Thursday, June 9, 2011

 Global Medicine Hunter News

FOR IMMEDIATE RELEASE

By Dr. Meg Jordan

SAN FRANCISCO---) In the past decade, the U.S. the obstetrical field appears to be doing all it can to scare pregnant women into unnecessary interventions--a slick pathway leading to the astronomical number of Cesarean sections in this country. We outstrip every other developed nation at a rate that rose by 53% from 1996 to 2007, reaching 32%.

The pregnant woman I interviewed for this story state they're too worried to undergo natural childbirth. Their doctors told them everything that could go wrong so they are simply scheduling their epidurals—or worse yet, C-sections—and foregoing the idea of a a natural method. "I don't intend to feel one contraction," said 32-year-old Shelly. "Why should I?"

It may be a surprise, especially to health professionals in the U.S. that solid research and "evidence-based" practice show that 80-90% of women can safely birth outside of a hospital – in a birthing center, clinic or at home.

But in the era of celebrities touting near-perfect bodies days after childbirth, and some even proclaiming, they're "too posh to push," it seems we need a renewed feminist movement to take back birth, and reveal the facts that are covered by the smoke-and-mirrors of high-tech medicine.

Suzanne Arms, a leading childbirth educator and founder of Birthing the Future international campaign, agrees that medicalized childbirth does have its place when it comes to life-saving techniques. "Hospitals, physician care, safer surgical techniques, technology and pharmaceuticals do have roles to play in childbirth," she says. "And at least 10%-20% of women across the world would prefer to, or may benefit from, what these potentially life-saving advancements have to offer them and their baby. However, to have the public believe that all birthing women and babies must birth in a hospital in order to be safe, is a dangerous misconception and makes poor use of resources."

More of Suzanne's thinking:

"What makes birth safe is, first, having a mother and baby enter labor in good health and the woman in a positive frame of mind. Healthy childbearing is primarily a function of public health and is directly related to the status and empowerment of women, not to obstetrics: having clean water, safe housing, adequate nutrition, knowledge of how their body, pregnancy and birth, work. The same hormones that govern healthy sexual response govern labor and birth. Naturally-secreted oxytocin (unlike the artificial form called Pitocin that's used to start or speed up 60% of U.S. births), keeps contractions effective and promotes the woman falling deeply in love with her baby and becoming a fiercely protective, yet calm, mother."

Suzanne led a conference in the Canary Islands this spring which attracted childbirth educators, mother-child bond researchers, and an international group of midwifery experts from over 17 nations. She believes that the role of midwives, to support the woman and protect the process and the mother-baby, which requires patience and presence, and the safeguarding of privacy so the mother's body can work effectively. However, the training of physicians is to look for potential problems, which tends to overtreat anything that might lead to a complication, and the treatment itself often begets more drugs, technology and surgery. It's the orientation that beckons problems in many cases.

Suzanne recommends that we put in place four changes immediately to end the of epidemic of birth trauma in women and babies and lower mortality and morbidity:

1) Transform all hospital maternity and neonatal units into "sanctuaries" for birth, following the principles of what promotes biologically natural, normal birth, and honoring the fact that birth is a deeply psychological, spiritual, sexual and social process, and critical to full bonding. Everyone loves their baby but love is not the same as bonding. Artificial birth practice hinder full bonding and make parenting much harder.

2) Train all physicians and nurses and shape hospital policies around a physiological model for birth, following sound biological principles, doing no intervention unless medically required and preventing and healing psychological birth trauma in woman and babies. This model is the Midwife Model of Care."It requires those caring for mother-baby in birth to know the woman (and her personal story and values), having cared for her during pregnancy and continuing provide care for and the baby in the first six weeks after birth (continuity of care). We must train enough midwives for every woman to have a midwife follow her from pregnancy through postpartum and have social workers and counselors be available to any woman and family who need it.

Fostering the mother-baby bond by fostering optimal birth and stopping the separation of mother and baby for any reason, is the key to breaking the vicious cycles of family dysfunction – abuse and neglect – where they start, at birth. It's also where we help humans achieve full brain and immune system potential.

3) Practice not stimulating the mother's neocortex in labor and treat each baby and woman as paradoxically both innately resilient yet highly sensitive and therefore vulnerable to psychological trauma. Create an environment of calm, lights low, soft voices, and affirming, empowering language. Policy changes are needed so that every mother-baby is cared for as one unit, without any separation, for any reason. This is critical in birth and also in neonatal intensive care. Learning how to be a truly sensitive care provider in birth requires addressing our own unhealed issues around birth and being centered in our own body, heart-centered. And, both doctors and nurses, because of the stress of dealing with complications and emergencies need regular help healing their own shock and trauma and practicing patience.

4) Reimburse the same for anyone who attends a "normal, natural" birth. Give incentives to practitioners for helping women achieve a state of high-level wellness in pregnancy. Pay no one (doctor or hospital) extra for performing interventions in birth (e.g. induction, epidural, cesarean, and circumcision). That will dramatically reduce our high rate of unnecessary intervention and cesarean surgery. Plus, it will make birth safer because every intervention interrupts the natural process and carries risk of harm.

Our neonatal and perinatal physicians must be valued as a costly resource, to be used only when necessary, and as an adjunct to – rather than in control of – nurses and midwives. Also reimburse women and couples when they take independently taught birth preparation and new parenting classes. Finally, reimburse "doulas", for they provide needed continuity and support for busy nurses and hospital-based midwives, who cannot stay at a woman's side throughout labor.

Over 60% could birth in a birth center located in their community, staffed and run by professional midwives, with hospitals and physicians having incentive to provide backup. An additional 10-20% can safely birth at home, accompanied by a midwife who has followed them through pregnancy and will care for them during the postpartum. Maintaining planned home birth is critical.

Communities should consider the following:

Create and promote medically-backed but midwife-run birth centers, supported by the medical community, and fully reimbursed, as does home birth. Planned and professionally attended home birth must be protected (not attacked, as it now is). And paying midwives well is necessary. It's a little known fact that, in societies that still do female genital mutilation (FGM), when a traditional midwife does it, she gets paid, but seldom gets paid for caring for a women in pregnancy, birth and postpartum. Economics do matter, as does the status of women and the status of midwives.

Strive to achieve that 60% of all births in a community occur in the birth center

Only home birth offers the model of what biologically normal birth looks like so that we have something to refer to when we design hospital birth, neonatal and postpartum units and birth centers. Home is where most women feel secure and the emotional component of birth, and maximizing the natural sexual hormones of birth, notably oxytocin, are what keep birth normal.

Suzanne says, "We all came into this world through the portal of our mother's body. Women never forget how they were treated in pregnancy, birth and postpartum. It's time to shift birth practices so they reflect the wisdom of what "evidence-based" care, traditional indigenous knowledge and intuition provide."

For more information, contact Suzanne Arms ( suzannebirthing@gmail.com, and BirthingTheFuture.org.

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Dr. Meg Jordan, PhD, RN, CWP, is an international health journalist, author, behavioral medicine specialist, and clinical medical anthropologist, Department Chair and Professor of Integrative Health Studies at the California Institute of Integral Studies. mjordan@ciis.edu