What better entry into the world than the loving sanctuary of one’s family home? The medicalization of birth in the US may account for its alarmingly high infant and maternal mortality rates––so let’s take a closer look when evaluating which environment poses the bigger risk.
**NOTE TO VIEWER/LISTENER: Anne read from a few online articles she had printed out right before their chat, but the print outs didn’t display a few things properly, and she guessed at source and date of a couple. The piece she thought was from Harvard Medical Review was actually from Harvard Business Review (link below), and the NPR piece on the Johns Hopkins study was from May 2016 (link below as well.)
We’ve included a few additional links as well, in order to help anyone get started in doing their own research about the risks and benefits of natural home birth vs medicalized hospital births. The transcript to the video can be found below the links:
New Studies Confirm Safety of Home Birth With Midwives in the U.S.
To lower maternal and infant mortality rates, we need more midwives
American Babies Are Less Likely to Survive Their First Year Than Babies in Other Rich Countries
The Rising U.S. Maternal Mortality Rate Demands Action from Employers
Medical Errors Are No. 3 Cause Of U.S Deaths, Researchers Say
Anne: 00:01 Hey Thea.
Thea: 00:02 Hey there, Anne.
Anne: 00:05 So we decided we want to talk about home birth this episode, and it follows on a friend is coming up to having her third child and has decided to do a home birth. And we were talking about it, and given that you had all of your boys at home, your healthy boys at home, and I had both my kids at home, and our mother had our youngest at home, we have some experience with that and thought it related to a lot of the other discussions we’ve had about empowerment, authority, autonomy, self responsibility and more. (That’s A loud, long train horn!)
Thea: 01:09 You know, it all depends on the personality, I think, of the train driver. They vary. Sometimes it’s like “HONNNNNK!”
Anne: 01:19 And what kind of day they’re having! So, just to start out with a couple of thoughts, and we’ll go from there. A lot of times I’ll be in a group of women or be talking to women about birth, and having had a home birth, and those that haven’t had that experience will often say, “Oh, how brave. You’re so brave.” (Wow. That guy is really agro!) So yeah, they’ll say, “Oh, you’re so brave.” And I always say, “No trust me, I think you’re the brave one.” The women who manage to have uncomplicated births without intervention, according to the plan that they had set forth when they came into the hospital––I can’t really even imagine having that experience. How much harder you would be to have had you know, as gentle a birth as birth can be.
Thea: 02:30 Right? Yeah. I mean, as birth is this place of absolutely power and vulnerability at the same time, and to be in a situation that you aren’t even really comfortable or quite relaxed. I can’t even fathom.
Anne: 02:52 I mean, any woman who’s gone through this knows––you’re in a different state of mind.
Thea: 03:01 If you’re allowed to be. And I wonder about that too. I mean, I think, I don’t know, I haven’t done it in the hospital. And I wonder if women who have given birth in hospitals have had varying experiences of being in that altered state. Or not.
Anne: 03:18 Or if they have to always kind of be on in order to say no or to watch what’s going on––I mean, just alone, so, you know obviously complications can happen in any situation, right? But first off most midwives are incredibly experienced at delivering babies, actually delivering them, not C-sections, but actually delivering them. And delivering them in a number of different circumstances. I mean, my son for example, the cord was wrapped around his head as happens In think in like a quarter of births. Right? My midwife who delivered our daughter, helped me deliver our daughter, she worked in the back countries of Amish land, right? She delivered twins, she delivered breech babies. She could do anything, you know? And it was wonderful to be in the hands of someone so beautifully experienced, no matter what came up. And of course, midwives, they bring the oxygen, they have a lot of things at their disposal right here at the house. And they have relationships with doctors at hospitals so that if you need to transfer, you can go there. But. Provided it goes just the normal course, you’re in your own home, you’re in your own bed or bathtub or whatever you choose. You are able to go at your own pace. You don’t have to speed it up or, or either say no constantly to Pitocin or finally accept taking Pitocin to stimulate your contractions in order to get things moving because the hospital won’t allow you to be there for longer than a couple of days, et cetera. Right? So many things. And on top of it, you don’t have to worry about people coming and checking, taking blood, all the things, who knows. I mean, I have no idea what it’s like ’cause I’ve not done it except for having watched documentaries on the difference between those types of births. But you know, you don’t need to be hooked up to machines. You don’t have the constant intrusion of people coming in and out. And more. So it just facilitates the birth experience happening healthily and smoothly.
Thea: 05:53 It does. As so many pieces of literature about the space of birth liken it to love making in a way, too. Because anything that requires a space of settling in, relaxing, letting down, opening up––t’s a very intimate experience. And picturing love making in the hospital, they don’t go so well together, you know. So I think that’s one picture. And another thing that was sparking in my mind while you were laying out those examples is––being a midwife, which is “with woman”, is “with them, is much like being a parent, knowing when to intervene and when to stay back and allow the process to simply occur. And you’re frankly allowing that space to be there. We’re doing that as parents for our children. Sometimes failing, sometimes being right on point. We’re doing that as teachers. Anything that is a guiding post requires that ability to know when to intervene and when to sit back to let the wisdom of the process have its place. And that’s what gets lost in the hospital, right? Because since we have all these things to check, we do. So that’s one part.
Anne: 07:31 Agreed. I remember even as a child being able to hold my youngest sister in my arms before she was even, you know, washed off and like insisting on that. I remember insisting that I wanted to. And mom was on the bean bag in our family room. It was an extraordinarily different experience than she had had with her previous three births with me and our other sister, she had had them in one hospital and had just pretty bad experiences being forced to inducebeing kept away from her child at length and more. I remember then with you, she tried a different hospital hoping that would be better. Not at all. And finally went to the next obvious choice, which was not even legal in the state at the time.
Thea: 08:39 I don’t know if it is yet. It wasn’t even 20 years ago.
Anne: 08:42 Right, where we grew up. Right. So I guess what I’d like to do, I think you had articulated this, maybe you want to say it again about just inverting…
Thea: 08:55 Well I’ve had those conversations with people too who’ve said how courageous to do it at home and my feeling quite the same as you. That, “No.” And then I was thinking that it’s really about taking that image, that picture of what birth is and it’s become inverted. It’s slipped through the wormhole to the other side, you know, the images of what’s courageous, and what’s comforting and safe, you know? And I think that there’s a lot of movement of that, at least in the communities that we live in, of people recognizing that birth needs to be re looked at to be redone, to be safe. And to be non medicalized to give families the best start. You know, I think one of the big parts of it being so medicalized is that it seems to create distance when there should be connection right off the bat, you know? And it’s hard enough. I mean, that’s the part that boggles my mind. It’s hard enough, just the actual physical laboring of it. And then really the weeks after of the care, I mean, it’s amazing what we do.
Anne: 10:24 Well, it’s, I mean, let’s go further. It’s not just, yes, the actual physical laboring, but I’ve never experienced anything like it. Right? And having done it we all, most women I think would agree you get to a point and I guess that that’s around transition, but you get to a point where you cannot imagine going further. It is unbearable. Right? And it’s hard to describe. It’s not a pain like, like a wound. It’s the most unpleasant discomfort I’ve ever had. That goes beyond pain, but it’s not sharp pain.
Thea: 11:21 I would even call it more, I mean, I know we all have our different colorings of it and I think that that’s such an interesting idea we’ve talked about even in another conversation––about what we identify as pain and how we articulate it and how we hold it in our understanding. But it’s more like “unbelievable.” It’s going to a space that is unbelievable. And there is required a complete surrender into what is unbelievable.
Anne: 11:54 Yes, yes. And a courage, I mean, and I, I remember…
Thea: 12:02 Your first birth? I remember it, too.
Anne: 12:04 Well, the first birth you remember because, and I’ll say to the viewer, this is after Thea’s third birth, third home birth, and she has her youngest in a sling having been born seven weeks before. And she’s there in my little apartment, you know, helping me along. And me in my heady way and crazy trippy way that birth sends you into not realizing that I was as close as I was, just somehow thinking that it was just getting, I was just getting more, more pathetically weak and unable to, to deal with it. And I remember you just marveling that I was still talking about it instead of just going into myself. Right? And then the second time Thea got there 15 minutes after the delivery of my daughter. And I remember at the point where my midwife was saying she’s, because of course the midwives arethey’re checking all the time. They’re monitoring the heart rate of the baby, yours, everything. Right? And intimately, and frequently. They’re right there. And she said, “Okay, you know, if they don’t come out,”––we weren’t sure, boy or girl––”they don’t come out in the next one or doesn’t start coming out, we’re going to have you change your position.” And in that moment, and she told me why, because her heart rate was, not coming up as quickly as it should. And I remember thinking, “Okay,” and all I could think of was that scene from Braveheart where Mel Gibson’s character’s be being disemboweled and he shouts “Freedom!” And I think to myself, because it’s based on a true story, I thought to myself, “If somebody could do that and shout ‘Freedom!”, I can do this and I can get her out.” And I did. Right? So it’s like we all go through all these different processes. (Laughter).
Thea: 14:25 (Laughter) Wow!
Anne: 14:25 But doing that, or as we were talking about earlier knowing very deep down that something has to be.You’re in touch with what’s going on there with your child. And I’ve heard so many stories from so many women who have said, whether it’s the doctor or the midwife or anybody saying no, you know, you’re not far, or you’ve still got a while…And the woman is just like, “No, I know they need to come out, and not only do they need to come out, I need to transfer because they need to come out now.” And the mother gets in touch with an instinct in her that she’s never had before. That that puts her authority over her child above all else. And in home birth in, in my experience and mind, really allows that to happen in a much more conducive way, I guess. Pardon me. Than the hospital, medicalized births.
Thea: 15:42 Yeah. A total different framework. Can we pause for one quick second?
Anne: 15:50 Yeah. As I get a drink of water so I don’t hack all over the place. Hold on. Yeah. Okay. So we just got off on a tangent, but I want to point out a couple of things to folks who are looking at this and are interested in the idea of home birth but are concerned about the risks. So this came out this last year or so (NOTE: IT WAS ACTUALLY MAY 2016) ––a study by researchers at Johns Hopkins medicine says medical errors should rank as the third leading cause of death in the United States. And that’s I have a feeling that’s probably even higher, you know, because that’s really what’s, what’s attributed to medical errors. And our experience you know, extensive experience in the hospitals taking care of our parents suggests to me that there are a lot of things, a lot of dots that are not connected where intervention causes more complications that lead to death as well.
Thea: 16:52 And unnecessary interventions and even mis and ill communicated Interventions. So much of it I think is like the whole system is so big that the communication channels are not connected and cohesive and things get missed, or whatever.
Anne: 17:13 Absolutely. It’s become quite dehumanized, you know, and you don’t want to really bring a child into such an dehumanised system to give them a good start, you know? And it’s not to say that there aren’t some hospitals with some really great teams and great departments that really––and I know there’s a movement to revamp that too, and to give women more options of even like water births in hospitals and try to create an environment that’s a little closer to a birth center. So I know that consciousness is there, but you could also just do it at home, you know? So then here’s another I think this was like Harvard Medical Review. (NOTE: IT WAS ACTUALLY HARVARD BUSINESS REVIEW.) I don’t have it printed out where it is, but “Rising US maternal mortality rate demands action from employers,” and it goes in to say “The US maternal mortality rate has more than doubled from 10.3 per 100,000 live births in 1991 to 23.8 in 2014. Over 700 women a year die of complications related to pregnancy each year in the United States. And two thirds of those deaths are preventable. 50,000 women suffer from life threatening complications of pregnancy. A report from the Commonwealth Fund released in December found American women have the greatest risk of dying from pregnancy complications among 11 high income countries.” Wow. And then another one I think this was CBS News. Yeah, and I think this is, let’s see. This was a 2013 story, but “US has highest first day infant mortality out of industrialized world, group reports. About 11,300 newborns die within 24 hours of their birth in the U S each year, 50% more first day deaths than all other industrialized countries combined. I mean…
Anne: 19:33 So, the other thing I want to bring up, and I don’t have all the data in front of me, but if you really, if you look into the history of midwifery and then the involvement ofthe movement toward surgeons getting involved in birth. I mean, because since time immemorial, really women have been…
Thea: 20:10 The carriers of birth. The holders.
Anne: 20:13 Yeah. The midwives have always been women. Until really the last couple hundred years. I imagine, I mean, it seemed like an easy gig. Right? And, you know, and they’re also, there’s good intention behind it too, because there were complications and there were complications for lots of reasons that don’t actually apply anymore.
Thea: 20:38 Sanitation, cleanliness, poverty.
Anne: 20:39 Absolutely. Not to mention––okay. Well then, then let’s get into this. So it’s like a little known tidbit that should be discussed a lot more in our history books when we’re looking at childbirth infant mortality infectious disease and more. But there was an epidemic of puerperal fever1700’s and on through the 1800s and the advent and during the real explosion of the industrialized revolution where surgeons were not washing their hands. And there was this, you know, it was like a progressive idea that washing hands is helpful in the medical field. There seemed to be a resistance to washing one’s hands. And so you would have the doctors, the surgeons leaving the corpse and death and going straight over to deliver babies. And that resulted in this huge epidemic of maternal mortality. It was this epidemic of puerperal fever. And that really didn’t start changing on an institutionalized level until the forties, the 1940s, where that became implemented as a rule that you have to wash your hands before helping deliver a baby. So it’s the implications of that are staggering. And it’s its own conversation or book really where you have to consider how that impacted the society, the societal fabric. You had hundreds of thousands of women dying in childbirth. So you had this staggering number of orphans resulting from that right around the time of the industrial revolution, which led to, you know, families without mothers child labor…
Thea: 23:07 The misery of a time. The children. Yeah. That’s amazing.
Anne: 23:11 Oh my God. When the women aren’t around to manage things on a whole, widespread level. So you had that and, and what was the other thing we were talking about? We’re just talking about like even just the birth practices of you know, the earlier part of last century, I mean, Twilight, chloroform, forceps, all those interventions…
Thea: 23:42 Vacuum.
Anne: 23:42 They look at that now and they realize how many deaths and complications that caused. Right? So I think that if anyone is remotely interested in the empowering and healthy experience of delivering your child at home, I would recommend, you know, a cursory examination of the real history of that. And why we have gotten so afraid of childbirth’s dangers and what those dangers really are now and how those factors can be controlled or what of those factors even apply anymore.
Thea: 24:31 Right. And, and what it would mean, really in a vast way, if as large portions of our communities started to really bring it back to the home space, what would that do to our communities in a broad and far seeing line? What ways would that change our initial bonding with our children and therefore our relationship and dynamics of parenting? I mean the relationship aspect goes on and on and on and trickles. If we can minimize those pivotal, intrinsic to who we become and what we work with traumas, as we come into the world. Because we all have our traumas to work through. And if in this basic, deep realm of entering the earth, if there’s love and warmth and safety filling us and feeding us as the parent and as the baby coming in, what would that do to our world? As opposed to the fear and tension and separation we experience.
Anne: 25:45 Absolutely. And traumas. I mean, just the interventions that are practiced as routine in the US birth practicesis traumatic. On first day of life, second day of life, you know. Just iimagine what it could be like for a human being to enter this realm and be laying there in one’s mother’s arms, in the warm and dimly lit room, quiet, surrounded only by loving family and friends.
Thea: 26:42 Reverent.
Anne: 26:42 Loving midwives. Because by the way, for anyone also wondering, the midwife always brings an assist, another midwife, they assist each other. There’s always two of them. What a difference would that make to our world if that’s how we all came into the world, right? So, so think about that. You know, we’re, we’re up on time. Maybe we’ll talk more about this.
Thea: 27:10 Yeah, there are so many angles and, and colorings of this dialogue that really play out into all of the things we think about. Really.
Anne: 27:20 It reverberates, right? So, hey, so if you want to give your child the right start? Let’s start at birth. Let’s start at birth.
Thea: 27:33 Yeah, let’s start at birth. Thanks. Great. Talk to you later.
Anne: 27:38 See you later. Okay. Let me end this again.