Ina May Gaskin and the Battle for at-Home Births
Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.
For women who choose to go through pregnancy and childbirth, the freedom to choose where and with whom to birth is not always immediately accessible. Before childbirth in hospitals became the norm, women birthed at home, under the care of a midwife. It wasn’t until the 1950s that childbirth care shifted significantly from midwives and homebirth to physicians and hospital birth. However, birth for healthy mothers and their babies does not necessarily have to be medicalized. And because it was becoming increasingly clear that birth was drifting, quickly, from the hearts and hands of women to the more medicalized, economic model put forth by hospitals, women’s health advocates interested in natural birth created a movement.
There is nothing inherently wrong with hospital birthing, of course (written from the heart of a mother who birthed two beautiful children in a hospital birthing center). It is the focus on economics, while having lost our sense of what birth is all about by straying far away from trusting women and women’s bodies, that is the “wrong.” We now have a cesarean section ratein this country of 30 percent – one out of every three births in this country is via c-section – that dangerously exceeds the World Health Organization’s recommended rate of 5 to 10 percent of all births. With a cesarean rate of over 15 percent, the WHO says, we’re in the realm of doing “more harm than good.”
We are not providing women with the optimal enivornments for birthing, or giving women the chance to choose where they wish to birth and with whom. There are of course many reasons for this, not the least of which is access. Women who have no health insurance are not in a position to “choose.” Pregnant women who live in a small town with one hospital that forces c-sections upon women who have had a previous c-section are not in a position to “choose.” Women who live in a state where midwifery, essentially homebirth, is illegal are not in a position to “choose.”
This cannot be what our mothers want or what we want for our mothers.
Things are looking up. According to a new report by the Centers for Disease Control (CDC) released this week, more women in the United States are opting to birth at home or out-of-hospital, when they are able, mostly out of a desire for a low-intervention birth or because of cultural or religious reasons, and sometimes because of lack of transportation.
The report also identifies reduced costs associated with out-of-hospital maternity care as a factor in the increased demand.
Over the last five years, out-of-hospital births (which includes home birth and birthing at a free-standing birth center) rose 3 percent and home births rose 5 percent after having sharply declined between 1940 and 1969 and then remaining static over the last few decades.
Approximately 17 percent of these home births recorded were unplanned – either because of transportation issues for women who live in rural areas or emergency scenarios.
The report acknowledges that home births were “less likely than hospital births to be preterm, low birthweight, or multiple deliveries.”
Out-of-hospital birth and home birth has been treated with more than a raised eyebrow by the media as well as some professional medical associations (specifically the American Medical Association (AMA) and American Congress of Obstetricians and Gynecologists (ACOG)) over the last few years.
The AMA passed a resolution in opposition to home birth stating that hospital births are the safest route for mothers and babies.
In a poorly reported segment on The Today Show a few months ago home birth was treated as a perilous fad spurred on by celebrities who birth at home with hordes of pregnant women clamoring to “do what Ricki Lake did.”
However, the report makes a point to note that in contrast to the AMA and ACOG, the organizations that represent physicians who facilitate birth in hospitals, “the World Health Organization, the American College of Nurse Midwives, and the American Public Health Association all support home and out-of-hospital birth options for low-risk women.”
As for midwives who attend home births and birth center births around the country?
The Big Push for Midwives Campaign Manager, Katie Prown, says, “Those of us who have been advocating for increased access to Certified Professional Midwives and out-of-hospital maternity care have long known that the research shows that AMA and ACOG statements about the safety of home birth and the reasons why women choose out-of-hospital delivery have no basis in the evidence,“ said Prown. “It’s great to be able to cite even more research on the safety of out-of-hospital birth and to be able to point to data showing that women in the United States do not, in fact, make decisions about where to have their babies for frivolous, selfish, or trendy reasons.”
September 18, 2010
One of my favorite parts of being a Postpartum Doula is meeting/chatting with a ‘soon-to-be’ expanding family..Couples expeceting their first-born or their 3rd and 4th at the same time (Twins!)..Every family is so different and have different expectations on how they want/imagine the Postpartum time to unfold.. Some people have a strict schedule they want to stick with and need help incorporating a new family member into the mix and some can’t even imagine what’s about to happen because they have never experienced it yet.
It’s easy to think of all the family members and friends that your surrounded with and how excited they are about the new baby and your new and expanding family..that it’s almost impossible to think that you would ever need an extra set of hands..
but you do!.. and this article tells you why..
“Let me know if I can help you in any way when the baby is born.” … “Just let me know if you need a hand.” … “Anything I can do, just give me a call.”
Most pregnant women get these statements from friends and family but shy away from making requests when they are up to their ears in dirty laundry, unmade beds, dust bunnies and countertops crowded with dirty dishes. The myth of “I’m fine, I’m doing great, new motherhood is wonderful, I can cope and my husband is the Rock of Gibraltar” is pervasive in postpartum land. If you’re too shy to ask for help and make straight requests of people, I suggest sending the following list out to your friends and family. These are the things I have found to be missing in every house with a new baby. It’s actually easy and fun for outsiders to remedy these problems for the new parents but there seems to be a lot of confusion about what’s wanted and needed…
1. Buy us toilet paper, milk and beautiful whole grain bread.
2. Buy us a new garbage can with a swing top lid and 6 pairs of black cotton underpants (women’s size____). 3. Make us a big supper salad with feta cheese, black Kalamata olives, toasted almonds, organic green crispy things and a nice homemade dressing on the side. Drop it off and leave right away. Or, buy us frozen lasagna, garlic bread, a bag of salad, a big jug of juice, and maybe some cookies to have for dessert. Drop it off and leave right away.
4. Come over about 2 in the afternoon, hold the baby while I have a hot shower, put me to bed with the baby and then fold all the piles of laundry that have been dumped on the couch, beds or in the room corners. If there’s no laundry to fold yet, do some.
5. Come over at l0 a.m., make me eggs, toast and a 1/2 grapefruit. Clean my fridge and throw out everything you are in doubt about. Don’t ask me about anything; just use your best judgment.
6. Put a sign on my door saying “Dear Friends and Family, Mom and baby need extra rest right now. Please come back in 7 days but phone first. All donations of casserole dinners would be most welcome. Thank you for caring about this family.”
7. Come over in your work clothes and vacuum and dust my house and then leave quietly. It’s tiring for me to chat and have tea with visitors but it will renew my soul to get some rest knowing I will wake up to clean, organized space.
8. Take my older kids for a really fun-filled afternoon to a park, zoo or Science World and feed them healthy food.
9. Come over and give my husband a two hour break so he can go to a coffee shop, pub, hockey rink or some other r & r that will delight him. Fold more laundry.
10. Make me a giant pot of vegetable soup and clean the kitchen completely afterwards. Take a big garbage bag and empty every trash basket in the house and reline with fresh bags.
These are the kindnesses that new families remember and appreciate forever. It’s easy to spend money on gifts but the things that really make a difference are the services for the body and soul described above. Most of your friends and family members don’t know what they can do that won’t be an intrusion. They also can’t devote 40 hours to supporting you but they would be thrilled to devote 4 hours. If you let 10 people help you out for 4 hours, you will have the 40 hours of rested, adult support you really need with a newborn in the house. There’s magic in the little prayer “I need help.”
Great video about the benefits of delayed cord clamping from midwife, Robin Lim, CPM – director of Bumi Sehat Birth Center in Bali, Indonesia.
The women of America deserve better than what the medical model of obstetrics has provided. The strength of a woman has no better champion than Margaret Thatcher who said, “Choice is the essence of ethics: if there is no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose.”
Read more: http://www.vcstar.com/news/2011/aug/27/fischbein-obstetrics-model-has-gone-too-far/#ixzz1WHwE11yQ
Stuart J. Fischbein, M.D. is an OB/GYN in Southern California who supports the midwifery model of care and women’s right to choose their attendants, place of birth, and how they birth.
Yunji De Nies interviews Ricki Lake and others to discuss what’s behind the increase in homebirth.