Birth Care in the United States
I have been a midwife for forty-five years. I have witnessed more than three thousand babies come into the world—at home, at a birthing center, and in a hospital as a labor and delivery nurse. I joined RC early in my career. I learned how important early messages can be in our life.
Over the years, many of my clients have asked me, “Why is the child I gave birth to at home, with you as the midwife, different from the children I had in the hospital before I met you?”
When so many people echoed the same comments, I quickly realized how important the early hurts and messages are and how much they affect our lives.
When I worked in the hospital, I saw how many of us were treated as we began life. Back in the 1960s and 1970s, and probably before then, the umbilical cord was immediately cut, and the mother had anesthesia or “twilight sleep” (Demerol [meperidine] and scopolamine). This made it hard for the baby to start breathing on their own. So, the baby was held upside down by their feet and swatted [hit] to induce breathing.
We used to give every baby an eye ointment for gonorrhea (a sexually transmitted disease that the babies didn’t even have). If a parent refused the ointment, then Child Protective Services would often be called to investigate the family.
I worked at a county hospital for about six years, during the late 1960s and early 1970s. Native and Indigenous women and Global Majority women would go there to give birth, when they couldn’t afford a private hospital. They would be put into beds for labor [childbirth], in a ward-like [compartment] space.
The women were not allowed to sit upright in the bed—they had to lie flat on their backs, for the entire time. They were not allowed to get up to pee—they had to use a bed pan. They would be taken to the delivery room, when it was time to push out the baby (unless they accidentally had the baby in the bed). There, they were put into stirrups [a frame that supports your feet], draped [covered with fabric], and had their hands tied down. Usually, a medical student would catch the baby. The baby would then be immediately taken to the nursery. The mother wouldn’t get to see or touch her baby, until she was able to walk to the nursery and get her baby, herself. Babies would be treated like they had no feelings—roughly, without caring—and would be left to cry by themselves.
When this medical model first took over birthing practices in the United States, it was a standard practice in private hospitals to separate the mother and baby. The baby would only be brought to their mother on a schedule, and the mother would be told not to unwrap her baby from the blankets.
Mothers were told not to pick up their babies when they were crying, or they would “spoil” them. They were told to feed their babies on a schedule, and not in-between the three or four hours, or they would “spoil” the baby. They were told that infant formula was better than breastfeeding, and that breastfeeding wasn’t good for babies.
The following practices continue to this day:
- Cutting the umbilical cord immediately, or very quickly, so that the baby is without oxygen from the cord until they breathe on their own [without assistance]
- Drying babies [to remove amniotic fluid] roughly after they are born
- Suctioning babies [clearing the airway], usually unnecessarily
- Taking the baby to a nursery, where the baby remains alone, until they are reunited with their mother
- Male babies having their penis cut [circumcised]
- Not encouraging babies to have their feelings, and stopping them from crying
Babies are left with distress recordings of being small, powerless, unimportant, isolated, and discouraged.
CONSUMER POWER
The consumer is powerful. The demands made by consumers to bring other family members into the delivery space are the only reason we now allow it. This especially includes fathers, along with anyone who is with the mother during delivery and labor. However, since COVID-19 restrictions began, we again only allow certain family members to be in the area.
Consumer power also changed episiotomy practices (cutting the vagina to enlarge it for the birth, which used to be done ninety-nine percent of the time). The only women who didn’t get an episiotomy were those who delivered the baby before the doctor could get there. Everyone wore gowns and masks, and the woman would be draped with sheets. The baby would come out through a hole in the sheet, so that no one could see the mother’s body. Now, the episiotomy rate is very low.
An article printed in the January 2023 American Journal of Managed Care says the following:
- The United States has the highest infant and maternal mortality rates, more than any other high-income country, and simultaneously spends the most funds on health care
- Of all countries in 2020, the United States possessed the highest infant mortality rate, at 5.4 deaths per one thousand live births, which is markedly higher than the 1.6 deaths per one thousand live births in Norway, which has the lowest mortality rate
- The U.S. Cesarean rate (birth by method of surgery) is about thirty-three percent, nationwide, which is one of the highest in the world
- The Black and Hispanic infant and maternal morbidity and mortality rates are five times higher than white rates
- U.S. maternal mortality in 2020 was over three times the rate in most of the other high-income countries, with almost twenty-four (23.8) maternal deaths for every one hundred thousand live births
The authors cited reasons for the danger of giving birth in the United States. These included inadequate prenatal care, the high rate of Cesarean section, and poverty, which contributes to chronic illnesses like obesity, diabetes, and heart disease.
At one point, I visited a country where almost every birth was handled by a midwife, no matter where the birth occurred, including in hospitals. I noticed that the children were different there. They seemed calmer, more present, and less angry—at least, based on my limited observation. This may be because they started life in a more gentle environment.
Port Angeles, Washington, USA
Reprinted from the e-mail discussion list for RC Community members
(Present Time 213, October 2023)