Excerpt from "Safer Birth in a Barn?" Midwifery Today, Issue 83
posted with permission
The protocols in the world of animal husbandry to protect an offspring at the time of birth—no strangers, dimmed lights, freedom of movement, familiar environment, unlimited nourishment, respectful quiet, no disruptions—are done without hesitation because to do otherwise invites "unexplained distress" or sudden demise of the offspring. These thoughtful conditions are the norm, along with careful observation to determine when to use the technological expertise in true emergencies. When we have veterinarians in our childbirth education classes, they always start to smile and nod when I tell this story. These are givens—instinctive givens, even, for animals of all descriptions!
Yet what are the "givens" for the human who births not in a barn, but in a "modern and advanced" hospital? In many cases, 100% the opposite! Usually a minimum of a dozen strangers pass through the world of the laboring mother in her first 12 hours in the hospital—security officer, patient transporter, triage secretary, admission clerk, triage nurse, resident and/or doctor on call, admitting nurse, first shift nurse, break nurse, additional nurse at delivery, doctor or midwife plus possibly students, anesthesiologist, pediatrician, etc. Bright lights in the triage and labor rooms are challenging to dim. Mothers are tethered to monitors or IV poles and are moved through a bright hall with unfamiliar sounds to a new room in a building devoted to illness/trauma that most have visited once briefly if at all. They receive poor quality "clear liquids only." They are exposed to voices of others in the hall or chatting by the attendants during contractions and endless disruptions throughout! But then, do we ever find that we have an offspring experience "unexplained distress?" Of course, and at frightening rates! Yet, oddly, many of these disruptions are promoted as minor inconveniences or necessary to "protect" the baby.
Curiously, while veterinarians commonly have to defend interventions in light of the additional cost and the risks associated with interfering with nature, providers caring for human mothers within the medical system more commonly are forced to defend why they did NOT intervene! Consider the high rates of inductions, epidurals, artificial rupture of membranes, immediate cord cutting, cesareans and the vigorous defense necessary to fight for anything different, especially if time is involved (time to go into labor, to progress, to push, to allow the cord to stop pulsation or to get "done" bonding). I've recently seen outstanding CNMs and obstetricians sacrifice their own political reputations and suffer departmental reprimands for births with great outcomes where they protected the mothers' yearning for privacy, allowed extended pushing time with great vital signs or, during a healthy normal birth, followed their intuition and honored the mother's begging to check heart tones frequently by hand during pushing instead of what the mother considered the massive intrusion of wearing the monitor belt. Interventions are considered to be the ultimate protection from litigation in human care, yet they contribute mightily to the high rates of distress in mothers and babies!
In animal husbandry, the first line of defense for protecting the unborn is to protect and nurture the nutritional needs and comfort of the birthing female. In the case of institutionalized birth for humans, however, in spite of evidence to the contrary, the norm is to act as if the nutritional needs and the comfort of the birthing mothers are of concern to, at most, the marketing and public relations department! It's an affront to common sense that as a society we are currently more accepting of the needs of foaling mares, whelping poodles and high-producing cows than of our birthing humans. From the high rates of fetal distress, meconium staining and breastfeeding problems, the consequences are clearly devastating to our infants, just as any decent horseman would predict.
"I'd take birthing in a barn over birthing in a hospital any day..."
Posted by Creeping Starfish on Jul 6, 2008
My feeling exactly! :)ReplyDelete
I grew up on a farm. Natural out of hospital birth was a no brainer for me.
I've never seen this illustration, and it hits home! Thank you for posting this.ReplyDelete
After growing up surrounded by foaling in the thoroughbred industry. I have seen so much intervention performed by non-veterinarians then I care to ever witness again. Interestingly out of all my family members my step-Dad the vet is the biggest spokesperson for choosing homebirth since his grandson was safely birthed at home by me in 2008.ReplyDelete