Photo credit: by John Carleton/ Flickr/ Getty Images
Modern-day medicine is failing American mothers in the delivery room. Although we are arguably the most developed nation in the world, our maternal and infant mortality rates are the worst among industrialized countries. Is it any wonder that some women turn to non-medical methods to safely birth their child? Apparently to Good Morning America (GMA) it is.
More than just the facts
On March 21, 2014, GMA aired a segment on recent reports from both the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) on water birthing. These reports found water birthing to be "risky" and "experimental," and advised women to use caution when choosing this method of childbirth. While the results of these reports are, to me, debatable, it wasn't what I found offensive about the piece. It also wasn't the strange celebrity angle they chose to take, implying mothers only choose water birthing to mimic celebrity trends. I didn't even take offense when they misrepresented natural birth advocate Ricky Lake's stance on childbirth, minimizing the amazing work she's done educating people on natural methods to a mere "passion for water birthing." No, what really offended me was the discussion they had after the clip aired.
The slam from the expert
GMA had a round-table discussion with an expert, OB/GYN Dr. Jennifer Ashton. Dr. Ashton's stance on water birth was evident from the first words out of her mouth, when she started with the snarky statement, "Grab your scuba tank ladies." She continued on, slamming the birth choice as she said, "Just because something is natural doesn't make it safe." Dr. Ashton went on to say, "(U)ntil we grow gills like a fish, I think that Baby should come out breathing air on dry land." But by far her most condescending comment was her answer to George Stephanopoulos' question of why mothers would choose to birth this way. Her answer, as an OB/GYN and expert? "They have a mermaid fantasy!"
Sadly, a typical OB/GYN stance
Dr. Ashton's view, while disappointing, isn't surprising. She's an OB/GYN, and American obstetrics has a history of minimizing the mother's role in childbirth. Since the early 1900s, when births were moved from the home to the hospital, the wants of the obstetrician have been placed ahead of the best interest of the mom. First, births were moved to the hospital for no reason other than to give obstetricians better training — very few would attend births at the home, where they'd been occurring. Then, the morphine/scopolamine combination "twilight sleep" was introduced, saving women from the pain and memory of childbirth, while allowing the obstetrician the ability to forcibly remove Babe from mom without any pesky screaming or annoying "helping" from the mom.
The man who changed childbirth
But the biggest offender in the obstetrical removal of maternal choice from the birthing process was easily Dr. Joseph DeLee. Dr. DeLee was an extremely influential obstetrician who, in 1915, wrote a popular book describing childbirth as a destructive, pathological process rather than a normal function of the female body. He almost single-handedly changed the obstetric focus during childbirth from responding to problems as they arose organically, to preventing problems through the routine use of interventions to control the course of labor. This change in thought was huge. This shift from viewing childbirth as a natural event where the mother needed assistance, to a pathological process where the mother needed saving resulted in the prevailing model we still see to this day. Medical interventions are used not on the comparatively small number of mothers who need them, but routinely on every woman unless they request otherwise (and sometimes even then).
It all starts with pain relief
This routine use of medical interventions is one of the main driving issues for moms who turn to natural methods of pain relief during labor. These moms are using hypnobirthing, Lamaze, Bradley Method and, yes water birthing, as a way to deal with labor pain without turning to medical solutions such as epidurals. The simple fact is this: If you get an epidural, you are likely to need more interventions. The epidural — which is the standard medical answer to labor pain relief — sparks a "cascade of interventions" often ending in surgery. It typically goes like this: Mom is in pain so she gets an epidural. The epidural slows the natural progression of her labor, so she needs augmentation by the drug Pitocin. Pitocin, a synthetic form of oxytocin, increases the intensity of contractions, causing the need for more pain medication, causing more slowing of labor progression and so on, and so on. It usually ends with the mom "failing to progress," and cesarean section delivery being offered as a saving grace to an exhausted mom who is just ready to be done.
Support the mom, decrease the need for surgery
If instead of immediately offering drugs, more doctors and hospitals supported the laboring mother as she attempted to ease the pain naturally, perhaps fewer births would end in the operating room. In the U.S., on average you have a 30 percent chance of delivering via c-section the moment you walk in the hospital door. Elect the epidural for pain relief and your likelihood of surgery more than doubles. AAP and ACOG think water births are risky? Try having your stomach sliced open and your organs moved as your baby is delivered, and then having to recover from major surgery while you figure out parenting a newborn. C-sections aren't without risk either. Mothers who undergo cesarean are more prone to a slew of surgical complications all the way through secondary infertility, emergency hysterectomy and death, and babies born by cesarean are more likely to have breathing problems and to develop childhood diseases such as diabetes and asthma.
GMA should support a woman's choice
Laboring in a water birth tub has been proven — by the AAP/ACOG reports — to ease the pain of first stage labor, which is the longest stage by far for most moms. If laboring mothers can get through first stage without medical intervention, they are far more likely to complete the birth of their child naturally. As said by Ali Tromblay, a midwife interviewed by GMA for their clip: "Being in the water allows women to be comfortable. And if they are comfortable and feeling safe they're going to have good outcomes and an experience they feel good about." And, as GMA expert Dr. Ashton said, "We need to keep our eyes on the prize, healthy baby and healthy mom." GMA would better serve that goal by promoting a woman's choice in delivery options, rather than mocking those who choose natural pain relief through water birth.