I stumbled on this image the other day on Pinterest and it’s been haunting me ever since. Likely not so much because I’m pregnant right now (or maybe it is) but moreso because of how much, and how often, I think about the state of maternity care in our nation.
Though I understand the photographer was simply paying homage to another photographer, using her newly born nephew as the subject, I find it speaks VOLUMES about birth in hospitals. And yes, I recognize that this post may piss people off. The good ones usually do. They touch nerves, they elicit guilt, they bring up memories you’d might have rather not remembered. But the truth is that our maternity care is abysmal, we’re doing it to ourselves (yes, even those self-selecting OUT of hospitals), and we can change it, if we just choose to open our eyes to what’s really going on.
Maternal Mortality in the United States falls behind 40 other countries at 11 deaths per 100,000 live births. It’s defined as the death of a mother, from a number of various causes, within 42 hours after giving birth (1). Severe bleeding/hemorrhage is listed as the top cause of death. One of the most used drugs during labor in American hospitals is Pitocin. Why? Because it (can) speed labor up (why, I ask, must labor be sped up and not allowed to go at the pace the woman’s body deems it should go?). One of the side effects of Pit is post partum hemorrhage (2). Ironically, it’s also administered by midwives FOR post partum hemorrhage. The drug works, much like our own natural oxytocin, to create uterine contractions. This can be a good thing, or it can be a very, very bad thing.
The use of Pit often leads a laboring woman towards an epidural a lot faster than she might have gone on her own (if at all). Pitocin contractions are notoriously intense, moreso than oxytocin contractions, and can come on stronger and more suddenly than a woman’s body (and baby) are ready for. So she asks for an epidural. Though epidurals are considered generally “safe” by the medical community, they introduce a whole host of other potential problems to a labor (3). It is extremely controversial to say that the likelihood of a cesarean delivery is greater with an epidural, but it appears more and more that this may be the case. And, though a cesarean is again, generally considered a “safe” surgery, it is still major surgery. And with that comes another host of potential side effects, including blood clots and anesthesia issues, and placenta previa and accreta for future pregnancies (4).
Maternal death is highly preventable. Highly. If modern obstetrics would just LEAVE BIRTH ALONE, and let it develop as it needs to, most of the time, it would be fine. The WHO believes our cesarean section rate should be at 10-15%. It’s currently above 35%. I refuse to believe that all of those are true, true emergencies. Yes, I know, yours was. I understand that, and this post is not to undermine your birth, how you’re processing it, or how it has been retold to you. What’s hard for me to process is how many women are told their c/s was an emergency, needed to happen, baby might die, and it’s largely because of how we care for women in labor in hospitals. Care providers push, nudge, outright force babies out of wombs before they’re ready, and we are left to believe that our doctor saved our sweet baby (and likely ourselves) from the throes of evil, scary, deadly labor. Except that many of the hospital interventions LEAD TO that “life saving” c/s. Again, I DO NOT wish to undercut YOUR experience, how YOU felt about it, or how it makes YOU feel. What I wish to highlight is the culture surrounding birth, and how it’s so much more about an institution (a patriarchal one at that, believe that women are simply not capable of doing this whole “labor thing” without modern science to help it along) rather than an individual. And again, until the institution can change, there’s little hope for women and babies.
So where the hell was I going with this little lesson in the “snowball of interventions”? I was getting to the picture, and what it said to me.
And to me, it shows a newborn, alone, on a hospital bed and I wonder, where’s mama? Because I don’t know of many mamas who’ve just given birth and would voluntarily leave that sweet baby, lying there, alone. That is, quite possibly, the most tragic thing I can think of.