In our culture, the most common image of birth is one of a woman who suddenly has a strong contraction, her water breaks and she is rushed to hospital in pain and screaming, only to be pushed onto a bed and hooked up to machines and drugs.
The woman struggles, puffs and pants, screams a lot, all the while being admonished to 'push.' Then the doctor comes in to pull the baby out and the show is over.
Contrary to popular belief, pregnancy is not a sickness and labour is not an emergency. Sadly, this image has become so pervasive that it obscures the very different view of birth held by other cultures.
The image people of many other cultures have is of a woman surrounded by loving and caring experienced women who support her through the birth process. The reality for these women is that they are prepared for birth, and they don't fear it as people in our culture.
Those people know that a woman's body is capable of giving birth, in most cases without technical assistance or medical care. Today, this knowledge is spreading into the western world, with recent surges in the practice of midwifery and the homebirth movement.
As a result of consumer demand, many free-standing birth centres have been established in or near hospitals around the world. They provide comfortable settings to give birth in and are designed to serve the needs of the mother and infant, with births attended by midwives and doulas - women who offer practical and emotional support during labour.
The labouring women are allowed to move around freely, take baths and showers, eat and drink as they desire and be free of unnecessary medical interventions. That system is not only the opposite of hospital maternity practices but also has far better outcomes than hospital births.
Recently there have been numerous studies which show that many of the common complications that arise during labour are contributed or even caused by medical interventions performed on labouring women in hospitals. I also believe that the common western image of labour causes many women to fear birth, preventing them from relaxing sufficiently during labour. This usually leads to complications and ultimately, a doctor-assisted birth.
The most common intervention routinely performed in hospitals is to have electronic foetal monitoring (EFM) - where an electronic sensor is strapped to the mother's belly or a needle carrying an electrode is inserted into the foetus' scalp, in order to monitor the baby's heart rate, rather than the traditional method of checking the baby's heart rate manually with a specialised stethoscope.
The benefit of EFM is that the baby's heart rate can be observed and any changes can be recorded, also allowing one nurse to monitor several babies at once from the nurses' station However, routine EFM generally means that the mother is restricted in her movements, often forcing her to lie still in bed. Unfortunately, lying on the back narrows the pelvis and slows the contractions, while working against gravity. This makes labour more difficult, which can lead to further medical interventions.
Another common hospital practice includes routinely injecting mothers with a synthetic form of oxytocin; the hormone the body produces to stimulate contractions, often after as little as 18 hours of labour.
When the body produces oxytocin, it also produces endorphins that help the mother to relax, and also alleviate pain, but the injected oxytocin comes without the body's natural regulation, and serves to make the contractions harder, stronger and more painful, which can lead to many serious complications.
Many recent studies show that the use of synthetic oxytocin greatly increases the risk of foetal distress, as well as the need for pain medications, episiotomies (where the opening of the vagina is cut), forceps or vacuum delivery and finally, caesarean section.
Pain medications and epidurals all cross over the placenta, adversely affecting the baby and slowing the contractions. This often leads to the need for further medication and treatment. Not only that, epidural can cause the mother's temperature to rise, which is harmless in itself, but indistinguishable from the temperature rise seen with infections, so the doctors must treat the mother and baby for suspected infection, meaning that the baby must spend it's first few days in the intensive care unit, and antibiotics are used, often unnecessarily.
While many people wonder what's so bad about that, there is a lot of recent research showing that these interventions increase the risks for both mother and baby.
One study by the US Centres for Disease Control and Prevention (CDC) followed more than five million births during four years and showed that caesarean section doubled the infant mortality rate compared to vaginal birth.
Especially disturbing is that the US has the highest first-world infant mortality rate, one comparable to many third world nations, despite being the country with the highest rate of medical management of birth, compared with Holland, the country with the lowest infant mortality rate, where 70% of births are attended by midwives, half of which are home births.
In my experience as a doula attending primarily natural home births, the women who chose to give birth at home all birthed successfully, without medical assistance nor medical intervention, while in hospital births, interventions and medical management were inevitable, though often unnecessary.
Of course I have attended births where problems arose, however in every case we were able to solve the problem naturally. For example; in cases of prolonged labour, usually all that is needed is to allow the mother to rest, and to wait for nature to take its course. Very often, when a labouring mother asks for pain medication, all she really needs is emotional support and encouragement.
Massage, changing positions and moving around are all things that can greatly help in shifting a "stuck" labour. In the hospital model, these things are discouraged in favour of medical treatments, all of which carry side-effects.
There are also a host of natural methods that can help a woman to cope with labour, such as acupuncture and self-hypnosis to alleviate pain, while giving birth in a pool or tub of warm water helps immeasurably in helping the mother to relax and to ease back pain.
There are also many herbal and homeopathic remedies that can aid in labour, and in recovery and lactating as well, such as Blue Cohosh tincture to help strengthen contractions and tone the uterus, and Shepherd's Purse to help stop bleeding post partum.
Of course there are a small number of births that really do require medical assistance, however for healthy women in a low-risk birth, the rates of necessary emergency caesarean at natural birthing centres like The Farm in Tennessee are between 1-2% and with the experienced knowledge of a midwife or doula present, there is time to get to a hospital if a real need arises.
For many women, the most beautiful part of birthing in the comfort of their own home is being able to hold their baby after the birth, safe in their own bed, and free from drugs and interventions.