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Tuesday, May 31, 2011

Natural care from Midwives vs. Medical Care from Doctors 101

Natural care from Midwives vs. Medical Care from Doctors 101

There are so many things I learned about womanhood and motherhood from my midwives.  I’ll never be able to capture the full essence of their wisdom with words, so instead I’ll just give you a taste of some food for thought.  Whereas hospitals view a labouring woman as a patient in need of medical intervention, midwives empower women to embrace the process and allow it to happen naturally.  Below is a summary of contrasts between Midwifery (M) and Western Medicine (WM) perspectives on childbirth.  Again, this is simply my understanding of the general consensus within each group – I realize there are exceptions to the rule.

Checking dilation
WM – In the weeks leading up to the due date, a woman should be checked for dilation to help estimate whether baby will arrive early, on time, or late.  In hospital births, women are often checked at regular intervals to track progress.
M – The onset of labour cannot be predicted.  Many women begin to dilate days or even a couple of weeks before baby’s arrival therefore it is irrelevant and unnecessary to check dilation prior.  Even during labour, dilation is only one of many indicators of progress.  Dilation is often hindered by stress and anxiety, therefore frequent checking can actually be counterproductive.  Some might even argue that farm animals are treated with more dignity than women since a labouring cow would be left alone since a farmer would likely be kicked in the head if he poked & prodded her every hour!

Length of Labour
WM – A woman’s labour is often hurried along by medical staff, with the underlying assumption that risks increase as time passes.  For example, if a woman’s water breaks, she is often told that she needs to deliver within 24 hours to avoid infection.
M – Each woman is different and will labour accordingly.  There is no real stopclock once labour begins – it can take hours or even days.  Even if a woman’s water breaks, her chance of infection is extremely low so it is unnecessary to react by speeding the process up.

Setting
WM – The hospital is the safest place for a woman and her baby.  It is important to have several medical staff present.
M – Unless indicators of risk arise, the best place to give birth is where the mother is most comfortable – which often means at home.  You can imagine how difficult it might be to give birth in a hospital bed if you compare being constipated and asked to have a bowel movement in front of strangers! 

Induction
WM – Once a woman reaches her due date, she may have to schedule a date for medical induction such as the use of pitocin or having her water broken with a needle.
M – A normal pregnancy lasts anywhere from 37-42 weeks, with first time moms usually at the longer end of the spectrum.  Induction is not usually discussed until about 41 weeks and 4 days – and natural methods (such as a castor oil concoction) are tried first.   Chemical induction is avoided since it can often begin a spiral effect of making further medical intervention ‘necessary’.

C-sections
WM – C-sections have become increasingly common in the last few decades and are used in more than 30% of North American births.  Apparently your chances jump even higher if you happen to be due right before Christmas or at other times that would be inconvenient for your doctor!
M – C-sections along with other medical intervention (e.g. forceps, vacuum, etc.) are needed in less than 5% of births.

Umbilical cord wrapped around baby’s neck
WM – This poses a serious threat to baby’s safety and warrants medical intervention to get baby out as soon as possible.
M – This is very common and not necessarily concerning unless there are other indicators of risk.  Many midwives have seen the cord wrapped around baby’s neck up to four times without harming baby in any way.

Risk of Hemorrhage
WM – It is unsafe for a woman to deliver outside of hospital since she could bleed excessively, putting herself at risk
M – The risk of hemorrhage during a natural childbirth is extremely low, but is often magnified in horrific media portrayals of childbirth.  Generally, excessive bleeding would only happen if the uterus fails to contract the placenta out after the baby is born.  Midwives offer an optional injection of pitocin as baby is emerging to help prevent this possibility and monitor bleeding carefully afterward to ensure mom’s safety.

Pain management
WM – The pain of childbirth is excruciating and unnecessary in today’s society.  Women would benefit from pain medication, such as an epidural, as soon as the pain becomes significant.
M – Contraction pains or ‘waves’ are necessary to help a mother’s body massage her baby out.  Epidurals are counterproductive since the numbing effect often makes it more difficult to push.  Natural pain management, such as water or acupressure points, are encouraged.

As you can see, I’ve become just slightly biased toward the natural view of childbirth.  The knowledge I gained from midwifery throughout my pregnancy allowed me to have such an amazing childbirth experience that I often catch myself daydreaming about the next time!  One last analogy I’ll leave you with when comparing a medical birth to a natural birth is considering the body’s reaction to consensual vs. non-consensual sex.  When a woman is comfortable and relaxed, the birth canal can expand for a positive and pleasurable experience.  Conversely, when a woman is scared, her body becomes tense and the same physical act can become painful and traumatic.  I don’t use this analogy to be dramatic or to suggest that medical professionals intentionally would ever intentionally harm a woman or her child.  However, I do feel that society’s shift toward medical hospital births is an injustice to women who are being convinced that they ‘need’ medical help to have babies.  I think we should listen to Dorothy and Oprah: we’ve had the power within us all along and we just need to embrace it!

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