The Unnoticed Merits of Having a Midwife During Pregnancy
In the classic novel A Tree Grows in Brooklyn, which takes place in early-20th-century New York, a midwife attends the birth of the desperately poor Francie Nolan. Later, Francie's aunt insists on having a doctor at her birth, evidence that she's moving up the economic ladder.
But as a recent New York Times piece suggests, it seems midwives are enjoying a resurgence in popularity, becoming "a status symbol" for the "hip." Choosing to deliver with midwives present, the article claims, is "no longer seen as a weird, fringe practice favored by crunchy types, but as an enlightened, more natural choice for the famous and fashionable," including for high-profile moms such as and Gisele
Well, in the United States, anyway. In other developed countries, being attended by a midwife is thoroughly ordinary. Four years ago, I gave birth to my second son at Forth Park Maternity Hospital in Scotland, with a midwife. In the UK, doctors typically attend only births that are considered "high-risk," and whereas I'd been classified as "high-risk" with my first pregnancy in the States, in the UK, practitioners are much slower to use that label.
The Times article seemed to assume that birthing with a midwife is somehow inferior—for why else would it be newsworthy that rich and famous women are choosing midwifery? It betrayed a certain cultural prejudice against midwives that's uniquely American. When U.S. doctors entered birthing rooms in the 19th century, it was with suspicion of midwives, who were mostly poor, uneducated, immigrant women and regarded as "dirty," "ignorant," and likely to be "dangerous." This despite the fact that the major killer of mothers in the 19th and 20th centuries, puerperal fever, was spread by medical doctors at much higher rates than midwives. In addition, doctors tended to "interfere" more extensively in births with the use of forceps and other instruments, so they had higher rates of injury and lacerations. Nonetheless, because of the "danger" of birth (sometimes caused by them), doctors came to regard their presence at births as indispensible.
It's that notorious interference—or intervention—that has more women today choosing midwives. Having benefited from medical advances that can make childbirth as safe as it is in the United States, many women are also realizing that typical Cesarean rates are unjustifiably high (one in three American mothers now delivers by C-section; in 1965, it was 1 in 22), and that birth is something that we do as whole people, not just pelvises and abdomens. Delivering with a midwife, even at home, is for many women just as safe as delivering with a doctor. But choosing a midwife represents not only a flight away from the highly medicalized birth but also a movement toward reclaiming the emotional, social, and spiritual dimensions of giving birth.
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