COMMON MISCONCEPTIONS ABOUT BIRTH
by Suzanne Arms, Birthing The Future
There are many myths about pregnancy, labor and birth. Many have been proven false by three decades of research. Unfortunately, few couples have had exposure to the outcome of this research. Here Suzanne Arms, a birth educator and researcher for more than 25 years, addresses some of the most common “birth myths”. Further research and information can be found on her website: www.birthingthefuture.com
Myth #1:
The hospital is the safest place to give birth.
Fact:
Despite 75 years of hospitalization for birth there is still no scientific evidence for this belief. The mere presence of a laboring woman in a hospital has been proven to increase the likelihood that she and her baby will be subjected to routine tests and procedures. These interventions are based on convenience and hospital protocols rather than need.
Fact:
Hospitals are not safe places for newborns, whose liver, brain and immune systems are too immature to ward off the noxious or toxic effects of routine procedures and hospital-born infections. Today there are 25 strains of pathogens completely resistant to all known antibiotics and most of these are found in hospitals. Babies who are physically separated from their mothers and do not receive breast milk after birth are at increased risk.
Fact:
A healthy woman, entering labor with no complications, is safest birthing in her own home, assuming a skilled midwife attends her with hospital backup. Freestanding birth centers have also proven to be safer than hospitals for this population of healthy women, who are at low risk for complications in birth and comprises 80% of all birthing women in
Myth #2:
Any birth that is not a cesarean birth is a normal birth.
Fact:
This year more than 50% of birthing women in many American hospitals will have their labors artificially induced or speeded up with drugs. 90% will be hooked up to electronic fetal monitors during labor. It is estimated that 80% of all women who have vaginal births will be drugged and/or anesthetized for pain relief and an equal number will have an episiotomy. 75% of our mothers and babies will then be separated before breastfeeding has even begun.
Myth #3:
Cesareans are only done when necessary and carry minimum risk.
Fact:
This year nearly 1 million babies – more than 1 out of every 5 – will enter this world by abdominal surgery. Almost 80% of these – more that 600,000 – will be medically unnecessary. The majority of these cesareans will be performed on healthy middle and upper class women, not poor women or pregnant teens that are the ones at higher risk for problems.
Fact:
Current obstetric texts state that the “expected maternal death rate” from vaginal birth is 6 per 100,000. The risk for maternal death rate from a cesarean is 4 to 7 times more than that of vaginal birth. In these same texts the expected death rate from cesarean is 100 per 100,000. Yet “once a cesarean always a cesarean” is still the norm, despite the fact that between 75 and 80% of women who have a cesarean can have a normal vaginal birth the next pregnancy.
Fact:
The average American vaginal birth (including prenatal care) costs $8 – 10,000 and the typical cesarean costs $12 – 20,000 and much more if the baby is in an ICU for any tests.
Myth #4:
Modern women should not have to endure pain in labor; it has no value.
Fact:
The normal pain of labor serves several physiological functions: it alerts the pregnant woman that labor has begun and she needs to find a private, undisturbed place to birth. Labor is physiologically designed to foster fiercely protective behavior in the birthing mother, without making her overly anxious. The pain of contractions is a result of the normal stretching of muscles and tissue. Anxiety and tension resulting from excessive fear intensifies the pain, makes contractions less effective and lengthens labor. Women can cope with labor pain if they have adequate privacy and support.
Fact:
Physiologically it is impossible to artificially diminish or numb the sensation of pain without also diminishing the sensation of pleasure. However, our own natural hormones place a woman in an altered state where the pain is easier to bear.
Fact:
Throughout history birthing women have always preferred to be cared for by another woman who is familiar to her. However, even the presence of a woman who is a stranger and does nothing but sit silently in the room, results in shorter, less painful and more effective labors. The woman’s experienced labor pain is directly related to how comfortable she is with her body and how much support and privacy she is given during labor. In repeated recent studies by pediatricians Marshall Klaus and John Kennell the continuous presence of a labor “doula” dramatically reduces the amount of drugs, anesthesia, cesarean surgery and the rate of all complications in hospital births.
Myth #5:
Drugs used in labor and delivery are necessary, safe and have no negative side effects on labor or on the well being of babies.
Fact:
Any drug – including artificial hormones to stop, induce or speed up labor – given to a mother in pregnancy, labor or while she is breastfeeding will get into her baby’s blood stream and settle in the baby’s liver and brain. Drugs in birth get to the baby in higher proportion than to the mother because of the baby’s small size. More than 80% of laboring women today get an epidural and most of them demand it, believing it doesn’t reach the baby.
Fact:
The mother and baby each produce hormones that prepare them to handle the stress of labor and prepare them for the enormous physiological and emotional changes they must go through after birth.
Fact:
The casual use of drugs in birth poses many immediate and long-term hazards, including compromising the establishment of breastfeeding and successful bonding.
Myth #6:
The bigger the newborn intensive care unit the better the hospital.
Fact:
As many as 20% of our nation’s full-term healthy newborns currently spend time in intensive care for no medical reason. Most of them are there for “observation” or “just-in-case” treatment because of drugs or procedures done on their mother.
Fact:
The additional cost of each day a baby spends in intensive care runs $2,500 - $7,500. Intensive care baby units usually have a 90% or higher occupancy rate. As soon as an intensive care unit is expanded, the number of babies sent to it increases because there is little incentive to keep babies out of ICUs, especially in big teaching hospitals.
Fact:
While in intensive care – even just for “observation” – babies endure numerous painful, risky and traumatic procedures in addition to maternal separation. The more aggressive the management of newborns in such nurseries, the greater the potential for long-term trauma for the child.
Myth #7:
Electronic fetal monitoring is necessary to insure the safety of the baby.
Fact:
Electronic fetal monitoring has never been scientifically proven either safe or effective for determining the well being of a baby during labor – even among women at high-risk for complications. Extensive research, as early as 1985, including a Harvard study of 10,000 women, showed no more than 1 baby’s life might be saved for every 10,000 women monitored. Internal monitoring (done most commonly) requires rupturing the amniotic sac and screwing a scalp electrode into the baby’s head.
Fact:
This expensive device was introduced in the early 1970’s and, following an aggressive marketing campaign in which nurses were hired to promote its “safety”, were bought by every hospital in the country within a few years. In most hospitals such monitoring is still used routinely. Hospital administrators see the monitor as a way to cut down on the nursing staff.
Fact:
The reliance on electronic fetal monitoring, rather than nursing or midwifery care, was largely responsible for the 300% increase in the
Myth #8:
Epidurals enhance normal birth and have no side effects.
Fact:
Epidural anesthesia can cause a rapid drop in the laboring mother’s blood pressure, resulting in fetal distress and an emergency cesarean. An epidural can also cause the baby to get stuck in the mother’s pelvis, leading to the need for forceps, vacuum extractor or cesarean. Babies whose mothers have had epidurals frequently have a difficult time getting breastfeeding started, which all too often results in their mothers quitting breastfeeding.
Fact:
96% of women who get a fever in labor have had an epidural. Since a fever in the mother may signify a dangerous infection in the baby, their babies are routinely sent to the intensive care nursery and aggressively treated for possible infection. Once there, theses babies endure frequent painful blood drawings, spinal taps, and are given full-spectrum antibiotics while tests are being done to determine whether they even have an infection. Epidurals often lengthen labor and cause problems for mothers and babies.
Fact:
86% of all babied given antibiotics in the ICU have mothers who have had an epidural.
Myth #9:
Obstetricians are trained to handle complications and therefore should be in charge of all births.
Fact:
Obstetricians are not trained to approach birth as a normal process and have little or no training in providing the pregnancy support and counseling and labor support that inherently keeps birth safe and normal. The average obstetric training includes one day on nutrition and no training on labor support.
Fact:
Most obstetricians do not show up at a birth until the woman is fully dilated and pushing. Because of this they are more likely to rush to judgment and treat any normal variation in a labor as a crisis.
Fact:
Most insurance companies and HMOs pay more money to the obstetrician for each intervention he or she performs and pay more when a cesarean is done. Juries tend to believe that doing a cesarean proves that a physician has done everything possible for the mother and baby. There is little incentive for using non-intervention labor aids and every incentive to do them for convenience, malpractice protection and personal profit.
Myth #10:
Midwives are not as competent as doctors and need direct supervision.
Fact:
When midwives attend women throughout pregnancy the rate of premature/low birth weight babies, infant mortality and the re-admission of babies to hospitals in the year after birth, is as much as 75% lower than for women seen by physicians, no matter what the woman’s risk level.
Fact:
Midwives identify problems as they arise and handle them before they become serious complications or emergencies. They are trained to consult with physicians and transfer care to a physician when necessary.
Fact:
The rates of cesarean, epidural and other interventions among patients of midwives practicing in hospital settings is a fraction of the rate for obstetricians. Midwives attending births at home and in birth centers have a 2-5% cesarean rate and employ natural, safe aids to keep labor progressing and help women cope with pain rather than drugs or anesthesia. Midwives seldom do episiotomies, preferring to protect a woman’s tissues from the scalpel or serious tears by skillful hands-on care and positions that aid smooth delivery.
Myth #11:
Babies do not remember their birth and the mother’s experience is quickly forgotten.
Fact:
A growing body of scientific evidence shows that babies do remember their births. Many adults and children have had spontaneous birth memories, even including details of things that were said to their mothers during labor!
Fact:
The experiences that happen to us from in the womb through the first hours after birth set physiological traces in the brain and nervous system that remain with us as definite pattern. For example: leading edge brain research shows, 1) there are likely two different ways memory is stored: things learned under extreme stress and things learned in an ordinary state; 2) the brains of babies and young children who have had too much stress may not know how to turn off the production of survival-based stress hormones for years to come.
Fact:
Even at the end of their lives women will recall the experiences of their births (except for the parts where they were drugged) with greater vividness and detail than any other life experience. A woman’s experience of birth is directly related to her sense of competence and confidence as a mother. A mother whose baby has been separated from her at birth is more likely to view her baby as delicate and feel more dependent on outside experts.
Myth #12:
Any caring person can provide a baby what he or she most needs.
Fact:
Newborn babies recognize and prefer their own mother’s scent and face to anyone else. They also prefer their mother’s voice above any other even in the womb, because hers is what their own heart and ears are calibrated to. Their sense of whether the world is a safe place and whether they can trust is largely related to their experiences with their mother. A mother mirrors the world to her baby by the look on her face, the tone of her voice, and the feel of her touch.
Fact:
Breastfeeding is more than delivery of breast milk into a baby’s gut.
Fact:
The amount of time a mother spends in intimate physical contact with her baby in the days following birth is directly correlated to how confident and compassionate she is as a mother. Mothers of babies who are closely bonded because of early and prolonged intimate contact respond more quickly and more compassionately to their baby’s cries in various studies.
This difference in mothers has been found to continue for 18 months and longer. A difficult and “high needs” baby’s very survival is dependent upon the strength of it mother bond. The weaker the bond the more likely the mother is to be unprotective, neglectful or abusive when under extreme stress or to permit someone else to harm her children.