Wiyama ~ Woman's Medicine

A Blast from the Past

Throughout history and up to the early part of the last century women gave birth in their own homes. They were traditionally attended by midwives, grandmothers, mothers and sisters. Many believe that the dawn of modern medicine prompted the change from midwife attended homebirths to physician assisted deliveries, but history shows that the first and most damaging interference with birthing choices was inflicted by the Roman Catholic Church. Women were considered ignorant and superstitious, and easily led into evil as a result. Midwives were required to undertake some religious training and were forced sign an edict promising that they would refrain from witchcraft or magic of any kind during the birth. Many midwives were condemned as witches or heretics for little or no reason at all. Following the advent of universities and formal education of physicians, midwives began to have laws forced upon them first by the religious institution, then by government, then by the ever growing medical establishment, all of which were male exclusive.

When the colonies were founded, midwives still practiced in abundance. However, because of the harsh conditions of the lives of the pioneers, the training of new midwives by the older more seasoned and experienced ones fell by the wayside. As a result midwives weren’t as skilled as they were formerly, and were limited in their abilities and opportunity for training by religious influence. The change brought about a great loss of life in both women and child. Midwives were held accountable even though the likelihood of the problem lie in the health and diet of the mothers. Midwives again became persecuted as witches and evildoers, and sadly many life was lost as a result of religious hysteria.

Later as science and technology advanced further, more and more women were seduced into the medical model of childbirth with promises of shorter and less painful labors, and better fetal outcomes. Truth be told, once midwifery skills improved in the United States, and infectious situations were improved, the infant AND maternal mortality rates were the same if not better in the homebirthing community. The post partum complication rate actually rose in the hospital births, as there were more intervention caused injury, effects and injury due to anesthesia and medication, episiotomy and forceps damage to vaginal tissues, and hospital borne staphylococcus infection which caused the wide spread of what was known as "Child Bed Fever". As the vast amount of side effects caused by chemical intervention became apparent it became necessary for physicians to find interventions to offset the interventions and thus the spiral effect began. The number of women breastfeeding their infants also declined drastically, as the complications arising from the medical intervention left women groggy, drugged and weak, and unable to care for their infants. Infants became the responsibility of nursery staff, and at the same time that the infant mortality rates were improved, the child abuse, neglect and abandonment rates rose.

The medicalization of birth served to forcefully remove the last remaining right that women had, that was to birth with dignity and peace of mind, and if necessary to die with the same. Women were taken from their homes, a warm and loving place they made for themselves and their families, and they were stripped, shaved, starved, cleaned inside and out, medicated and told to submit to the whim and will of a male physician who had often not even seen her before. She then had her most private regions cut, probed and experimented on, and her baby most often ripped from her body via the use of cold metal forceps.

Back to the Future

So one might ask where has all of this gotten us? Lower infant mortality rates? Yes, more babies are born alive and remain alive after birth. The rates themselves would have improved drastically with the fashion, dietary and hygienic changes that occurred in our society naturally. Have we seen better outcomes for the mothers? Statistically yes, more women survive childbirth, but at the expense of their psyche and emotional balance. Many women feel like a minor participant in the event of birth rather than the giver of life, this title has been handed over to the life saving physicians.

Yes birth in the hospital has changed since the days of the knock’em out, drag’em out delivery practices of our mothers, some ways for the better, as in more family oriented birthing approaches and better childbirth education. In some ways the hospital birth experience has changed for the worse. Women who are now politically active and financially contributing members of our society are discouraged from too much education beyond the typical "what to expect from the hospital 101", from listening to their bodies and spirits, from having a mind, and from speaking from their heart. They are still striped of their dignity, forced or manipulated into uncomfortable situations, misinformed or uninformed about medical procedures, and are continually coming away from what should be a joyous experience feeling sad, unfulfilled and often times abused.

What about C-Sections?

One last note before we get on to the feel good portion of this article. The number of babies that are born surgically in this country hovers at an astounding rate of around 25%. That is to say that approximately one woman in four will have a c-section in her birthing years. A woman who has 4 or more children is likely to have at least one of them delivered by cesarean section. Another alarming fact is that the C-section rate in the USA has risen steadily for the last 7 years!  It would appear that childbirth is becoming more complicated or women are becoming unable to give birth.  Is this a realistic idea? Is this necessary? In many cases the complications compromising the health of mother or baby are intervention caused, and in other cases a simple failure to fall within the "normal" ranges or failure to have patience. Every birth and pregnancy are different, and there is seldom such a thing as "normal" or "textbook" where childbirth is concerned. Many of these surgical deliveries are unnecessary, complicated, costly and very damaging to the psyche of the women who have themselves needlessly cut open.





Why Do Women Choose Homebirth?

To some women the idea of giving birth in their won home is normal, natural and very comforting. Many of them have had prior hospital births that were unfulfilling or traumatic. The process of learning about and choosing to give birth at home is one of empowerment. It is about choices, planning and family involvement. It involves ethical, educational and even spiritual searching. It is about giving over to a force as great as life it’s self rather than giving in. It is HUGE.

The possibilities are endless as to where and how you labor, when and how you give birth and whom you have around you. In a homebirth you and your partner decide how involved in the birth each member of the birth team is and exactly what their rolls will be. You have the flexibility to change your mind about any of it if it doesn’t suit you when the time comes. Imagine asking your physician to step aside while you or your partner welcomes the baby into the world.

For some families, homebirth is not just the only logical choice;it is the only choice at all.

Is Homebirth For Everyone?

This is a complicated question; the answer is yes and no. Every woman is entitled to the right to make all the choices and decisions regarding her care and that of her baby, easily and unpressured. Every woman is entitled to the education required to make those choices in confidence. Every woman deserves to birth with dignity and peace of mind. Every family, immediate and extended, has the right to be involved in the birth as deemed appropriate by the birthing parents. Some women however, for whatever reasons are better off seeking the care of a physician who can manage a complicate labor and/or birth. Some women aren’t interested in going through the discomfort and work of labor, or are mystified by the idea of a technologically managed delivery. Some women are afraid. These women are most likely not candidates for homebirths.

Women with complicated conceptions or pregnancies aren’t necessarily ruled out for homebirth. The birthing family and her midwife must make this discernment. If it is determined that a pregnancy is a bit too complicated for the midwifery model of care, have heart. There are options for birthing naturally, peacefully and with dignity in the hospital. Ask your midwife or doula about these options.

In the End

The choice to birth at home or in a more clinical setting is ultimately that of the birthing family. Women should be encouraged to explore their options for birth, educate themselves and surround themselves with people who will be supportive of their decisions. Most communities have homebirth support groups, and other organizations that lend support to a woman’s rights to choices. Explore your feelings, educate yourself, consult supportive professionals who encourage you to do what feels right to you, and have a peaceful birth!

© Jo L. Davis, DEM, PMUS, EMT-B, 2009