Are We Being Ripped Off With Over-Medicalised Births?
By: Liisa Halme
Tags: Birth, Birthing, Homebirth, Birth Trauma, Pregnancy

Can giving birth be an ecstatic, rather than a traumatic and disempowering, experience?

I am writing this on the morning of the ‘due date’ (or shall we say ‘guess date’) of my second child. I am in eager anticipation, not just of finally meeting my new baby and holding her in my arms, but of the actual birthing process itself. I rarely tell anyone this but my first words after giving birth to my son, naturally at home three years ago, were ‘I want to do it again!’ I meant giving birth itself, not just the end result of it.

Was it quick? No. Was it easy? No! It was the most challenging, intense experience of my life and there were both sweat and tears, but it was also the most rewarding, magical, empowering, and life changing event — not just because I ended up with the new love of my life in my arms. It was the experience of giving birth itself that was ecstatic. Unaltered, undisturbed and completely primal. I was at home, in my safe space, with my few chosen people to relentlessly support and nurture me. I had the most soothing beautiful music I’d chosen, candles, essential oils, and lots and lots of love and tenderness surrounding me. The birth unfolded beautifully with the help of all that. Yet, it wasn’t just these factors which made it so special.

A rite of passage

After my son was born, I was naturally high from the actual birthing experience for months. I thought about it every single day, with euphoric awe. The best I can describe it as, is a rite of passage that prepared me for my new life as a mother. (And I had always been told by various doctors that I couldn’t get pregnant naturally, if at all… but that is another story!)

So why has birth become such a pain, a ‘necessary evil’ — sometimes so much so that we would rather have invasive and risky abdominal surgery just to avoid having to go through it? (Without taking away from the fact that sometimes, though much less frequently than performed, surgery is indeed necessary.) Why have we come to believe that giving birth is a medical emergency, rather than a natural process that the body knows how to carry out quite effectively? This is a trick question, for the question is also the answer: because the belief that birth is a painful medical event that needs to be managed and controlled with medical procedures, has made it a reality! It is the very mistrust in our own bodies, the expectation of pain, difficulty, and complications and the presence of excessive monitoring that brings about the need for more interventions. How?

Expectations

A few generations ago, birthing was a family event. It happened most often at home (in my country of origin, Finland, usually in the sauna). There were other mothers, grandmothers, and perhaps older siblings present — the nearest and dearest womenfolk to support the birthing mother. Perhaps a midwife if one was lucky. Most women, by the time they were giving birth themselves, would have already witnessed a natural birth.

Most of what we hear from each other and see in the movies and on TV these days is pain and agony. I remember seeing a video in primary school of a woman giving birth, and I still remember that woman lying on her back in stirrups, screaming with a twisted face and her jaw clenched with tension, with a male doctor next to her telling her to push. It looked like the opposite of empowering, magical, and joyful. It seemed more like humiliation and torture! The sad thing is that this is what most of us these days have come to expect.

The fear-tension-pain syndrome

It is the fear and expectation of pain that produce excessive amounts of true pain because of the pathological tension it creates in the physical body. This is called the Fear-Tension-Pain Syndrome (FTPS). When this vicious cycle is established, it creates a crescendo of events which are experienced as true pain, which justify more fear and stronger resistance, which contribute to even more pain and more difficult labour… “The most important contributory cause of pain in otherwise normal labour is fear.” [Read.G.D.]

This doesn’t mean that the pain women experience during labour isn’t real. Quite contrary: it is very real indeed. But it doesn’t have to be so! Our body is beautifully designed to create a nothing less than mind-blowing cocktail of hormones that can help us experience intensity, even ecstasy, instead of pain.

Better than all the drugs on the planet

These hormones can see us through normal childbirth without pharmaceutical drugs that have a not-so-great effect on the body’s natural processes (in a same kind of way the anaesthetic a dentist applies to your mouth affects your ability to speak, eat or drink normally) and that also end up in the baby, and thus affect the bonding process and establishment of breastfeeding.

But in order for these incredible hormones, namely oxytocin (the ‘love hormone’), endorphins (natural opiates and analgesics, hormones of pleasure and transcendence) and prolactin (hormone of mothering and surrender), to exist at the required peak levels to make the labour smooth and enjoyable, the woman needs to feel private, safe and unobserved. When adrenalin and noradrenalin (the fight or flight hormones, also needed in the later stages of birth) kick in too early they reduce the production of the ‘feel good’ hormones and significantly reduce blood flow to the uterus and placenta. This can cause adverse fetal heart rates and more fetal distress. Stress-induced adrenalines (for example if the woman feels disturbed in her environment or is under pressure with time) can stall and stop the whole birth process. This often triggers a cascade of interventions.

The ‘Law of the sphincter’

Labouring attached to machinery or IVs that restrict our movements, under bright lights and observation by people we barely know (in the worst case scenario, people we have never met before), having frequent internal checks performed, who can feel private and unobserved? Again, sometimes they are necessary, but in most low-risk births they are not. It is often the very things that are supposed to protect us from the dangers of childbirth that actually make it more complicated, painful and difficult. How? Can you imagine trying to do a number two on the toilet, with bright lighting and having your nether regions observed by strangers who are timing and measuring your progress, giving you a deadline by when you need to have finished your business?! Ok, point made, but what does having a poo have to do with giving birth, you may ask…

Ina Mae Gaskin, the most famous midwife and childbirth educator of all times, refers to it as the ‘Sphincter Law’:

Sphincter muscles of both anus and vagina do not respond on command. Sphincter muscles open more easily in a comfortable, intimate atmosphere where a woman feels safe. The muscles are more likely to open if the woman feels positive about herself; where she feels inspired and enjoys the birth process. Sphincter muscles may suddenly close even if they have already dilated, if the woman feels threatened in any way.

Medical support

Of course there are times when medical intervention is required and when it saves the lives of babies and mothers. We are lucky to have access to advanced medical support when we need it. And many women indeed feel safest giving birth in a hospital, which makes is the best place for them to birth. But all too often, the current medical model is simply in the way of the natural process because of strict hospital policies, time limits and protocol, which feed the lack of belief in the body’s capability to do it on its own. One intervention leads to another, and birth easily becomes a traumatic medical event where women feel at the mercy of the hospital staff and procedures. Perhaps the medical model could better support the natural ability of a woman to give birth and apply the principle of ‘leaving well alone.’

What can we do?

The best thing we can do as women is to educate ourselves on the physiological processes of the birth and of the pros and cons of different interventions in different situations. This way, we can approach birth without unnecessary fear and make educated choices for ourselves and our babies. It is necessary to remember that we always have a choice to decline any procedure that we consider unnecessary — even if the hospital staff make it sound like we don’t.

-We can practise inducing the relaxation response in the mind and body through guided relaxation and breathing exercises.This helps keep muscle tension to a minimum, allowing the body to birth in the optimal way.

-We can eat well and exercise during pregnancy to be fit and healthy for birth.

-We can choose as our caregivers professionals who trust in our ability to birth naturally. Caregivers who are willing to wait and do nothing if no intervention is necessary, who understand the importance of our emotional well-being before and during birth, and who are willing to support us in the way we want to birth our children. (I highly recommend pre-natal education courses such as CalmBirth or SheBirths for all of the above.)