August 30th, 2011


homebirth: vs. apathy or vs. science?

I'm currently reading "Brought to Bed: Childbearing in America 1750-1950" by Judith Leavitt. I'm in the early chapters and it's really taken a hold of me because childbearing in America in 1750? REALLY GRIM. We forget how good we have it. About 1 in 150 births resulted in death of the mother, which doesn't sound so striking until you figure that the average woman had 5-7 full-term pregnancies, so she faced that 1 in 150 statistic over and over again. It means that among women of childbearing age, about 1 in 30 would die in childbirth. They saw it and knew it, they made arrangements for care of their babies if they couldn't be there, at the same time they celebrated their pregnancies they mourned for the possible loss of their young lives. It reminds me of the post I made after having a baby about why the women's movement took so long to gain ground... were women being forced out of government posts and forbidden from schools? A little. But mostly we were dying in childbirth! That sort of thing tends to hold you back from your life goals, a little!

I've been in all these pregnancy communities over the past year, celebrating natural birth and hearing that our bodies were designed to give birth and it's this beautiful wonderful thing. When that viewpoint is debated now, it's truth isn't debated, just it's importance. There's a lot of "choice feminism"... the idea that any woman getting to do what she wants is good for women everywhere. I usually saw two sides of the story: first was the pro-homebirth side, with its midwives, experts, books, and $300 hypnosis study courses. The other side was just a "you're overthinking this" side, women who wanted an epidural two weeks before their due date because they didn't give a crap, just wanted to get pregnancy and birth over with as early as possible. The two sides generally agreed to disagree.

In the midst of this I recently ran across Dr. Amy Tuteur's blog, The Skeptical OB, who is presenting a different side to the debate: lambasting homebirth for being incredibly dangerous. And, while she's at it, lambasting feminists for letting women's choices fly in the face of science. While I hate people who throw feminism under the bus (it can be your movement, make it what you want, that's my view) a little part of me sees her point because I've always mourned the fact that science and feminism, and therefore science and women, don't intersect much. Feminism is a study of humanities, it's made up of writers and lawyers and historians... science has to pass by the wayside. Too many of my fellow women engineers don't want to identify as feminist, they don't see how the movement relates to them. Not coincidentally, there aren't many women engineers.

Dr. Amy points out again and again that what's natural isn't necessarily what's good... this applies to the homebirth movement and definitely to the anti-vaccine movement. Yes, nature has gotten us this far, we've survived thousands of years. But it can keep our species going just fine if 99% of the women and 90% of the babies survive childbirth. That's good enough for nature. Nature doesn't care about you as an individual... just its letter grade. Which, lets face it, is an "A"!

Science can, and does, do better, but the message isn't getting out. And while the message isn't getting out, women are dying in childbirth again. Dr. Amy's blog is reporting each and every story... and not in a nice blameless way.

There's a balance here. Like any natural birther, I'm bothered by the repetitive stories in pregnancy communities where a woman is induced for sketchy reasons, labors slowly under epidural, is given pitocin to speed things up which puts the fetus in distress and a C-section is required. But at least in that story, everyone involved is safe and alive. We shouldn't go back to 1750 in our reactions, we shouldn't form all our opinions based on Ricki Lake documentaries. We have to stay open to what science can do here, even if it's harmed women in the past, because nature has harmed us too. It's more complicated than just shunning one side entirely.