I think I have to get this book. It’s called Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank By Randi Hutter Epstein. The author was recently interviewed on “Fresh Air” from NPR and I had a chance today to read the excerpt (linked above) and listen to the interview. Although her bit about Eve was a little too matter of fact for me (did that really happen- the whole rib, and apple thing?) it seems like an interesting and intriguing book worth a read for all interested in birth. We need to know the history because if we don’t know where we’ve been, then we don’t know where we’re going-right?
Apparently, men have been writing the books (literally) on birth since the beginning even though they knew little about it, and were unable to attend childbirth for many hundreds of years or more. Not surprising. Having read many feminist books about the anthropology of birth, this is not news, but just the little she spoke about it in the interview shows that she has done her research. We can see medical involvement in birth evolve before our very eyes!
One point she brings up in the interview is that before the natural birth movement that reached its pinnacle in the 1970’s, women were demanding twilight sleep during birth and it was a feminist stance to demand that they don’t feel a thing during labor. It was their right. In the 1970’s, it became a feminist issue to have a natural birth, on their own terms and be present for it all. And now the pendulum swings……
The conclusion Ms. Hutter Epstein comes to is this: The issue is not pain medication or no pain medication. For decades, perhaps even millenia (I need to read the book) certain women have been dissatisfied with their doctor patient relationships and have demanded the opposite of what has been proposed to them thus creating a gradual swing in cultural thought around labor and birth. (See? My point all along. If women have power nowhere else, they can have it during birth.)
This is why it’s important in this day and age that midwives, nurse-midwives and doctors all be able to practice within their scope of practice, without restrictions and threats of legislation against one another. There are birthing women for every type of birthing practice and there should be truth and transparency about all the different approaches so women can make informed decisions about how they would like to (ideally) birth. Institutions build on a patriarchal platform like the AMA (and dare I say the ACNM) are fighting for more than their piece of the pie by putting down the ‘less educated’ practitioners. I think the evidence is pretty clear. Outcomes are nearly the same, and if anything, the medicalized ‘safe’ birth by ‘the most educated’ is in fact the least safe.
Assisting birth is learned best hands-on. It is a natural process that sometimes requires intervention which may or may not require classroom education. These organizations are missing the point, even after all these years. Women want choice. Some want an epidural after their first contraction. Some want a c-section on a certain date without ever going in to labor. Some want a natural hospital birth, some want a home birth- and everything in between. Many do not get what they want, but it should only be due to the circumstances of their particular birth situation, not because of lack of choice.
Perhaps Ms. Hutter Epstein’s book will open up a dialogue. Birthing women have been through countless atrocities and lack of power or choice at the hands of the medical profession and their interventions with birth. Medicine has also done great things and saved many women’s lives. Still, the maternal mortality rate is not what it should be, and we still need to be looking at why and try not to repeat mistakes made in the past, and identify mistakes we are making in the present. We need to be constantly and vigilantly looking at what works, and what doesn’t and grow and change and put our egos aside, our degrees in a drawer, and come to the table together to give birthing women the best possible care based on a combination of evidence of what works and what kind of birth they want.