In New Jersey, your likelihood of receiving a cesarean section is nearly 40%, despite the World Health Organization concluding, “[T]here is no justification for any region to have a rate higher than 10-15%”(1) because according to current data, “cesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates”(WHO).
If only 1 in 10 births result in a life-saving c-section, why do in 4 in 10 women receive one?
Why, in New Jersey, are 4 in 10 babies born via major abdominal surgery that includes risks of permanent disability and death?
OUR CONCEPT OF BIRTH IS BROKEN.
We do not allow women to birth in a normal, physiological manner, similar to all mammals.
Welcome to the “CASCADE OF INTERVENTION”
A step-by-step process of how birth is medically sabotaged from the moment you leave your house.
1. STAY IN BED AND ON YOUR BACK
Bed rest is associated with poor-quality contractions, shoulder dystocia, slow dilatation and effacement, low blood pressure, long labor, failure to descend, more pain, and an increased risk of c-section because of fetal distress or failure to progress. During pushing, laying on your back increases your risk of the use of forceps, vacuum, and episiotomies, as well as increased rates of pain and c-section (Zwelling)
2. CONTINUOUS FETAL MONITORING
When you are hooked up to a continuous fetal monitor, your movement is very restricted, as you are hooked up to machines (see above!). Continuous fetal monitoring should be used exclusively for high-risk pregnancies as it can inhibit position changes, comfort measures (such as baths and showers), and prevent the focus on the well-being of laboring woman who may be ignored in deference to the monitor tracing (Alfirevic et al.).
3. NO FOOD, NO WATER
It is policy for women to not be allowed to eat or drink while in labor, “just in case” they need to have a surgical birth. This can last for days if a woman is laboring slowly or being induced. Dehydration and maternal stress effects birth outcomes, however, studies show that light food and drink during labor does not influence outcomes in mother or baby (O’Sullivan et al.)
4. YOU NEED DRUGS TO SPEED UP YOUR LABOR.
Like all birthing mammals, your body now believes this place [a hospital] is an unsafe place to give birth and your stress hormones are doing their job: shutting down labor (Lothian 2). This is termed, “failure to progress” in the hospital. The laboring woman will then be injected with an synthetic form of oxytocin known as Pitocin, which causes the brain to not release endorphins in response to the pain, making her more likely to request an epidural. (Lothian 1).
INFORMED CONSENT means you understand that:
The administering of Pitocin into your body during labor may result in: postpartum hemorrhage, pelvic hematoma, irregular heartbeat, stroke, fatal spontaneous bleeding, high blood pressure, and uterine rupture and DEATH. Side effects on the baby include: low Apgar scores at 5 minutes, slow heartbeat, central nervous system disease/permanent brain damage, neonatal seizures, retinal hemorrhage, and DEATH. (FDA)
5. A NEEDLE IN YOUR SPINE
More than half of all laboring women receive epidural analgesia, an opioid anesthetic injected in the spine to eliminate the intense pain resulting from the Pitocin. Epidurals are associated with longer labors and an increased risk of instrumental delivery, intrapartum fever, and sepsis in infants, as well as lower instances of spontaneous vaginal delivery (Lieberman and O’Donoghue).
6. YOU DON’T KNOW HOW TO PUSH
When your baby is being delivered by your doctor, he or she will perform a cervical check, tell you that you are 10 cm dilated, and then begin to coach you on how and when to push your baby. Be prepared to observe the worst conditions for a natural birth; on your back, with your feet anchored in stirrups, holding your breath, as you push against all the natural processes. This kind of coerced pushing results in maternal fatigue, increased trauma/tearing to the perineum, as well as low oxygen and acidosis in the baby (Simpson). The supine position also narrows the hips by 30%, as opposed to upright positioning, such as sitting, standing, or squatting (Pyanov). Have you ever watched a giraffe, elephant, horse or any other mammal birth on their back? No? Then you shouldn’t either!
INTERVENTIONS CAN BE AVOIDED WITH EDUCATION
These are just some, not even all, of the interventions a woman can expect to experience while giving birth in a hospital. It is called a “cascade” because one thing causes another; the stress of dehydration and hunger, coupled with restricted movement and limited comfort measures, causes the failure of progression, which leads to Pitocin, so you beg for an epidural, which causes oxytocin levels to drop so nurses increase your Pitocin (Lothian 1), and if your baby is not in distress already, you still have to push, which can last 2 hours for a first-time mom.
It is no wonder why 1 in 3 women experience trauma while giving birth. Birth trauma is associated with postpartum depression and PTSD (Alcorn et al.). These mental health effects that negatively impact mother-baby bonding can have lasting consequences on the child’s social, emotional and mental development (O’Hara and McCabe).
Studies consistently show that having a doula present improves birth outcomes:
- Shorter labor by 41 minutes on average
- 25-39% less likely to receive a C-section
- 8-15% more likely to have a spontaneous vaginal birth
- 10 % less likely to receive an epidural
- 38% less likely for baby to have low Apgar scores at 5 minutes
- 31% less likely to feel dissatisfied about your birth (Dekker)
YOU DESERVE BETTER. YOUR BABY DESERVES BETTER.
A DOULA WILL HELP YOU MANIFEST YOUR IDEAL BIRTH.
REFERENCES
“Appropriate Technology for Birth.” Lancet (London, England), U.S. National Library of Medicine, 24 Aug. 1985, www.ncbi.nlm.nih.gov/pubmed/2863457.
Zwelling, E. “Overcoming the Challenges: Maternal Movement and Positioning to Facilitate Labor Progress.” MCN. The American Journal of Maternal Child Nursing, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/20215946/.
Alfirevic, Z., et al. “Continuous Cardiotocography (CTG) as a Form of Electronic Fetal Monitoring (EFM) for Fetal Assessment during Labour.” The Cochrane Database of Systematic Reviews, U.S. National Library of Medicine, 2008, pubmed.ncbi.nlm.nih.gov/16856111/.
O’Sullivan, Geraldine, et al. “Effect of Food Intake during Labour on Obstetric Outcome: Randomised Controlled Trial.” The BMJ, British Medical Journal Publishing Group, 25 Mar. 2009, www.bmj.com/cgi/doi/10.1136/bmj.b784.
Declercq, Eugene, et al. “Major Survey Findings of Listening to Mothers(SM) III: Pregnancy and Birth: Report of the Third National U.S. Survey of Women’s Childbearing Experiences.” The Journal of Perinatal Education, U.S. National Library of Medicine, 2014, pubmed.ncbi.nlm.nih.gov/24453463/.
Seitchik, J, and M Castillo. “Pitocin®(Oxytocin Injection, USP) Synthetic .” FDA, FDA, 1982, www.accessdata.fda.gov/drugsatfda_docs/label/2014/018261s031lbl.pdf.
Lothian, Judith A. “The Birth of a Breastfeeding Baby and Mother.” The Journal of Perinatal Education, U.S. National Library of Medicine, 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1595228/.
Lieberman, E., and C. O’Donoghue. “Unintended Effects of Epidural Analgesia during Labor: a Systematic Review.” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, 2003, pubmed.ncbi.nlm.nih.gov/12011872/.
Simpson, KR. “When and How to Push: Providing the Most Current Information about Second-Stage Labor to Women during Childbirth Education.” The Journal of Perinatal Education, U.S. National Library of Medicine, 2006, pubmed.ncbi.nlm.nih.gov/17768429/.
Lothian, Judith A. “Do Not Disturb: the Importance of Privacy in Labor.” The Journal of Perinatal Education, U.S. National Library of Medicine, 2004, www.ncbi.nlm.nih.gov/pmc/articles/PMC1595201/.
Pyanov, Maria. “Small Pelvis? Big Baby? Here’s The Truth About CPD.” BellyBelly, 2 June 2020, www.bellybelly.com.au/birth/small-pelvis-big-baby-cpd/.
Alcorn, KL, et al. “A Prospective Longitudinal Study of the Prevalence of Post-Traumatic Stress Disorder Resulting from Childbirth Events.” Psychological Medicine, U.S. National Library of Medicine, 2010, pubmed.ncbi.nlm.nih.gov/20059799/.
O’Hara, MW, and JE McCabe. “Postpartum Depression: Current Status and Future Directions.” Annual Review of Clinical Psychology, U.S. National Library of Medicine, 2013, pubmed.ncbi.nlm.nih.gov/23394227/.
Dekker, Rebecca. “Evidence on: Doulas.” Evidence Based Birth, May 2019, evidencebasedbirth.com/the-evidence-for-doulas/.
