Two Birth Philosophies

March 30, 1997

Dear Sheri,

Thank you for writing with your views on childbirth! I am glad to talk to you about ways to bring healthy babies into the world.

There is a fundamental difference between hospital and home birth philosophies.

Hospital birth philosophy says that there is a good chance that nature will fail. Indeed, to avoid malpractice suits, doctors must assume that something will go wrong and make ready preparation for crisis. Hospital staff are ever ready to intervene if anything happens--or even if something doesn't happen! If the mother is not progressing "fast enough" by the obstetrician's standards, it is not uncommon that a cesarean section will be performed.

To justify their presence at the birth (and to justify the bill afterwards), obstetric staff must "do something." An IV must be inserted into the mother, an epidural must be established, the mother's perineal tissue must be cut (episiotomy) to ensure a "good outcome."

Telephone interviews that I conducted in September of 1997 confirm that Northern California hospitals have a 60% routine episiotomy rate for first-time mothers, 50% for second-time mothers. These numbers do not include episiotomies for mothers whose births have been diagnosed as complicated. In addition, routine episiotomy is a surgical process that has no medical justification.

Compare this a midwife-assisted birth. The midwifery philosophy is that things will go well, that nature will succeed as it has for millennia in the perpetuation of our species. There is no arbitrarily defined "fast enough" as regards the birth process. No interventions take place, as long as there is no danger to mother or baby. To stimulate labor, the mother is not given a synthetic drug but encouraged to walk. She is encouraged to listen to her body, to "go with what she feels."

Regarding the difference in these philosophies, G.J. Kloosterman, chief of Obstetricians and Gynecologists at the University of Amsterdam Hospital, writes:

"Spontaneous labor in a healthy woman is an event marked by processes so complex and so perfectly attuned to each other that any interference with these processes will only detract from their optimum character. . . ."

Mothers whose births are diagnosed as "complicated" should, of course, have the choice of hospital birth. There is no doubt that obstetric technology has saved lives, both of mothers and infants. The question is, at what cost to normal-birth mothers who choose hospital birth thinking it the safest option? Medical research studies show that the cost (physical and emotional damage) to most of these mothers and their babies is great.

Women whose pregnancies have not been diagnosed as "complicated" should know that it's okay to have their babies at home, that it's safer (for many reasons) than hospital birth.

The burden of proof is on technology to show that it can produce safer birthing outcomes (for both mother and baby) than nature. But no published medical research study shows this. Indeed, every published medical research study comparing midwife-attended with hospital birth concludes the same thing: midwife-attended birth is safer for mother and child than hospital birth.

You say that women who have given birth in a hospital may "feel guilty" about their choice. I can see no reason why women should feel guilty about the childbirth choices they have made. Women have not had access to all the recent scientifically researched information on childbirth options that we now have.

In addition, I'm sure no one would advocate keeping our present knowledge about the detrimental effects of spanking under wraps just because some obstetric staff might "feel guilty" about having spanked newborns in the past. We must go forward with the knowledge that we acquire. We must let what we learn inform our decisions. If we learn that technology does not deliver what it promises, we must turn back to nature.

As you mentioned, I have put my money where my mouth is. I believe that no obstetrician or perinatal nurse (or any other individual) will offer $1,000 (or even $10) of their own money for a research study that shows hospital birth to be less safe for most mothers and babies than home birth with a trained midwife in attendance—because a plethora of such studies exist!

I offer $1,000 for a study showing hospital birth to be safer than midwife-attended birth because I believe it will encourage research on the part of individuals. When individuals research this issue, they will find out for themselves that hospital-birth safety is a myth.

Some recommended books on childbirth:

1) Suzanne Arms, Immaculate Deception II: Myth, Magic and Birth (1994)

2) Henci Goer's Obstetric Myths Versus Research Realities: A Guide to the Medical Literature (1995)

3) John Robbins, Reclaiming Our Health (1966)

4) Murray Enkin, et al., A Guide to Effective Care in Pregnancy & Childbirth (1996).

I hope this letter speaks to some of your concerns.

Yours faithfully,

Jock Doubleday

Director

Natural Woman, Natural Man, Inc.

A California 501(c)3 Nonprofit Corporation

http://www.gentlebirth.org/nwnm.org

director@SpontaneousCreation.org