OUT OF THE WOMB, INTO
THE FIRE
The Myth of the
Safety of Hospital
Childbirth
(A Response to Nina ShapiroÕs
article "Birth Control"
in The Seattle Weekly, November 26, 1998)
by Jock Doubleday
[with
updated links and information
as of May 20, 2006]
1. Myth Killer
When you kill a myth, it is like being born.
I know that this is true because I killed one myself, a few
years ago, with the help of the professional mythoclast, or myth killer, Joseph
Chilton Pearce.
In the early 1970s, Pearce wrote a book entitled Magical
Child. Despite its
technical language and heavy reliance on medical studies, this book sold an
enormous number of copies and is still in print today, 20 years later.
The thesis of Magical Child is that human potential is vastly
beyond our current notions and that certain culture practices are the cause of
our diminishment. One such detrimental practice, Pearce argues, is the
medicalization of childbirth, which is designed to thwart at virtually every
stage natureÕs 3-billion-year-old plan for the miracle of birth.
Pearce describes in heartbreaking detail the drama of
modern obstetricsÕ "cascade effect," in which one medical
intervention creates the need for another: how anesthetic (pain-numbing) drugs
slow the synchronous movements by which the infant is expelled from the womb,
extending delivery time to torturous lengths; how the slowing of labor causes
increased fear in the mother; how the motherÕs fear causes her lower uterine
muscles to tighten, stopping labor and causing intense pain as her upper
uterine muscles continue their contractions; how the motherÕs increased pain
justifies increased medication; how increased medication (each dose of which
passes through the placenta to the infant in forty-five seconds) destroys the
delicate hormonal conversation between the mother and infant; how the drugged
infantÕs inability to send its final "IÕm ready" hormonal signal to
the mother precludes the possibility of a vaginal birth; how the motherÕs
recovery time from her now "justified" C-section makes it impossible
for her to bond with her newborn in the first critical moments after birth; how
the lack of a bond (what Pearce calls "a safe place to stand")
affects the child in untold adverse ways for his or her entire life; how the heavily
drugged child is unable to respond to its world and engage in primary learning;
how the motherÕs "postpartum blues" is a direct result of technology
misused.
2. True Believer
Thus it was with some dismay that I read Nina ShapiroÕs
November 26 article "Birth Control" in the Seattle Weekly.
In this article, Ms. Shapiro advocates the use of
anesthetic drugs for childbirth–on the grounds that these drugs are safe
for both mother and baby. She argues that the "cult" of natural
childbirth has suppressed information about the true magnitude of birthing
pain, what she calls its "root canal" intensity. She contends that
birth cult members "guilt" women into choosing an unnecessarily
painful method of birth, that the cult itself is led by misguided gurus, that
for "ease" in childbirth, a truly informed choice leads inevitably to
state-of-the-art obstetrics technology, that technology is the salvation of
women desperate to avoid the travail of Eve.
Ms. ShapiroÕs arguments are–and I use these words in
their full meanings–completely uninformed. They are composed of parroted
"mythological truths," beliefs that are not true but that are taken
on faith by the culture at large. The belief that the world is flat, or that
herbal healers are demonic and should be burned at the stake, are examples of
outdated mythological truths.
Ms. ShapiroÕs fact-unencumbered, me-centered,
high-sounding, "I was in no mood for sappy sentimentalism" style
epitomizes the kind of writing that does the most damage to the truth. Its
absolute self-confidence, combined with its absolute ignorance, strikes a blow
below the level of reason, convincing by brute force alone.
Ms. ShapiroÕs statement that the natural childbirth
movement "insists on women feeling pain" is so fantastically wrong
that it would be laughable if it werenÕt so dangerous. Her belief that
"fulfilling my babyÕs needs means obliterating my own," is
unfathomable. As an eight-year researcher on the subject of childbirth, I
believe that the only possible merit of Ms. ShapiroÕs article is as a diary
entry.
Ms. Shapiro sees herself as wise, awake, aware, a debunker
of myths, an "explorer" discovering truths tragically buried by a
small but powerful brain-washed faction. But the territory she purports to
explore was bull-dozed, graded, and paved over by corporate America 50 years
ago. She is like Columbus discovering Spain.
Common features of the landscape of Ms. ShapiroÕs
"brave new world" are epidural anesthesia, the episiotomic knife,
Cesarean section, and a sycophantic surrender to hospitalsÕ corporate line.
3. The "Primitives"
Chanting "informed choice," Ms. Shapiro remains
uninformed. Although she refers to a desire to "learn" about
childbirth, we discover that her reading is limited to two books, both of which
she disdains: Pregnancy, Childbirth and the Newborn, which she disdains because
it speaks of "savoring" the birth experience, and What To Expect When
YouÕre Expecting, which she disdains because it is 1) "sentimental"
and 2) respectful of the birth practices of traditional cultures.
Regarding what she terms "primitive" culturesÕ
birth practices, Ms. Shapiro writes (with her usual arrogance):
"everything is so natural that the infant mortality rate is abysmally high
. . ."
Of all the "facts" composing the mythological
bubble of the safety of technological childbirth, this "fact" is the
one that I believe has been responsible for the greatest number of infant
deaths in the civilized world. While it is true that, in comparison with
Western infant mortality rates, traditional culturesÕ rates are high, these
higher rates are not due to birthing practices, but to disease.
As John Robbins writes in his meticulously researched and
relentlessly mythoclastic Reclaiming Our Health (1996):
"[Western civilizationÕs] 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. 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 [emphasis
mine]."
What the statistics show, in essence, is that antibiotics
and other public health advances are saving babies at a rate faster than the
routine use of obstetrics technology is killing them.
Indeed, 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 birth (Chamberlain et
al. in Sheila KitzingerÕs Homebirth, 1991). ("Routine use" means "use in births
other than those that are high-risk.")
In America alone in the last 50 years (1948-1997), the
routine use of obstetrics technology has been directly responsible for, at bare
minimum, 1,282,500 infant deaths (Doubleday, "Obstetricians Should Be
Heroes," 1998).
The routine use of obstetrics technology has also lead to
higher rates of infant morbidity (Henci Goer, Obstetric Myths Versus
Research Realities,
1995, p. 332); higher rates of maternal morbidity and mortality (Ibid.); and
higher rates of child abuse, specifically for C-section infants (Nancy Cohen,
Open Season: Survival Guide for Natural Childbirth and VBAC in the 90s, 1991, p. 25).
4. Fear
"In truth, I have long been scared of
childbirth," writes Ms. Shapiro.
Pregnant at the time of the writing of her article, Ms.
Shapiro admits she wants to learn anything she can to "make the experience
easier." Relating the story of her own motherÕs natural birth, she writes:
"[S]he described it as feeling like she was being split in two."
Rolling her eyes at the natural childbirth movement, she adds: "God forbid
women should seek [drug] relief from laborÕs all-too-normal torment."
But is childbirth pain truly normal? Or necessary?
Nancy Griffin writes in "The Epidural Express: Real
Reasons Not to Jump On Board" (Mothering, Spring 1997):
"The main cause of pain in a normal childbirth is . .
. the ÔFear-Tension-Pain Syndrome.Õ . . . [O]ur biology provides us with
powerful instincts during birth. The first is the need to feel safe and
protected. All mammals will instinctively seek out a dark, secluded, quiet,
and, most of all, safe place in which to give birth. While birthing, mammals
give the appearance of sleep and closed eyes to fool would-be predators, and
they breathe normally. Some (those who don't perspire) will pant in order to
cool down, but humans will most easily achieve a relaxed state through closed
eyes and abdominal breathing. This relaxation slows down the birthing mother's
brain waves into what is called an alpha state, a state in which it is
virtually impossible to release adrenaline, the "fight-flight" hormone.
Physical comfort becomes critical, along with the need to have a
"nest" ready for the baby. Hospital environments often
unintentionally disrupt the birthing atmosphere by introducing bright lights,
lots of people, noise, and fear-inducing exams and machines."
How exactly does the motherÕs fear lead to pain? Griffin
explains:
"The uterine muscles are beautifully designed to deal
quite effectively with danger, fear, and stress in labor. The uterus is the
only muscle in the body that contains within itself two opposing muscle
groups–one to induce and continue labor and another to stop labor if the
birthing mother is in danger or afraid. Emotional or physical stress will
automatically signal danger to a birthing mammal. Her labor will slow down or
stop completely so that she can run to safety. In modern times, this goes
haywire. We can't run from our fears–which may include the "horror
story" our best friend told us about her birth–or even from our
hospital or physician. Instead, we may release adrenaline, which causes the
short, circular muscle fibers in the lower third of the uterus to contract.
These muscles are responsible for stopping labor by closing and tightening the
cervix. The result is that we literally "stew" in our own adrenaline.
At the same time that the long, straight muscle fibers of the uterus are
contracting to efface and dilate the cervix, the short, circular muscle fibers
of the lower uterus are also contracting to keep the cervix closed and
"fight" the labor. The result? The very real pain of two powerful
muscles pulling in opposite directions each time the birthing mother has a
contraction."
Having established a direct connection between fear and
pain, Griffin concludes:
"By learning to deeply relax mentally, physically, and
emotionally; actively dealing with fears about birth; and choosing a birthing
environment that feels safe and protective, birthing women will not have to
experience the traumatic pain caused by the "Fear-Tension-Pain
Syndrome."
Suzanne Arms, a seminal figure in the natural childbirth
movement, writes in Immaculate Deception II: Myth, Magic and Birth (1994):
"Television and the press and birth stories focus on
the drama and risks of birth . . . Perhaps the most important thing anyone can
do for a woman going into childbirth is to help her shed her misconceptions and
diminish the fears about giving birth that she has picked up in the course of
her life."
5. The Epidural Express
"Somewhere along the line," muses Ms. Shapiro,
"the movement to empower pregnant women to make informed childbirth
choices turned into a pressure-laden, guilt-inducing campaign for the right
kind of birth–that is, the "natural," unmedicated variety. . .
. Isn't it interesting . . . that the movement that's supposedly feminist is
the one that insists on women feeling pain?"
Reading a list of descriptions of the potential side
effects of various anesthetic drugs, Ms. Shapiro writes: "It's like
reading the packaging on aspirin: Yes, it might cause ringing in the ears or
hearing loss, but is the risk great enough to stop a reasonable person from
taking it?"
Let us look at the risks associated with the administration
of anesthetic drugs in childbirth, starting with the risk to the in utero
infant. Nancy Griffin (Mothering, Spring 1997) writes:
"All [anesthetic] drug dosages are determined by the
mother's body weight . . . Because the mother's body weight is approximately 20
times greater than that of her unborn baby at term, there is always a chance
that the baby will receive an overdose–perhaps the most compelling food
for thought in any discussion on drug usage in childbirth. Following birth, the
newborn must metabolize these drugs partly through liver function. Since the
newborn arrives into the world with an immature liver, drug metabolism
increases the likelihood and severity of newborn jaundice.
"The Physician's Desk Reference (PDR), a well-respected guide to
all drugs, their usage, cautions, and side-effects, states the following about
the Caine derivatives used in epidurals: 'Local anesthetics rapidly cross the
placenta (by passive diffusion) and when used for epidural blocks, anesthesia
can cause varying degrees of maternal, fetal, and neonatal toxicity. Adverse
reactions in the mother and baby involve alteration of the central nervous
system, peripheral vascular tone, and cardiac function.'
"Research done in the last five years [1992-1997] on
the effects of epidural anesthesia on newborns has shown that epidurals result
in lowered neurobehavioral scores in the newborn; a decrease in muscle tone and
strength, affecting the baby's sucking ability, which can lead to breastfeeding
difficulties; respiratory depression in the baby; greater likelihood of fetal
heart rate variability, thereby increasing the need for forceps, vacuum, and
cesarean deliveries and episiotomies."
Now Griffin gives us the possible side-effects for the
mother:
"The PDR goes on to list the following possible
maternal side effects for Caine derivatives: 'Hypotension, urinary retention,
fecal and urinary incontinence, paralysis of lower extremities, headache,
backache, septic meningitis, slowing of labor, increased need for forceps or
vacuum delivery, cranial nerve palsies, allergic reactions, respiratory
depression, nausea, vomiting, and seizures.'
"A review of the literature reports that on average,
70 percent of women receiving an epidural during labor experience side effects.
The most common include postpartum urinary retention, severe backache, loss of
motor power, prolonged first- and second-stage labor, malpositioning of the baby
at the end of second-stage labor, hypotension, and in their babies, poorer
motor organization.
"Very rare but possible risks of epidurals include
trauma to nerve fibers if the epidural needle enters a nerve and the injection
goes directly into that nerve; a drug overdose resulting in profound
hypertension with respiratory and cardiac arrest and possible death; and
central nervous system toxicity resulting from an injection directly into the
epidural vein. Epidurals increase maternal and fetal healthcare costs and the
professional liability of healthcare providers. Other medical interventions,
such as IVs, continuous electronic fetal monitoring, the use of additional
drugs, bladder catheterization, frequent blood pressure monitoring, continuous
administration of oxygen, and forceps, vacuum extraction, and episiotomies
often become necessary as adjunct medical care to an epidural. Epidurals can
prolong a labor, leading to the possible need to augment labor with Pitocin (an
artificial hormone that mimics the action of oxytocin, the natural hormone that
triggers labor and causes uterine contractions)."
Such is the argument against the use of epidural anesthesia
in the year 1998.
On the other side of the argument, we have this brave,
technology-cheerleading assurance from Ms. Shapiro: "Epidurals now allow
women full consciousness and an active role during labor."
6. $25,000 Credential
Ms. Shapiro bemoans a dearth of "experts" to tell
her what to do. Although I do not claim to be an expert, for eight years I have
made a study of childbirth-related medical research. As I am neither an
obstetrician nor a midwife, I have no professional bias.
What I found in my eight years of research is that there is
no evidence, not a single study, in this or in any other country, in support of
the routine use of obstetrics technology.
In fact, the conclusions of medical research studies are so
overwhelmingly in favor of natural childbirth that, in Midwifery TodayÕs Autumn
1998 issue, I offered $10,000 to the first person who could produce a study
published in an industry journal in any country, in any time period, showing
hospital birth to be safer, in any category, for most mothers and babies than
home birth with a trained midwife in attendance.
No one has claimed, or even attempted to claim, the money.
At this time, I would like to increase the offer to
$25,000. [Note: The offer has since been increased to $50,000:
$50,000 Reward
The absence of science behind the safety of
technological childbirth for the vast majority of women and babies allows me to
make the following offer, which begins officially on December 25, 2005 (the
publication date of the first e-book edition of Spontaneous Creation: 101
Reasons Not to Have Your Baby in a Hospital, Vol. 1):
I, Jock Doubleday, will
pay $50,000.00 (fifty thousand U.S. dollars) to the first person who sends me
by email, and in its entirety, a controlled comparative study published in a
recognized industry journal from any country, in any time period, demonstrating
hospital birth to be safer in any category (i.e., infant morbidity, infant
mortality, maternal morbidity, or maternal mortality) for most mothers or
babies than home birth with a midwife in attendance. The term
"midwife" does not include Certified Nurse Midwives, who, because of
their conventional medical training, and in spite of their good intentions, may
bring the fear-based medical model of childbirth with them into the home, thus
skewing home birth outcomes toward the technological. The sample size of the
study in question must be, at minimum, 2,000 persons, with a minimum of 1,000
persons in each of two matched groups. The groups must be matched, at minimum,
by age, socioeconomic status, nutritional history, nutrition during pregnancy
(including the ratio of raw to cooked foods), drug history (including
pharmaceuticals, cigarettes, alcohol, and vaccines), drug use during pregnancy
(including pharmaceuticals, cigarettes, alcohol, and vaccines), and partner
status. Any written claim to the $50,000.00 reward is also an agreement to pay
the 501(c)3 California nonprofit corporation, Natural Woman, Natural Man, Inc.,
$100.00 (one hundred U.S. dollars), should the study attached to such claim be
found to be either 1) irrelevant to the offer or 2) methodologically or
structurally flawed and thus invalid. This offer has no expiration date unless
and until superseded by a similar offer of higher monetary compensation made by
Jock Doubleday.
Contact:
director@SpontaneousCreation.org
http://www.spontaneouscreation.org/SC/50,000Reward.htm] . . .
7. Strange New World
Vaclav Havel, president of the Czech Republic, wrote thta,
when one steps out of a myth, "the world takes on a strange new
aspect."
In this strange new world, mythological bubbles float
serenely. They had been invisible to you, but now you are invisible to them.
They are completely vulnerable to you, as for your whole life you had been
vulnerable to them. One very large bubble floats by. Around its circumference
are the words: We have not discovered a cure for cancer. You reach out
tentatively and touch it. Pop! Another bubble drifts into view: The cause of
cancer is in nature, not culture. You reach out and touch it. Pop! Health care
is found in bottles of drugs, doctorsÕ offices, and hospitals. Pop! Tools can
improve on nature's wisdom. Pop! Technology is our salvation. Pop!
Suddenly you realize that you are no longer a subject of
corporate America–whose ads create the mythological fabric that controls
us–but a free-feeling, free-thinking, free-acting individual with unbound
potential.
Ms. Shapiro concludes her article with a graceful bow to
reason: "If I heard a clear case against using drugs on the grounds that
they endangered me or my baby, IÕd face my fear and prepare to do
without."
I believe that this article presents such a clear case. I
believe that Ms. Shapiro should face her fear. I believe she owes it to her
unborn baby and to herself to step outside the mythological bubble in which she
has so long lived.
I believe it is time she were born.
* * *
Jock Doubleday
Director
Natural Woman, Natural Man, Inc.
http://www.GentleBirth.org/nwnm.org
http://www.SpontaneousCreation.org
director@spontaneouscreation.org