So often when we get caught up criticizing each other, bemoaning the typical standard of care in hospitals, and talking to death what evidence-based maternity care looks like, we are overlooking something big. For the eons that humans have walked this earth, women have been having babies. Many women and babies died; many did not as evidenced by the current world population. We are moving backwards in maternal outcomes in the United States, and a disturbing number of people think it's normal if not acceptable.
I love to read birth stories in general, but this year I felt like I had an inside joke with the long-deceased mother of Christ. Mary's story is a birth story. How funny that two thousand years later millions of people recount and ponder the moments in which she experienced what is one of the most profound moments in a mother's life: birth, the process by which our babies move through our bodies and into our arms. I'm not going to delve into the spiritual side, which I do believe exists, but the human side. For those of of faith, one of the biggest mysteries of that faith is the fact that Jesus was fully divine and fully human. Whether you're following that train of thought or believe that the story is a slice of history or a myth, thanks for reading and bear with me. References to follow once I have all of my bookmarks and books at my fingertips.
She was likely lonely and afraid, not as the mother of the Word made Flesh, but as a teenage girl away from home about to give birth in a strange place without her mother, sisters, or aunts to serve as her guides. I bet I was the only one in church last night imagining what laboring on a donkey would have felt like, imagining what might possibly be going through this girl's mind.
Did she pray? Did she cry? Did her fiancée wipe her brow and hold her? Odds are good that she was not lying on her back with her knees pulled into her chest as the shepherds counted to ten. I'd guess she was drawn instinctively to the warmest, darkest corner of the stable or space. She probably lifted her dusty skirts and squatted just like any good ancient would to defecate. Her baby probably gently landed on cloths, straw or Joseph's waiting hands. The sound of his first grunts and cries were likely the sweetest thing she'd ever heard. Nobody rushed to clamp and cut the cord, no overly anxious nurse whisked him to the other side of the room to be weighed and measured. She probably waited, took that moment to exhale, and reached for him. She probably sat back and opened her garment to place him on her chest where he nursed his fill and slept.
In those days, I can only imagine that a woman prayed to survive pregnancy, give birth to a live and full-term child, not to die of infection or blood loss postpartum, and to remain healthy and nourished enough to breastfeed. In Mary's case, I guess I should add in not be stoned for a forbidden pregnancy it of wedlock. That's a pregnancy concern that has never worried me. There were no prenatal tests or checkups. There was no "deadline" after which a greedy, lazy, or overbooked care provider would arbitrarily schedule a birth. Cesareans weren't an option when desperately needed, much less purely elective ones for frivolous social reasons. An obstructed labor meant at least one would not survive. In many cases, there was no one but another woman who'd had a baby to provide support. They just wanted to live and for their babies to live.
Have we forgotten that ultimate goal? It sure seems like care providers who casually intervene in otherwise normal, healthy pregnancies have. They are risking lives inducing, augmenting, and performing more than twice the cesareans WHO has recommended since the 80s.
The birth plan choices we have are privileges as many women in the world still struggle to survive and produce offspring who will survive. Abuse and overuse of tests, procedures, and interventions intended for rare problems disgusts me. It should disgust you too that over 20 countries are ahead of us in terms of maternal and infant outcomes.
There is good evidence to support that more interventions in labor do not produce a healthier baby. Why do it, then, if it is a fact that maternal morbidity and mortality increase as those interventions increase. There is a direct correlation. Have we lost sight completely of the thing the human race has been struggling for thousands of years to do--bring more women healthily to and through labor and enable them to hold and nurture their healthy newborns?
We have reached a new low in maternity care when maternal mortality has risen for the first time since blood banks and antibiotics became widespread. Yes, the actual number is small, but maternal mortality has doubled in the last 10-15 years. Doctors don't seem worried about that, but they sure are worried about those numbers that say twice as many babies die in utero past 42 weeks. It's a smaller percent increase than our maternal mortality rate. Let's compare it to the number of non-medically indicated inductions that end in cesarean, the number of women whose fertility is affected by a cesarean, or the number of women who suffer from 3rd and 4the degree perineal lacerations. I don't see shifts in practice there regardless of piles of studies.
Chances are nobody will be telling my birth stories or yours in two thousand years, but I'd settle for moving towards a way of mother making that truly values the lives of both mothers and babies, nurtures the unique dayad that is created, and seeks to lessen number of challenges we must face to get our babies here safely.
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