Medicalization of Childbirth

Over the past 100 years, birth in the United States has changed drastically. Some argue that birthing today is better than ever because we are taking advantage of technological advances to make birth safer for women and babies. However, we must also examine and recognize the affect that these changes have on women and their birth experiences. Is our “improved” way of birthing really a change for the better? Feminist theory explores the many existing challenges American women face when they birth in the United States.

In the 1700s, 1800s and early 1900s, women all over the world gave birth at home. Although it was not exactly their choice to do so, women gave birth in their own homes, barns, sheds, and even on street corners with friends and family by their sides. One midwife, Martha Ballard, kept records of her experiences while attending births. She noted that of 814 births she attended from 1785 to 1812, no mothers died during childbirth, only 5 died in days after birth, 14 babies were stillborns, and 5 babies died shortly after birth (Chase & Rogers) This may seem like too many deaths but we must take into consideration the high likelihood of this midwife’s lack of medical training, and access to technology and equipment.

In the early 1900s, male doctors suddenly became a part of the womanly process of giving birth. It was seen as an improvement in one area of birth, as doctors provided a “safer” environment if anything were to go wrong. Along with this came the struggle for women to birth in their own ways, the ways they had been for so many years. The power was swiftly shifted from women to men.

One example of this power shift is birthing positions. For hundreds of years, women had birthed in any way they were comfortable, including squatting, sitting, laying, standing, and even on their hands and knees. As soon as men entered the delivery room, women were told to lay flat on their backs with their legs up and open. The flat on the back position of giving birth became standard. Women were ultimately brainwashed into thinking that this was the best and only way to birth. This new standard birth position often caused more pain for women and led to slower progression of the baby down the birth canal.

By the 1940’s hospitals became the hot spot for childbirth. Half of all births took place in a hospital because taking advantage of a clean, safe facility filled with doctors seemed like the most logical thing to do. However, often times, the doctors who were in charge of caring for laboring women were unfamiliar with the normalcy of live birth as they had little or no hands on experience taking care of women in labor and delivering babies. This resulted in very poor care for laboring women. By 1960, the hospital birth rate was almost 100%.

One major problem with this drastic shift from homebirth to hospital birth was the weeding out of midwives. In many other countries, when birth moved into the hospital, with the women went the midwives. However, this did not happen in the United States. Many doctors did not support the attendance of midwives at birth as it was often seen as unnecessary seeing as the doctor would be available when needed. To understand the problem with this, one must recognize the major difference in care provided by the two.

Lay midwives were women who attended birth to oversee the progression of the laboring woman and her baby. Although these women were not trained properly, medically speaking, they had perfected the effective ways to comfort a women giving birth by witnessing many births and hands on experience. A person who properly comforts a woman during labor and delivery can make all the difference in the outcome of a birth experience. This is what was lost when hospitals and male physicians became the main place and method of delivery.

Another result of medicalized birth is a high rate of intervention, which often times leads to more intervention and is usually unnecessary in the first place. Interventions such as twilight sleep (in the early 1900s), inductions, episiotomies and cesarean sections (C-sections) are some of the common happenings at hospitals. Normal, natural and usually perfectly healthy events such as slow progression of labor and trouble pushing the baby through the vagina are excuses frequently used by doctors to step in and intervene.

Many women in the 60s, 70s, and 80s lived through traumatizing events during their births. One woman shared her birth experience from 1972, “Upon arrival, I was taken to a small, barren room to be “prepped,” meaning my pubic hair was shaved and I was given an enema. I didn’t get a vote in this process; it was standard procedure for al laboring women…from this moment forward, I couldn’t leave the bed, sit, stand, roll over, or leave the room” (Seelhoff, 42). This type of practice is an example of birthing protocol in many hospitals during this time.

In the 1970s, after too many women went through experiences similar or equivalent to the latter, they joined forces and initiated the Women’s Health Movement and the Natural Childbirth Movement. Women began to take control of their bodies, and their births. Homebirth and midwives made a come back and birthing centers were established as an alternative to hospitals and provided a safe, comfortable, homelike place for women to give birth. Women attended each other’s births to provide emotional support and physical comfort for one another.

While a small percentage supported the Natural Childbirth Movement, the majority women stayed where they thought they belonged, in the hospital. The C-section rate was climbing and the quality of care of declining. By 1990, the C-section rate was 23.5% and many of these were elective. Many people began to see the C-section option as a safe alternative to going through the pains of childbirth. What many people did not realize was the amount of risks associated with an elective C-section, such as infection, injury to mother’s internal organs, heavy blood loss, a painful recovery and the recurrence of C-section. These risks are often hidden or kept “hush hush” to keep up the façade that hospitals and doctors are the safest best.

Today, we see the vast majority of women in America give birth in a hospital. Less than 1% of women give birth at home, and midwives attend only 8% of births. Feminist views of birth in the United States include the theory that birth has become medicalized and is illogically seen as risky. Within this theory is idea that women have lost control of power when it comes to giving birth since male doctors began attending birth in the early 1900s. Birth can be a natural, beautiful process if we let it be. Unfortunately for our women and babies, today this is not the norm.

Media is also very fond of portraying birth as a dangerous process, one that needs to be handled by doctors, and doctors only. We often see dramatic births on TV in shows like ER, and Grey’s Anatomy. This gives us a distorted view of the way birth really is. Another problem is the celebrity trends regarding birth. Many celebrity icons including Britney Spears, Angelina Jolie and Madonna have given birth via elective C-section and are very publicly honest about it. This has created the false thinking that an elective C-section is the best, safest, and pain free way to go. This is a major problem because it means more women surrendering power to their doctors and not taking initiative to make informed decisions about their births.

Many people believe there are no choices about giving birth. We have seen a lack of education among the American people about the benefits of using a midwife and/or having a homebirth. We do, however, see the hospital birth represented as the best way for every woman to give birth. Although many people do not know this, today midwives are medically trained to handle most instances in which something has gone wrong in the birthing process or with the baby or mother. The rare cases when something occurs that a midwife cannot handle are few and far between. When this does occur, midwives have a back up hospital and doctor available and can transfer the woman to ensure she has the best medical care.

The unfortunate truth is that birth in the United States has become extremely medicalized. We must see that it is very important for women to have the information that allows them to make the choices for how they want to give birth. It is a right that every woman deserves and through educational support, we can work toward providing these empowering choices for women in the United States.