Have you ever been on a drive and say 15 minutes in you think to yourself, “Woah, how did I get here? You realize you’ve lost your way and you need to turn it around and go back to the start.
In this week’s episode, we’ll be taking a look at the past, the history of midwifery and women’s care as it pertains specifically to the United States, and delving into some of the reasons that compared to many other westernized countries, women and babies in the US have abysmal outcomes. We’ll be sharing just how lost we’ve become when it comes to maternity care, and how we should really turn this car around.
Janelle Alier is a Certified nurse midwife local to me, and one of the coolest women around. As she’ll explain momentarily, she’s worked with moms and babies in a number of capacities, and she recently opened her own homebirth practice, Paris Mountain Midwifery.
Show Notes:
Anciently (ex. Ancient Greece), women were held in high regard and valued as healers. When the mindset began to change, in a way this was the beginning of the end. This change corresponded more with religious and theological changes, not the dawn of medicine.
Protestants burning “witches”—women healers
Much of the knowledge gained over time began was lost with these women
Colonial America- childbirth attendants were women/midwives/family matriarchs
1800s- medical schools are popping up. Physicians were around, but not trying to be involved at all
19th century—we could charge a fee! Began being interested in birth. Obstetrics
Midwifery predates medicine: Rachel’s midwife is mentioned in Genesis
Varney’s Midwifery includes transcripts from Doctors meetings talking about the “midwife problem”
One doctor said the answer was to “educate the ignorants”. This started a campaign to portray midwives as dirty and uneducated.
Laws began to change—it became illegal for midwives to practice the way they had. They now had to obtain licensure by the state, which was almost impossible to do.
What’s happening to birth at this time? Physicians recognize that the midwives are more skilled and have better outcomes, but they did not try to work with or learn from the midwives.
Obstetrics in its infancy—it’s not going great! Many deaths in the early years are now attributed to anesthesia
They were giving morphine and narcotics, which we now know doesn’t lessen the pain, it just makes you care less… and forget.
Culturally there was not a lot of accountability. Family members were told that the women didn’t survive because “birth is dangerous.”
Late 50’s, early 60’s- nearly all birth occurred in the hospital
In the late 60’s and 70’s, there was a small subset of the population who revived the natural childbirth movement, but by that point, the medical model was so mainstream that this movement was considered radical
80’s and 90’s- c section rates soared
In the last few years, we’ve realized we’ve lost our way. The profession of midwifery is becoming more organized, though there’s not tons of money for research, scholarships etc. as there are for medical students.
In South Carolina, Black Grand Midwives were the women delivering babies and taking care of the communities.
What do we do?
More midwives, more midwives of color, better integration of midwives and the hospital setting (if a mother needs to transport to the hospital, that should be easy).
In other areas of the Westernized world (Europe, Scandanavia, the UK, Australia, New Zealand etc.) midwifery wasn’t wiped out the same way it was in the United States. And their outcomes are much better than ours.
In the UK—there are 5-6 times more midwives than OBs. Everyone starts with a midwife, and if you need a physician, you get referred by your midwife. The OBs manage higher risk care while midwives manage low risk birth.
In the US, only 10% of births are attended by midwives. In Alaska, it’s up to 30%, whereas in Arkansas, it’s more like 1-2%.
If you overlay a map of birth out comes by state and the integration of midwives… you see that where there are more midwives practicing, there are better birth outcomes.
In the US, we have 1% of planned homebirths in the home. Most American midwives work in the hospital. Globally, not only do they have more midwives, but they also have more options. You can have a midwife at home, or she can follow you into the hospital and continue care (this is not the case in the US).
Episode Roundup
Ep 264:The Opposite Of A Traumatic Birth with Regina Lowenfield
Ep 263: VBA3C?! You’re Not High Risk Until You’re High Risk with Jan DeAngelo
Ep 262: The Body-Mind-Birth Connection with Errika Horner
Ep 261: A Beautiful Shoulder Dystocia? With Coco Brown
Ep 260: A Failed Epidural and a Victorious Homebirth with Brianna Peters
Ep 259: Responsive Sleep for You and Your Baby with Taylor Kulik
Ep 258: How To Turn Your Passion For Birth Into A Full-time Career As A Doula with Kyleigh Banks
Ep 257: From Questioning Yourself to Questioning the Birth System with McKenzie Ulmer
Ep 256: From Changing Care Providers to Midwife Continuity with Shayna Piva
Ep 255: Deep Familial Connection Through Homebirth with Anna Rivera
Ep 254: From Interventions to Undisturbed with Bree Darby
Ep 253: Finding Joy While Experiencing Secondary Infertility with Shyla Brown
Ep 252: Minerals, Lymph, Fascia, Oh My! With Margaret Barry
Ep 251: A Deeper Understanding of the Transformative Power of Birth with Karey Hoffmann
Ep 250: Coming Into Your Own and Advocating for Your Dream Birth with Cortney Steffensmeier
Ep 249: Surrendering to Physiological Birth and Motherhood with Jessica Livengood
Ep 248: Game-Time Birth Decisions with Katelyn and Thomas Fusco
Ep 247: Making Birth Choices From a Place of Empowerment with Leigh Anne McGiff
Ep 246: Birth in Captivity to the Freedom of Homebirth with Esmeralda Carrillo
Encore: Birthing Instincts With Dr. Stu
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