Some in the media and health care arenas have made condescending quips about the "uprising" of natural childbirth and some have even called it a "fad." Certainly we know that natural childbirth has been around for thousands of years. I won't go into the full history of that in this post (for a later time...history of health practices is one of my favorite topics to research). I want to just speak to the women in my generation and those who are just before and coming after. This generation of natural birthing women, that is mainly women currently in their 20's and 30's, have excitedly assimilated to the natural birth philosophy. I do get this sense sometimes in talking with young birthing women that perhaps they do not fully know the history of natural childbirth. At times (and this is not widespread) these women are a bit overzealous about their views on natural living. I think it is also safe to say that many of these zealous women don't know what was required to "reclaim" natural childbirth in America. Natural childbirth, sadly was a right that had to be fought for and we women in this generation are now reaping the benefits of the people who were independent and bold enough to forge the way for us.
I'd like to take you on a more recent history on natural childbirth as it relates to the current general obstetric climate. A brief recent timeline:
Up to the 1900's: midwives or skilled older women in the townships attended births in the homes. Women gave birth in their homes, men were rarely part of the birth experience. It was considered a womanly practice. After the turn of the century, there were reported campaigns where the reputation and skills of midwives were dragged through the mud. Ads taken out in newspapers that depicted photos and stories of midwives practicing "witchcraft" or being poor, dirty, fully unfit and untrained to care for birthing women. The public largely bought into it (sound a little like today?)
1914 Twilight Sleep was introduced to birthing women (some women reportedly even demanded it when they heard it was all the rage.) Twilight Sleep was a concoction of Morphine and Scopolamine. The intention of the concoction was to deaden the pain of childbirth (with morphine) and also (the Scopolamine) was to help women enter into a state of euphoria and amnesia and be unaware of the pain and trauma of birth, later awakening to meet their baby. It was also around this time that the maternal mortality rates in the U.S. started to climb and were one of the highest compared with other industrialized countries. This is a fact still true today.
1930's The shift began where women started having babies in hospitals attended by physicians and home birth became less and less common. By the 40's and 50's "natural" childbirth was the rarity and highly managed, highly medicated hospital births attended by physicians, GP's, some family practice, some OB's were the mainstay. Midwifery seemed to disappear at least to the public eye. The shift forced midwives to practice underground.
Then came the 1970's and this is were I would like to spend some time. Many women started to see that the "benefits" of the modern use of modern obstetrics were not benefits at all. Certainly, I am sure women during the 30's 40's 50's and 60's saw this as well, but perhaps didn't have the courage and information to go against the "experts" or even their friends and family. Perhaps it was the hippie attitude following Vietnam or in rebellion to the 50's and 60's where "the man" was seen as rigid and had paternalistic attitudes that caused these flower children to go counter-culture. Some women chose natural childbirth because they were fearful that medical interventions would cause more harm than good. Some chose home birth viewing hospitals as uncomfortable, frightening and cold places to give birth and physicians no less the same. Some sought natural birth because they knew it to be the safest for their bodies and their babies. Some instinctively knew that a woman's body could be trusted to give birth with little to no management. But these women were up against a huge wall. Talk about "the man." Fighting for natural childbirth in the hospital was truly a fight every step of the way. Many hospital physicians and nurses had the expectation that good little patients are to be compliant and respect the experts. That women have no knowledge or expertise to know how to give birth and should not doubt the opinion of the experienced physician. When some physicians or nurses did not feel "respected" they would belittle and frighten and threaten the laboring women, breaking her will and her spirit (this still happens at times today, but not without backlash). Electronic fetal monitoring was new, shiny and believed to be the most accurate "non-invasive" way to determine a baby's well-being in utero. Women were told they could not get out of bed, they certainly may not walk around or eat or drink nor could they be trusted to be off the monitor. Husbands started to be a part of the birth experience more often, but some staff also tried to boss them around.
As to home birth, finding a midwife had it's own challenges. Midwives were underground, many people still saw them as granola, unshaven, new age hippies that weren't grounded in science and practiced pagan rituals (and some were and did.) Add to this the difficulty not just in finding a midwife but a good, skilled and experienced midwife. The disapproval or even outright disdain some women experienced from family members, friends, pastors and certainly the medical community, over their desire to birth at home with a midwife would be enough to more than discourage many women. But it didn't. Brave women forged through the medical big brother system found their fellow woman midwife and had their babies at home with their husbands by their side and welcomed their little ones into a calm, warm environment.
Robert Bradley, Frederick Leboyer, Ferdinand Lamaze and Grantly Dick-Read and others all had an influence on the information that was being given to families about natural birth. After a few decades in the American dark ages of birthing practices, the light started to come on again. More and more women saw that natural birth was possible and even preferable to highly managed "deliveries." What was different now, versus the centuries before was that women were beginning to realize that birth didn't have to be fearful. A laboring woman didn't have to be controlled by the fear that she or her baby might die at any point. Rather than just saying childbirth is part of life and something you just have to grin and bear, women were actually being encouraged to relish the labor and birth experience, to trust the way they were designed--for birth! and that less fear actually meant less painful births.
So here we sit, in 2010. We still have a very very long way to go in reclaiming some of the things we have lost along the way. Some must be reclaimed and some things must be claimed for the first time. Even in the recent decades, women were still told that birth was an accident waiting to happen, that it was painful, traumatic and scary and could end in death or severe damage. Some people still feel the same way today. Many people are still spouting these claims as though every birth carries the same amount of risk and therefore "every birth is risky." We are now starting to truly understand that birth can actually be an event that is anticipated, for the experience itself as well as for the end result. Labor and birth don't have to be "endured" but can be exciting challenges that are full of wonder and power. A birthing woman does not have to be tough and grin and bear it, she can actually enjoy labor and birth. Yes, enjoy! It is entirely possible! We are starting to finally grasp today that natural birth isn't about being fearful or distrusting of doctors, hospitals, needles, medical interventions or birth itself. It is about the fact that womens' bodies were designed to give birth, just as they were designed for sex or for breastfeeding or for walking or eating. Unmedicated birth is an extremely doable event and brings tremendous rewards. The "birth high" after a planned and prepared for natural birth is like none other. We also benefit from the availability of modern medicine when we really do need it and the choice to accept or decline. And we have access to education, information and research on pregnancy and birth that did not exist in the years past.
But we women in this generation haven't gotten here on our own. Most of what we know and understand about birth today comes from the millions of caregivers, birthing women and their families who went before us. Of course there is more work to be done and more attitudes to be changed. Please don't forget to whom we owe our gratitude when it comes to the rights we enjoy as we birth our babies today. Women like my mother who, in the midst of the 70's birth wars, began her birthing career (8 babies by the 90's), all naturally, all with my dad at her side advocating for her, all her way, and most of them at home. Women like my mom and even my sisters forged the way through birth in hospitals and at home and helped shape the attitude of physicians and even the general public about pregnancy, labor and birth. We owe these women so much thanks.
Ladies of my generation, please do not forget where we have come from. Natural birth is not new, neither is breastfeeding or gardening or cloth diapering or eating whole foods or making healthy choices for our families. We are not the first or the bravest or the most in tune with birth and our bodies. We women in this generation have privileges that our mothers did not have. We actually do have choices and options in our labors and births. Our mothers did not have those choices. Though we do know more than we did in the decades past, it is not because this generation of women is smarter or more savvy or more forthright about their preferences. It is because of the work that others have done and hardship that others have suffered that we reap the benefits. Instead of thinking we are the pioneers in the arenas of birthing, cloth diapering, etc, let us in humility and gratefulness pay it forward. Let's make things even better for the next generation. Let us take our ability for sacrificial love that we bring to mothering and extend it to families around us and those following us.