#FirstWorldproblems, reads the hashtag after a severe comment left by a man on a blog post. The post was an intimate piece about how the writer's birth experience had left her traumatised for years and post-natally depressed. I read her honest, open words with empathy, and I couldn't help but marvel at the man's callousness.
First World problems.
In a way, he is right. In the most powerful country in the world, the U.S., women are the least empowered during childbirth. Despite the U.S. government spending the most money on highly medicalised care, a labouring woman is more likely to die during childbirth in America than in any other developed country in the world, including some underdeveloped countries, for example Albania.
Part of the problem is due to a wide disparity between the conditions that science shows are optimal for childbirth, and what the Western medical profession advocates. Many traditional birthing methods have actually been found to be less risky for the birthing mother, such as delivering the baby while squatting, avoiding regular internal examinations, and avoiding continuous monitoring of the baby's heartbeat during labour, but as of yet the science has not filtered down to the hospital setting, and women are often advised to do the opposite of what would actually be safest and best for them.
While medicine has its place in treating the few women and babies who really do need the additional care and intervention in order to thrive, mostly it causes problems for the labouring women who would otherwise be fine without it. Today, childbirth is viewed and treated as a medical procedure that carries dangerous risks with it. Historically, women were supported by a midwife throughout pregnancy and labour, but in hospitals today this consistent support has become the exception rather than the norm. Continuous care in and post-Biblical times is believed to have led to healthier mothers and babies, but in the early 20th century doctors began to challenge traditional midwifery, claiming that modern medical procedures and techniques were better than the traditional folk medicine practiced by midwives. Slowly the art of midwifery was medicalised and taken over by surgeons and doctors, and the knowledge and experience that midwives passed down to new generations of women has been lost today as midwives struggle to tick boxes that have been set for them, juggle paperwork and follow protocols, and answer to senior doctors - who do not attend births, but look at the notes that follow them - instead of focusing on providing care.
At the intentional community The Farm Midwifery Center in the U.S., co-founder and long-term midwife Ina May Gaskin has successfully been delivering babies in a home-like environment with a minimum intervention rate since the 1970s. Women travel from all over the world to give birth on The Farm, because the studies and statistics of the Centre speak for themselves. The C-section rate at The Farm is less than 2%, compared to the U.S. national average of 32.8%in 2012, and the current rate of 25% in the U.K. Infant mortality and maternal death rates at The Farm are 0%.
Research released by the British Medical Journal this year found that planned home births are less risky than planned hospital births, particularly for second-time mothers. The study found the risk of severe complications to be one in 1,000 for home births and 2.3 in 1,000 for hospital births, and was based in The Netherlands where home births account for around 20% of all births. Less than 2.4% of births are planned at home in the U.K. An Oxford study also found that planned home births and births at midwife-led units are more cost effective than hospital births. Since the statistics are in favour of home birth, why are the rates so low in the U.K, and why do so few midwives support them?
Women's needs in childbirth haven't changed over the centuries, and a growing awareness of the current lack of emotional support and care for pregnant women explains the rise in the use of independent doulas in recent years, as doula presence has been shown to significantly lower the risks for a woman in labour. Without this care in the hospital setting, women are easily disempowered because their instincts are not respected, trusted or understood. The wisdom of our ancestors, the way they birthed and nurtured pre- and post-natal women, is sorely missing from the ward today.
The language of birth today speaks for itself - we are told that midwives 'deliver' the baby, not the mother or the mother's body, which is so perfectly designed for just this task. The female body, which knows when and how to expel the baby at exactly the right time, is told that it is not on time - it is 'early' or 'late' according to the estimated due date, even though only 4% of women actually deliver on their EDD.
Then there is the closed-minded Western view of childbirth that prevents meaningful dialogue about these changes - so recent in the history of humankind - from taking place. As with any form of trauma, women who have had difficult births due to their environment and the people surrounding them need to be able to offer essential feedback so that the system can adapt and change to suit pregnant women's needs. 'First World problems', people quip meanly, as if birth trauma is the price a woman must pay for having a healthy baby, as if babies would not survive without all the interventions. Instead of valuing and responding to women's experiences, women are told to shut up and put up with it.
Over-reliance on medical practices and procedures worldwide has stolen childbirth from women. The very research that was developed to reduce physical problems for women during childbirth is leading to more interventions and complications than ever before, and untold mental pains, which are carried forward through generations of traumatically-birthed babies. As the example of The Farm and the home birth statistics demonstrate, birth does not have to be like this. Childbirth can be empowering for women, a source of strength upon entry to new motherhood, a rite of passage. In a few undisturbed cultures around the world, it still is.
But not in this one.
First World problems, indeed.