The choice of where and how to have a baby should be up to each individual mother. There are benefits and drawbacks to all different kinds of births depending on a number of factors.
For a healthy mom and a healthy baby, we tend to favor a natural home birth, but it’s not for everyone. I personally favor home birth for the freedom it allows the mother and the baby. Additionally, childbirth in hospitals has a long and dark history, and often times do not have the mother or baby’s best interest in mind.
Before hospitals, we were obviously delivering babies at home. So why did we stop? How did childbirth go from being a natural, fairly simple process to being a health emergency?
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Childbirth in Native American tribes/prior to western colonization
Prior to western colonization, women gave birth with minimal problems as well as minimal recovery time. A healthy woman could deliver her own baby, recover quickly, and resume a normal life almost immediately.
When we promote at-home birth, this is the model we try to strive for. Birth in Native American tribes appears to be the most natural example of birth we’ve got on record. It would also be safe to say that prior to the colonization of North America, Native Americans had a much healthier lifestyle than the white man.
There is little to no data recorded about what childbirth was like, how often mothers died, and how often babies died in birth. It has however, been reported that women often returned back to normal life very quickly after childbirth.
depart alone to a secluded place near a brook, or stream of water . . . and prepare a shelter for themselves with mats and coverings, where, provided with provisions necessary for them, they await their delivery without the company or aid of any person. . . . They rarely are sick from child-birth [and] suffer no inconveniences from the same.
Native American customs of childbirth
At home birth prior to hospitals after colonization
Until the mid-early 20th century, home birth was still the norm. Women gave birth at home and births were attended by female relatives and midwives.
Birth was usually painful, and difficult and both mothers and babies often died during childbirth. Your risk of dying from childbirth was generally around 1-2% per child. Women that had seven or eight children (as many women did) had a much higher chance of dying from childbirth. Additionally, there was about a 20% chance that your child wouldn’t make it to their fifth birthday.
As early as the mid 18th century we saw an increase in doctors attending childbirth as opposed to midwives. The logic was that doctors had more training about anatomy and were thus more qualified to deliver children.
Wealthy women began looking for more pain-free alternatives to traditional childbirth in the late 19th century. In 1900 half of babies were still delivered by midwives. By 1935 only 15% of babies were delivered by midwives.
Hospital births became more commonplace in the mid-early 20th century after the push for pain relief during labor. In the 19th century, prior to twilight sleep, other drugs were used to help eases the pain of childbirth. Most commonly, chloroform was commonly used to help ease pain, but prior to chloroform, ether was used in the 1840s. Later Chloroform was popularized by Queen Victoria, in 1853 when she gave birth to her eighth child.
What Is Twilight Sleep?
Giving birth in hospitals became widely popular in the early 20th century. Prior to a push for hospital births, we saw more and more doctors attending home births. It was said that doctors were more equipped to deliver babies, as they had actual medical training, and a better understanding of anatomy, compared to midwives who often learned the trade from their mothers, or from giving birth themselves. This eventually led to more births in hospitals.
Additionally, poorer and middle-class families began giving birth in hospitals for sanitary reasons. Houses were often crowded and dirty, not an ideal place to give birth. Hospitals were also sometimes cheaper than a professional midwife.
Shortly after the popularization of childbirth in hospitals, twilight sleep became popular.
Twilight sleep is a form of childbirth that was labeled as painless, due to the drugs women in labor were given. Women were often given a mixture of scopolamine and morphine to reduce pain and put them in a state of semi-consciousness or unconsciousness.
Twilight sleep was developed by German doctors in the early 20th century. Wealthy German women would travel from all over Germany to give birth under twilight sleep. Women would travel to the clinic as early as a month before childbirth to allow doctors time to figure out the proper dosage of medication in order to assure women experienced painless childbirth.
When American doctors began the practice of twilight sleep themselves, they did not take the time to assure each woman was given the proper dosage of medication. The twilight sleep drugs were treated as a one size fits all. Additionally, doctors in America often did not have the proper medical training to go through the medical procedures necessary for a successful twilight sleep birth.
Women were often tied down to beds and left alone for hours at a time. Other times they were left in a room with many other women also in labor. Twilight sleep didn’t actually make labor painless, often women would thrash and scream in pain and would then come back to consciousness after birth and have no memory of the pain, or the delivery itself.
After labor, women often had difficulty bonding with their babies, difficulty breastfeeding, and severe postpartum depression. Women also had very traumatic memories of childbirth if they were able to remember the experience.
Twilight birth was popularized around the time of the women’s suffrage movement, with a push for more painless alternatives to natural childbirth. Later, in the 60s, following the hippie movement, there was a push for natural childbirth once again as women learned more about the horrors of twilight sleep.
Modern births in hospitals
Today when we think of childbirth, especially in the U.S, we usually think of birth in a hospital, with a woman hooked up to IVs stuck in a bed under fluorescent lights. That was the vision of childbirth that was presented to me for many years, and it was not something I wanted to experience.
Modern day birth in a hospital it generally not as disconnected from nature as it was in its peak in the 1950s. There are generally options for the mother, such as water birth or natural child birth with no epidural.
That being said, often times in a hospital you’re under a time limit. If you don’t give birth in a certain amount of time you may be given drugs to induce labor, or you may have to undergo a c-section.
With the possibility of a C-section, women are not allowed to eat or drink anything except ice chips, when in labor. Additionally women are often times constrained to the bed and are not supposed to move around.
Of course, there’s also the atmosphere of the hospital. Hospitals are very sterile, less than welcoming environments. Nurses and doctors are constantly coming and going, and overall it can be an unfamiliar uncomfortable environment to give birth in.
Many hospitals in the U.S have extremely high rates of c-sections (some up to 50%). The CDC recommends that C-section rates stay around 15%, where the World Health Organization recommends no more than 10%. The current national average is around 34%.
The pain of childbirth is one of the biggest concerns today that goes into rather women want to have natural childbirth or use medical intervention. While an epidural may temporarily relieve the pain of childbirth, upwards of 35% of women who have an epidural experience hindered ability to breastfeed, difficulty to bond with the baby, or difficulty recovering after pregnancy.
Compared to women who give birth at home, women in hospitals have a higher rate of intervention (c-section, epidural, etc). Women in hospitals have higher rates of postpartum infections and higher rates of postpartum hemorrhages.
At home births today
The reality is, we’ve been doing childbirth at home longer than we’ve been doing it in hospitals! When I think of being pregnant and giving birth now I can’t possibly imagine being in a hospital or really anywhere other than the comfort of my own home.
Many studies show that at home birth is safer than hospital birth, in many cases. Home births have less of a chance of C-section, hemorrhage, infant distress, and infection, to name a few.
Today, around 1% of births are home births in the U.S.
At home births allow you to be completely in control and in charge of the decisions that are being made (provided you have a midwife who works well and communicates with you or you do an unassisted home birth).
The moment baby is born you have the opportunity for skin-to-skin contact for as long as you and baby need. There’s no risk of medical interference (20 years ago when I was born, doctors took me away and gave me antibiotics against my parents’ will). You have time to ensure the natural progression of childbirth as it should happen, rather than on a hospital timeline, and without hospital intervention.
For a healthy mother who’s had a healthy pregnancy, a home birth will probably be your healthiest option. At home, you have the ability to allow your body to give birth in its most natural state. Allowing your body to give birth in its own time, naturally in whatever way works best for your body is the best thing for you and your baby.
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