January 23, 2013

Mommy Dearest

It’s now been several months since I read Birth Matters by Ina May Gaskin. You might know that I have a midwife crush on Ina May. She’s an inspirational figure in US midwifery, and I think I may have read all her books now. Even before I finished Birth Matters, I knew I wanted to blog on it, but it’s such a big topic that I haven’t been able to figure it out. You see, it’s all about how broken the US maternal healthcare system is.

Over the summer I tried to come at it from a numbers and figures perspective. There’s just too much! It’s not really about what gets covered or where you deliver. That’s important, sure, but more importantly it’s about the fact that you and I, child bearing women of this generation, have a better chance of dying because of childbirth than our mothers. In 1987 our maternal mortality rate was 6.6 deaths per 100,00 live births. In 2010 it was 12.7—nearly double.

I’m going to be honest. That statistic alone makes me want to throw up in my mouth a little bit. If you start digging, the news only gets worse because our own Centers for Disease Control believe that maternal mortality is vastly under reported (perhaps by as much as three times).

It might be hard for you to put those numbers in perspective. It doesn’t sound like that much. Sure, you can see that it’s nearly doubled, but it still seems low. Think about the fact that in 2008 the World Health Organization ranked us 50 on a list of maternal mortality around the world. That means there are 49 other countries that do it better than us. There’s no excuse for this. None. But what is most hurtful is the fact, and it is a fact, that the rate is going up not because there’s anything wrong with women but because we’ve over-medicalized birth. We’ve taken something that’s a normal process and turned it into a medical condition. And if it’s a medical condition, then we have to treat it. But in this case, the treatment is causing more harm than good. You’d be surprised how many women die from complications of their C-sections. Perfectly normal, healthy women.

Now I am going to state clearly that I do not mean to vilify life saving medical treatment. There is a time and place for birth interventions. I personally know more than one woman who, without doubt, would have died, and her baby would have died, without a C-section. I am fervently glad that we have the medical options that we do. I also know women who were, by their own estimation, given unnecessary C-sections.

Think of it this way, there is truth in the saying that more isn’t always better; sometimes it’s just more. Two Tylenol cures your headache. A bottle of Tylenol kills you. Just because we have all these wonderful interventions doesn’t mean that we need to use them during every single birth. But we as women have let it happen.

I join with Ina May in calling for an explosion of midwifes in this country. We need to reclaim the midwifery model of care that believes in every woman’s inherent ability to birth babies. This is the model that is used in the countries with the lowest maternal mortality rates. And if you think this is just some free-love, hippie ideal, take a look at the statistics from Ina May’s midwifery practice. As reported in Birth Matters, of 2,844 births, 94.7% were at home. Her C-section rate is 1.7%. (The national average is 30%.) Out of all those births they’ve lost four babies and zero mothers. Her numbers are astounding and completely unheard of in this country. Yes, the women who deliver with her are low risk. She doesn’t include women with severe complications in these numbers. But the vast majority of pregnant women ARE low risk. This could be how birth could look across the country.

I could definitely go on at length on this issue because I am so passionate about it. I’d love to talk about the interventions, natural child birth, midwifery care, the works. But the bottom line is that no matter how you gave birth or where you think it’s best to give birth, we can all agree that no woman should die because of it. Tragedies happen, but the scale of this tragedy—of mothers being torn from their families—we have brought on ourselves.

Take the time to question your doctor. Take the time to educate yourself. Choose a midwife. Write your congressman to help expand access to home births. It’s time for mothers to dictate how we want to birth.

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