We have watched a shifting of
birthing protocols over the past few years and a restoration of the role of the
midwife. This is obviously controversial
although from this item it appears that what is needed is a more active merger
of the two methodologies and the elimination of any divide.
Without question no birth should
ever be other than minutes away from emergency support. The death rate of mothers and babies drove
the business into the medical world from the beginning. No family is without missing mothers, brothers
and sisters from before the 1950’s when hospital care became common place.
After saying that however, any protocol
that eases the birth process is very welcome and needs to be supported.
Midwives Use Rituals to Send Message That Women's Bodies Know Best
ScienceDaily (Dec. 16, 2011) — In reaction to what midwives view
as the overly medicalized way hospitals deliver babies, they have created
birthing rituals to send the message that women's bodies know best.
The midwife experience uses these rituals to send the message that home
birth is about female empowerment, strengthening relationships between family
and friends, and facilitating participatory experiences that put mothers in
control, with the ultimate goal of safe and healthy deliveries less focused on
technological intervention.
These are some of the findings from an Oregon State
University researcher and
licensed midwife who witnessed more than 400 home births in order to document
an extensive list of practices utilized by midwives to express the symbolic
difference between home and hospital births.
In a study now online in the journal Medical Anthropology
Quarterly, Melissa Cheyney, an assistant professor of medical anthropology at
OSU, charted specific rituals used by midwives. In addition to witnessing and
documenting home deliveries, she also conducted more than 50 in-depth
interviews with midwives and their clients.
"This is about invoking the mind-body connection," Cheyney
said. "We know, for instance, that midwives have better health outcomes in
some areas, such as reduced rates of surgical delivery and labor induction,
than hospitals. But I wanted to examine how ritual might play a part in
producing these positive health outcomes."
Cheyney said evidence shows that hospital births result in about
triple the rate of cesarean section for low-risk women compared to
midwife-attended home births. Because of her unique role as both a researcher
and midwife, Cheyney was able to gain access to hundreds of home births in
various parts of the United
States , and also witnessed more than 60
hospital births.
What she found was a network of common practices, messages and
beliefs that resulted in midwives constructing woman-centered rituals around
pregnancy and birth that were set up in opposition to what they believe are the
overly medicalized practices of hospitals.
For instance, Cheyney found that midwives conducted many of the same
diagnostic procedures as a physician would prenatally, from blood pressure and
weight checks to blood testing and fetal heart tone evaluation. But midwives
chose to get the entire family involved, often asking the partner to palpitate
along with the midwife or allowing older children to hold the equipment used to
listen to fetal heart tones.
"The participatory nature was a key component to creating a ritual
that empowers the woman and her family to feel in control," Cheyney said.
"Many midwives also downplayed the centrality of monitoring and
resuscitation equipment setting them off to the side, or placing them under
baby blankets during labor so women would not be reminded of the technology in
the room. Mothers and babies were still monitored closely, but the monitoring
was not made the central focus."
The differences aren't so much in practice, she argues, but in
performance.
Cheyney also documented the use of common phrases to create birthing
mantras. She lists phrases such as "don't fight it," "let your
body do it," "open," and "let it be strong," as key
components to the home birth ritual. Many mothers that Cheyney interviewed
reported feeling strong and capable during their labors, and women who compared
their hospital birth to their home birth reported feeling like they were
"doing something, rather than just lying there passively waiting."
Midwives also commonly expressed the statement that they were simply "guardians,"
and that women have all the tools inside of them to birth their own babies.
Cheyney said she was interested in documenting these home birth rituals
in part because past anthropological studies have already looked at the rituals
that characterize hospital deliveries. It is Cheyney's belief that both of
these sets of rituals have caused a wide chasm between the 99 percent of the U.S.
population that chooses hospital births and the 1 percent who choose home
births.
"Just as women and their doctors who deliver in the hospital often
feel convinced that their birth was the only safe and 'correct' way, women and
midwives who deliver at home feel strongly that they have the solution,"
Cheyney said. "They believe it with every cell in their body because they
have lived it."
The result, said Cheyney, are two deeply entrenched belief systems
that have trouble meeting in the middle, prompting many of the tensions between
midwives and obstetricians -- a major concern for Cheyney and other
researchers as the number of home births in the U.S. is on the rise.
In contrast, countries such as Canada require midwives to be
trained in home, birth center, and hospital deliveries. And Dutch physicians
are required to complete midwifery training if they want to attend low-risk
deliveries.
"How can you speak across divides unless you experience both
sides?" Cheyney said. "To use a travel metaphor, it's easy to
criticize a country you've never visited."
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