Once upon a time childbirth was considered a mystery that belonged to women — now you can see live births broadcast all over the internet. The face of birth may have become a public one, but there are few a still mysteries left, such as how a doctors became such a key part of modern birthing, why different techniques come in and out of vogue, and how fertility and infertility have evolved into a billion dollar industry..
Randi Hutter Epstein, M.D., author of the book “Get Me Out — A History of Childbirth” answers a few questions about delivery methods, pain free births and the evolution of the medical practice of birth, and has an offer for one reader to receive a copy of her book.
There’s a great deal of focus on how birthing was once under the eye of women, primarily midwives, and slowly was taken over by men and “official” medicine. How is the resurgence of midwives and non-traditional hospital birthing is affecting the way women give birth currently, both physically and emotionally?
The resurgence of midwives and non-traditional practices is offering women options—and options are always a good thing. I like to say that we now live in a very polarizing time for childbirth. Some women want the works—a hospital birth, drugs, maybe even a c-section on demand followed by tummy tuck. While others want to be home with a midwife and completely drug-free. The opportunity for couples to be able to mull over the issues and figure out what they think works best for them is wonderful. Of course, the downside is that options are scary. In some ways, it would be easy for someone to tell you that a scientific study has proven the healthiest and safest way to give birth is by doing this or that. But that is likely never to happen. Why? Because childbirth falls into the gray zone. When you are pregnant, you are not really a patient (you’re not sick), but you are not completely yourself. Your body is changing and you may need medical assistance and professional expertise. The issue is which profession to do you turn to? So my answer is really wishy-washy. I think choices are great for women, particularly those who want the option of working with a midwife (and many women can have it both ways, a midwife with a doctor-back up); but options can be anxiety-producing as well.
Many people in today’s culture seem to see c-sections, especially c-sections that are “elective,” as a type of birthing failure on the part of the mother, believing there is never a reason for a c-section. What is your feeling about this type of c-section shaming, and is there a way it can be addressed to help women feel better about all birthing options and choices.
We are so judgmental starting at conception. What should be the most intimate and personal moment has always been public. The question is: Why is it anyone’s business how you chose to give birth? But for some reason, going back in history, we have always judged each other about our birth choices. It’s not just c-sections. Women who have epidermals say they feel guilty admitting to it. And we’re not talking women’s groups. We’re talking about women holding a newborn in the grocery store and other strangers asking how they gave birth and whether it was drug-free. Unfortunately, today, I think women feel pressured to go through pregnancy looking beautiful (skinny except for a little pregnancy bubble), slip out the baby drug-free, and fit into your jeans by day two. There are so many more important things to think about from conception to college. In truth, few women elect to have c-sections who do not really need them. I think what happens is that doctors suggest that they get a c-section, and women, all too often, reluctantly agree.
Pain-free birthing has come in and out of vogue over the last century. You mention that in early 1900′s it was considered liberating to not feel birth — now it’s thought to be more empowering to feel everything when you are in labor. Why do you think that the public opinion on pain keeps shifting back and forth?
Everything has to do with doctor-patient relationships. When we are angry with our doctors, we want to do everything the opposite. So, women in the turn of the century—feminist crusaders—were beginning to be angry with the paternalistic practices of the all-male medical establishment. When doctors said you had to give birth without drugs, women demanded the opposite. During the second wave of feminism, when doctors liked having their parturient women drugged and easy to deal with, women fought for the opposite, pushing for natural childbirth.
In your book you track the evolution of birthing practices, many of which seemed utterly modern at the time and now seem grotesquely dangerous. Is there any current popular approach to conception and birth that you think will eventually be looked at as totally crazy?
I hope that in years to come we can figure out a way to use fewer drugs to help infertile patients make one baby at a time successfully. Right now, we pump women up with hormones so they spew dozens of eggs. Sometimes we create several embryos and we just choose a few that look right. We really have no way to predict which egg should go with which sperm, or which embryo is guaranteed to make a baby.
Interested in reading Epstein’s book for yourself? The author will be giving away one free book to a Care2 reader — one commentor on this thread will be chosen at random to get a paperback copy! Leave a comment before Tuesday at 8 pm Eastern to enter.
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