Obstetricians Should Be Heroes

by Jock Doubleday

Is hospital birth safe?

Americans believe that it is. One of the main reasons is that the medical community has for many years told us a grand lie. Here is the lie: "Declining infant mortality rates are due to advances in obstetrics technology."

The truth is something quite different.

Obstetricians, perinatal nurses, and hospital administrators who use this steady decline in the U.S. infant mortality rate to justify the practices of modern-day obstetrics are playing a deadly shell game.

Infant mortality is defined in the medical literature as: "Death, by any cause, of infants under one year old." The hospital obstetrics community wants us to believe that the steady decline in infant mortality in the U.S. (and in all developed countries) is due to modern technological birthing procedures. In fact, the decline has nothing to do with birthing procedures. The decline is due to the widespread use of antibiotics. Essentially, what studies show is that antibiotics are saving babies at a rate faster than the routine use of obstetrics technology is killing them.

John Robbins writes in Reclaiming Our Health, 1996: "The British Journal of Obstetrics and Gynaecology, for example, published a study [Marjorie Tew, "Do Obstetric Intranatal Interventions Make Birth Safer?" July 1986, pp. 684-89] which concluded that the historical decline in maternal and infant mortality (death) and morbidity (injury and illness) has not been due to obstetrical medical interventions. Rather, these gains have been due to the development of antibiotics, the addition of vitamin D to milk (thus preventing rickets), advances in public health, sanitation, and nutrition, improvement in women's working conditions, and other measures that improved maternal health prior to birth."

Robbins continues: "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 [emphasis mine], do not save lives. In fact, study after study shows that they actually lead to higher death rates for both mothers and babies."

In developed countries around world, including the United States, the routine use of obstetrics technology is 2 to 19 times more likely to lead to infant mortality than midwife-attended births [Chamberlain et al. in Sheila Kitzinger’s Homebirth (New York: Dorling Kindersley, 1991)]. Thus, saying that obstetrics technology is responsible for the decline in the U.S. infant mortality rate is analogous to saying that the Vietnam War was responsible for a decline in the U.S. adult mortality rate.

Are these statements really comparable? Yes, in two ways. They are both oxymorons; that is, they make no sense. More specifically, they both promise that lives will be saved in scenarios in which lives are actually lost. Indeed, in America alone in the last 50 years (1948-1997), the routine use of obstetrics technology has been directly responsible for a far greater number of American deaths than the Vietnam War.

How is this conclusion reached?

The number of live births in America from 1948 to 1997 was 180,456,000. The infant mortality rate (IMR) for this period averaged over 15 deaths per 1,000 live births.

During those 50 years, hospital births accounted for more than 95% of all U.S. births. Ninety-five percent of 180,000,000 (rounded down from 180,456,000) total live births = 171,000,000 live hospital births. Infant mortality for those 50 years, with an IMR of 15, is 2,565,000 (171,000 times 15).

Generously assuming that midwife-attended births reduce infant mortality by only one-half (the minimum that U.S. studies indicate), we conclude that 1,282,500 (2,565,000 divided by 2) deaths of live-born American infants up to one year of age, in the past 50 years alone, are directly attributable to the routine use of hospital obstetrics technology.

It should be noted that the figures used in these computations, all generous to the hospital obstetrics community, do not count higher hospital rates of infant morbidity [Henci Goer, Obstetric Myths Versus Research Realities: A Guide to the Medical Literature, (Bergin & Garvey, 1995, p. 332)]. Nor do they count higher hospital rates of maternal morbidity or mortality [Ibid., p. 332]. Nor do they count damage done to the baby, and to society, when the mother-child bond is broken, as so often happens in hospitals. (Joseph Chilton Pearce writes in Magical Child: "In 1982, the state of California completed the largest study ever undertaken on the root causes of crime and violence. The number one cause was found to be medical interference with childbirth in our hospitals.") Nor do these figures count higher rates of child abuse that occur with hospital-birthed (specifically C-section) infants [Nancy Cohen, Open Season: Survival Guide for Natural Childbirth and VBAC in the 90s (Bergin & Garvey, 1991, p. 25)].

Considering only the category of infant mortality, the routine use of obstetrics technology in the last 50 years in America alone has caused, at bare minimum, 1,282,500 infant deaths. The Vietnam War was responsible for 58,169 American deaths.

Prescription for action:

1. Obstetricians must immediately stop making routine deliveries. They must reserve their surgical expertise and state-of-the-art technology for complicated births.

2. Insurance companies must reimburse for trained midwife-attended births.

3. Mothers-to-be must make the choice for midwife-attended, not hospital, birth. This choice will immediately and powerfully affect the $20-billion-a-year U.S. childbirth market. (Cesarean section is the most common operation performed in America, fantastically profitable for the hospital obstetrics community.)

The choice for midwife-attended birth will force most obstetricians to become midwives, if they don't mind taking a cut in pay for providing health care services that actually stand the best chance of promoting health in their clients.

Obstetricians should be heroes. They should save the day when nature fails. In over 90% of births in America, today, nature doesn't stand a chance.

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Jock Doubleday

Director

Natural Woman, Natural Man, Inc.

http://www.GentleBirth.org/nwnm.org

http://www.SpontaneousCreation.org

director@spontaneouscreation.org