Many birth choice advocates, myself included, like to talk about the differences between high-intervention, medicalized childbirth versus low-intervention, low-tech childbirth. There are benefits and drawbacks to both, but generally speaking, when we say that the low-intervention model of childbirth is "safer" according to the body of evidence, we are speaking about low-risk women.
There are many obstetricians (who are often pro-intervention) who will state that the only low-risk pregnancy is one diagnosed in hindsight--that is, after the mother has given birth safely without any problems. This is a view which I do not agree with, and one which largely ignores the entire point of prenatal care: that of diagnosing and treating certain conditions before the onset of labor.
There is one noted author and birth choice advocate, Robbie Davis-Floyd, P.h.D., who has written several articles and books on the culture of medicalized childbirth in our society. One such article, The Rituals of American Hospital Birth, is based upon the premise that every society, every culture had a set of rites built around birth (along with other major life effects, like marriage, or death). Dr. Davis-Floyd is an anthropologist at the University of Texas at Austin, and has studied the culture of hospital birth in our society in depth.
She writes, "Rites of passage generally consist of three stages, originally outlined by van Gennep: (1) separation of the individuals from their preceding social state; (2) a period of transition in which they are neither one thing nor the other; and (3) an integration phase, in which, through various rites of incorporation, they are absorbed into their new social state" (1994).
Pregnancy, then, is one long practice in separation, which is symbolized by how a pregnant woman eats, drinks, and behaves differently from her peers. Furthermore, her reduction from a fully independent and autonomous individual to that of a semi-dependent who is deemed by society, her peers, and her physician to require instruction and care in order to protect herself and her baby from the vagaries of the reproductive process, also emphasizes her new status as being set apart from others (Davis-Floyd, 1994).
The integration Davis-Floyd speaks of includes the intense rites practiced in the medicalization of labor and delivery. Floyd states, "Routine obstetric procedures are highly symbolic. For example, to be seated in a wheelchair upon entering the hospital, as many laboring women are, is to receive through their bodies the symbolic message that they are disabled; to then be put to bed is to receive the symbolic message that they are sick" (1994). How is this important? Because this message emphasizes the belief that the woman is dependent upon her physician and the hospital (institution) and its goodwill, for her health and wellbeing. This message is repeated through the administration of gratuitous I.V., continuous fetal monitoring leads being attached (either external or internal), blood pressure cuffs, and even the epidural. It is as if, and Floyd points this out, that just as her baby is dependent upon the umbilical cord for life and health, she is just as attached through these various "umbilical cords" to the institution for her life.
Davis-Floyd continues this analogy in her thoughtful and insightful article, and it is one of the reasons why I have come to practically idolize her. I firmly believe that her writings should be required reading for any medical student wishing to specialize in obstetrics. Pregnant women who read it may come to view many "necessary" interventions in a very different light (and certainly be more informed for the experience than with What to Expect when You're Expecting).
Personally, I admire any author who can ream the obstetric field so thoroughly and with such flawless logic, without degenerating into sarcasm, histrionics, or other emotion-based tactics.
You know, the kind of tactics many (cough-choke, don'tyoumeanmost?) OBs use to "motivate" women to do their bidding?
Davis-Floyd, Robbie. (1994). The Rituals of Hospital Birth. In Conformity and Conflict: Readings in Cultural Anthropology, 8th ed. (pp. 323-340). Retrieved on October 4, 2008 from http://www.davis-floyd.com/ShowPage.asp?id=158
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2 comments:
I recently had the experience to take my wife to the hospital because of pregnancy. I saw them putting her on a wheelchair. I asked her, “Why are you on a wheelchair?” She replied that it was for liability reasons. Even though she knew the reason of the wheelchair, I believe that in her inner subconscious state, she absorbed the message that she was sick. That’s how she acted the rest of the day.
I liked the analogy of the fetus being dependent upon the umbilical cord and the pregnant women being dependent upon the various machines she is forced to be hooked to if/when she is hospitalized. I suppose you can't just walk in if you're ready to have your baby - you must be made to feel dependent on the medical establishment. I have never given this much thought because it is such a standard practice, but when you really think about it that type of mentality is kind of strange. If the woman is at a high risk, has high blood pressure, or the baby is at risk I think it would be another story. But why should a healthy pregnant woman be subjected to this? It is good to question these standards of practice because they are not suitable in every situation.
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