The industrial revolution of birth (alternate title: Why I won't stop talking about it)

I am reading this fascinating article. I know it’s way too long for most people to read through (although I thought it was worth it), I’m sharing my favorite points. =) Enjoy:

I have seen, over years of practice in maternal-fetal medicine, an odd and somewhat unsettling pride among women who announce that they have a “high-risk pregnancy.” Although the inherent literal meaning of the term high-risk pregnancy is one that entails a greater risk of a poor outcome (for mother or baby,) the subtext seems to be that high risk equals high value. In some cases it is difficult to persuade a low-risk woman to continue her care with a general OBGYN practice instead. “But I’m high-risk,” she says. Does she really mean, “I’m high-status,” or “My baby is high-value,” specifically, more precious than someone else’s? Is it a statement of importance? Does it mean that she is special? Or is it a Disneyfication of a primal human endeavor, longing for the synthetic and dramatized experience in preference to the authentic? These questions are raised, but cannot possibly be answered, in this commentary.

(I have noticed the same thing. Mothers that are afflicted with various health problems tend to almost seem proud of them. I wonder sometimes how many actually have real handicaps, or which have been fear-mongered by their doctors into believing that they couldn’t possibly survive without monthly or yearly exams, medications, etc for completely preventable conditions.)

But across the developed world, or across medium- and high-income countries, there is no additional benefit of further increase in cesarean rate (Althabe 2006.): Slovenia, with a 12% cesarean rate, has the same maternal mortality ratio as the US. Nordic maternal mortality ratios are only a fraction of the American, at a 50% lower cesarean rate. Neonatal mortality does not change in high-income countries across a range of CS rates from 10-40%. (Althabe) Infant mortality rates as low as 4 per 1000 are achieved at CS rates of 15% in a number of countries, contrasting favorably with the US infant mortality rate of 7 per 1000: the American system results in infant mortality nearly twice as high achieved at the cost of twice as many cesareans. It is hard to make the argument on a population basis that abdominal delivery is safer for mothers or babies, at least after a minimal necessary rate is achieved.

(In other words, while many moms are lead to believe that their c-section was “necessary”, for whatever reason, the facts prove that it simply doesn’t make a difference in maternal or infant mortality rates.)

In the US, we have heard arguments that women are entitled to autonomy in making their birth choices, and that therefore it is ethical to perform cesarean for no reason other than maternal request. Curiously, this vaunted autonomy stops at the door of the labor room. Women are implicitly allowed, or encouraged, to make only those choices which increase the power of the physician and which decrease their own.

(’Nough said.)

 Stipulate that antibiotics and blood banks are good and necessary things, and that emergencies may, in fact, develop: still, the majority of births will be normal. Or they would be, without interference. The species that cannot birth its young becomes extinct. But fear has pushed nearly all American childbirth into the hospital, a campaign which continues even now that that battle looks to have been won. (American College of Obstetricians and Gynecologists, 2008) Still, despite the implied promise of safety if all the rules are followed—ID bracelets, intravenous lines, electronic fetal monitoring—labor may follow an unpredictable path. The definition of “normal” becomes ever narrower, and toleration of deviance ever lower. The final stage of this philosophy takes the process of birth away from the woman entirely and turns it into a surgical procedure performed by the doctor. Childbirth becomes a manufactured experience, shorn of any real risk or real power, one in which the woman is so far alienated from the capabilities of her body that she is only a package on an operating table for a professional to open.

(Emphasis mine. I had to restrain myself from highlighting the entire paragraph. This is truth right here.)

The industrialization of food production is, perhaps, a harbinger of the industrialization of childbirth. Food production was once local, varied and small-scale, but farms have been taken over by huge conglomerates, and monoculture of a small number of genetically uniform crops has replaced variety. The disappearance of cultivars—that is, the loss of deviants—means that random natural events could wipe out large swaths of the food supply. To draw an even more pointed parallel, meat in America is cheap and widely available because of industrialized animal production. These animals lead narrowly confined lives from conception to death. Reliance on a small number of breeds, confined animal feeding operations, and the production line essentially turn animals into factory products. Industrial animal production has exacted a price in ways that until recently were invisible to the average consumer: the pollution of air and groundwater, the increasing potential for foodborne illness, the escalation of antibiotic resistance which begins in industrial herds but moves into human populations, even the quality of those animals’ lives. Clearly, industrialization has a downside, although we may not notice the drawbacks until all competing models have vanished. While some would object to drawing an analogy between industrial food production and industrial childbirth, I submit that in both cases we see a conversion of a living creature to a commodity, with an emphasis on the end product and a marked disinterest in the natural process over time. Women can be processed through the childbirth machine and handed a baby at the other end, stripping them of their central role at the heart of things, and turning them instead into objects that someone else operates upon.

Sometimes those of us who are birth advocates feel as though we are shouting from the rooftops and being completely disregarded. This is why we feel so passionately about this topic. This article has summed up why it is important that we teach our daughters that birth is normal and beautiful and safe. This is the heart of motherhood and of femininity and it is being taken away from us. Women are becoming like men, and worse- like factories.

We feel like pulling our hair out when we hear of a friend, sister, or even acquaintance who was forced to experience an unplanned c-section and led to believe that it was necessary for whatever reason. Because we know that it could have been different for her with proper care and nurturing from other wise women (and herself!) instead of a hurried undereducated physician. We mourn the loss of confidence and ability that results. Because ultimately, it does affect every single one of us.