In order to understand how we’ve arrived at the state of maternity care today, it’s important learn a bit about birth history.
In the U.S. in 1900 less than 5% of births took place in hospitals, yet the shift was already in place to make birth a medical condition rather than a physiological process. By 1900 nearly half of the nation’s births were attended by physicians, and only the poor continued to have care provided by midwives.
By 1915, “twilight sleep” was being used as a means to manage labor. Twilight sleep was characterized by large doses of narcotics for pain relief, and scopolomine, an amnesiac. The results of twilight sleep were insidious. Women were socially isolated upon admittance to the hospital; heavily drugged, women were strapped down to the beds in order to keep from hurting themselves as they thrashed around uncontrollably during labor.
Around that same time, a prominent obstetrician named Dr. Joseph DeLee began discussing birth as a “pathological” process. He viewed birth about as “normal” as a mother “falling on a pitchfork,” and was a staunch proponent of the eradication of the midwifery profession, and of the hospitalization and sedation of all laboring women. He advocated for twilight sleep and forceps delivery. As a result, a study of births between 1915 and 1929 confirmed a drastic increase – 41% – in infant mortality due to birth injuries resulting from obstetrical interference with birth. (White House Conference on Child Health and Protection 1933.)
Take a listen to the following accounts of these types of births.
Her account is from the 1960’s, and so you can see how long these types of experiences held on in this country. And did you catch “The Husband Stitch?” Not only were women stripped of all autonomy, power, and dignity during birth, the objectification persisted in the mutilation of their bodies for the pleasure and satisfaction of men. Women were reduced, effectively, to machines and playthings to be strictly monitored, repaired and enhanced along the assembly line.
Now check out a black woman’s experience in the same hospital:
We’ve come a long way from the era of of knock-’em-out-drag-’em-out births, but we still have a long way to go. Today more than 60% of women receive epidural anesthesia in labor; only a scant 1% of women are birthing at home; and the U.S. still stands near the bottom of the list of infant mortality rates when compared to other industrialized countries. (See my prior post on infant mortality here.) The fact is, women still rarely have autonomy and power as a rule in birth. And the majority of women harbor heaps of anxiety as they approach labor and birth – a result of more than a century’s worth of paternalistic practices eroding a woman’s confidence in her body’s ability to give birth.
Let me tell you a well-kept secret: Women are not only capable, but are at their most powerful when they innately birth their babies.
A strong and systematic misogynistic movement stole a precious commodity from women at a time when women had very few rights and little respect. But I’ll tell you that there is presently an equally strong uprising of women who are fed up with the limitations placed on them inside of institutionalized birth. And it will be women who will make the long overdue reclamation of birth.
“Well-behaved women seldom make history.”
– Laurel Thatcher Ulrich
You might also enjoy my follow-up article on culture’s influence on birth here.