When it is time for a woman to give birth, the decision of where she would like to give birth and who will deliver the baby is hers, and hers alone. It is her body, and it is her baby. She is the only person that knows herself and where she’ll be most comfortable; when your body is able to relax, it will help the birthing process go more smoothly.
Let me begin by describing natural childbirth for anyone who hasn’t experienced it. Labor pains are different than any other type of pain you have ever had; It’s not like breaking a bone or stubbing your toe. Labor pain has a purpose, which is to move your baby down and out. A number of things go into an effective labor, including the environment of the room, the emotions of the mother and the hormones her brain is secreting.
There are two common types of maternity care available to women in the land mass often referred to as the United States: Midwifery or humanistic and obstetrics or techno-medical. Midwifery, which has been around since the beginning of mankind, is centered around women by women. Midwives understand that labor is something that women do, not something that happens to them. Childbirth is as natural as blowing your nose and midwives trust the mother’s body to do what it was designed to do.
Midwives tend to understand the mind/body connection, something that seems to be forgotten by obstetricians. In my experience, I’ve found midwives to be more compassionate than obstetricians. Most midwives also have longer prenatal appointments which leaves more time for questions and discussions about birth. When a woman is more relaxed, there is less chance of complications during delivery, so there is great importance in being around someone who is reassuring.
In the early 1900’s, government regulations and smear campaigns made the modern home-birth midwife an outlaw. By 1930 all but ten states had begun to regulate midwives. The Massachusetts Supreme Court was the first to make midwifery illegal, in 1907. In the South, midwives were initially supervised rather than criminalized, although this policy had explicit segregationist motives. By the 1950s, midwifery survived in pockets of the South and West. In 1957 there were just two midwives known in all of New York City.
The other side of birth is the Techno-medical side or Obstetrics, which is fairly new to the birth scene. Obstetrics was advertised to be safer than midwifery even though the maternal and infant mortality rates were higher. Obstetricians often assume that because labor is painful it must be treated like a sickness, with drugs and medical interventions. They tend to think birth must take place within 24 hours of hospital admittance, often giving intravenous drugs to stimulate labor. Obstetricians often induce a woman before her due date with the reasoning that her baby would be to large to pass through her pelvis. Obstetricians attend a four year residency; The first year is centered around “natural” birth and the following three years are spent learning about all the technology and equipment used. As the old saying goes, if you have a hammer in your hand, everything looks like a nail. I don’t want to be that nail.
While there are exceptions to both these models of care, I would generally advise going to a midwife. A small percent of pregnancies present dangerous conditions that require the mother to be carefully monitored at the hospital, but there are reasons for women to go to obstetricians; such reasoning would categorize these mothers and their pregnancies as high risk.
Although I strongly encourage midwives to get formal training, and would make the personal decision not to hire a midwife who has not received formal training, those who practice unlicensed or unregulated should not be threatened by the state. It is up to the mother to decide who she feels comfortable letting assist in the delivery of her child regardless of whether they have been given government permission to practice.
Certainly if there is a significant issue with a midwife, obstetrician, etc., licensed or unlicensed, as well as any other type of business, I believe that it important to publicize the issues in order to help keep other members of the community informed.
In 1974, the Virginia department of health discontinued licensing midwives who weren’t registered nurses and by 1977 legislation prohibited practice by those who didn’t already hold licenses.
1. T.A. Wiegers, J. van der Zee, and M.J. Keirse, “Maternity Care in the Netherlands: The Changing Home Birth Rate,” Birth 25, no. 3 (1998): 190-97
2. Block, Jennifer. Pushed: The painful truth about childbirth and modern maternity care. USA: Da Capo Press, 2007. Print.