Laboring Under Delusions
How our technocratic, fear-based, factory birth system harms women and babies
I have a history of infertility and miscarriages, along with debilitating nausea and vomiting that lasts the entire gestation, so each pregnancy is met with prayerful anticipation. My births, however, have been wonderful, natural, empowering events...that necessitated commitment, preparation and hard work on my part. (Home waterbirths are every bit as wonderful as you’ve heard. I’ve had a land birth and I’ve had waterbirths...and you couldn’t pay me to give birth out of the water. They don’t call it the “aqua”dural for nothing! Check out the myriad advantages of waterbirths for Mom and baby at the Waterbirth International website.)
We’ve all seen the quintessential cinematic or television portrayal of birth: Surrounded by monitors and equipment in a brightly lit room, a screaming woman lies in a hospital bed, begging for drugs. The room bustles with nurses and an OB or two, the scene is rife with panic. Someone yells, “PUSH!” or “I see a head!” in a voice edged with terror that should be reserved only for a devastating catastrophe like an impending Tsunami wave about to engulf an entire village. What drama! What trauma! What rubbish! But this is the typical version of birth we serve to society. The message is that birth is damaging, dangerous and an event to be feared.
The fear of birth is the beginning of intervention disaster. Our culture (the industrialized world, primarily the United States) teaches women to fear birth. Fear is paralyzing...it is powerful...it is profitable. Fearful parents are more easily led down the lockstep of “standard procedure” interventions. A fearful woman in pain has trouble making wise decisions. So much of birth is a mental exercise. Just like an athlete, you must “get your head in the game.” Attitude has a significant impact on outcomes. An attitude of fear debilitates. An attitude of peace, understanding, acceptance and a sound mind empowers. Fear-based decisions are faulty decisions. When you fear or fight the pain of birth, the laborious activity of birth, you impair your body’s natural ability to work with the baby and the process to achieve a positive outcome. Women who do not fear birth, who have not been indoctrinated to do so, who do not fight or interfere with the process, have much higher likelihoods of positive, natural results. What you believe about your body and your ability to birth has a tremendous impact on your birth outcome. Attitude is one of the most crucial elements to a successful birth.
Our modern birth system is a technocratic system. A technocracy is a society controlled by an elite of technical experts. Much of our society, including the entire medical industry, is technocratic. In the pregnancy/birth realm, the technocratic model defines the female body as broken...a compilation of defective parts that creates a dysfunctional reproductive process necessitating medical and technological intervention. This could not be further from the truth! Our bodies were designed for birth. The female body is not inferior and every human body is a wonderful, incredible organism of holistically integrated members.
“Anybody in obstetrics who shows a human interest in patients is not respected. What is respected is interest in machines.”
— Rick Walters MD, February 1986
We exist within a broken birth culture. We are told we cannot birth on our own. We are told that pregnancy is an illness and birth is dangerous. We are told that we are broken and we believe the lie. We are told that we need to be saved from ourselves when neither evidence nor experience supports that claim. Even women who desire and pursue “natural birth” often operate with ingrained presuppositions fed to us by the industry. The majority of women (and men, too) labor under a (sometimes subconscious) fear of the process, “giving ear to the voices of doctors, tests and technology that assert birth is dangerous and needs highly skilled assistance ‘just in case something goes wrong.’" (quote from Anne Frye, CPM, prominent midwifery educator) That fear is unnatural...it is something in which our society has been indoctrinated over many decades. The assertion that hospital births are the safe option and that homebirths are risky is simply fallacious. An honest assessment of the evidence-based data refutes that claim. We must stop the hypermedicalization of birth (to borrow a phrase from the great birth liberator Ina May Gaskin). There is no such thing as a safe drug, nor a risk-free surgery. Both carry side effects and complications that corrupt our bodies.
“I’ve always had a special place in my heart for those women who choose home birth. The reason for this is that these women trust themselves more than doctors and hospitals.”
— Christiane Northrup MD, Women’s Bodies, Women’s Wisdom
If you are one of the five percent of women who has a legitimate physiological/anatomical difficulty/malfunction that precludes you from normal birth, that necessitates medicalized birth, you have my genuine sympathies and my respect for battling your impediment and bringing your baby into the world. You are the minority...the rare exception...for whom the protocol of emergency/technological birth measures are prescribed. But for the industry to apply that paradigm to the rest of us...to seek the medicalization and enforced technological protocol for all normal birth...is criminal. Normal birth is NOT a medical event.
OBs who desire to normalize “abdominal” birth have completely lost touch with the reality of the human form and its natural function. There is no such thing as abdominal birth (aka cesarean section) without the risk-bearing tools of the factory birth system. A c-section is not a birth process at all...its “intent” is to be an emergency, last ditch effort. To elevate the c-section to a place of normalization along with natural vaginal birth borders on insanity. A c-section is an invasive surgery, not a birth. A woman is restrained to a table, she (and consequently her baby) is drugged, and her abdomen is sliced open, her internal tissues, musculature and an organ cut into, and her baby forcefully removed. As a genuine lifesaving, RARE procedure, we can accept such a violation. But let us never accept or promote it as an elective, normal birth option. Christiane Northrup, in her book, Women’s Bodies, Women’s Wisdom, describes OBs that believe the c-section model to be the preferred baby delivery system. These doctors, at best, are deluded. According to their paradigm, it’s nothing short of miraculous that the human race made it to the 20th century.
“We do not see childbirth in many obstetric units now. What we see resembles childbirth as much as artificial insemination resembles sexual intercourse.”
— Ronald Laing, Psychiatrist
The industry seems blind to the fact that women have been populating the earth into the billions for millennia before the medicalization of birth. To claim that birth can only be safe and successful as a result of our modern, technocratic system is both arrogant and ignorant. The United States boasts the most technological birth system in the world, yet suffers one of the worst infant and maternal mortality rates in the developed world. In California alone, the maternal death rate tripled between 1996 and 2006. Nationally, cesarean sections are a significant factor in maternal death. And rather than doing some serious self-reflection, the ACOG spends its time and resources vilifying homebirth. Even the CNM paradigm has shifted through the years to become aligned with the ACOG version of reality. So many CNMs now are just mini-OBs. Some know very little about botanical and nutritional therapies and do not advocate the complete pursuit of the instinctive, unfettered birth process. I recently heard a student CNM rail against homebirths, saying she would never support a woman’s desire to birth outside the hospital system. “Babies die at home!” she said. Well, it is rare, yet sadly, it can happen. I grant you, life can be harsh. We despair to see a baby die in any environment. Bad things can happen, sometimes out of our control. But let us not be ignorant of the facts. Babies die in hospital births. Moms die in hospital births. Why does mainstream media neglect to seriously report the plight of maternal deaths as a result of the hospital birth system?
Hospital L&D protocols and procedures create a cascade of interventions that routinely results in harm (from mild to severe) to mothers and babies. The typical crisis outcome is the c-section, which accounts for 33% of births nationally (some states are at 40% and some hospitals are at 50%). Too often, the hospital instigates the cascade of events and policies (epidurals, pitocin, fetal monitoring, mom in bed, etc.) that leads to birth complications, ends in a risky surgical delivery, and later the OBs thump their chests, claiming to have "saved" you and your baby. Well, it's partly true...they did save you...they saved you from the harm they caused you, significantly adding complications to you and your baby's birth and postpartum recovery. Yet the birth industry "experts" profess that they are providing the best, safest care...that they are protecting you. From what is the ACOG so desirous to protect women and babies? Peaceful, empowering, health-promoting, drug-free vaginal births? The fear-based, “broken body” paradigm causes industry practitioners and protocol makers to see every pregnancy as an illness and every birth as a disaster waiting to happen. They foolishly apply a (profitable) “one-size-fits-all” approach and work to convince all of us that it is sound practice. The industry needs to take a step back and begin to accept and practice what I believe is an essential, needful mantra: “Just because you CAN doesn’t mean you SHOULD!”
The birth industry applies the emergency procedure approach necessary for only five percent of women to all pregnant women. They treat all infants at birth like the endangered babies of drug-using, disease-riddled mothers. These presuppositions determine hospital birth policy. When was the last time you knew a pregnant mom who had gonorrhea? Not common. Yet the industry has made it standard treatment to fill ALL newborn’s eyes with chemical gunk to "protect" from that disease. How many moms do you know who are prostitutes or IV drug addicts? Not too many? Yet industry policy is to vaccinate ALL newborns for Hepatitis B. The industry’s policies are not evidence-based necessities. The ACOG-driven policy of punishing midwives...of vilifying, outlawing and delegitimizing homebirth...does not stand on evidence-based science; it can only be compelled by profit and/or a desire for control and conformity. The ACOG stands ready with PR pitbulls and regulatory buddies to attack the moment they perceive (or design stories of) anything going awry in the homebirth realm. But where is that fire in the belly for publicizing and prosecuting those responsible in the hospital system when babies and mothers are harmed...even killed...by their interventions and procedures?!
“Birth matters. It matters because it is the way we all begin our lives outside of our source, our mothers’ bodies. It’s the means through which we enter and feel our first impression of the wider world. For each mother, it is an event that shakes and shapes her to her innermost core. Women’s perceptions about their bodies and their babies’ capabilities will be deeply influenced by the care they receive around the time of birth.”
— Ina May Gaskin, CPM, Birth Matters
The birth industry operates with a factory widget approach. Because of this flawed technocratic paradigm, the OB system sorely lacks good prenatal care. Good prenatal care involves a genuine relationship (including quality and quantity time spent) between the pregnant mother and her chosen support practitioner...it is more than tests and technological monitoring. It is not common for OBs...or even many CNMs, sadly...to educate women about how to be truly healthy during their pregnancy and to prepare for their best possible birth outcome (nutrition, exercise, herbs, lifestyle, etc). Birth industry practitioners don't tell women about the wonderful red raspberry leaf that strengthens, tones, then repairs the uterus, and helps to alleviate postpartum depression. They don't teach women about how to avoid posterior baby positioning that leads to labor complications (even c-sections), and what you can do to rotate a posterior baby before/during birth. They don't teach women about the optimum exercises and practices for birth preparation, nor do they encourage women to move into and explore the best birthing positions during labor/birth. In general, typical OB care includes vast unnecessary (and problematic) technological interventions, viewing all women the same, giving them all the standard protocol...it is the factory approach to childbearing, and it doesn't work. This birth culture disempowers women, keeps them disconnected from their bodies, babies and the birth process...it keeps women steeped in fear and self-doubt...and it perpetuates the lies to the next generations.
“The gap between actual obstetric practices in the Unites States and what scientific evidence indicates obstetric practices should be continues and will be slow to change until there is sufficient pressure—from women, scientists, politicians, and the media—to force more evidence-based practices.”
— Marsden Wagner MD, Born in the USA
Any perspective, finding or practice outside the established accepted industry norm is routinely vilified, slandered, mocked, or suppressed. If you don't walk to their beat, you're out of line. The minute someone questions "conventional wisdom" and it gets big enough to make ripples, the hounds are released. It's so typical and common that it's humorous. Someone comes close to rocking the boat and the PR dogs bark out their mantra..."that cannot be proven," "that is unsafe," "that is not approved." And when the establishment gets caught with dirty hands, caught in deceptions, caught altering results, caught with egg on their faces, the response is first silence, then more mud-slinging at those who are outside the box...the hounds just shout their mantras louder: "Unproven, dangerous, unproven, dangerous! We are the only truth, we are your only hope." As if saying it will guarantee their continued stranglehold on society.
In 2007/8, there sprang forth a handful of exposes on the birth industry, including Ricki Lake's documentary The Business of Being Born, Jennifer Block's book Pushed and Marsden Wagner's book Born in the U.S.A. Their message was neither new nor revolutionary (the flawed technocratic, medicalized, for-profit American birth model is rife with problems), but perhaps it was the frequency or consolidation of the voices that created ripples in the sea of public consciousness. As a result, growing numbers of women began to question the "party line" and sought alternatives. My friend, a licenced midwife in California, told me that she had never busier. As the seedlings of this rogue enlightenment nudged their way to the light of day, the threatened status quo responded in typical form to squash any growing opposition. The ACOG came out with its bald-faced lie...um, I mean statement...that homebirths are dangerous. This was followed by a bout of propaganda in which news outlets ran stories about the horrors of out-of-hospital births. My then-pregnant, homebirthing friend told me, with infuriated passion, "It makes me so angry that I want to go outside, squat in my front yard and just push this baby out!" My sentiments exactly!
After a significant study was published in 2009 that showed planned homebirths with professional midwives were "just as safe as hospital births," the ACOG released more negative press, decrying homebirth. This kind of defensive fear-mongering flies in the face of the historical facts regarding the safety and desirability of the age-old natural birthplace...the home. As the interest in homebirth and empowered choice has grown, so has the establishment's mud-slinging. The message is clear...you cannot birth without us. The birth industry chants this disinformation as loudly as it can, using various mediums to do so (including popular television series, corporate media "news reporting," advertising, control of the medical journals, etc.).
“Women were...telling me they’d felt tremendous pressure from their medical providers to go against instinct and research—to induce labor, to schedule a cesarean, to lie back during labor when every cell in their body felt like moving. Women are supposed to push their babies out; instead, they felt they were being pushed around.”
— Jennifer Block, Pushed
One of the most irksome segments for me in The Business of Being Born was the OB interviewee who likened homebirth to driving without wearing a seatbelt. Not quite! Driving without a seatbelt in the birth realm is a couple who refuses to become informed consumers. It is a mama-to-be who doesn’t take advantage of the essential therapeutic modalities (like botanical medicine, chiropractic care, acupuncture, exercise and nourishing diet) that create a healthy baby and positive birth outcome. I’m turning the tables on the OB’s statement. Homebirth is akin to driving without a seatbelt? Nonsense. Let's use an analogy to describe the risks women take when they enter the hospital birth industry. That scenario is akin to a woman being tranquilized, strapped into a straight jacket, shoved into a giant hamster ball and pushed toward a cliff.
The system says, “You can’t do it.” The system says, “Our way is the only way. Our drugs are safe...this procedure is necessary...you have no alternatives...those other options are dangerous, unproven, ineffective, blah, blah, blah. Trust us. Believe us. Obey us.” We listen to the voices and we make ourselves victims. Why do we listen to the lies? Truly, there is no substitute for the care of a well-trained, knowledgeable midwife (literally "with woman"). The birth industry cannot offer you anything that comes close. The birth industry's drugs carry significant risks to mother and baby. Epidurals are anesthetics derived from the Caine family of drugs, such as bupivicaine (a relative of cocaine), and are often combined with opioids and narcotics. These drugs are certainly not benign; neither is pitocin (which is not even approved for elective inductions). The birth industry's standard protocols (such as constant electronic fetal monitoring) do not facilitate the birth process, have not been proven to improve outcomes, and often lead to unnecessary and undesirable complications. Babies are negatively impacted by drugs and procedures used during hospital births...a possibility that is avoided with homebirth. The placenta is not an impenetrable fortress through which no toxins pass. Women understand this instinctively and work during pregnancy to protect their babies from drugs and toxins. So why would we expose our babies to a dose of extraordinarily potent and toxic drugs during birth?
Fundamentally, it is a distrust of our bodies that makes us vulnerable to the factory system. Why do we listen? Our bodies DO work...it is a rare event that they need medical help. We need to understand that good midwives can alleviate many undesirable acute situations that could emerge during birth at home (such as shoulder dystocia or neonatal resuscitation). Midwives also know to recognize the signs of impending complications (both prenatally and during labor) and seek help if necessary. But above all, midwives RESPECT and support a woman's choices in pursuing her best birth. We need to redesign our paradigm. We need NOT be led by fear and expect undesirable outcomes. Expect success, work for it, and you will be amazed at the results.
As a society, we choose how young women view birth...either with fear, or with awe and confidence. The tragic irony is that for all our modern female liberation and empowerment, American women allow themselves to fall prey to the patriarchal technocratic baby delivery system that is founded on the erroneous belief that our bodies are flawed and broken and that we need to be saved from ourselves. We allow ourselves to be abused by a misuse of technology. As a culture, how far will we stray from the natural processes of life? How long will we continue to disempower women in this most natural feminine realm? Why are we allowing them to destroy our right to choose how to birth our babies? How many of you know a woman (perhaps yourself) who regrets her industrial birth outcome? How many of you know someone, mama or baby, altered or harmed by the standard procedures? Ladies, if you want to be empowered, start by taking back birth! Our daughters need not be victims of this system. We have the power to change the factory birth model and our cultural attitude...one birth at a time.
For citations, statistics and information:
Birth as an American Rite of Passage: Second Edition by Robbie Davis Floyd
Birth Models That Work by Robbie Davis Floyd
The Thinking Woman's Guide to a Better Birth by Henci Goer
Ina May's Guide to Childbirth by Ina May Gaskin
Birth Matters: A Midwife's Manifesta by Ina May Gaskin
Birth without Violence by Frederick LeBoyer
Childbirth without Fear by Grantly Dick Read
Gentle Birth Choices by Barbara Harper
Birthing Normally by Gayle Peterson