Modern Obstetrics – Surviving Birth

Humans are the most prolific species on the planet, and we would not have reached this status without having a proven method of bringing our young into the world.

Modern Obstetrics – Surviving Birth

If you go to youtube and watch a few birth videos of women in hospitals, and a few of animals, you will probably notice something. Animals move lots, and are – for the most part – left well alone as they give birth. Humans are contained in the same supine lithotomy position, with lots of people surrounding them, all giving directions. You could be forgiven for thinking that humans are hopeless at giving birth without assistance.

Woman giving birth to baby in obstetric hospital
Mothers and babies deserve to thrive, not just survive birth.
Credit: Graham Richter | CC BY-SA 2.0.

It’s true that SOME women need medical intervention to safely welcome their babies, but the vast majority of us give birth quite successfully, without any intervention. Humans are the most prolific species on the planet, and we would not have reached this status without having a proven method of bringing our young into the world.

Modern obstetrics has done some absolutely, undeniably amazing things in the last few decades. Many women and babies are here today,  in large part due to the timely use of obstetric intervention, however if humans had not so successfully created our current level of comfort in more basic areas like food and shelter, there would have been no time to develop surgical techniques, medications, testing, and machinery used routinely during pregnancy and birth.

These days there is increasing pressure on the non medicalised birth practices to provide evidence that they are in fact safe without the routine use of obstetrics. We have a one in three caesarean rate in many wealthy  industrialised countries, and the majority of people believe firmly that giving birth without medical assistance is unlikely or even impossible, furthermore many believe it is outright dangerous.

If we suppose that 33% of women have caesareans as a life saving measure – because we know that very few are sought by women to avoid birth – then we have to wonder how humans ever made it to such a state of proliferation. If one in three births ended with either the death of the mother or the loss of the baby, it would quite literally be impossible for our species to have ever survived for so many thousands of years, let alone to have flourished as we have. Look at the species which are struggling to survive or extinct. What do they have in common? A low / slow rate of reproduction, and loss of habitat. Humans suffer from neither of these.

All over the world, women die giving birth without medical assistance, but we need to take into account factors outside of birth itself, which have a great influence on survival. When women live without complete nutrition, and without clean water for example. These women are far more likely to die without medical support than a fully nourished woman, residing in a developed country, with access to plenty clean water. When a woman has spent her entire life since girlhood without proper nutrition, her odds of giving birth safely are decreased, her whole life expectancy is decreased. However, many women still give birth to live infants, and survive under these conditions.

South Sudan currently has the highest recorded rate of maternal deaths in the world with the latest figures showing that 2054 women per 100,000 die during or shortly after childbirth. As a percentage, this means that 2.05% of women who give birth, will die. With these figures as the worst reported figures in the world, it’s possible to see how humans have survived, and supported the creation of modern obstetrics. If one in three died, we’d have gone the way of the dodo long before Julius Caesar was ever welcomed in a fabled first time caesarean.

Many critics of “the natural birth movement” claim that opposition to intervention kills, they falsely claim that those who support a woman’s right to choose birth without intervention, would rather see women dying that accessing intervention. This perspective is a bizarre interpretation, or perhaps a deliberate misrepresentation of the truth, for who in their right mind would suggest that it is better to die than to undergo a caesarean?

Reaching a point where no woman or baby ever dies during or after birth is, quite simply, impossible. Birth is unpredictable, and forcing every woman to undergo the same interventions during birth does not make birth safer. We can not predict how each woman and baby will respond to those interventions, much as we can’t predict which children will be allergic to peanuts.

Three nurses in pink with baby
Surviving birth is a cause for celebration. License: Creative Commons CC0.

There are entire families who believe that the women within are unable to give birth because the last generation or two has all done so by caesarean, however in order for those women to have made it to the 20th and now 21st century, there must have been millions of women with their genetics, dating back thousands of years, that have all successfully given birth. Why have their bodies stopped working in the last half a century? They haven’t!

With a one in three caesarean rate and an extremely negligible unhindered birth rate (meaning births that have zero obstetric intervention) it is time that the spotlight was turned around and centred firmly back on modern obstetrics. We need to seek a happy medium between interventions and nature, and we need to take that balance and offer it to the women in countries everywhere from Southern Sudan to Australia, to see if we can’t genuinely improve outcomes worldwide.

The earth is populated by more than seven billion of us because of our breeding capacity. The reality is that some women and babies will always be casualties of birth, but with good nutrition, clean water, antibiotics, and a handful of other practices, the vast and overwhelming majority of women survive birth, in fact even without those things, a relatively high proportion of us survive. Obstetrics is not responsible for the survival of humankind. Humankind is responsible for the creation and perpetuation of modern obstetrics. We now need to take responsibility for the fair and equitable distribution and safe application of it in childbirth worldwide.

WW Discourse - Have your say!