NCNM is a pretty amazing place, full of amazing people and amazing things. One such amazing thing is the Helfgott Research Institute. The Helfgott Research Institute is a professionally independent, non-profit research institute whose mission is to conduct rigorous, high quality, research on the art and science of healing, specifically working to understand natural forms of medicine. Together, scientists from the fields of naturopathic medicine, Chinese medicine, acupuncture, immunology, and nutrition apply their expertise to the study of natural medicine. It is an absolutely fascinating place to hang out.
I've been lucky enough to spend some time in Helfgott and work on a collaborative research project studying the cost effectiveness of birth setting, specifically in hospital versus out of hospital birth. Most of you probably know that pregnancy and birth is a subject that is quite near and dear to me and I am really excited for the opportunity to work on this project. In doing my research and collecting data for this project I'm come across some disheartening statements. Both the American Medical Association and the American College of Obstetricians and Gynecologists discourage options like home birth and contend that hospitals are the safest place to have a baby. This is troubling to me because ALL of the research I have found suggests that at best, this statement is only partially true and at worst, it is false and misleading. For normal, low-risk pregnancies, studies have shown home birth to be a very safe option. In fact, the United States is the only country in which obstetricians are the primary care provider for pregnant women. That means in every other country midwives are considered the normal care provider.
Although I love "natural" birthing methods and ideology, I am hesitant to categorize myself as a "natural birth advocate." What I do advocate is the opportunity for women to have the birth experience they want; an experience in which they feel comfortable and safe. If that means being in a hospital bed with all the latest technology and interventions just a nurse call-button away, then by all means that is what should happen. But if it means sitting in a blow up pool in your living room watching Oprah between contractions then that should be an option too. Women should be educated on their options... all their options, and not be made to feel guilty or inadequate for their choice.
In the United States, more than half the women who give birth are given drugs to induce or speed up labor; for nearly a third of mothers, childbirth is a major surgery, the cesarean section, and the current media buzz is over a woman’s “right to choose” a scheduled cesarean. At the same time, however, there are limits on a woman’s right to choose a normal birth. Due dates are increasingly tantamount to deadlines. Women who have had a previous cesarean are in many cases being denied vaginal birth all together. The old debate over “natural childbirth” seems quaint at this point.
Today, what is normal is being redefined: from vaginal birth to surgical birth, from “my water broke” to “let’s break your water,” from “it’s time” to “it’s time for the induction.” Women are even beginning to deny normal birth to themselves. If “normal” means being induced, immobilized by wires and tubes, sped up with drugs all the while knowing that there’s a good chance of surgery, well, might as well just cut to the chase, so to speak. “Just give me the cesarean,” some are saying.
However, there are still those mothers-to-be who long for the simpler times before micromanaged childbirth was the norm and epidurals and episiotomies were considered standard care. For these women it has become increasingly harder to find physicians who will support the type of childbirth experience they want, one in which physiology is promoted while unnecessary technology is impeded. Adults seeking medical care have both the right to receive medical treatment and the right to refuse treatment. They have the right to know the risks and benefits of each treatment option, including the option of no treatment at all. The legal term is informed consent which the
In the decades prior to Roe v. Wade, physicians decided whether women deserved “therapeutic” abortions. Feminists argued that the decision to have or not to have an abortion was one that the woman had the right to make because women are the ones who had to live with the consequences. Women’s bodies, women’s choice. Yet the argument for the right to abortion wasn’t necessarily grounded in bodily integrity, but in equality. Women could never achieve full social, economic, and political participation without control over their reproductive lives. Abortion was a proxy for equal rights.
This may explain why mainstream American feminist groups have been slow to recognize the right to reproduce along with the right to be free from reproducing. A focus of the women’s movement was shaking off motherhood as what solely defined womanhood. So perhaps there has been a reluctance to watch over the process that makes women mothers. This is the last leap for the feminist movement. This is the last issue for women in terms of actual ownership of their bodies.
Our country has created a mythology of women who are irresponsible and don’t care. We talk about welfare queens, crack moms, and murderous women who have abortions. A culture that allows such language to permeate our subconscious inevitably dehumanizes all women, including mothers. This thinking perpetuates a phrase often invoked in exam rooms and delivery rooms: the goal is to have a healthy baby. This phrase is used over and over to shut down women’s requests. The context needs to be that the goal is to have a healthy mom. Because mothers never make decisions without thinking about that healthy baby and to suggest otherwise is insulting, degrading, and disrespectful.
What’s best for women is best for babies. And what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the experience that most women have. In today’s age of evidence based medicine, women need to know that standard American maternity care is not primarily driven by their health and well being or by the health and well being of their babies. Care is restricted and determined by liability and financial concerns, by a physician’s malpractice insurer. The evidence often has nothing to do with it.
Today women have unprecedented access to the information they need to make the best decisions for themselves, and therefore the best decisions for their babies. They are in fact in a far better position to make evidence based decisions than their doctors. They have the right to make those decisions, and they should make those decisions.
The goal is to have a healthy family.
