In the early hours of this morning I enjoyed the privilege of assisting my friend M giving birth to her fourth baby, a girl and her first daughter. It all happened on her living room floor in front of a glowing wood-burner. It was a fantastic experience for me to witness (for the second time) how wonderful childbirth can be if it is managed as a natural rather than a medical procedure. Anybody who has watched the Channel 4 documentary series ‘One Born Every Minute’ or has experienced childbirth in hospital will know that medicalisation of childbirth has gone too far. Before the 1700s childbirth was customarily a domestic event, attended by female friends, relatives and local women experienced in delivering children. It still is for much of the world. Say this to most people and they will argue that maternal mortality was much higher then too. But today in a country with good sanitation, ‘…with very few exceptions, technology has no place in childbirth’
But male obstetricians have other ideas and began defining ‘normal’ standards for childbirth as the 20th century progressed. This was in keeping with drives for standardisation in the wider medical world. Deviations from normality were seen as reasons for medical intervention, and childbirth became an ideal sequence of events to be monitored and managed. The best place to monitor and manage these events is in a hospital and it is now normal and indeed recommended and expected that women will have their babies in hospital. The trouble is that a hospital birth is much more likely to include interventions. A recent report from the World Health Organisation showed that in China there was a direct correlation between increased institutionalised birth settings and an increase in caesarean birth to levels well above their recommended rates.
In hospital there seems to be an eagerness to get the baby; there is always an eye on the clock and if it is deemed that labour is not progressing, a piece of equipment will usually appear. The cardiotocograph which measures the maternal and foetal heartbeat has been popular since the 1970s. Being attached to this machine means the labouring mum has to be flat on her back on the bed with two belts over her stomach which are attached to the machine. This is obviously not a good position in which to labour and unsurprisingly many research findings have been produced which state that CTG confers little or no benefit for women and babies who are low risk, and actually increases operative interventions with their own inherent risks. It seems almost routine now that breech presented babies or multiple births will be born by planned Caesarean section even when this may not be necessary. But because mums often put themselves in the hands of the medical profession, this is what happens and midwives lose their skills and confidence in delivering a baby in any situation not considered the norm. Mums too lose confidence in their own body’s ability to give birth; young mums in my ante-natal classes were already afraid of labour pain and planning their epidurals. Having just watched a 44 year old breathe out her baby with no pain-relief or intervention of any kind, it seems such a shame that in the UK less than 2% of women choose to have their baby at home.