- Jeannine Parvati Baker, "Vision of Unity" (1949-2005)
How do homebirthing, birth centers, hospital birth, and unassisted birthing all fit together? Is there a place for each of these options in the spectrum of maternity care for modern mothers? How does one decide what choices are best for you and your birth? Is the medicalization of birthing helping some mothers and harming others? Can many women birth wonderfully while unattended while a few need skilled care providers? What can we do to create the best birth possible for babies today?
When it comes to Conscious Birth, I believe it is ideally best honored, protected, and respected - with independent midwives available in all communities to all mothers for homebirth and birth center care. Women who choose to birth unassisted, should do so only because they are prepared, confident, and healthy, not because of a lack of access to better options or trusting care. There should be excellent and respectful care given at mother and baby-friendly hospitals for high-risk pregnancies and births, without unecessary intervention, and utmost honoring of the mother-baby synergy. I envision a world in which all communities have safe hospitals with low-c-section rates, doulas, waterbirth facilities, and lactation consultants, as well as community-based birthing centers with midwives, gardens, and waterbirthing facilities, plus skilled homebirth midwives and postpartum support for homebirthing families.
I am so grateful for both the medical and midwifery knowledge that is available today for mothers and babies. One thing Western medicine is really good at is surgery - when performed with discernment for appropriate reasons and in the circumstances that other options are not viable. If a person needs surgery today the results are better than any other time in recorded history. Yet surgery and pharmaceuticals both have major impacts and consequences upon the body and are drasticly overutilized and abused in Western medicine today - particulary in birth. For a natural process like birth, unnecessary intervention will lead to complications and interfere with the biological cascade of hormones inherent in facilitating bonding, breastfeeding, and attachment. While surgery has improved the outcomes of lives in fields including emergency medicine, in birth the overuse of surgical delivery has in fact caused a rise in maternal deaths. It is a fallacy to think that more lives of mothers and babies are saved today in the Western world because of interventions in childbirth. In the last decade in California, the c-section rate has doubled and at the same time the maternal mortality rate has tripled in conjunction.
The World Health Organization has recommended for decades that the C-section rate should be no higher that 15%. However in the US we are double that, in some hospitals it is over 50, 75, or even 90%! In countries such as Brazil the c-section rate is close to 95% of women in urban areas. Some women need surgery but not nearly as many as are receiving them now.
In the US, at the Farm Midwifery Center in Tennessee, run by Ina May Gaskin and the Farm Midwives, they have a less than 2% c-section rate from over 30 years of practice, including opening their doors for decades to any women who wanted a natural birth. Women frequently used to show up at their door in late pregnancy or labor, without ever having seen them before, and even with this diverse population they still have an incredibly low c-section rate. Ina May also writes in her latest book "Birth Matters" that a woman today has more than double a chance of dying in birth than her mother did. Clearly, the increase in high-tech birth is not improving upon Mother Nature.
In the past, before the industrialization of childbirth, women sometimes died in childbirth because of lack of access to medical care. Improvements in nutrition and public sanitation both create huge improvements in maternal health and outcomes. Good nutrition for all ages of life and clean water, air, and public sanitation are on the top of the list of necessary things for good health and healthy mamas and babies everywhere. Surgery and pharmaceuticals do not improve childbirth outcomes as much as access to healthy foods and preventing toxicity from the environment, pollution, or lifestyle.
In countries where midwifery is the primary source of care for birthing women, the maternal and infant mortality rates are lowest. In the US, the reporting of statistics for maternal mortality is skewed and the actual numbers are much higher than what is known. Ina May Gaskin has a project called the Safe Motherhood Quilt Project in which she is raising awareness about the huge number of deaths in the US related to complications from birth that are unacknowledged. Such as a women recieves a c-section, goes home, has an infection, dies, and it is not reported as related to the surgical birth, because she has already left the hospital.
The reality is that women have very little influence on the choices available to them in birth in the US and in countries around the world, leading to their choices and needs being controlled by the pharmaceutical companies, insurance companies, hospital administrations and corporations, and governmental agencies with big money interests in mind and pocket.
I am inspired by Dutch model of maternity care in which midwives and doctors work together, healthy women automatically get a midwife, unless you risk out and then get a doctor, and all mamas have a home nurse visit postpartum for over a week to help out. I think that undisturbed birth is an ideal, and that the modern midwife should be very hands-off. I am not a fan of unnecessary cervical and vaginal exams, forced pushing, manually dilating the cervix, breaking the bag of waters, and other interventions that doctors and midwives do regularly that can cause complications.
The experience of pregnancy, giving birth, and becoming a mother has huge impact upon the women's life resulting in physical, emotional, mental, spiritual, and social changes. Birth is a life-changing experience and it can be empowering or traumatic, depending upon the care, support, and environment that women and babies are surrounded with. There are resources today for mothers healing from birth trauma, as well as for babies and bonding. I recommend exploring the information from the pre- and perinatal psychology field at www.birthpsychology.com as well as body-mind-spirit integrated bodywork practices including craniosacral therapy, aquatic bodywork modalities, massage, and mother-baby support groups.
What is really best for mamas and babies? To be truly deeply supported - from preconception through postpartum, to have access to gentle knowledgable midwives, waterbirth centers, compassionate mama and baby friendly hospitals, and healthy nutrition from the beginning. There is no right or wrong way to birth - each mama must decide what it best for her and her baby in the moment - that is a conscious birth. I believe on a soul level that our babies choose the experiences that are right for them, we grow and they grow from what experiences are given in life.
Birth is phenomenal. Birth is sacred. Birth is the gateway of life. We are the guardians, and it is time to protect our birth rights!
By Kara Maria Ananda
Conscious Birth Ambassador