Giving birth in a stable might be better than a labour ward
From Best Daily on Tuesday, Dec 23 2014 with New Zealand modifications by Denise Hynd
The ‘greatest birth story ever told’ has a lot to teach 21st century policy makers, writes Milli Hill
© Getty Images
When it comes to giving birth, maybe newer, shinier and more technological isn’t necessarily better. The world was baffled recently when new UK guidelines for pregnant women stated quite clearly that hospital was the LEAST safe place to give birth – how very mysterious! Could it be that those beeping machines and vigilant docs, which we’d all been led to believe epitomised progress and were so very essential to our labours, were actually making things worse?!
It seems like the world is finally waking up to the fact that birth is something so fundamentally human – like eating, sleeping, making love – that it does not benefit from the interference of modern technology. With birth, we need to go back to basics, and to allow ourselves to be mammals. And so, although the straw might be a little spiky on the knees, a stable might be just the place to have a baby. Here’s why:
OK, so there was an Ox and an Ass (we’ll come to them later), but it’s unlikely that Mary had to introduce herself again when the shift changed or talk through her birth plan with a dozen different strangers. This sense of privacy would have made her more likely to produce Oxytocin, essential to the progress of labour and birth, and often called the ‘shy hormone’, because it’s production can be hampered by interruptions. If you’re male or have never had a baby, this clip might help you understand how some bodily functions are very difficult under observation:
No glaring electric lights in the stable, just good old-fashioned darkness – and the glint from an unusually large star, I’m told. But a dimly lit corner of a warm safe place just ‘feels’ right for all mammals. When wild animals give birth in captivity, their human carers go to great lengths to make a dark, safe space for them, understanding only too well that problems can arise if they are disturbed. As well as the privacy that darkness offers, it’s also all about hormones: in darkness we produce melatonin, and this works in partnership with other hormones like oxytocin, essential to the progress of labour and birth.
There might have been some rolls of hay to lean on or a manger or two to hang off, but there certainly wasn’t a bed, and it’s likely that Mary birthed, like many women of that time, with the help of brightly painted birthing bricks, brought by the midwives and used to squat or kneel on. This ‘active birth’ – with the woman shifting position several times in response to her body’s needs – is rarely seen in hospital deliveries whether on TV or not, though the bed slap bang in the centre of these delivery rooms gives women a strong message that this is the ‘way it’s done’. In reality, restricting movement makes for longer labours and putting women on their back narrows the pelvis making it harder for baby to get out.
Lucky old Mary would never have been told “Time’s up, you’ve failed to progress”, but for modern women, time features heavily in their childbirth stories. “You’ve been pregnant too long, we need to induce you”, “You’re not dilating fast enough, we’re going to speed you up”, “You’ve been pushing for over two hours, time for the forceps.” No wonder there was such a great sense of peace in that stable: what a relief it would have been to give birth without the sound of ticking in your ears.
In the modern age, we’ve become obsessed with cleanliness, perhaps to the point of threatening our well-being. Scientists are now beginning to study the Microbiome, the colony of bacteria that lives on us and in us, and the vital role they play in our health. And guess when the microbiome begins? At birth. Scientists have found noticeable differences in the microbiome of babies born at home versus those born in hospital, and the difference is also clearly marked between vaginally and caesarean delivered babies. Being born vaginally, and in a home-from-home environment like a stable, could have made for a very healthy start in life.
The presence of animals in the birth room might seem odd, but perhaps it could have been strangely comforting. Added to this, it’s surprisingly healthy: scientists also tell us that living in close proximity to animals may be good for our immune system and overall health. In fact, the scientist who led the recent study ‘The Home Microbiome Project’ went straight out and got a dog, having discovered that a key to good health was having a rich, diverse microbiome, and that this could be instantly improved by ‘opening windows, adding plants and getting a pet.’ Or, in Mary’s case, a stable, a couple of palm trees and a sheep or two.
One to one midwife
We don’t know for sure who attended Mary in labour, but almost certainly, a woman from Bethlehem would have been sought, and she would have brought herbs, birth bricks and a wealth of experience and reassurance. She would have stayed with Mary from start to finish – a luxury modern women can only usually rely on if they hire anIndependent Midwife or are citizens of Aotearoa- New Zealand The ‘one woman one midwife’ model of care that Mary and New Zealand women enjoy has been shown to improve both quality and safety at no extra cost, but it is yet to be implemented across the board in the UK, despite NICE recommendations.
A Doula or not??
Forget the three wise men, it’s likely that Mary’s midwife had a helper or two and that the stable was filled with the birthing wisdom of women, who would have held her hand, looked into her eyes, and told her, “Yes you can” anytime she said, “No I can’t.”
A ‘Hands off’ approach
For biblical women like Mary, the only hands on her in labour were probably simply those of reassurance, but not many 21st century women can make this claim. Even if they are one of the minority who give birth without caesarean, or instrumental delivery, they probably still have plenty of poking around, from the obligatory ‘sweeps’ to get labour started, to regular exams in labour to make sure they are not ‘failing to progress’. Whilst such exams may sometimes be helpful or necessary, often they do nothing but disturb the mammalian brain and undermine a woman’s confidence in her body.
No crib for a bed
In spite of the typical Nativity pictures, Mary and her newborn probably didn’t bother much with the manger but instead enjoyed all the benefits of immediate skin-to-skin once the birth was over. This instinctive response was over-ridden by the heavy-handed approach of the mid-twentieth century, when babies were whisked off to be washed and placed in the nursery. Now initiatives like Baby Friendly from UNICEF encourage mothers to reconsider the many benefits of skin-to-skin contact; from calm babies with more stable heart rates, to improved rates of breastfeeding, to better bonding, to a more diverse microbiome. And where modern women can often feel conflicted by confusing co-sleeping advice, Madonna and child presumably bedded down in a loving snuggle with no such worries.
We like to think we’ve come a long way since biblical times, and of course it’s true that birth is a lot safer now: in some circumstances, medical help is a life-saver. But it seems like in our rush to embrace medical technology, there are some things we’ve forgotten. We’ve built labour wards that might have every modern convenience but are missing some of the basic essentials. Perhaps in 2014, as well as encouraging more home births, policy makers might, like the Wise Men of old, bring some new gifts to labour ward: darkness, privacy, freedom of movement, support from women we know, and trust in the process of birth.