Submission for “Other Voices” section of the UNION Newspaper 8/25/06
MAKE MATERNITY CARE MOTHER AND BABY-FRIENDLY
By Deborah Jordan
On September 3, I will make my stage debut in a stage read play called BIRTH that will “BOLDLY go where no play has gone before: between the legs of seven laboring women”. Whether you’ve given birth or not I think you’ll find the naked truth about how American women feel poignant and hilarious. We are one of 20 cities, around the world including New York, Washington DC, Los Angeles, and New Delhi, India, participating in BOLD (Birth On Labor Day), a global movement to make maternity care MOTHER-FRIENDLY. The play deals with the controversial role technology plays with this most natural process.
The World Health Organization states “no region in the world is justified in having a cesarean rate greater than 10-15 percent” but in 2004 the US cesarean rate was 29.1 percent. Surprisingly, this procedure is sometimes performed for pain avoidance, patient or provider convenience, legal concerns or financial incentives. My character, Beth, an intelligent professional women decides to have her baby by “elective” cesarean two weeks into her pregnancy with the cooperation of her doctor because she is convinced that natural birth is not clean, civilized, or easy to recover from when in fact the opposite is true. A woman has a 2-4 times greater chance of death from a cesarean than a vaginal birth. What Beth doesn’t know is that “elective” cesarean also increases the risk to the baby of premature birth, respiratory distress and even with mature babies, the absences of labor increases the baby’s risk of breathing problems and delays mother-newborn bonding, a subject of paramount concern for both.
The American College of Obstetricians and Gynecologists (ACOG) recommends women be encouraged to labor and have a vaginal birth after cesarean, however, many hospitals in North America, including our own Sierra Nevada Memorial & Auburn Faith, do not encourage or allow this even though studies show a 75-90 percent success rate in vaginal deliveries after previous cesarean.
In my work, I encourage women to cultivate confidence in the intelligence of their body’s design and their capacity to manage labor pain naturally. I support women in being discerning consumers within the childbirth market in America. I join the playwright in support of CIMS (Coalition for Improving Maternity Services) whose promotes a wellness model of maternity care to improve birth outcomes, substantially reduce costs (to consumers), and require interventions to be scientifically evidence-based instead of fear-based.
Henci Goer, in her book The Thinking Woman’s Guide to a Better Birth, cites results in the late 1980s that show hospitals can reduce cesarean rates by instituting policies that include: second opinion of emergency cesareans, trial of labor for all women with previous cesarean, waiting longer before determining failure to progress, peer review process, and the use of more reliable testing to diagnose fetal distress. It is believed that the absence of these practices in the past has led to unnecessary surgeries. She notes that in Chicago when, over a two-year period, the cesarean rate dropped from 17.5 to 11.5 percent, the hospital lost $1 million in revenue. We must be aware that vaginal births are not as lucrative for hospitals.
Many times the disregard for the baby’s need to initiate labor starts with the routine practice of artificially inducing labor elevating a woman’s chance of a cesarean birth. An “off-label” drug called Misoprostol, an ulcer medication that is not easily controlled, can cause the uterus to overcontract sending the baby into fetal distress and is currently being used in our county to “terminate” pregnancies and induce labor. What price do babies pay for someone to make a buck and what price does society pay when the baby’s readiness is not honored?
We must dispel the myth that technology is superior to nature. Hospitals, birth clinics, and home birth services can apply for Mother-Friendly designation if they comply with CIMS’s Ten Steps (www.motherfriendly.org). The tenth step is to comply with the World Health Organization (WHO) and UNICEF’s “Ten Steps of the Baby-Friendly Hospital Initiative” to promote breastfeeding.
Childbirth practices affect us all. Birthing women and couples do the awesome service of bringing the next generation into the world. These babes will be the adults of tomorrow. A few months ago I received a postcard for the next International Congress of the Association of Prenatal and Perinatal Psychology and Health. It says: “The physical and mental health of an adult is deeply rooted in his or her womb life. Thus the well-being of nations is linked to prenatal life.”
Deborah Jordan, member of Birth and Early Parenting Educators-BEPE, mother of two, is a writer and Certified Prenatal Yoga and Meditation Instructor in Nevada County. She teaches private lessons and conducts her programs at Wild Mountain Yoga Center. Contact her at: www.bodhibabyyoga.com