Then and Now: Having a Baby

Perhaps it’s our unstoppable drive to avoid anything uncomfortable, or maybe a general insistence on avoiding all pain. But women, me included, have allowed the medical system, our families, friends and other social pressures to take away one of the most beautiful parts about being a woman: becoming a mother.

Until the '20s, most women gave birth at home with the care of a midwife or other women. Only in the past 90 years has going to the hospital become the norm. 

Pioneers and Native American’s on the Plateau 1850 - 1920

Pioneer women delivered each other's babies. Any woman that wasn’t having a baby was part of the birthing team. Mothers who delivered while traveling on the Oregon Trail were allowed three days to rest and regain their strength, then the wagons started moving again.   

Native American mothers during this time were also attended by close female relatives. Women were thought to have close connections to “Mother Earth” and many Native American societies were matriarchal because of the appreciation given to the creation of life. 

During this time period, infant and maternal mortality were more a result of unsanitary conditions and poor nutrition than any factors related to their care during birth. Natural childbirth was the only option available, even for the very wealthy women who were cared for by doctors. 

Hospital Births Begin 1920- 1960s

When births moved into the hospital in the early 1900s, there was a sudden spike in infant mortality due to improper use of forceps and over medication of mothers during labor. This was a shocking time in our history where most women were completely anesthetized during labor and several hours after the birth. Active labor often takes more than 12 hours. 

Women were put into what became known as “twilight sleep.” They woke and met their babies several hours later with no memory at all of the birth of their children. Postpartum depression was much more prevalent, yet went undiagnosed because of negative social implications for women. Breastfeeding became unfashionable and was something only poor women did because they couldn’t afford the newly developed formula. 

Doctors, (who were always men), realized the consistent source of income that childbirth presented. Natural childbirth and home births were also becoming unfashionable and considered something that only the very poor had to endure. Midwives were demonized and driven underground. 

Ask your mothers, grandmothers, aunts and other women who had babies in the '60s about it, but chances are that many of them don’t remember a thing about the day their babies were born. My grandmother has no memory of either of her deliveries. She does have significant memories of the disembodied feelings of coming out of anesthesia and the strangeness of meeting her children for the first time outside of her body. 

Natural Childbirth Movement, 1960s

After 50 years of twilight sleep, women began searching for ways to take the birthing process back. In Bonney Lake, a woman named Nancy Spencer began to learn the trade of midwifery and along with other’s like her; Nancy helped to write legislation in Washington recognizing midwifery as a profession and demanded licenses and standards. 

It was also during this time that hospitals began to allow husbands and other family members into the labor and delivery rooms. The horrors of twilight sleep quickly disappeared as fathers saw women strapped to beds to avoid hurting themselves while under anesthesia. 

Issues in Modern Hospital Births

The current national average for cesarean section is around 32 percent. In sharp contrast, the world health organization has determined that the healthiest c-section rate is 5-10 percent. Each hospital is different and there are many arguments and theories about why this rate is so high in the US. (Washington State’s rate was 30.4 percent in 2009)  Looking at local intervention rates, in 2009 Good Samaritan hospital had a c-section rate of 28.4 percent. Enumclaw Community Hospital was even better at 22.8 percent.  Click here for my source and to check out other Washington hospitals.

One explanation for the high c-section rate is the use of labor-enhancing drugs. The use of drugs can cause labor to progress unnaturally fast and painfully. This extra stress on mothers and babies often leads to conditions which are dangerous and the body’s natural processes take over, slowing labor further. The reaction to this process in a medical setting is more intervention, often in the form of a c-section. 

Critics argue that real reason for speeding up labor is to increase the profits of hospitals. By ensuring that babies are born within 24 hours of arrival in the hospital, costs are lowered and more mothers can deliver in a shorter period of time.  

The most troubling part of our high c-section and intervention rate is the fact that outcomes are not always good. The United States ranks second to last in infant mortality among the developed countries in the world. Babies are three times more likely to die within the first 24 hours of birth in the US than they are in Japan. This is true despite the fact that the US has more specialists and doctors per patient than any other modern country. 

Natural Childbirth, Midwifery and Home Deliveries Today

In 2011, if you tell your friends and family that you are planning a home birth or heading to a birthing center to see your midwife, you may just hear words like "that's just scary" or "what if something goes wrong?" Conversations like this, filled with social pressure and followed with stories of the pain of labor, have led most women to seek care and birth plans that involve hospitals. 

But there are some basic things to consider before you are pushed into feeling like you are a dangerous person for choosing something so natural. Number one, women have been having babies since we became mammals and can do it -- quite often-- all alone if need be. Every woman was born to have a baby, that’s just how nature works. Also, pregnancy is not an illness! Generally speaking, there is no need for intervention beyond monitoring to ensure everything is OK. 

Midwives are medical professionals; they are licensed by the state. In 1994, the State of Washington published a study that showed that outcomes were the same for healthy mothers and babies, whether delivered by a midwife or a doctor. 

If the monitoring and the prenatal care preformed by a midwife indicates a need for further intervention, a midwife will refer you to a doctor. They work closely with perinatal specialists, neonatalologists, and pediatricians in cases when mom or babies are sick. 

Cost is another factor. Paying cash for a midwife is usually cheaper than paying the out of pocket maximum for a hospital birth. Midwives in Washington are covered by most insurance companies  and are approved for state medical assistance.  

In addition, the personalized care and close relationship developed over the course of a pregnancy create a birth scenario that is relaxed and comfortable. Mothers are encouraged to eat, move, and sleep when they feel like it during labor. A midwife isn't going to walk in, flip on the lights and take your blood pressure while you are trying to rest between contractions. Your birth plan will in fact be the plan, because there isn't any administrator working hard to fill the beds in your house with the next patients.   

By staying at home and choosing natural childbirth, a mother is able to breastfeed her baby immediately. This intimate first contact has health benefits for both baby and mom, jump starting the bonding process. Mom can have a home cooked meal as soon as she wants it and won't have to ask to take a shower. And again, there is no one coming in your house three to five times at night, turning on the lights just after you get the baby to sleep to check your vital signs. 

Childbirth can be a medical procedure, and is for many women. It has become a hurdle that you have to get through to get a baby. But it doesn’t have to be that way.  It can be a life changing empowering experience, in a hospital, at home, or in a birthing center.     

There are times when hospital deliveries are a must. My second baby was 7 weeks early and I can not put into words how much I appreciate the doctors, nurses and staff that helped my family and me through that difficult time. But, when mom and baby are doing just fine, a natural birth at home is perfectly safe and filled with little-known benefits. 

We are very lucky to have several midwives available for both home and birthing center deliveries in our local area.  Here is a short list of just a few in our area:

Nancy Spencer, The Lakeside Birthing Center

Susan Sherwood, All About Birth Midwifery  

Ann Olsen, Midwife Ann

For a complete listing of licensed midwives in the area, visit the Midwives Association of Washington State.