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Birthing in the United States

Social anthropologists and sociologists have conducted numerous studies of obstetrics, of midwifery, and of the importance of 'place' in the birth story. These analyses have added to academic's understanding of alternative birth, but have had little impact on mainstream obstetrics, nor have they led to increased demand for midwifery care by childbearing women. Clearly, something is missing.

Perhaps more ethnographic studies are called for, as described in Anthropology News, March 2009, or perhaps it will be the rising percentage of maternal deaths that will cause a change, or perhaps more Hollywood movies showing birth as something other than a medical emergency will increase demand for proactive birthing. [view source]

Robbie Davis-Floyd, Birth as an American Rite Of Passage, 1992 Revised edition 2004, Barbara Katz Rothman, Brigitte Jordan and Nancy Stoller Shaw.

Some facts about birth in the United States

The United States has a cesarean birth rate of over 30 percent, which is at least 20 percent higher than a worst-case scenario of necessary c-section according to the World Health Organization

What hospital staff believe

"Hospital doctors and hospital-based midwives, with one exception, expressed the view that birth MUST occur in the hospital to be safe." One doctor in Southern Oregon county said of his colleagues: “When they hear that homebirth is relatively safe, they just don’t believe it because they all know of cases where a mother or baby has transported and they WERE in danger. The findings just don’t fit with their experiences.” When home births are transferred to a hospital, hospital physicians expressed fear and frustration at suddenly having to care for another doctor's patient (in the US, women choose one doctor or home-birth midwife for pregnancy and delivery). “Imagine our perspective. This woman comes in with her midwife after a failed homebirth. We’re out in the hall arguing about who is going to go in there. There is a lot of risk involved for us, plus we know we are likely to have a hostile interaction and/or a noncompliant patient. It’s not something we’re going to look forward to.” Hospital staff also expressed the belief that many midwives make high-risk situations more dangerous by being difficult to work with. They said midwives have patient charts that include "a whole bunch of psychosocial stuff that we don't care about like her diet in the first trimester or how the woman feels about giving birth." In a situation already transferred to hospital, in other words, something has necessitated the change to a high-tech medical environment, "… they come in for our help and then they act like they are trying to protect the patient from us." [view source]

Cheyney, Melissa and Everson, Courtney, "Narratives of Risk: Speaking Across the Hospital/Homebirth Divide", Anthropology News, March 2009, pg 7


What the midwives say

Homebirth midwives cited some different definitions of 'high-risk', such as age of mother. Women over 40 and women whose babies still haven't turned are not necessarily going to run into problems with a well-cared for homebirth. Yet, they said doctors judge them by the exception rather than the rule. "From their perspective, every homebirth is a transport, otherwise how would they know about it?" Physicians form opinions on the safety and acceptability of home delivery based on anecdotes rather than scientific evidence. [view source]

Cheyney, Melissa and Everson, Courtney, "Narratives of Risk: Speaking Across the Hospital/Homebirth Divide", Anthropology News, March 2009, pg 7



Why Are Our Babies Dying?: Pregnancy, Birth, and Death in America discusses the role of socio-economic risk factors as predictors of infant mortality among young women of color in Syracuse's inner-city population - with implications for many other cities in the country. …  According to a review: "The book also provides an example of the unintended and often undesirable effects of social and environmental restructuring programs such as urban renewal.… For example, policies designed to provide incentives for single mothers to wed might be well meaning but seem uninformed by the demographic characteristics of inner-city African American communities. Lane argues that for most African American women, being a single mother is not a matter of preference but the result of statistical realities of African American demographics that stem from the disproportionate incarceration of African American men. The dearth of men leads to an unhealthy outlook in which African American women unduly accord a social advantage to their men. This situation not only engenders feelings of powerlessness and devaluation but leads to distorted relationships. Men simultaneously carry on more than one relationship, and women not only compete for their affection but also leverage pregnancy to seek greater commitment." … There is a discussion of the negative effects of funding policies that promote abstinence rather than provide support for sex education and information on pregnancy avoidance. Lane also examines the effects of risk factors such as developmental delays, exposure to lead and teen smoking on negative birth outcomes such as premature delivery and low birth weight babies. In spite of significant reductions in teen pregnancy in the last two decades, the phenomenon of "babies having babies" is still a serious issue in African American communities. [view source]



Real help for real people

birthing project usa"Each of the founding mothers of The Birthing Project were paired with a pregnant teen or woman, serving as her friend, elder sister and advocate during her pregnancy and until the child’s first birthday. The founding father provided support to the babies’ fathers."

"Since then, over 10,000 babies have been born into over 90 birthing Projects nationally. Although our services target African American women, we welcome pregnant women of all ethnicities who need medical care and social support to optimize their birth outcomes." go to the Birthing Project USA


Interested in more? Here are other articles:
birth bonding
Breast-feeding cesarean
midwife North America
postpartum depression US

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