Tuesday, January 13, 2009

Medicalization of Childbirth

I wrote this paper ( not perfect I know) about 5 years ago for a class in College I thought others may want to read it. I found it interesting to read now that I am pregnant again. My format got a little screwy when I copied and pasted it but here it is....

Medicalization of Childbirth
For hundreds of years woman delivered their babies at home with the use of a midwife another woman who has experienced childbirth in the past: sisters, mothers, or grandmothers would be there to assist the woman going through the childbirth process. In the early 1900’s this all changed when our knowledge of medicine increased. More woman began going to hospitals to deliver their babies because they were swayed by there doctors that the hospital would be safer place to have their children .Is it really safer to deliver in a hospital or is it the greed of doctors that pressured woman into going to the hospital?
When most people think of hospitals, we think of a white and steel sterile environments that inhibit the growth of bacteria. On the contrary, hospitals have many forms of bacteria that could be deadly to persons with lowered immune systems. In fact, hospital-acquired infections are becoming more difficult to combat (Hospital Topics 1). So the sterile environment that we were think we are giving birth in does not exist, we are just meant to believe that hospitals are safer cleaner places so woman would want to have their babies in the cleanest environment possible. I
am not arguing that there would not be bacteria in your home if you were to do a home birth but, there is probably less harmful bacteria than in a hospital that if full of sick people. Infants have low immune systems when they are born so to scare woman into thinking that the most sterile place to give birth is a hospital seems beneficial to the doctors and the hospital by creating life long patients or should I say life long customers which is what the medical community seems to want. Most everything in life comes down to money why should childbirth seem any different.
Before the 1900 Midwives were the ones who assisted births and cared for woman when going through the childbirth process. It was not until the after the 1900’s that we noticed a shift to male doctors. In 1858 physicians, surgeons, and apothecaries formed a group called ‘doctors’ (Cahill 5). This change brought on the shift from midwives to doctors. During the 20th century there was a great change from midwives to doctors. Since medical doctors could perform surgeries and give anesthesia, this caused many women to choose doctors instead of midwives. Woman at this time knew that childbirth was painful and doctors were saying that if you gave birth in a hospital they could help control the pain by administering drugs. Doctors also use fear tactics on woman by saying that male doctors had standardized medical training, which midwives did not. Doctors then stated that if something were to go wrong what better place to be in than hospitals where there was the newest technology to help the problem.
The use of forceps was introduced around this time to help ease the
baby out of the birth canal but unfortunately, this caused more deaths than helped because doctors did not have proper training on the use of forceps. The use of forceps or failed induction usually required a caesarean section that midwives could not perform (Cahill 8) Donnison’s 1977 argument that the medical men deliberately set out to frighten woman into believing that male attendance was necessary by exaggerating that the dangers of childbirth (Cahill 7). The brainwashing that male doctors caused resulted in many women turning away from midwives to male doctors in a hospital setting to give birth to their children. Historical analysis reveals that the professionalization of medicine necessarily constructed male medical knowledge as scientific and therefore superior to female intuitiveness and experience (Cahill 9).
Since the medicalization of childbirth, it seems the caesarean rate has gone up and that most woman seems to deliver during the week not on the weekends making it more convenient for the doctor (Matcha 181). What does not make sense to me is that many of these changes including the medicalization of childbirth were to make the doctors more money. Well if I am the one paying the doctor why does it seem like we are getting less attention but paying more. Doctors are not usually not there
your entire delivery but midwives are but they are paid less. It does not make much sense that the midwives work more but are paid less. This all
goes back to the fear that Cahill stated earlier through this medicalization process woman have been pressured by fear into giving birth at a hospital with a doctor not a midwife.Childbirth is and always has been a natural process so why did we feel the need to intervene. I believe that early doctors had a ‘GOD’ complex and went a little to far when technology was at its peek. We have made some great medical discoveries but childbirth itself was not a discovery nor was pregnancy. Childbirth has been going on for hundreds of years without the intervention of medicine and since we as a species are here today proves that we survived and that we knew what we were doing back then. It is true that many women have died during childbirth before medicalization, but have doctors taken the medicalization of childbirth to far. Is there a happy medium that someday doctors will be able to find between natural childbirth with a midwife or medicalizaed childbirth with a doctor. I believe we are well on our way in finding that medium but it is going to take a lot of time.
Currently midwives seem to be more accepted by society and are backed by doctors incase there may be a need for caesarean sections but are modern midwives becoming more medicalized or are doctor becoming more demedicalized, it is hard to say. In 1996 a group of six midwives and six gynecologists came together from around the world and met at the WHO headquarters to discuss their differences and weigh the evidence (Hoope-Bender 2). The conclusions made were that they both wanted the same out come, the delivery of a child in the safest way. The problem is that they have different views on what is the best and safest way to bring a child into the world. It is hard to say which is method is better but we can try to figure out which method safer. During this meeting, they decided that a midwife is the best healthcare worker to take care of a normal pregnancy in the most cost effective way (Hoope-Bender2). This statement leads us to believe that doctors would be the best choice if money was not an option and if you had a complicated or high-risk pregnancy. This coming together between doctors and midwives is a great milestone for the midwives since during the early 20th century most doctors did not accept them. This recent acceptance shows great promise for the healthcare of pregnant women. Much still needs to be learned about the differences between midwives and doctors but it does not help midwives when the American Medical Association makes claims against midwives. This shows us that some parts of the world doctors and midwives are coming together but in other parts like Australia they are still fighting against each other in this ongoing feud of who is better at taking care of a women going through childbirth (Fahy and Pesce).In the book Baby Catcher by Peggy Vincent, a midwife who recalls a time in the 1960’s when she was on rotation in the obstetrics ward as a student nurse. She watched and helped a woman go through labor that would not listen to the doctors and refused to lie down during her labor. Peggy kept telling this woman that she was going to get her in trouble if she did not lie down. The woman in labor said to Peggy that she had given birth to two babies at home with the help of her granny and never again would she give birth in a hospital. Peggy learned then that the medical profession would not let this woman deliver her child they way she felt was right by instincts even though she had done it twice prior. At the end of the story she ended up drugged against her will after the baby had come out because the doctors thought she needed it. (Vincent 17-20). This was a very sad story and a good example of how the medical profession has led woman away from using her intuition on what is right when delivering her child. The current medical profession seems to have the idea that they know what is best for woman because they have a degree that says so. I do not agree with this theory and think that some serious changes need to be made in the medical community, but I fear this will never happen due to malpractice lawsuit that patients could throw on doctors by saying that they were in so much pain they did not know what they were saying
Midwives have been given a bad rap over the years but I believe that they are just as capable of caring for a pregnant woman than a doctor. Midwives spend more time listening to what the woman wants and what she feels is right, not what medical standards view as right. Childbirth is a natural process and woman need to listen to their own intuition and have someone who supports them through this process. We do not hire doctors to deliver the babies of dogs they know how to do it through instincts, just as Homo sapiens do and have done for many hundreds of years why should things change because our technology has.

1 comment:

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