Don’t Believe the Hype

This article from The Wall Street Journal provides some great historical information that connects meaningfully with my previous post (Home)Birth is Safe.

The author, Nathaniel Johnson notes that,

In 1923, Mary Breckinridge started the Frontier Nursing Service in rural Appalachia….Within a decade, the astonishing impact of that care was apparent. The women the Frontier Nursing Service cared for, who were desperately poor and usually gave birth at home, were 10 times less likely to die in childbirth than the average American at the time. The nation as a whole wouldn’t catch up until the 1950s, after the widespread acceptance of antiseptic and the discovery of antibiotics.

Given that antiseptic practices and the use of antibiotics are available and in use in midwife-attended home births today, it makes sense that, as Sheila Kitzinger has argued, it is not a high level of medicalization that makes birth safer – it is overall health: access to good pre-conception, prenatal and postpartum healthcare, good quality nutrition, access to clean water and access to skilled birth attendants. This has been borne out the world over, regardless of whether women are typically birthing at home or in hospitals. Access to medical interventions for the few women who actually need them is important, which is why midwives are thoroughly trained to detect possible complications before they become problematic and why they only support home births for women who are not at risk. Obstetricians are trained to deal with problems when they arise, but midwives are far more likely to be able to prevent them in the first place. Continue reading

Sometimes moving forward means taking a step back…

For quite some time now when a woman was nearing the end of her pregnancy and the baby was known to be in a breech position in the womb, her doctor automatically scheduled her for a Caesarean. Even in cases where the woman was seeing a midwife, that breech presentation led to a transfer of care and a scheduled Caesarean. It was believed that, despite the risks of major surgery, a birth via Caesarean was the safer choice for both mom and baby. In many cases, women were able to get their babies to turn – by using acupuncture, chiropractic treatments, moxabustion, pelvic tilts, swimming (complete with headstands in the pool!), visualizations and/or external versioning. Sometimes those stubborn babes would just turn right back around though, frustrating their moms who were hoping to avoid surgery. No one really knows why, but some babies just don’t want to come out head first. Sometimes they’re curled up and their bums present first (frank breech), sometimes their feet are the first thing to emerge (footling breech) and sometimes they lie sideways (transverse breech), but no matter what, if their heads weren’t positioned to come out first, their moms were booked in for surgery. Continue reading

Technological ≠ Scientific

There was a really excellent article by Alice Dreger in The Atlantic that made the rounds a couple of weeks ago. The article, entitled The Most Scientific Birth is Often the Least Technological Birth was rightfully celebrated by birth advocates who believe in evidence-based practice as the best way to improve obstetrical outcomes AND maximize satisfaction for individual women with regards to their birth experiences.

A lot of the time – and not just when it comes to birth, though I will be coming back to that topic (of course) shortly – we have a tendency to see things in terms of conflicting pairs, what semioticians call binary opposition. For example Light//Dark, New//Old, Good//Evil, Presence//Absence, Male//Female, Science//Nature, etc. Contemporary communication theory explores the way that these pairings in language are embroiled in how we see and construct our world (i.e. culture). Essentially, we can only understand ‘good’ in the context of its pairing with ‘evil’ for example, or ‘light’ in terms of its relationship to ‘dark’. Without the opposing term we are unable to define either. Driven by the psychological urge to categorize and order our world, we find comfort and satisfaction in these constructs. Unfortunately, as post-structuralist theory demonstrates, in every pair one of the two terms tends to assume dominance (culturally speaking) over the other. Quite often this privileging is determined by prejudicial assumptions of the larger culture (that is, it is often imbued with values that are tainted by ethnocentric or gender-biased perceptions of reality).

So, how is my nerdy fascination with language and culture connected to birth, you ask? Continue reading