Friday, March 15, 2013

How do we go about changing the culture of birth?

I am inspired by this quote:

Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” 

I attended a film showing of the classroom edition of the "Business of Being Born" at the University of Cincinnati last night.  I had seen the movie before.  Many times.  I've met many of the people in the movie ~ Robbie Davis-Floyd, Ricki Lake.  But I looked at it through new eyes.  The eyes of the college women in attendance.

Their questions hit me to my core.  "I want to talk to my gyn about my body BEFORE I start even thinking of pregnancy."  "Why is there such a disconnect" (when speaking about the US's pitiful maternity statistics).  And from one of the veteran women in the crowd - "I thought when I gave birth in the 70s that my daughters would have it better than me.  What happened?"

What happened indeed.  That seemed to be the question of the night!  How do we go about changing the culture of birth? 

Here is how I see the culture of birth in this country:

Birth is still a vital life experience to all women, regardless.  They are not taught about their bodies, pregnant or non-pregnant.

Obstetricians are caring and skilled individuals.  They are not taught about "normal" or physiologic birth.

Nurses are also caring and skilled individuals. They are not taught about "normal" or physiologic birth.

Midwives are caring and skilled individuals and ARE taught about "normal" or physiologic birth.  In many states, midwives are underutilized and in the case of non-nurse midwives, outlawed.

Childbirth educators who could teach the women are minimalized by the OBs and nurses, whom they could also learn from via in-service education led by the childbirth educators.

OBs and nurses (and some midwives) work for hospitals which are businesses and in the words of Suzanne Arms, hospitals are designed for the mass care of the masses.  Not the individual care of the individual. 

Childbirth education programs are always on the chopping block, even in times of economic prosperity but always during tough economic times.

So we basically have a situation where careproviders who are not taught about  "normal" or physiologic birth are working for an institution who needs, by definition, to make money and care for women who are not taught about "normal" or physiologic birth but often do want that type of birth.

How I see changing the culture of birth:

Childbirth education - begin with women.  Then move to student and existing OBs and nurses for education about physiologic birth.  Once the information is out and embraced, as in the 70s, hospitals will have to comply with the wishes of the women...the consumers.  Midwives will take their rightful place as providers of care for low risk women and OBs (the surgeons) will rightfully care for the high risk mothers.  Hospitals will actually save money, US maternal/infant morbidity and mortality statistics will improve.

Now, that wasn't so hard.  Was it?


Beloit Health System said...

Nice post on the topic related to child birth !!

Lindsay Dorff said...

Thank you for your post -- such a thoughtful response to a question I ask myself a lot! I especially appreciate that you did not demonize OBs like I see many natural birth advocates do, which is unfortunate because I really think that attitude stops us from moving forward. In addition to medical changes, I also think we need to try and encourage birth to be depicted more positively in media. Unfortunately, most women go into their first births with Hollywood drama as their only frame of reference, and birth has the potential to be much more beautiful than that :-)