Misplaced Fear

by Jan Tritten

[Editor's Note: This editorial originally appeared in Midwifery Today, Issue 67, Autumn 2003.]

Jan Tritten, Michel Odent and Naolí VinaverI find it fascinating that women are afraid of the wrong thing when it comes to birth. They are afraid of birth when it is what they are perfectly designed to do. The thing they should be afraid of is whom they put their trust in and where they birth. Normal birth with a doctor in the hospital is almost always a recipe for disaster with lifelong, far-reaching effects. Doctors are not trained in physiological miraculous birth. They are needed as surgeons and high-risk specialists. They are highly trained in pathology.

Misplaced fear is perhaps the single most dangerous thing a birthing woman can have. Blessed is the rare woman who stumbles upon a protective midwife to help guide her through the modern pitfalls of pregnancy and birth in the 21st century. Reflect on this a minute. Something that is a miracle and the culmination of womanhood in many cultures, through self-fulfilling prophecy, becomes hell on earth because of misplaced fear and misplaced trust. Trust in the medical profession for a normal physiological function is a societal, cultural and personal disaster. Using an obstetrician for normal birth is like using a pediatrician as a babysitter, according to Marsden Wagner.

I love the way a midwife friend describes cesarean birth. She says to ask any mother what she remembers about her birth. The woman who had a cesarean cut remembers forever the last painful contraction and the feelings of fear and failure that went with it. The mother who had a natural birth remembers the power and love of bringing forth her baby. "I did it," a woman in Western culture will often say. Ecstasy and joy are often her fruit. I was elated for three years after my first homebirth. In other cultures (and times), women do not even question whether they can do it. Every woman, it is assumed, can.

Fear, a normal healthy protector of humans and animals alike (we are, after all, animals), has turned on us. It rarely protects us anymore but causes us to miss the miracle and ecstasy and healthy start birth was designed to be. Fear permeates everything in birth. It is the force behind all of the bad decisions a woman makes. Fear even affects the amount of pain we experience, as does expectation. Brilliant women who research and challenge everything in their culture readily and unnecessarily go to the chopping block in birth. The sad thing is that the effect of this ripples through their lives and their babies. Trust and fear are opposites. Why do we not challenge the current way of birthing? How can we help women turn their fear into trust?

I see the strangest fear-producing headlines in the news. "Doctors Stumped. Ten Percent of All Babies Born Prematurely." There's a nicely packaged fear-producer. The woman often thinks, "I better go to a doctor and the hospital in case I have a premature baby." All these iatrogenic conditions, and women walk right unto the path of the "doctor-caused" intervention. There is an induction rate of 67 percent and epidural rates of as much as 95 percent in some hospitals. With no nutritional counseling and the fear and stress that women are under, is it any wonder they have premature babies one out of 10 times?

We see similar scary headlines about preeclampsia, the mystery "disease" they can't figure out. Feed the mother. Quit worrying her with expensive tests of no value and make sure every mother gets a midwife. A woman today is stuck in a fear-producing, dangerous, deceptive and lying medical system with practitioners who know absolutely nothing about having a baby by the process designed by God. It is not a medical event. There is almost no hope of a peaceful pregnancy and joyous birth within the medical system. Every woman needs and deserves the kind of nurturing and care a midwife provides.

So, where does this leave us? How can we counter the fear? Birth change will probably not come from women by themselves. Medicalization and reality TV have disempowered too many of them to form a strong coalition of mothers with midwives, as happened in New Zealand. It will be the midwives, doulas, childbirth educators and activists. This is a big job, but look around. There is no one else but you carrying this knowledge. With the gift of the knowledge comes the responsibility to carry it to society. Together we can do this.

It may sound impossible, but we need hope and action. If you give up hope you won't take action. I have talked about changing birth many times in Midwifery Today. Sara Wickham's "26 Ways to Change Birth Globally" is on our Web site at www.midwiferytoday.com/articles/changebirth.asp. We must keep having this discussion as we take stock and take action. Perhaps we cannot change the entire world in our lifetimes, but more women are now breastfeeding. Activism has helped. Perhaps when women see the direct connection between birth and breastfeeding, some action will be taken in the hospitals. So much money is made in the process of industrializing birth. But if we can help women understand the miracle they are missing, fear will turn to trust and change will occur. If we can help them realize the joy and ecstasy possible there might be a chance to normalize birth. The first battle is in the mind. How can you help? What will you do? Together we can. Together we must. So let us forget our petty battles and fight the fight we were born for.

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Jul. 23, 2008 at 2:44 PM

What about all the women in 3rd world countries who have still births because they didn't have medical intervention?  Or all the women in these countries who die during childbirth because everyone assumes they can do it naturally?  I watched a program on PBS a couple nights ago about births in African nations.  So many woman die because they are miles from a hospital and are just lying there trying to birth a baby because it is what their bodies are meant to do.  Unfortunately, we are having bigger, healthier babies these days and medical intervention is very very neccessary in so many cases.  My mother wouldn't dilate at all with my brother, almost tore open from the inside with me, and had to have forceps to pull my sister out.  There are so many times that women just can't do it without a medical doctor on hand to help.

I'm not disagreeing with you because I myself am interested in finding a midwife, but I just wanted you to know that either you have been lucky enough not to need an OB or you just haven't looked at the other side of the spectrum.  With Americans having HUGE babies, we are needing doctors to be there!  I had meconium in my water when my DD was born, had I birthed at home, we would have had a pretty serious situation on our hands if my DD would have taken her first breath with that meconium in her mouth and lungs. 

So, we never know what to expect and it can be very risky.  Since hospital births and OB's being there for our prenatal and birthing care, the rate of dying during childbirth has decreased expnentially. 

But....statistics can be used to tell a story in any way you want.  they are very misleading..

so...there's the flip-side of that coin.  I hope you can see it in the eyes of us mothers who feel safe in a hospital...

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Nov. 7, 2008 at 4:58 PM

According to what I learned, African women don't die because they're away from hospitals but because they're unable to feed their body and baby correctly. Give any woman nutritious food, clean water and a stress free pregnancy (civil war for example or other economical disaster) ) and compare again. This article is about Fear and how this feeling interact with a natural experience. An excellent book to read is  "Childbirth without Fear" by G Dick-Read. I will quote Laura Kaplan Shanley, Unassisted Childbirth:" Like their animal sisters, women will someday deliver their own babies peacefully and painlessly at home. Women will understand that birth is only dangerous and painful for those who believe it is".

"With Americans having HUGE babies, we are needing doctors to be there!" Where do you get your info?. And even huge baby can be deliver safely as long as the mom relaxes enough and is able to walk around and change position ( wich is not the case in hospital where women are lying on their back and  strapped to bed)

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