All Knowledge is Worth Having: Examining Maternity Care

Occasionally when coming across criticism about birthing alternatives from those specifically biased against birth outside of hospital settings, the concept that not all resources are reliable comes up as a means to discourage the sharing of articles and discussions on the disparity between current maternity care and evidence-based research. The media heavily plays on the sensationalism of the hospital versus home debate, targeting the insecurities parents have in regards to optimally growing and birthing their children. Usually a heavy level of fear-mongering is employed to persuade against considering alternatives in childbirth even from the women themselves, especially those who have had complications in their pregnancies and births (regardless of labour setting), often making them emotionally invested in discouraging the exploration of this topic as a means of coping with their own difficult experiences perhaps. 

What results is a suspension of honest dialogue about the uncomfortable reality of the maternity care crisis currently underway in our country because some women’s experiences are being overlooked in order to maintain the illusion that obstetric care is the ideal approach to delivering children. The very sharing of personal observations and evaluations of these research studies by those directly affected by it (the birthing women themselves) is brushed aside in lieu of the biased opinions of those currently practicing in the medical field. This is not stating that the contribution of obstetric surgeons and L&D nurses aren’t valid, only that it is a small part to the complexity of what encompasses women’s health. The western medical industry for example is renowned for its ignorance regarding incorporating the duality of physical and mental health in assessing ailments, grossly limiting their understanding about the root causes of issues and overcompensating with interventions. This issue is precisely why the legitimacy of ordinary women’s experiences and impressions needs to be acknowledged, as anecdotal evidence has shown just how distressing and ineffective modern maternity care is in regards to supporting normal physiological birth.

In as far as primary research studies go; they are not helpful to the average person due to the requirement of critical skills in evaluating the conclusions drawn for value. Despite attempts at avoiding bias, it is impossible to circumvent completely and often what is revealed under scrutiny is the lack of important variables considered when making assumptions about optimal approaches to maternity care. A crucial aspect to the puzzle is the understanding about what normal physiological birth entails and what needs to be done to support it, which is not currently represented in obstetric care. The cause of this requires exploration of obstetric history which is riddled with a gross lack of evidence-based beliefs and practices, which is alarming in itself (excellent literature on this topic would include reading: Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block, Obstetric Myths Versus Research Realities: A Guide to the Medical Literature by Henci Goer, Immaculate Deception II: Myth, Magic and Birth by Suzanne Arms, Immaculate deception: A new look at women and childbirth in America by Suzanne Arms). The consequence of this is the publications of medical recommendations that are deficient in critical data, since the majority of research papers on the subject are funded by these medical establishments whose main objectives are preventing liability suits, not optimal care of mother and infants. Hence the growing rate of cesarean sectioning, despite poorer perinatal outcomes for example.     

This is where the myth that obstetric care is the best and safest option for all women, even perfectly healthy ones, comes in. This ignores the accumulation of anecdotal evidence from the midwifery model of care that is more knowledgeable about normal birth which is apparent in its growing volume of statistical outcomes. Especially in countries whose maternity care systems implement the use of midwifery primarily instead of specialists like obstetricians for normal pregnancies. The level of positive feedback from women who have experienced both hospital births and then home births in Canada and the States make it very apparent that the quality of care is vastly different. However what is presented in the media is much of the fear-mongering about ‘complications’ in homebirths that are exaggerated for shock value by journalists that have very little working knowledge about the physiology/psychology of birth, which is obvious to those who are aware of the politics involved around maternity care.   

You have to keep in mind that the rate of unnecessary interventions that cause birthing complications to begin with is very high, especially in hospitals where it is not actually tracked statistically as such. Mothers and infants who survive certain complications within hospitals are considered ‘saved’ by their attendants, despite the growing evidence that many of these issues are rooted in their interference of the birth process to begin with. The revival of the midwifery model of care is still fairly recent as well and they are still strongly controlled by the medical industry as far as policies go and often those unnecessary interventions from this approach to childbirth are still present even in home birth settings, causing many of the preventable issues which are more apparent to the average viewer than what occurs daily in hospital settings. Homebirths on the other hand are much more scrutinized, hence the media frenzy about them. Often the complications that required a transfer from home would have occurred regardless if in hospital as well but this is purposefully overlooked (or due to ignorance about birth management) in order to maintain the deception that the medical model of birth is superior. Discerning a true medical complication from labour mismanagement must be done by the individual analysis of women’s birth experiences and not clumped together under the ‘home vs hospital’ inflammatory debate.

The dialogue that occurs between women, midwives and doulas that is based on direct experience reveals a noticeable pattern of how normal physiological birth can unfold if properly supported rather than interfered with. It is through women’s birth stories and through conscious attention to ideas and concepts that emerge outside of research papers that one can glean the true wisdom about women’s bodies. It is important to immerse oneself in all forms of knowledge in order to get an adequate view of what the birthing climate really is for women today. Therefore we cannot altogether dismiss the importance of what is written by the women themselves who are the ones who are doing all the work, experiencing the truth of their bodies every day. These sources are also important and deserve validation.