . the threat which education and the media represent to learning . . ." (Medical Nemesis, 7)

Marjorie Tew writes that "care by obstetricians is not only incapable, save in exceptional cases, of reducing predicted risk . . . it actually provokes and adds to the dangers . . ." (Home Birth: The Issue of Safety, 267 in Laura Kaplan Shanley, Unassisted Childbirth, 47)

Marjorie Tew writes: "Death rates remained high until 1870, but thereafter they experienced a spectacular and sustained decline. The grateful public were disposed to give the medical profession the credit for this improvement and the medical profession was certainly not disposed to disclaim the honour. Instead it enjoyed the heightened prestige. The honour was, however, misplaced as later epidemiological analysis, which evaluates the effects of the treatment of disease on patients as a whole, was to prove [see McKeown, T., Medicine in Modern Society (London: George Allen and Unwin, 1965]. The great decline in mortality was brought about not by life-saving medical treatments, but by the life-saving consequences of non-medical developments. The most frequent causes of death had been infectious diseases, including cholera and tuberculosis. The chief reason for the decline in mortality was the decline in deaths from these causes. . . . [I]mprovements in provisions for public health, in nutrition and in other living standards had been more effective in combating infectious diseases and reducing infant mortality than the immunization and serum treatments which became available in the 1930s. It is virtually certain that the reasons for the parallel decline in mortality which took place in other industrializing countries over the same period were the same." (Safer Childbirth? A Critical History of Maternity Care, 3-4)

Two studies found that maternal mortality is as much twelve times greater if a woman is delivered by C-section. (See D. Lehmann, et al., "The epidemiology and pathology of maternal mortality: Charity Hospital of Louisiana in New Orleans," Obstet Gynecol, 1987, 69, pp. 833-844 and P. Moldin, K.H. Hokegard, and T.F. Nielsen, "Cesarean section and maternal mortality in Sweden, 1973-1979," Acta Obstet Gynecol Cand, 1984, 63, pp. 7-11.)

Beth Shearer, in "Cesarean Birth: Indications and Consequences" (in The Encyclopedia of Childbearing, 57), writes that a C-section-delivered woman has a two to four times greater chance of dying than a vaginal-birthing woman.

One study found that cesarean mothers have a 26-times-greater risk of dying. (Evrard, John R. & Edwin M. Gold, "Cesarean section and maternal mortality in Rhode Island: Incidence and risk factors 1965-1975," Ob Gyn 50(5) 1977)

Epidural anesthesia results in a significant drop in maternal blood pressure, which can be fatal to the mother. (Henci Goer, Obstetric Myths Versus Research Realities, 253; Henci Goer, The Thinking Woman's Guide to a Better Birth, 134)

"Those biased in favor of hospitals may say there is not enough data to scientifically prove home is a safe alternative, but the fact is that all available data favor the home and incriminate the hospital for most births. According to the World Health Organization (WHO) there is no scientific data anywhere in the world, past or present, that prove hospitals are a safe alternative for most women." (David Stewart, "The Limits of Science in Childbirth," in David Stewart, The Five Standards for Safe Childbearing, 55; see also Tew, M., Safer Childbirth? A Critical History of Maternity Care, London: Free Association Books, 1998; Wagner, M., "Why Midwifery is the Safest Form of Maternity Care," Amicus Brief, World Health Organization, Geneva, March 1991, reprinted in NAPSAC News (1991):16(2):1)

2. You want your baby to live.

An American-born baby is 1.6 times more likely to die in the first year of life than a Swedish baby and 1.35 times more likely to die in the first year than a Dutch baby. For a country that spends considerably more on perinatal medical services than any other in the world, this is not justifiable. The reasons for the consistent superiority of pregnancy outcomes for Sweden and The Netherlands lies in their emphasis on midwifery, good nutrition, natural childbirth, and breastfeeding, and, in the case of Holland, an emphasis on home birth – all of which are lacking in the American system. (David Stewart, "Skillful Midwifery: The Highest and Safest Standard," in David Stewart, The Five Standards for Safe Childbearing, 156)

I have been astonished to discover that the medical literature is full of studies which reveal that the practices that lie at the heart of modern obstetrics, when used as a matter of course, do not save lives. In fact, study after study shows that they actually lead to higher death rates for both mothers and babies. (John Robbins, Reclaiming Our Health, 23)

"You say some of the children died?"

"Oh, so many of them, despite what we did for them, or maybe because of what we did to them. But it doesn't matter! It's a perfect system now, isn't it?"

(Tom Cruise ("Chief John Anderton") and Lois Smith ("Dr. Iris Hineman"), in the movie, Minority Report, screenplay written by Scott Frank and Jon Cohen)

I would have thought I'd be with you

until my dying day . . . (Sarah McLachlan, "Plenty," Fumbling Toward Ecstasy CD)

The swans are gone. Still the river

Remembers how white they were. (Sylvia Plath, "Three Women," in Winter Trees, 63)

If your baby is born at home with a midwife, rather than delivered in a hospital by an obstetrician, he is six times more likely to survive his first year. (Joseph Chilton Pearce, Evolution's End, 126. Full reports available from NAPSAC International, Box 646, Marble Hill, MO 63764)

The decline has been due to advances in public sanitation and maternal health care. (Marjorie Tew, "Do obstetric intranatal interventions make birth safer?" The British Journal of Obstetrics and Gynaecology, July 1986, 684-689)

Marsden Wagner, former director of the World Health Organization's Women and Children's Health Division, writes: "We should not be surprised with the recent poor track record of high tech birth. For many decades in the middle of the twentieth century the number of babies dying around the time of birth was decreasing but this was due not to medical advances but mainly to social advances such as less severe poverty, better nutrition, better housing and, most importantly, to family planning resulting in fewer women with many pregnancies and births. Medical care also was responsible for some of the decreasing mortality of babies but not because of high tech interventions but because of basic medical advances such as the discovery of antibiotics and the ability to give safe blood transfusion." ("Technology in birth: First do no harm," http://midwiferytoday.com/articles/technologyinbirth.htm)

advances in public health have been saving babies at a rate faster than the increasing use of hospital obstetric technology has been killing them. Mayer Eisenstein writes: "Pouring money into extensive prenatal testing, fetal monitoring and interventionist birthing practices such as cesarean section deliveries has not decreased, but has in fact increased, our infant and maternal mortality rates. . . . The United States has the highest infant mortality rate among the top twenty industrialized nations. . . . The U.S. has fallen to 24th place from its former 5th place as a safe country in which to have a baby. The unscientific medicine practices at births over the past 30 years has plunged America to the dead-last position among the top industrial nations in numbers of healthy babies born to healthy mothers." (The Home Birth Advantage, 18, 97, 121)

John Robbins gives us comparative birthing statistics from the Netherlands: "In 1986, obstetricians delivering babies in hospitals had a mortality rate nine times greater than midwives delivering babies in the same hospitals. And midwives who delivered babies at home did better yet, with only 1 death for every 19 for obstetricians in hospitals." (Reclaiming Our Health, 24-25)

Judith Pence Rooks gives evidence for the superiority of midwifery care: "Senator Robert Kennedy's 1965 visit through the Mississippi Delta country resulted in a federally funded County Health Improvement Program for Holmes County, Mississippi, which was started in 1969. . . . Large numbers of nurses from throughout the southeastern region, as well as other parts of the country, applied (Yzodinma, 1995). The infant mortality rate in Holmes County declined from 42.5 to 21.8 per 1,000 births during the first three years of the nurse-midwifery project (Meglen & Burst, 1974)." (Midwifery & Childbirth in America, 48)

Sue A. Blevins writes: "Many people attribute midwives' record of success to the fact that they do not assist with high-risk deliveries. To address that issue, researchers excluded physicians' high-risk cases from their study of lay midwives in rural Tennessee. The American Journal of Public Health reports that even with comparable low-risk deliveries, lay midwife-assisted home births were as safe as physician-assisted hospital births. Moreover, physician-attended hospitals births were 10 times more likely to require intervention (forceps, vacuum extractor, or caesarean section) than midwife-assisted home births. Those findings are supported by international studies. In the Netherlands – where more than 32 percent of births are attended by lay midwives at home – research shows that the perinatal mortality rate was lowest in cities that had the highest proportion of home births. A study on Dutch births by the British journal Midwifery concluded that perinatal mortality was "much lower under the noninterventionist care of midwives than under the interventionist management of obstetricians." ("The Medical Monopoly: Protecting Consumers or Limiting Competition?" CATO Policy Analysis No. 246, December 15, 1995)

The folks at www.goodnewsnet.org write: "[Lewis] Mehl and his colleagues (1975, 1977) reviewed the medical records of 1,146 home births attended by five home delivery services in northern California between 1970 and 1975. [Mehl LE, Peters CH, Whitt M, Hawes WE. Outcome of elective home births. A series of 1146 cases. J Reprod Med 1977;19:281-90. ] These investigators provided detailed descriptions of demography (e.g., urban or rural), attendants, population served, process of care, outcomes, and complications. The incidence of various events among home births was compared to the incidence of similar events in the birth population of the state of California or as reported in the literature. No maternal deaths were noted, and the perinatal mortality rate of 9.5 per 1000 births was lower than the California average." (Research Issues in the Assessment of Birth Settings, Institute of Medicine, National Academy Press, Washington, 1982, p. 76) . . . From the same source (Figure 1, p. 175): In the state of Oregon from 1975-1979, there were approximately 3-4 neonatal deaths per 1000 births in homebirths attended by midwives, as opposed to approximately 9-10 deaths per 1000 births for all residents. The same figure indicates approximately 5 infant deaths per 1000 births in homebirths attended by midwives, as opposed to approximately 12 deaths per 1000 births for all residents." (Research Issues in the Assessment of Birth Settings, Institute of Medicine, National Academy Press, Washington, 1982, p. 175; http://www.goodnewsnet.org/practice/saftysta.htm)

In a "cease and desist" letter to Dr. Steven Polansky, board member the California Association of Obstetricians and Gynecologists, from Faith Gibson, LM, CPM, Director of the California College of Midwives, Ms. Gibson wrote (on Mothers Day, 2000): "During a recent hearing in the Virginia State legislature an ACOG representative testified in opposition to midwifery licensing. At the conclusion he was asked by a senator if he had any evidence that home birth is unsafe or that nationally certified professional midwives are not performing well in other states. His answer was "No. No evidence." . . . More than 100 scientific studies, peer-review articles and reports from the World Health Organization statistically support the efficacy of domiciliary midwifery services for low and moderate risk women. In contrast, not a single study has ever been published proving hospitals to be a safer place for this same low-risk population to give birth or establishing obstetricians to be safer caregivers for healthy women." (Faith Gibson, letter to Dr. Steven Polansky, board member the California Association of Obstetricians and Gynecologists)

"The Safety of Home Birth Attended by a Direct-Entry Midwife: What Science has to Say." compiled by Michael J. Stark, Ph.D. for the Maryland Friends of Midwives.

"The safety of birth outside a hospital attended by a lay midwife is well established through controlled scientific studies. Such studies are the only reliable means of establishing this safety. What follows are the references to and brief summaries of the conclusions of articles which have appeared in scientific journals pertaining to the safety of home birth attended by a direct-entry midwife. Where possible, the safety has been expressed in terms of neonatal or perinatal mortality in deaths per thousand births. When considered together, these articles support the conclusions that home birth attended by a direct-entry midwife is at least as safe as hospital birth. These articles also establish that home birth has additional advantages beyond the good survival rates of infants so born."

Abernathy, Thomas J and Lentjes, Donna M. "Planned and Unplanned Home Births and Hospital Births in Calgary, Alberta, 1984-87," Public Health Reports. 104 373 (1989)
Planned home birth: 61, Control group (Hospital): 33,777. The article does not study neonatal mortality but relies on other measures of birth outcome (onset of respiration, duration of labor, gestational age and birth weight)

Burnett III, Claude A et al., "Home Delivery and Neonatal Mortality in North Carolina," Journal of the American Medical Association. 244 2741 (1980)
Planned home births attended by a midwife: 768, Control group (hospital)242,245. Neonatal mortality: 4/1000 (12/1000 for the control group.)

Campbell, Rona et al., "Home Births in England and Wales, 1979: Perinatal Mortality According to Intended Place of Delivery," British Medical Journal 289 721 (1984)
Intended home births 5917, no control group. Neonatal mortality: 4.1/1000.

Cunningham, John D, "Experiences of Australian Mothers who Gave Birth Either at Home, at a Birth Centre, or in Hospital Labour Wards," Social Science Medicine 36 475 (1993).
The article studies the reported birth experiences of mothers electing home births and compares them with mothers electing births in other locations.

Declercq, Eugene R., "Out-of-Hospital Births, U.S., 1978: Birth weight and Agpar Scores as Measures of Outcome," Public Health Reports 99 63 (1984).
Midwife attended home births: 9,504, Control group (hospital): 3,268,805. The article doesn't use neonatal mortality as a measure of birth outcome.

Durand, A. Mark, "The Safety of Home Birth: The Farm Study," American Journal of Public Health 82 450 (1992).
Midwife attended births: 1,707, Control group (hospital): 14,033. Perinatal mortality 10/1000 (control group 13/1000).

Fedrick, Jean and N.R. Butler, "Intended Place of Delivery and Perinatal Outcome," British Medical Journal 763 (1978).
Home births: 156, Control group (hospital):311. Death rate 8/1000 (Control Group: 13/1000) The article concludes that hospital births are safer than home births, however it makes no accounting for birth attendant.

Hinds, M Ward, Gershon H. Bergeisen, and David T. Allen, "Neonatal Outcome in Planned vs Unplanned Out-of-Hospital Births in Kentucky," Journal of the American Medical Association. 253 1578 (1985).
Planned home births: 575. Control Group unspecified. Neonatal mortality: 4/1000

Mehl, Lewis E. et al., "Outcomes of Elective Home Births: A Series of 1,146 Cases," Journal of Reproductive Medicine. 19 281 (1977)
Perinatal mortality: 9.5/1000 (Control Group: 20.3/1000).

Murphy, J.F. et al., "planned and Unplanned Deliveries at Home: Implications of a Changing Ratio," British Medical Journal 288 1429 (1984).
Planned home births: 315, Control group: 44,521. Neonatal mortality: 3.2/1000 (Control Group 10.7/1000)

Schneider, Dona, "Planned Out-of-Hospital Births, New Jeresey, 1978-1980," Social Science Medicine. 23 1011 (1986)
Planned out-of-hospital births: 775. The article use birth weight as a measure of outcome. It examines the demographic makeup of women electing home birth more than it examines outcome.

Schramm, Wayne F et al., "Neonatal Mortality in Missouri Home Births, 1978-1984," American Journal of Public Health 77 930 (1987)
Planned, professional-attended home births:1770, Neonatal mortality:5/1770 (Expected 3.92/1770).

Shearer, J.M.L., "Five Year Prospective Survey of Risk of Booking for a Home Birth in Essex," British Medical Journal 291 1478 (1985)
Planned home births:202, Control group (hospital):185. No Perinatal deaths in either group. Other factors show home birth outcomes better than hospital births.

Shy, Kerekwood K., Floyd Frost, and Jean Ullom, "Out-of-Hospital delivery in Washington State, 1975 to 1977," American Journal of Obstetrics and Gynecology. 137 547 (1980)
Home births: 1614, Control Group: 157,868. Neonatal mortality: 28/1614. The article concludes that home births are more dangerous but doesn't account for birth attendant. Of the 28 neonatal deaths, 15 were the result of prematurity. Of these, 12 births were unattended.

(Michael J. Stark, www.frognet.net/~midwife/science.html)

Rooks gives us figures from the first part of the century: "Early in this century, levels of both infant and maternal mortality in the United States were as high as they are in many developing countries now (Maine, 1991). Maternal mortality plateaued at a high level (600 to 700 deaths per 100,000 births) between 1900 and the mid-1930s and then began a steep decline coincident with the availability of antibiotics, blood transfusions, and drugs to treat pregnancy-induced hypertension (Maine, 1991; Loudon, 1992; AbouZahr & Royston, 1991). The most important contributing factor was the sudden availability of antibiotics. Sulfonamide drugs were being used for obstetric infections by the late 1930s. Penicillin became available to the civilian population at the end of World War II. The number of infection-related maternal deaths fell from 3,719 in 1937 to 392 in 1954 (Maine, 1991). Similar drops in maternal mortality occurred throughout the Western industrialized world. The U.S., the Netherlands, and Britain experienced dramatic reductions in maternal mortality starting in the mid-1930s but had very different forms of maternity care: In the United States obstetricians delivered most of the babies in hospitals. In the Netherlands professional midwives delivered most of the babies in homes. Britain had both home an hospital births and used midwives, general practitioners, and specialist obstetricians. These differences had no apparent effect on the rate of maternal mortality (Maine, 1991)." (Midwifery & Childbirth in America, 30-31)

Ivan Illich writes: "Life expectancy in the developed countries has increased from thirty-five years in the eighteenth century to seventy years today. This is due mainly to the reduction of infant mortality in these countries; for example, in England and Wales the number of infant deaths per 1,000 live births declined from 154 in 1840 to 22 in 1960. But it would be entirely incorrect to attribute more than one of those lives "saved" to a curative intervention that presupposes anything like a doctor's training, and it would be a delusion to attribute the infant mortality rate of poor countries, which in some cases is ten times that of the United States, to a lack of doctors. Food, antisepsis, civil engineering, and above all, a new widespread disvalue placed on the death of a child, no matter how weak or malformed, are much more significant factors and represent changes that are only remotely related to medical intervention." (Limits to Medicine, 86)

Judith Goldsmith writes: "The period of transition from breast milk to other foods was one of the most vulnerable in a tribal infant's life, and it was during this time – not at birth – that the highest infant mortality occurred." (Childbirth Wisdom from the World's Oldest Societies, 196) See also Richards, Audrey I., Chisungu: A Girls' Initiation Ceremony Among the Bemba of Northern Rhodesia, (London: Faber & Faber, 1956); Schapera, I., Married Life in an African Tribe, (Evanston, IL: Northwestern University Press, 1966); Talbot, P. Amaury, Life in Southern Nigeria (London: Macmillan, 1923); Fuchs, Stephen, The Children of Hari (New York: Praeger, 1951); Embree, John F., Suye Mura: A Japanese Village (Chicago: University of Chicago Press, 1939).

There is not a single study that shows that delivery with forceps is medically indicated in any circumstance. Many studies do show, however, that the routine use of forceps routinely causes infant injury and death. (See Doris Haire, The Cultural Warping of Childbirth, 19)

Vacuum-assisted traction has almost as abysmal a record as forceps delivery. (Henci Goer, The Thinking Woman's Guide to a Better Birth, 117-118)

"A large study of over half a million babies in California [Towner, D., et al., "Effect of mode of delivery in nulliparous women on neonatal intracranial injury," N Eng J Med 341 (1999):1709-1714] provides information on brain injuries according to method of delivery for first babies:

"Intracranial haemorrhage risk:

"Forceps: 1 in 664

"Vacuum extraction: 1 in 860

"Caesarean - in labour: 1 in 907

"Caesarean - no labour: 1 in 2750

"Spontaneous: 1 in 1900

"So, as compared with normal vaginal delivery, the risk of the baby having a recorded subdural or cerebral haemorrhage goes up 3.4 times for forceps delivery, 2.7 times for vacuum . For babies who have both vacuum and forceps it is 7.3 times. There are also higher risks for facial nerve injuries (particularly with forceps), other injuries, and convulsions. Although the overall risk is higher for caesareans done during labour than before labour, the highest risk of all was for caesareans done in labour after a failed attempt at vaginal delivery

"AIMS Comment

"We are very grateful for this study because it is based on a large sample of birth records in California. It is also useful in distinguishing between risk of caesareans done during labour and those done without labour. We are not too happy about unassisted vaginal deliveries being called "spontaneous", when in the USA, as here, they are anything but. How does the haemorrhage risk equate with oxytocin use in labour, rugby-coach instructions to push, and the position of the mother allowed for the delivery?

"We should not assume that cases of haemorrhage convulsions, etc diagnosed and recorded on hospital case notes represent the full total. We know of a number of cases of mothers being accused of harming their babies because there was evidence of subdural haemorrhage; many of these babies had vacuum deliveries.

"Vacuum deliveries are now replacing forceps deliveries because they are less likely to cause injury to the mother, but from the cases we see, we are only too well aware that the risk depends on the skill, judgment and experience of the operator. What we would like to see is more attention paid to the skilled midwife who can help the woman achieve a normal delivery without mechanical help." (http://www.aims.org.uk/reswin99.htm)

warning advisory "FDA Public Health Advisory:

"'Need for CAUTION When Using Vacuum Assisted Delivery Devices'

"May 21, 1998

"To: Obstetricians, Birthing Centers, Nurse Mid-Wives, Pediatricians, Ultrasonographers, ObGyn Nurses, Family Practitioners, Radiologists, Hospital Risk Managers, Hospital ObGyn Departments

"PURPOSE

"This is to advise you that vacuum assisted delivery devices may cause serious or fatal complications, and to provide guidance to minimize the risk. While no instrumented delivery is risk free, we are concerned that some health care professionals who use vacuum assisted delivery devices, or those who care for these infants following delivery, may not be aware that the device may produce life-threatening complications (see attached list for sample of references). We are also concerned that if health care professionals responsible for the care of neonates are not alerted when a vacuum assisted delivery device has been used on a particular infant, they may not adequately monitor for the signs and symptoms of device-related injuries. . . ." (www.fda.gov/cdrh/fetal598.html: "FDA Public Health Advisory: Need for CAUTION When Using Vacuum Assisted Delivery Devices"; see also Henci Goer, The Thinking Woman's Guide to a Better Birth, 118)

The U.S. hospital cesarean section rate presently stands at 26.7 percent. (National Vital Statistics Reports, Vol. 51, No. 11, Table 7 www.ican-online.org/news/062503.htm; see also www.usnews.com/usnews/nycu/health/articles/020805/5csec.htm)

surgically born babies are kept in the hospital three times longer than their vaginally born counterparts (Yvonne Brackbill, et al., Birth Trap, 24)

wheeled from the reception area to the prep room to the labor room to the delivery room to the recovery room and finally to the postpartum room William and Martha Sears write: "The moving about from home to hospital, labor room to delivery room, and wheelchair to bed to delivery table, plus dealing with disturbing routines, were the hardest parts of labor." (The Birth Book, 6)

on average, seven different drugs are administered to mothers during hospital vaginal deliveries and 15.2 different drugs during cesarean deliveries (Doering, P.L. and R.B. Stewart, "The extent and character of drug consumption during pregnancy," JAMA 239 (1978):843 in Yvonne Brackbill, et al., Birth Trap, 19)

All drugs that find their way into your bloodstream find their way into your baby's bloodstream – usually within 45 seconds. (Joseph Chilton Pearce, Magical Child, 58)

Judith Goldsmith writes: "Anesthetics in particular can travel right through the placenta to the child, and it can take days after the birth for their effect to wear off, leaving the new mother wondering why her child takes so long to respond to her or anything else." (Childbirth Wisdom from the World's Oldest Societies, 159)

toxin-containing vaccines Dr. Viera Scheibner, author of Vaccinations: 100 Years of Orthodox Research, sums up the position of researchers not funded by pharmaceutical companies: "There is no evidence whatsoever that vaccines of any kind . . . are effective in preventing the infectious diseases they are supposed to prevent. Further, adverse effects are amply documented and are far more significant to public health than any adverse effects of infectious diseases. [Vaccinations have] caused more suffering and more deaths than any other human activity in the history of medical intervention." (Vaccinations: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System)

Richard Anderson writes in Cleanse & Purify Thyself, "Many people consider the vaccination of children the worst crime in the history of mankind." Cleanse & Purify Thyself: Book 1: The Cleanse, 22)

In the Fall of 2000, members of the Association of American Physicians and Surgeons (AAPS) unanimously voted for an end to all government-mandated childhood vaccines. Jane M. Orient, M.D., AAPS Executive Director, said: "Children face the possibility of death or serious long-term adverse effects from mandated vaccines."

Vaccine Information Sources (list compiled by Jock Doubleday):

VACCINE EFFICACY?

http://www.vaclib.org/sites/debate/index.html

http://www.thinktwice.com/

http://www.whale.to/vaccines.html

http://www.909shot.com/

http://vaccineinfo.net/

http://www.foundationforhealthchoice.com/

http://www.avn.org.au/

http://www.vaclib.org/

http://www.thedoctorwithin.com/

http://www.vaccinepolicy.org/

http://www.whale.to/v/obomsawin.html

http://www.know-vaccines.org/

http://www.vaccine-info.com/

http://www.vaccines.bizland.com/

http://www.geocities.com/Heartland/8148/vac.html

http://www.informedparent.co.uk/

http://www.vaccinationnews.com/

VACCINE INGREDIENTS

http://www.vaclib.org/basic/vacingredient.htm

http://chemfinder.camsoft.com/

AIDS LINKED TO MASS POLIO VACCINATION

http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/AIDS/

http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/AIDS/River/Hooper_00/

ANIMAL VACCINES

http://www.healthy.net/library/articles/ivn/animals.htm

http://www.ahvma.org/

http://cyberpet.com/cyberdog/articles/health/vaccin.htm

http://www.canine-health-concern.org.uk/

http://www.shirleys-wellness-cafe.com/petvacc.htm

http://www.animalhomeopathy.net/

ANTHRAX VACCINE

www.gulfwarvets.com/anthrax.htm

ANTIBODIES AND VACCINES

http://www.whale.to/vaccines/antibody.html

http://vaclib.org/intro/qanda3.htm

ARMY VACCINES

http://www.gulfwarvets.com/winds.htm

http://www.all-natural.com/gwi-1.html

ASTHMA AND VACCINES

http://www.whale.to/vaccines/asthma.html

http://www.whale.to/v/asthma3.html

AUTISM AND VACCINES

http://articles.mercola.com/sites/articles/archive/2008/01/02/vaccine-induced-autism.aspx

http://articles.mercola.com/sites/articles/archive/2000/10/01/autism-mercury-part-one.aspx

http://articles.mercola.com/sites/articles/archive/2001/02/24/autism-mercury-part-two.aspx

http://www.wellbeingjournal.com/index.php?option=com_content&task=view&id=491&Itemid=77

http://www.unlockingautism.org

http://www.taap.info/articles.asp

http://www.autismuk.com/

http://www.mercola.com/2001/mar/7/autism_vaccines.htm

http://www.garynull.com/Documents/autism99b.htm

CHILD ABUSE (shaken baby syndrome) AND VACCINES

http://www.falseallegation.org

http://www.freeyurko.bizland.com/contents.html

CHURCH OF VACCINATION

http://www.healthy.net/asp/templates/article.asp?PageType=Article&ID=1121

CONFLICT OF INTEREST AND VACCINES

http://articles.mercola.com/sites/articles/archive/2000/05/21/research-for-sale.aspx

http://articles.mercola.com/sites/articles/archive/2000/09/24/vaccine-approvals.aspx

http://www.wellbeingjournal.com/index.php?option=com_content&task=view&id=52&Itemid=65

http://www.mercola.com/2000/oct/15/congress_conflicts.htm

http://www.mercola.com/2001/sep/15/vaccines.htm

http://consumerlawpage.com/article/vaccine.shtml

http://www.cspinet.org/new/200303101.html

DIABETES AND VACCINES

http://www.nvic.org/vaccines-and-diseases/Diabetes/congressionalhearing.aspx

http://www.nvic.org/vaccines-and-diseases/Diabetes/juvenilediabetes.aspx

DIPHTHERIA (DPT) VACCINE

http://www.whale.to/v/asthma3.html

DPT VACCINE LINKED TO PARALYTIC POLIO

http://www.pnc.com.au/~cafmr/online/vaccine/polio.html

DISEASE THEORY AND VACCINES

http://www.pnc.com.au/~cafmr/reviews2.html#pasteur

http://www.pnc.com.au/%7Ecafmr/reviews2.html

EXEMPTIONS / WAIVERS FOR VACCINES

http://vaclib.org/exemption.htm

http://www.geocities.com/titus2birthing/VacRefuse.html

http://www.nccn.net/~wwithin/exemptions.htm

http://www.geocities.com/titus2birthing/WhyChoose.html

http://www.know-vaccines.org/exemption.html

http://www.gval.com/exempt.htm

FLU VACCINE

http://www.healthy.net/library/articles/ivn/flu.htm

FORCED VACCINATION

http://www.naturalnews.com/022384.html

http://www.youtube.com/watch?v=r6Vj0EX_STU

http://www.wnd.com/news/article.asp?ARTICLE_ID=54095

http://www.globalresearch.ca/index.php?context=va&aid=1117

http://www.disinfo.com/content/story.php?title=Help-Stop-Forced-Vaccination-Children

http://www.naturalnews.com/022384.html

GARDASIL (HPV) VACCINE

http://www.wnd.com/news/article.asp?ARTICLE_ID=54095

HEPATITIS B (HEP B) VACCINE

http://www.vaccinationnews.com/DailyNews/June2001/HepBVaxReactOutnumbCases.htm

http://www.vaccinationnews.com/DailyNews/July2001/HepBDis&VaxFacts.htm

http://www.vaccinationnews.com/DailyNews/August2001/HepBVaxForNewborns.htm

HOMEOPATHY AND VACCINES

http://www.healthy.net/library/articles/moskowitz/vaccination.htm

http://www.healthy.net/library/articles/moskowitz/unvaccinated.htm

http://www.tinussmits.com/english/

http://www.animalhomeopathy.net/

IMMUNE SYSTEM AND VACCINES (autoimmune disorders)

http://www.healthy.net/library/articles/neustaedter/immune.htm

MMR VACCINE (Measles Mumps Rubella)

http://www.nvic.org/vaccines-and-diseases/MMR.aspx

http://cryshame.net/index.php?option=com_search&searchword=pport

MMR AND AUTISM

http://www.autismuk.com/

POLIO VACCINE

http://www.vaccines.plus.com/

http://thinktwice.com/s_polio.htm

http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/AIDS/

RUBELLA VACCINE

http://thinktwice.com/s_rubell.htm

http://www.garynull.com/Documents/autism99b.htm

SIDS (sudden infant death syndrome) AND VACCINES

http://www.pnc.com.au/~cafmr/coulter/sids.html

http://www.pnc.com.au/~cafmr/coulter/vacc-deb.html

http://www.pnc.com.au/~cafmr/newsl/kalo.html

TETANUS VACCINE

http://www.whale.to/a/tetanus.html

http://www.whale.to/vaccines/tetanus.html

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=1565228&dopt=Abstract

TUBERCULOSIS AND VACCINES

http://www.whale.to/m/point1.html

UNVACCINATED CHILDREN

http://www.healthy.net/library/articles/moskowitz/unvaccinated.htm

VACCINE ADVERSE REACTIONS

http://www.gn.apc.org/inquirer/vaccio.html

VACCINE ARTICLES

http://www.ivanfraser.com/articles/health/vaccination.html

http://www.curezone.com/art/1.asp?C0=735

http://www.icpa4kids.com/pediatric_chiropractic_articles_immunizations.htm

http://www.healingwell.com/library/health/thompson2.asp

http://www.wellbeingjournal.com/index.php?option=com_content&task=view&id=52&Itemid=65

http://www.mercola.com/2003/jul/12/vaccine_procedure.htm

http://www.healthy.net/clinic/familyhealthcenter/children/vaccination/articles.asp

http://www.korenpublications.com/

http://www.wellbeingjournal.com/index.php?searchword=vaccines&option=com_search&Itemid=

VACCINE CHALLENGE (Jock Doubleday's)
http://www.spontaneouscreation.org/SC/$75,000VaccineOffer.htm

VACCINE CHALLENGE (Viera Scheibner's)

http://vaccinationnews.com/DailyNews/October2001/VaccinationChallenge.htm

VACCINE CRITICS

http://www.whale.to/m/critics.html

VACCINE HOAX

http://www.whale.to/a/hoax.html

VACCINE LINKS

http://www.vaclib.org/links/vaxlinks.htm

http://wolfcreekranch1.tripod.com/human_vaccines.html

http://www.industryinet.com/~ruby/vaccinations.html

VACCINE PACKAGE INSERTS (pdf files)

http://www.vaclib.org/chapter/inserts.htm

VACCINE SITES (GOVERNMENT) Vaccine Adverse Event Report System (VAERS)

http://www.fda.gov/cber/vaers/vaers.htm

VACCINE QUOTES

http://www.whale.to/a/hoax.html

VACCINE BOOKS

Jamie Murphy, What Every Parent Should Know about Childhood Immunization
Tim O'Shea, The Sanctity of Human Blood: Vaccination Is Not Immunization
Neil Z. Miller, Vaccines: Are They Really Safe and Effective?
Robert Mendelsohn, How to Raise A Healthy Child in Spite of Your Doctor

Walene James, Immunization: The Reality Behind the Myth

Tedd Koren, Childhood Vaccination: Questions All Parents Should Ask

Randall Neustaedter, The Vaccine Guide: Risks and Benefits for Children and Adults

Raymond Obomsawin, Universal Immunization: Medical Miracle or Masterful Mirage?

Ethel Douglas Hume, Pasteur Exposed: The False Foundations of Modern Medicine

Harris L. Coulter and Barbara Loe Fisher, A Shot in the Dark: Why the P in DPT Vaccination May Be Hazardous to Your Child's Health

Leon Chaitow, Vaccination and Immunization: Dangers, Delusions and Alternatives

Harris L. Coulter, Vaccination, Social Violence and Criminality: The Medical Assault on the American Brain

Viera Scheibner, Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System

Neil Z. Miller, Vaccines, Autism, and Childhood Disorders

Neil Z. Miller, Immunizations: The People Speak!

Catherine J.M. Diodati, Immunization: History, Ethics, Law and Health

Epidemics: Opposing Viewpoints (Opposing Viewpoints Series, Unnumbered) by William Dudley, Ed., Mary E. Williams, Ed., Greenhaven Press (January 1999)

VACCINE BOOK SITES

http://www.know-vaccines.org/reading.html

http://thinktwice.com/vaccine.htm

http://www.korenpublications.com

http://www.cure-guide.com/Vaccine_Guide/vaccine_guide.html

http://www.noamalgam.com/vaccinations.html

http://www.vaclib.org/sites/debate/about.html

AUTISM BOOKS AND ARTICLES

http://www.autismwebsite.com/ari/index.htm

http://www.impossiblecure.com

http://www.baps-online.co.uk/28.html

VACCINE BOOK REVIEWS

http://www.pnc.com.au/%7Ecafmr/reviews2.html

VACCINE VIDEOTAPES

http://www.vaclib.org/basic/products.htm

"Formulas are an attempt to duplicate that which cannot be duplicated – a biologically unique food, specifically tailored to each baby by its own mother, and administered by the warmth, security, and softness of the breast – a feat no bottle could even dimly approach. No one knows how many [North American] babies have died by not breastfeeding; but since the introduction of formulas they number in the hundreds of thousands. No one knows how many children have acquired life-long allergies and other disabilities from not being breastfed but they number in the millions – and perhaps you are among them." (David Stewart, "The Proper Relationship Between Doctors, Hospitals, and Normality," in David Stewart, The Five Standards for Safe Childbearing, 74-75; see Jelliffe, D. & E. Jelliffe, Human Milk in the Modern World, Oxford Univ. Press, 1978)

David Stewart writes: "The physiological benefits of breastfeeding are innumerable. The face, jaws, and occlusion of the teeth develop far better than they do in bottle-fed infants. Speech is clearer in the breastfed . . ." ("Breastfeeding: More than a Standard," in David Stewart, The Five Standards for Safe Childbearing, 385)

David Stewart writes: "By every criterion – historical, anthropologic, physical, medical, scientific, emotional, and financial – breastfeeding must be a standard for childbirth." ("The Proper Relationship Between Doctors, Hospitals, and Normality," in David Stewart, The Five Standards for Safe Childbearing, 74-75; see Jelliffe, D. & E. Jelliffe, Human Milk in the Modern World, Oxford Univ. Press, 1978)

The United States is currently ranked 28th in infant mortality. (www.modimes.org/files/international_rankings_1998.pdf)

David Stewart writes: "The international standing of the U.S. [in terms of infant mortality rates] did not really begin to fall until the mid-1950s. This correlates perfectly with the founding of the American College of Obstetricians and Gynecologist (ACOG) in 1951. ACOG is a trade union representing the financial and professional interests of obstetricians who have sought to secure a monopoly in pregnancy and childbirth services. Prior to ACOG, the U.S. always ranked in 10th place or better [in infant mortality]. Since the mid-1950s the U.S. has consistently ranked below 12th place and hasn't been above 16th place since 1975. The relative standing of the U.S. continues to decline even to the present." ("International infant mortality rates – U.S. in 22nd Place," NAPSAC News, Fall-Winter 1993, p.38; www.goodnewsnet.org/practice/saftysta.htm). See also Henci Goer, "The assault on normal birth: the OB disinformation campaign," Midwifery Today 63 (Autumn 2002); also at http://www.midwiferytoday.com/articles/disinformation.asp)

Robin Karr-Morse and Meredith S. Wiley write: "Each year the Children's Defense Fund publishes a yearbook entitled The State of America's Children. According to their 1996 and 1997 issues: The mortality rate for American babies under the age of one is higher than that of any other western industrialized nation; African-American babies are more than twice as likely to die in their first year of life as white babies. . . ." (Ghosts from the Nursery: Tracing the Roots of Violence, 13)

David Stewart tells us that an extremely conservative estimate is that least one baby dies a preventable death "every 29 minutes" in American hospitals. (See David Stewart, "Skillful Midwifery: The Highest and Safest Standard," in David Stewart, The Five Standards for Safe Childbearing, 195)

"hospitals have been shown to underreport neonatal deaths." (Yvonne Brackbill, et al., Birth Trap, 61)

"The outcomes of our births at The Farm Midwifery Center demonstrate how rare it is for complications and difficulties to occur when women are properly prepared for birth and when technological interventions are kept to a minimum – that is, used only when necessary. Ninety-four percent of women gave birth at home or at our birth center. Fewer than two percent had cesareans. Fewer than one percent had their babies delivered by forceps or vacuum extractors." (Ina May Gaskin, Ina May's Guide to Childbirth, 147)

Shivam Rachana writes of the problems with current routine hospital practices:

"Routine sucking out of airways strips protective lining for the reception of air; sets up conditions for asthma/allergies; baby deprived of experience of establishing its own breathing regimen; contributes to diminished sense of self-confidence.

"Air conditioned air for first breath: disconnects the baby from its organic reality – planet earth.

"Disorientation

"Loss of nourishment: the cord carries blood that is 30-50% of the baby's total blood supply. It is high in iron and oxygen.

"Lack of support by the cord-placenta waste disposal system highly compromises immature systems, e.g. liver, kidneys.

"Postpartum haemorrhage: the clamping of the cord before it has emptied itself of blood sets up an implosion on the maternal site, and an effective rupture occurs on the uterine wall.

"Blood banks: recent recognition of the value of cord blood and its healing properties has led to the establishment of 'cord blood banks' for use in the treatment of childhood leukaemia. It is pertinent to ask that if cord blood is so valuable, what does it mean for the newborn child to be deprived of it?

"One may well ask whether the routine deprivation of this vital blood from the newborn is a contributing factor to childhood diseases such as leukaemia and other forms of cancer." (Lotus Birth, 51)

3. You don't want a cesarean section.

This year 1 million [U.S.] babies – more than 1 out of every 5 – will enter this world by abdominal surgery. Eighty percent of these – more than 600,000 will be medically unnecessary. The majority of these cesareans will be performed on healthy middle and upper class women, not poor women or pregnant teens, the ones at higher risk for problems. (Suzanne Arms, www.birthingthefuture.com/AllAboutBirth/birthMythFact.php)

I want only to be closed up again and rescued from this cold, bone-hard place. I begin to shiver. The shivering turns into a rattle, rhythmic quaking. "I'm so cold," I say. "I'm freezing to death." Why does no one warm me? Or cover me? Why aren't they moving to turn up the heat in the room? My teeth chatter so loudly I can hardly speak. I start to vomit. "Can you stop that?" says the surgeon, irritable or alarmed, I can't tell which. "I need to get this small intestine back in." . . . With my abdomen still split open, I want only not to die. (Naomi Wolf, Misconceptions, 139)

We have reached a crisis situation in some parts of the country where over 50% of women are having cesarean sections. Some women are being encouraged to endure so many cuts to their belly that I wouldn't be surprised to hear of someone sewing in a zipper. (Deanne Williams, ACNM Executive Director, www.vbac.com/proforum/uswomen.html)

Cesarean section is a prime cause of maternal and infant morbidity (injury and illness) and maternal and infant mortality (death) Marsden Wagner, former director of the World Health Organization's Women and Children's Health Division, writes: "Why is it that an article published in a leading American obstetrical journal proving that elective repeat caesarean section has a 6 times higher maternal mortality than vaginal birth (Pettiti et al. 1982) had no apparent effect on the rapidly rising caesarean section rate in that country? Why can a leading medical journal, in all apparent seriousness, publish an article [Feldman, G. and J. Freiman. "Prophylactic caesarean section at term?" New England Journal of Medicine 312(19) (1985):1264-1267] suggesting that all birth be caesarean section? Why is it that when the possibility of caesarean section arises, women are not told as part of their informed consent that the procedure increases the chance of their dying and increases the chance that their baby will have a life-threatening illness?" (Pursuing the Birth Machine, 185-186)

Robert K. DeMott and Herbert F. Sandmire write: "Some researchers have offered improved neonatal outcomes as justification for the