Monday, August 30, 2010

History of Birth in America

I thought that I would share with all of you my paper that I wrote for my monitrice/midwife's assistant certification course. My assignment was to read Witches, Midwives & Nurses: A History of Women Healers by Barbara Ehrenreich & Deirdre English and write a paper on a particular point of interest. I have always been fascinated with the events that led to the establishment of the American maternity medical system, so I took this opportunity to research the history of birth more thoroughly and organize my thoughts into this paper. If this topic also interests you, I would love to hear your feedback!

Reading Witches, Midwives & Nurses peaked my curiosity about how our modern American maternity system was established, comparative to more humanistic models in other parts of the world. What happened to our culture that enabled the development of the majority of births being “produced” in a hospital setting under the primary care of obstetricians? To explore this question further, I read three other books: Lying-In: A History of Childbirth in America by Richard W. & Dorothy C. Wertz, Brought to Bed: Child-bearing in America, 1750-1950by Judith Walzer Leavitt, and Birth as an American Rite of Passage by Robbie Davis-Floyd. I came to realize that there were multiple cultural, political and scientific threads that converged from the middle of the nineteenth century through the twentieth century, facilitating the development of America’s modern maternity system.

What were the cultural events and beliefs that fueled this system and enabled it to become institutionalized into our culture?

  • The American culture was based on the Protestant idea of man’s power over nature. This also led to an acceptance of man-made science dealing with the powerful natural experiences and replacing the ancient wisdom and magic of pregnancy and birth. This entire transformation of pregnancy and birth needed to be culturally controlled and standard obstetrical procedures filled this need for society.
  • The strong definition of sex roles at the turn of the century reinforced a male dominated culture when mostly men were becoming doctors.
  • The feminist movement focused on women becoming doctors instead of the right of humanistic care for women.
  • Americans became more mobile, which led to women leaving their support networks and this left doctors to fill the gap. The mobility of society also broke up the networks that supported midwifery. This lack of support enabled the doctors to easily make women feel fearful that they were weak and susceptible to disease and eager for their aid.
  • Strong American class distinctions allowed for the upper & middle class to feel as if they were getting better care through the new specialized doctor that used technology. There was a belief that doctors made birth “less dreadful.” This left the lower classes to still receive midwifery care and as a whole midwifery care started to be looked down upon. Multiple women’s magazines, groups and advocates of women’s health supported and advertised this new and improved specialty.
  • During the nineteenth century, ailments became fashionable in the upper class. Women at this time were expected to be weaker than men. Both of these fueled the new idea that a pregnant woman was sick and needed to be managed by a male doctor.
  • This new “American” way to have a baby fueled the desire for second generation immigrant families to Americanize themselves by going to an obstetrician and having their baby in the hospital.
  • During and after the industrial revolution, the idea of going to the hospital to be “processed” in a factory was the new way to produce things. Also, the machine is now replacing the organism as the way the world is organized, and this created an idea of our bodies working as a machine that can essentially be controlled. Culturally there was a distancing taking place from birth being a human experience and women becoming passively dependent on medicine. This was also the time where the power of the institution over the individual was being developed.
  • Women began to want a break from their “confinement” of pregnancy and the hospital took them away from their dreaded housework and obligations.
  • During this time women’s identification as a woman and mother was taken away which erased the woman’s power over the process and obliterated their own birthing traditions.
  • These choices from generations past declared the choices for each subsequent generation. Women’s choice to have more doctors made less midwives; their choice to have more hospitals meant less home births. Now multiple generations later, the choices of childbirth are limited.

What were the political events surrounding the development of our modern maternity system?

  • Once created, the medical profession grew rapidly, making doctors more accessible.
  • The development of the nursing profession created more nurses than midwives. This fit with the cultural establishment of the hierarchy within a medical establishment and fueled the patriarchy of American society.
  • The feminist movement focused on integrating women into a male dominated profession rather than attacking the male dominated medical profession.
  • The establishment of medical schools and certifying doctors forced midwives to legitimize their knowledge while possibly losing the essence of being a wise woman.
  • Corporate patronage and support of the new, larger medical schools eliminated the smaller midwifery schools for women and minorities.
  • Doctors were not being trained alongside midwives which created a loss of shared knowledge and competition between the two.
  • Centralizing care and institutionalizing medicine brought doctors power and prestige.
  • The rise in lawsuits and malpractice insurance became deterrents against physicians to humanize and personalize American medicine. This led to the establishment of standardization in the maternity system.

What were the scientific developments that stimulated the American maternity system we have today?

  • The lure of technology, which began with the development of forceps, was strong in a society where technology was a sign of progress.
  • The discovery of bacteria and the Germ Theory created a mystique of medical science. Since the knowledge was coveted by the medical profession, they gained the superior knowledge that women no longer owned.
  • Modern science allowed society to grow rapidly alongside the medical profession.
  • The development and use of pain relieving medicines created the lure of a pain free birth that you could only get in the hospital with a physician in attendance.
  • The fear of puerperal fever, syphilis, gonorrhea, and other transmittable diseases created the “cleansing” of women in the hospital and the inherent idea that women are diseased and need doctors to cleanse and manage them.
  • The development of automobiles enabled rural women to receive urban hospital care.
  • As doctors learned about scientific causes of ailments, they started to lose interest in the behavioral and environmental causes of diseases and birth traumas. This was the start of practitioners treating the disease instead of counseling the woman.
  • The discovery of the Germ Theory also created a frenzy of cleanliness around the home and birth was viewed as dirty, so going to the sterile hospital was appealing.
  • Stemming from Greek Aristotelian traditions, the male body became the prototype of a perfect machine, while the female was defective and needed to be manipulated by man. This also fit well into the Protestant belief of woman being less than man.

The convergence of these culture, political and scientific beliefs and events have brought us to the system that is in place today. It is unfortunate that we are now bound by a dehumanizing maternity system. I am hopeful that midwives will continue to pass down the sacred wise woman knowledge of birth and that we will all educate women and let them demand to be cared for in a humane and safe way, making access to midwifery care a human right among all classes.

Thursday, August 19, 2010

Want a Personal Fairy?

Some of my posts have been really deep lately, so I thought I would lighten it up a little bit! The following is a post that MODG posted on her blog: Thanks, MODG, for officially declaring that myself and all of my doula sisters are now officially FAIRIES!

The hippies know something that the rest of us don’t. Well since I am falling somewhere in between hippie and gossip girl, I’m going to ruin the hippie code and tell you what they have going on. I hope they don’t kick me out of the club. I was pretty close when I wore the 4 inch heels to see the midwife last week. She was having NONE of that.

Ok, hippie secret. So they figured out a way to do something that I have been trying to find a way to do my whole life. And not only are they doing it, they got their husbands on board to pay for it.


So here’s how they did it. They were like, you know what? My husband is a lame tard and I don’t trust him at all to do the stuff I need when I give birth and I may squeeze his head off with the forceps. I am going to hire a personal assistant who does whatever I say and who is a baby birth expert and I’m going to call it something hippie sounding like “Doula” so they get confused and just go along with it.


You hire a doula when you get preg and they are there for you throughout the whole pregnancy with secret tips and tricks to make you feel better and will give you massages and will bring you secret herbs from their magic gardens and are basically birth geniuses. And they work for YOU, not the hospital, not your husband. So they do what you say.

So you best believe I jumped on that shit immediately. B was pretty much on board because he faints if the tampon doesn’t flush in the toilet. So he can play brickbreaker on his blackberry while me and the doula work it all out.

MODG, eat this flower and your baby will float delicately out of your vagina. OK fairy whatever you say.

Here was my criteria in hiring a doula:

1) She has to be pretty but not prettier than me.

2) She has to have a lot of secret magic. Like stuff that I don’t know about involving aromatherapy, herbs, spells and ESPECIALLY know how to make my vagina stay in one piece when I deliver this 23lb baby.

3) She has to think I’m funny.

4) She has to have really long hippie hair.

And would you believe that I found her? I did. I did. I DID. And not only does she meet all of my criteria, I THINK that she may be a fairy (!!!!) I know. She is tinier than me with super white skin and looong black hair and wore a little blue fairy dress. In our interview I was like, Fairy…do you have secret tricks and can you please detail them for me? She’s like, yes I do but I can’t tell you now. SUPER SECRET TRICKS!!! Obviously she was hired.

So my fairy has already been at my beck and call via email. I’m betting she regrets this arrangement already. And when Plankton wants to show his hairy face, she’ll come to my house and then follow me to the birth center and make sure everyone does what I want when I want, like a good personal fairy assistant. She also comes for a few visits to our house to do secret stuff.

Also she is a birth photographer as a bonus. I’m going to have a strict no pink parts policy. But I do enjoy a photo shoot. And I KNOW you’ll on be on me for pictures like the second Plankton pops out with his laptop in hand.

So, my recommendation ladies is if you EVER have the chance to hire a personal assistant/fairy, DO IT. Pregnant or not. Husbands are easy to convince of this stuff.

If you have detailed doula questions, I recommend asking my virtual doula Zdub. She would be my actual doula if she didn’t live in Colorado. But she scores 300 hippie points for living there.

Monday, August 9, 2010

A New Hope

First of all, I want to say "thank you" to Sarah and Sally for the positive feedback and getting me motivated to post again :) I have so many birthing thoughts swirling around in my head that I want to share, so I will start with the most positive...

I have started studying for my midwife's assistant/monitrice certification through Birth Arts International, and my first assignment is studying the history of midwives and birth assistants. I LOVE IT!! First of all, I have a great excuse to get more books and read for hours on end, but mostly I love learning how our present birthing society was created. The hopeful part is that we haven't been entrenched in this highly medical model of care for very long and now there are some really strong signs that our birthing culture is waking up and noticing that there may be a better way for women to give birth and for babies to come into this world.

Let's all applaud ACOG for declaring that VBACs should be an option for women and celebrate the fall in circumcision rates to 33%!! Hopefully, this is just the beginning. I am imagining an ideal birthing culture in the next 100 years where women have a choice in where and who attends her birth and midwives and doctors will all be working together to provide optimum care for pregnant mamas.

In order for this to happen (& preferably sooner), we all need to educate ourselves on the facts of our birthing culture and how it can be improved and, most importantly, TALK ABOUT IT & SPREAD THE WORD!! There is no need for our sisters and babies to struggle through a time that should be so beautiful!

Here are the books that I am reading:
Witches, Midwives & Nurses by Barbara Ehrenreich & Deirdre English
Lying-In: A History of Childbirth in America by Richard W. Wertz & Dorothy C. Wertz
Birth as an American Rite of Passage by Robbie E. Davis-Floyd