Suzanne Arms’ Letter to the Editor at Newsweek Magazine
Re: the Cesarean Birth Article
Note to Readers: I sent this to Newsweek in response to the December 4th article title “Right to Choose” and I hope others will be concerned enough to write them as well:
For the past 27 years I’ve devoted my life’s work to studying the American Way of Birth and challenging the ignorance, greed and misconceptions that drive this $50 billion a year high-tech industry that is running amok and causing widespread harm.
I am dismayed at your outrageous, confusing and misleading article on Cesarean surgery for birth (“The Right To Choose“). It is likely to lead millions more women and babies under the knife for no medical reason, and to result in more injury, death, disfigurement and long-term dysfunction for both mothers and babies in America. It perpetuates the myth that American obstetricians care so much that they are only trying to give women the cesarean births they want!
My 1975 book Immaculate Deception was, I believe, the first examination of the American Way of Birth, an investigation into what really goes on inside the hospital. The sequel to that book, which came out in 1997 (“Immaculate Deception: Myth, Magic & Birth“) went deeper into the multiple issues concerning this $50 billion a year profit-making industry. I do not claim to know everything about birth and its impact on individuals, families and society. But I do know this, and my views are backed by solid scientific evidence: your article demands retort.
How can anyone condone major abdominal surgery (with all its numerous costs and risks – long-term as well as immediate) for one out of every four women in the U.S! Especially since this country spends more money per capita on birth than any country in the world and has some of the worst outcomes in mother and baby health (currently our infant mortality rate places us 24th in the world, equal to Cuba). The World Health Organization states that there are no known benefits to women or babies when a nation’s cesarean rate rises to higher than 7%. Yet the U.S. rate is 300+% higher than that and rising. And doctors, who fought to retain a virtual strangle-hold over birth in this country, find technological birth much easier and more rewarding for themselves. After all, it’s what they’re trained to do: drugs, mechanical intervention and surgery. Plus they get paid more in the U.S. for performing a cesarean than for waiting out a vaginal birth.
Your writer, like most of the public and health professionals in this country, erroneously equates “natural birth” with medical hospital birth, a technological event that bears almost no resemblance to the natural (i.e. truly normal) process of a healthy woman and baby successfully conducting their birth, following the natural rhythm of their bodies, without outside intervention. Obstetricians are trained to views all birth as a catastrophe waiting to happen and justify their numerous routine interventions in approximately 95% of all American births even long after scientific evidence proves those medical interventions serve no good for the vast majority of mothers and babies and increase the risk of complications and harm.
The writer quotes physicians exclusively, including the current president of ACOG, Benson Harer, and David Walters, both of whom are obstetricians who publicly endorse cesarean on demand. She also refers to a study of British female obstetricians, 31% of whom say they would prefer to have their own babies born by cesarean. Of course! Obstetricians are specialists in drugs and surgery and not even trained in physiological (natural) birth. Not one midwife is quoted. Yet midwives are, and have always been, the experts in natural birth and in preventing complications. And the only mother quoted in the article is one who chose to have 2 repeat cesareans for no medical indication.
Your writer failed to mention that natural childbirth is a crucial developmental process that benefits mothers and babies in numerous ways. Not one word about the intrinsic value to both a woman and her baby of going through this profound “right of passage” the way our bodies and psyches are designed to do it safely and effectively.
You’ve done women and babies (and men too) an enormous disservice by implying that the female body and the infant’s body aren’t designed for birth, that the physiological process of labor is without value, that modern women should not have to endure the pain and discomfort of labor now that we have drugs to induce it, speed it up, sedate, narcotize and anesthetize them. The baby is a product in the technological medical paradigm and labor is simply an unpleasant and wasteful means to an end. Unfortunately this approach does not take into account the numerous proven risks of tampering with a subtle biological process when there is no reason to. Each and every intervention into that process is likely to alter the entire process and introduce harm when there was no problem to begin with.
In addition, no one is talking about the impact of all of our modern drugs on a baby’s sensitive and vulnerable nervous system and brain, which are in a state of rapid development at birth. Nor are they talking about the impact of the cascading effect of interventions that often cause the newborn to end up in an intensive care nursery, subjected to further traumatizing procedures in addition to the trauma of being separated from its mother during the uniquely sensitive period right after birth.
Finally, there is the issue of what kind of mothers we are creating through our modern routine birth practices. I would argue that our species need fiercely protective mothers who trust their baby and feel confident in their own bodies and their capacity to respond to their baby and be a competent mother. Birth is truly our species-wide initiation into motherhood and being self-confident, trusting our bodies and our babies, and being fiercely protective of them comes largely through going through the process fully. These traits do not easily come from scheduling our cesarean (any more than they are the product of our watching TV in labor, casually chatting with those around us, as our epidural anesthesia removes us from the sensations and effort of labor and from our baby). In fact, there is ample scientific and clinical evidence that mothers who have learned to doubt their body’s competence in birth behave differently with their babies in the months and years following, and that mothers of babies who’ve spent time in an intensive care environments , separated from their baby much of every day, tend to be overly anxious and overly dependent on outside authority for making decisions about the care of their child on into the future.
Yes, labor is painful and demanding for most women (at least in modern societies). We’re trained to be almost pathologically afraid of labor and to shun any loss of control that the process naturally brings. But let’s put it in perspective. The pain of labor has a reason and numerous functions that cannot be replicated artificially. Muscles and tissue are stretching in ways they’ve never had to stretch before. Even the pain of contractions has a function: to gets a woman’s attention and cause her to stop what she’s doing in her ordinary life and engage fully in the process. A human infant needs a fully present and functioning mother to help it as it makes its way out of its mother’s body and into the world.
No. No woman should be have to labor alone and unsupported. Every woman deserves ample emotional and physical support, surrounded by people of her choosing, whom she trusts. I would add that every woman should be able to give birth in an environment that is a sanctuary. The hallmarks of a sanctuary are the very things that keep labor normal: respect, quiet, awe, sacredness, and sufficient privacy to go deep within. It is possible to create environments for birth, in hospitals, as well as in homes and birthing centers, where these principles prevail.
Of course, every birthing woman and baby should have access to skillful care by individuals able to observe that birth remains within the range of physiological normal and capable of handling complications if they do arise. Fact: complications in birth can most often be handled effectively with minimal intervention, reserving cesarean surgery, which is the greatest intervention, for those 5 or 7 mothers and babies out of every 100 who may truly benefit from it. The immediate risks to their well-being and the long-term implications are just too great to perform this major surgery lightly.
Women have been so bullied and frightened into accepting whatever doctors and other outside “experts” want to give them in birth that we’ve lost our senses. Have we lost our ability to hear our inner voice, to respond to our gut feeling? No. Most women, like most men, are today in a state of numb denial about birth. We’ve become consumers in what is perhaps the most significant passage in a human being’s life (other than birth and death.)
What a specious argument it is for obstetricians (and anesthesiologists) to tell us that it’s they who have our best interests at heart. Their claim that “We’re just wanting to give women what they want” is cynical and would be laughable if it were not so deadly serious. Look at the history of medical abuse in childbirth and the assaults that doctors have perpetrated on women and babies in the name of fixing faulty biology and having control: myriad dangerous and unproven drugs such as “twilight sleep” and thalidomide given like candy; routine epidural anesthesia; routine episiotomy; routine circumcision; routine maternal deprivation; routine bottle feeding).
Our sensitive human nervous system and brain is not designed to handle drugs of any kind during this process. Nor is it designed for us to be deprived of making our own way down the birth canal of a mother who is aware, in her body, and equally engaged in the process. That’s why cesarean-born babies have such a high incidence of breathing problems, breastfeeding problems and other assorted problems.
The practice of obstetrics is rife with dislike and mistrust for women and for childbirth. Obstetrics has a long and nasty history of attempts to suppress, vilify and destroy the practice of midwifery and the right of a woman to birth in her own home. The obstetric profession has perpetuated (if not actually created) most of the fears that drive women today to believe they are “choosing” their artificial induction of labor, their epidural (anesthesia) and their cesarean surgery. It’s a manufactured choice, false to the core.
Women must find their true voice once more. It is there, just hidden beneath the layers of socialization. Birth is not a commodity to be purchased. Nor is a baby a product. Birth is a process to engage in directly and fully. The rewards are enormous and deep and not to missed.
It is empowered women and strong, self-confident mothers who start grass-roots movements that improve society. It is such women as these who will one day fight on behalf of the midwives in this world and challenge policies that deprive women of midwifery care and push women back to fulltime work where they must be apart from their babies 10 hours a day just weeks after they give birth. Men can and must help in this struggle. But women must wake up and come to their own defense and the defense of our children.
Obstetricians today are attempting to frighten healthy women from birthing naturally in hospitals, and keep them from birthing at home or in birth centers. It is they who continue to try and drive midwives out of hospitals and to prevent midwives who work in birth centers and homes from practicing or from having the medical hospital backup. In so doing they have actually made childbirth less safe. Shame on those obstetricians. And what does the average obstetrician offer a woman in labor? Not his or her continuous nurturing presence in labor. Not labor aids that carry no risk of harm and are proven to be effective, such as food and drink, massage, water birth, homeopathic remedies, moving around in labor and being upright for birth. No. Their “armamentaria” is very limited: artificial stimulants to induce labor, narcotics, sedatives and anesthesia, electronic fetal monitors, electrodes screwed into the baby’s scalp early in labor requiring rupture of the membrane, surgical incision into the female genitalia, vacuum extractors on the baby’s heads, and cesarean surgery.
Newsweek readers have a right to know that every one of the numerous routine procedures and drugs obstetricians continue to use on laboring women can alter the normal course of labor, create complications, affect the baby and can cause lasting trauma, in addition to denying the vast majority of mothers and babies the many benefits of natural normal births.
American obstetrics is, I repeat, a $50 billion a year industry. It is driven by motives of profit and greed and mistrust of women and the biological process. Along with its allied pharmaceutical and product industries, modern obstetrics practiced routinely is harming millions of mothers and babies and compromising the public’s health by introducing harm for no medical reason. It’s services are justified in approximately 5% of births, not 95%. Currently this model is being aggressively marketed to the “developing” world (read that, new market), wreaking havoc in less countries that do not have the resources to fix the problems modern obstetrics creates. This is especially true where women come to birth in poor health and give birth or live in places that do not have sophisticated, high-tech skilled professionals to save lives needlessly jeopardized.
Fact: the overwhelming majority of women need neither a doctor nor a hospital, and certainly do not need drugs and mechanical or surgical intervention if they come to labor in good health. What women need is adequate food and housing, and emotional and spiritual support in pregnancy, as well as good preparation for natural childbirth.
So, I challenge you, Newsweek magazine, and all of the health professionals who follow modern party line about childbirth. Read your own scientific research and discover the evidence. Ferret out the true needs (as distinct from the created, false needs) of birthing women and give them the information they need to make truly informed choices that support their inner knowing. Let’s have some real investigative reporting. Let’s see an article on what organized medicine in the U.S. and much of the Western world has done for a century by announcing that every woman needs to birth in a hospital with a physician. There has never been any reputable study proving that the hospital is the safest place for all women to birth or that every women needs a doctor in childbirth. Women need the right to “choose” a cesarean the way teenagers need the right to “choose” to smoke cigarettes as a means of proving that they are free and hip and have control over their lives.
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