Monday, November 18, 2013

The Evolution of Midwifery

Back in the olden days, midwives had all kinds of herbs, mushrooms and stuff to help women through the ordeal of labor and childbirth. I bet they had them chewing tree bark, I bet they had the laboring mothers chewing on medicinal leaves. I bet they tried as hard as they could to ease the pain. I'm sure of it. Wanna bet?

The revival of midwifery in the U.S. has been fraught. Ina May Gaskin and the others who brought it back into practice had to fight hard against the medical establishment of the time. Childbirth was medicalized in the 1940s. A lot of things were medicalized at that time. The common wisdom for the next two or three decades was that the doctor knew best and the patient should just do as he said, without asking too many questions. It was a very harsh moment in modern medicine. The doctor reigned supreme. Almost always, that doctor was a man.

The practice of doping women up, strapping them down, then yanking out the babies with a pair of tongs, holding the newborn upside down while slapping its ass until the baby cried, continued through the 50s and much of the 60s. It explains a lot about we baby boomers, those hideous births. Can you imagine? The husband/father/partner was not present. His job was to pace back and forth in the waiting room, his pocket full of cigars to share when the baby arrived. Babies were delivered in operating room settings. The doctors wore masks - it was truly crazy. I believe the UFO recovered memories from people who believed they were abducted were really recovered memories of highly medicalized births. But that's another blog post.

Hence when Ina May Gaskin created The Farm (her birthing commune), what she was up against was powerful. I can only imagine the scorn with which she was treated by the medical establishment of the time. This link is to a Salon article about her. A nice profile.

I understand why they had to be so macho back then, but what I've been wondering is why they're still so macho. Because they are, they really are. I've never met a midwife who didn't have an agenda, that being "natural" childbirth. EVERYONE MUST HAVE A "NATURAL" CHILDBIRTH - OR ELSE! It's a crusade. There's fire in their eyes when they talk about it. It is intense!

What "natural" childbirth means is no pain medication. Every pregnant woman who works with a midwife is encouraged to prove herself in labor and delivery. Not only must she give birth to a baby, but she must also prove that she can go the course, hang in there no matter how horrible it is, without any support for pain.

For some women, childbirth is perfectly doable without pain medication, also without a great deal of assistance, but for many, it is a life or death ordeal. In the past, these women and/or their babies died, in great numbers I should say. Every woman is built differently in body, mind and spirit. I think it's a sexist thought form that every woman should be great at having babies. It doesn't make any sense.

I've seen midwives deny pain medication for women in labor even while giving them intravenous fluids and other medications (to stop nausea, for instance). I've seen midwives try to talk women out of pain medication even when the women had been in labor for 24 hours or longer and were crying out in agony, begging for relief. What is that about?

I witnessed a midwife offering a Percoset to a woman moments after the baby was born, after talking her out of the epidural. That does not make sense. Does it?

It's brutal, attending births with midwives, I tell you. When I attended births, it was as a doula. I was there for the mother and did not have an agenda, except to assist the mother in every way I could. My goal was to go with the flow of the moment rather than follow a particular script. When they asked for pain relief, I made sure they got it. I've had to shout at midwives to make that happen, make a scene at the nurse's station. It's bizarre!

Why? Why is this cruelty still thought necessary? The dreaded epidural does not cross the placenta; it does not affect the baby. Anesthesiologists are so good with this procedure these days - women still have sensation, just not excruciating pain. Women can and do push out their babies after an epidural. Why is it still so reviled?

Why haven't midwives incorporated acupuncture and herbs into their practice? In China, certain surgeries are performed without anesthesia, because acupuncture is so good for easing pain. Why hasn't this "natural" process been integrated? The only pain relief I've seen them offer is the injection of water under the skin at the sacrum, usually for back labor. The shots are horribly painful, though afterwards they seem to bring relief temporarily. But they hurt like hell. It seems a part of the hazing to me.

As for going up against the medical establishment, I wonder how it is midwives haven't noticed that obstetrics has changed drastically since 1971, along with the rest of modern medicine. I don't know of of any hospital where super medicalized labor/delivery is the rule of thumb. What is going on?

Yes we do a lot of C-section births, including for women who worked with midwives and were offered no support for their pain. I have several theories on that, too. That's another blog post.

May midwifery soften now that it's mainstream. May midwives learn how to ease pain with herbs, with acupuncture and other natural methods. May they befriend the anesthesiologists, work as partners with them when that is the best way to bring the baby into the world. May they back away from the macho model of childbirth. May it be so.


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