Women Can Birth!
The Herstory of Birth.
Birth Images from Ancient Times is the first of 4 YouTube videos titled the Timeless Way created by Mother’s Advocate, which show images and explain birth practices from as far back as 20,000 years ago. This ‘herstory’ is one of communities knowing that women can give birth, because until the last 100 years or less (especially in rural communities), birth was part of everyday life and birth was women’s domain.
For generations, women who had given birth then supported others in their community during pregnancy, labour and birth. Care of childbearing women by other women was an extension or consequence of the valued role of an experienced mother or grandmother. Most of the knowledge and practices that were learnt and shared between women, across and down the generations was the basis of the practice of midwifery till birth, and midwifery training was moved to hospitals. The names each culture gave to their traditional maternity carers reflected their practices and, or esteem; ‘Midwife‘ is Old English meaning ‘with woman‘ and the French ‘Sage Femme’ translates as ‘Wise woman‘.
Women supported other women emotionally and physically to labour, birth and breastfeed usually in their homes. In some cultures there were special places for birth; such as the birthing stones for Royal Hawaiian women. The birthplaces of many famous people around the world (such as Beethoven, Thomas Edison, Margaret Thatcher, Nelson Mandela and Katherine Mansfield) are evidence of the normality of home birth. Other now historical sites, where families lived and worked such as flour mills, were also family birthplaces. The Toodyay (WA) O’Conor’s Mill museum exhibit shows 1920′s photos of the miller and his family including a set of twins, who were born on the top floor which was accessed by a series of ladders. Girls of earlier generations, when families were bigger than today, knew birth as a normal, positive event which brought others into their homes to share the care of the mother, baby and family.
The fourth Timeless Way video explores historical records and images about the loss of traditional midwives’ knowledge and practices as men increasingly took control of hospital-based and then state regulated maternity services, mostly in the last century. With the removal of “mother” figures and their networks of confident supporters as well as having restrictions imposed on their ability to move or eat in labour childbirth became increasingly less bearable, thus women accepted the offer of numbing drugs. Women’s acceptance of drugs and bed as ‘the’ place to labour unknowingly increased their lack of control, mobility aand the need for doctors to pull their babies out with forceps.
By the 1980′s the nightmare consequences of previous decades of “Twilight Sleep” labours were forgotten, so healthy women began to accept the new technologies of fetal monitors, ultra-sounds and epidurals in labours which would previously have been safely assisted by other women and a midwife’s skill. These technologies have subsequently lessened the value and ability of midwives, and doctors to gently listen and feel to asses the welfare of a baby in the womb. Like-wise, increasing Cesarean section rates have seen a diminishing of skills and confidence to vaginally deliver breech and multiple births. These losses have recently been recognised as contributing to the outcomes of studies which incorrectly supported more surgical deliveries of these babies.
However at the same-time some midwives, particularly in the UK and Holland, continued to support home birth and had positive outcomes for women who then led pushes for more women-friendly hospital options, beginning with having a ‘supportive’ partner present, to move about in labour and even to birth in water.
Unless they have been ‘educated’ to go to hospital, women in less-developed countries often still have confidence in their abilities, trusting their instincts and, or traditional practices to birth even in natural disasters such as a flood. However, the fact that this woman is doing what comes naturally is not acknowledged in media reports of these incidents, rather they are portrayed as miraculous escapes from death. Similarly, when women in first world countries birth in unusual places or situations it maybe miraculous to “freakish” but never that women’s bodies and babies do know how to birth by themselves. Even when those present in unplanned deliveries follow their instincts rather than medical advice and have a safe outcome, there is no questioning by the media about any medical interferences in otherwise healthy pregnancies. An example of this is the reporting of a father who unraveled his baby’s cord from around its neck instead of clamping and cutting it as directed by phone emergency services.
Today most European women are healthier than those in previous centuries, but trust in their ability to grow and birth a baby (second smallest circle of risk) has been replaced by fear and misunderstandings about how to help themselves through these processes. This fear is spreading around the world along with the adoption of technology oriented maternity services and its unquestioned support by mass media. Statistically women are more at risk of death due to obesity (maroon circle) or a traffic accident (green circle of risk) however there is no community or individual fear about getting in a car, even when pregnant. Rather, fear of birth or “Tocophobia” is a modern epidemic such that the word ‘abnormal’ has been dropped from some explanations of its meaning. Thus many people now believe that “Childbirth is dangerous“, not a wonderous, evolved means to grow healthy individuals as experienced by home birth families and their midwives. Meanwhile science has shown that belief affects our health in many ways, including blocking our ability to birth or even to become pregnant.
Many pregnant women hear only scary birth stories these days, and the MOH admits that in NZ hospitals: “Common procedures used during childbirth include: induction, epidural, episiotomy, manual removal of the placenta, and the management of postpartum haemorrhage . ……….. Nationally, there were 33 hysterectomies related to childbirth in 2007.” Such a reality suggests that many midwives do not know how to promote, protect or support natural birth in a hospital, because most NZ women have the same midwife’s care in labor as through-out their pregnancy and post-natal period. Despite the New Zealand College of Midwives Consensus statement that: “Women who are experiencing normal pregnancies should be offered the option and encouraged to give birth in primary maternity facilities or at home. The evidence clearly demonstrates that women who receive effective antenatal care and are assessed to be at low risk for complications, will give birth to healthy babies and need fewer interventions if they are supported to give birth in a primary maternity unit or at home.” many NZ midwives do not offer the option of home birth (or primary unit) care to women.
Midwives, the MOH and media need to publicise the growing numbers of studies which show home birth to be as safe as hospital birth, and a more satisfactory outcome for mothers and families. A successful home birth is about helping the woman and her family to labour and birth instinctively. The benefits and means to access labour hormones and active birth should be part of midwifery and DHB maternity information as well as influencing the layouts and decoration of maternity environments. Informed public debate around Home Birth, the consequences and means to counter increasing rates of childbirth intervention needs to be a topic in NZ media.
Perhaps the lessons of David Attenborough to respect and support the natural birthing instincts and needs of animals can be transfered to the care of labouring women, as we seem to be re-learning the value and ability of women to nurture their newborns. Reflecting on the above matters or attending a Home Birth Aotearoa support group and, or discussing any concerns with an experienced home birth midwife will help Kiwi couples to regain this trust? Women have shown me that those who make a heart and body connection with their baby in pregnancy then work with, or allow that knowledge and trust to guide them through labour to birth instinctively and powerfully.
PS Here is a song to go with this blog called Full Circle by Judy Small, the video was done by Homebirth Australia as part of their ongoing campaign for Australian governments to equally fund a woman’s choice of care by a midwife to birth at home!