Childbirth, the American Way?

Lucie Bryantbirth trauma

As many may know, the majority (about 98%) of women that give birth in the United States, do so in a hospital, Then, there is that small percentage that believes childbirth should happen at home, or a birth center. But, do you also know that prior to the 1930’s the majority of women gave birth at home, surrounded by women in their community, with the assistance of midwives?

Western medicine as a whole is best for medical emergencies in general. However, more often than not, medical interventions are overused in childbirth. And despite many of these medical interventions, maternal death rates are rising in the United States! In the US the current maternal mortality rate is a whopping 26.4 per 100,000 live births! The worst in the industrialized world! Now, compare this to the U.K. at only 9.2 or better yet, look at Finland at only 3.8 or Denmark at 4.2! What are they doing different? Why are we missing the mark?

Maternal deaths per 100,000 live births

Source: The Lancet
Credit: Rob Weychert/ProPublica

Is it possible that the answer is the fact that the childbirth industry in the US is worth, on the low side, about $50 billion per year?

According to an article written in 2013 by the NY times, the United States charges the highest amount for birth than any other industrialized nation. However, as huge of a problem as one can see this is, this is just the tip of the iceberg. The other issues that may be in direct correlation with these astounding disparities in maternal mortality is the level of care received by Americans. In most of these countries listed on the graph, midwives are the first line of care! The midwifery model of care, and often birth center or homebirth is primary unless a true risk factor is confirmed during the pregnancy, such as pregnancy-induced hypertension (high blood pressure), pre-eclampsia, uncontrolled gestational diabetes, etc…This is not the case in the U.S. Our first line of care is Obstetric care, with approximately 27% receiving a form of the Midwifery Model of Care and less than 2% of women delivering at home or at a birth center! Incidentally, the cost of the Midwifery Model of Care is but a fraction of the cost of Obstetric Care and hospital delivery.
Lay all of this aside and now I will list the top 3 reasons to consider the Midwifery Model of care and Birth Center or home birth rather than the “norm” in the US (obstetric care and hospital birth).

First, Time is not on your side. With typical obstetric care/hospital birth labor is a timed event. You are often given a specific amount of time to give birth, before the interventions begin to speed things up. Often leading to the cascade of interventions which most often leads to cesarean section (1 in 3 women in the US, Higher in Pasco County).

Second, Birth interrupted by strangers. As many may know, there is an entire staff in the hospital such as, nurses, and housekeeping, and medical and/or nursing students (teaching hospitals). Then, there is the infamous, shift-change! Physiological birth is interrupted by this procession of strangers! A calm quiet atmosphere surrounded by people you know and trust has been proven to reduce stress during labor and increase the likelihood of safe, uninterrupted delivery.

Finally, Fear tactics, rather than shared decision making. Although I feel this should not be the norm, a women must be a strong advocate in order to have the birth she desires in a hospital setting. Although there may be times that interventions may be necessary, informed consent should be used rather than fear tactics. Often, especially in the case of the Cascade of Interventions, fear is used as a way for the medical system to do what they deem necessary.

With childbirth there is an opportunity for you to feel empowered. Do your research, interview your doctor or midwife, choose your birthplace. Find people who support you!