LOOKING FROM DIFFERENT PERSPECTIVES: Part #2
During Follow-Your-Doctor’s-Orders trend there were both mothers, fathers and birth professionals who were frustrated with how this natural and normal phase of women’s lives became so medical.
Without a doubt childbirth was acknowledged as an event that had many and diverse problems. However, that isn’t true of every birth. This is where the complexity of pregnancy and childbirth is SO real. Here are just a few examples:
- A woman with multiple health problems (you name them and be extreme!) can pop her baby out.
- A woman who ate right, exercised, thought good thoughts, chose a home birth with a midwife could 1) Not cope well 2) Have a undiagnosed baby with major health issues 3) Have her midwife get caught in a snow storm.
- A woman wanting a Caesarean might find herself giving birth on the way to hospital.
- An unborn baby diagnosed with a major health issue might require a woman to have a non-laboring Caesarean even though she has no health concerns and desperately wanted a home birth.
- And we’re just talking about modern women!
What the medical profession did was standardize birth and treat everyone as though a Problem was right around the corner. The vast majority of families trust professionals. If you work on your own car then you know something about cars but if you don’t, you trust your mechanic. We don’t fill our own teeth. Obstetricians are highly trained professionals. Hospitals are not just places where you go when you’re sick or dying, they are places where you go to prevent potential problems associated specifically with childbirth. Many of the life threatening problems cannot be pre-diagnosed such as a cord around a baby’s neck, a placenta that separates, a tear that is massive, an embolism or even an obstructed labor.
So childbirth is confusing. This causes stress in expectant parents who are doing their best. During Follow-you-Doctor’s-Orders the hospital was perceived of as being clean and safe and obstetricians were seen of as highly skilled professionals. There were families who wanted more humane birth and more choices.
Families wanted to have choices specific to their unique situation. There were also obstetricians who were frustrated with childbirth always being so highly medicalized.
While consumers started to organize as advocates of natural and normal birth, there was also a movement to re-instate midwives as birth professionals. Having obstetrical nurses in the US was unique and reeked of the submission of women in a male dominated profession. Having removed midwives from the modern maternity system played into the message that midwives were persecuted. There were and always will be both lay midwives, obstetrical nurses, GPs and obstetricians who attend home birth outside the ‘system’. There was also a movement to create Birth Centers. Consumers wanted ‘choice’ as to where they birthed, with whom and what happened to them.
(In countries that already had integrated midwives into their modern maternity care, midwives sought to 1) Not be trained as nurses first 2) Have autonomy of practice 3) Be able to attend home birth and continue care if a transfer occurred 4) Be seen as separate from the medical system.
It was in this period that a few obstetricians developed Skills-based resources for families.
Dr. Fernand Lamaze. He was French! This is from Wikipedia
‘Based on Ivan Pavlov‘s theory of conditioned response, psychoprophylaxis strove to eliminate the pain of childbirth through education about the physiological process of labor and delivery, through the trained relaxation response to uterine contractions, and through patterned breathing intended to both increase oxygenation and interfere with the transmission of pain signals from the uterus to the cerebral cortex. Lamaze was so impressed by what he witnessed that after he returned to France, he devoted the rest of his life to promoting psychoprophylaxis’.
Dr. Grantly Dick-Read. He was British and wrote Birth Without Fear. His belief was that childbirth is a normal event which, barring rare complications, should be allowed to proceed in its natural fashion. He was instrumental in the development of the National Childbirth Trust in the UK. Grantly Dick-Read’s philosophy was not actually ‘taught’ nor skills based but conceptual … don’t be afraid and trust birth.
Dr. Robert Bradley. He was American. This is from Wikipedia
‘His book Husband-Coached Childbirth, first published in 1965. The Bradley Method emphasizes that birth is a natural process: mothers are encouraged to trust their body and focus on diet and exercise throughout pregnancy; and it teaches couples to manage labor through deep breathing and the support of a partner or labor coach.’
These three obstetricians were the initial Face of Change in childbirth. They were the fathers of the Skills-based childbirth trend. They were DOCTORS! They advocated: skills, trust, instinct and natural concepts around the birthing process. Then came others.
Natural birth advocates, those who supported home births and midwives were incredibly impacted by these pioneers. These groups wanted more choices in all births: rooming in, early discharge, late cutting of cord, getting out of bed, being able to eat and drink during labor, having more than one support person, baby to belly, baby to breast, delayed delivery of placenta, no cutting down there … and the list goes on and on!
Those working in the modern maternity system were also impacted by these three men. First Lamaze and then Bradley classes sprang up every where. This created the societal expectation that all families learn, practice and use birth and coaching skills. This directly had an impact on all birth professionals. Over a 20 year period in the US, they saw millions upon millions upon millions of skilled birthing women and successful coaching dads. Of course, not every one exhibited a high level of skill but this was an incredible change from what had gone before.
Birth Plans didn’t exist yet. The change birth professionals saw occurred during the Follow-Your-Doctor’s-Orders trend.
Given this incredible success with a Skills-based childbirth trend, you’d think that childbirth advocates would have continued to promote the Skills-based trend along side what they wanted … a Choice-based trend. That didn’t happen.
NEXT POST: LOOKING FROM DIFFERENT PERSPECTIVES: Part #3