And no, I don’t mean drug-free. I just mean this:
Leaders of Canada’s pregnancy specialists are urging doctors not to induce labour unless there are compelling medical reasons.
The call is part of a campaign to “normalize” childbirth and efforts to reduce Canada’s soaring cesarean section rate. Some studies suggest inducing labour in a first-time mother significantly increases her risk of a C-section.
It’s great to have modern drugs and medicine at one’s disposal. But it can be taken too far. I’m not much of an expert, but I always thought babies came when they were ready and that nothing could really get them going before their time (as any 40-week-pregnant woman can tell you). Forcing Mother Nature’s hand may sometimes be the best, or least worst, option available. But doing it routinely just for convenience’s sake can’t be a good thing.
Rebecca adds: In normal cases, though, a C-section is riskier for mother and baby than a vaginal birth, with or without medication. I really see this as an issue of how we frame childbirth, what we believe about women’s bodies, and once again, the illusion that we can control everything.
When something goes wrong after an intervention, the assumption seems to be that the intervention was necessary and carried some risk, whereas when something goes wrong with no intervention, the assumption is that an intervention would have fixed it. In urban Brazilian hospitals C-section rates are around 80%. There is no question that the great majority of these are not medically indicated, and that a large number of these women and children suffer avoidable problems.
The fact that so many women and doctors opt for C-sections when, by any rational medical standard, the risks outweigh the benefits, is a serious problem.
Véronique adds: I love those professional associations’ statements. They have such an ability to state the obvious. The problem with the medicalization of childbirth is not that interventions are performed for no good reason but that women and their caregivers really think they have a good reason even when they do not. And who will challenge them? My last labour – baby is 3 ½ months – was induced because labour didn’t start spontaneously after the membranes ruptured. What I found difficult to accept was that labour had to be induced right away. Surely, they could give me a couple of hours? It’s not like my body had never done this before, right? Not only that but 9 years ago, when I had another pre-labour rupture, they – the medical practice guidelines – gave me 18 hours to deliver safely after the rupture. But there’s nothing like a couple of aptly quoted statistics on transmission levels of nasty group B strep to get an expecting mother – and fathers are probably worst – going medical.
The same goes for levels of c-sections. Yes, there is increasing momentum for c-sections on maternal request — a topic I have published on in 2007 – but those c-sections are still marginal compared to the “medically needed” ones. When you start scratching a little however, you see that while most c-sections are medically needed, the need is often created by other medical interventions such as inductions, epidurals, continuous fetal monitoring or non-physiological position (i.e. lying on your back as opposed to letting gravity be your friend). That’s one side of the c-section epidemic. The other side is increasing maternal age causing complications (things the women’s liberators didn’t tell you), increasing rates of medically assisted reproduction (or what I call “Your body didn’t really think it could handle it…”) causing complications such as multiple gestations and premature childbirth and increasing maternal girth causing blood-pressure and diabetes-related complications.
I had five natural drug-free deliveries – including one breech birth and 3 homebirths – and one induced but otherwise drug-free delivery. I should have had drugs the last time. But despite the complications, the pain, and the fact that I always promise myself never to do this again, childbirth remains the most empowering of experiences.by