Sunday, April 3, 2011

Change #24 Teach Youth about the History & Evolution of Birth in Our Culture

Dear Birth Peeps,
On Friday I was a guest speaker at a charter high school in Santa Fe where my eldest son, Sky, is a history teacher. The kids in three of his classes got a kick out of having their teacher's "mom" be his guest speaker! I shared a few colorful and key highlights of childbirth and medical history with the students, and answered questions about birth in our culture.

Childbirth will be one of the great rites of passage in many of these youths lives, and yet they are not prepared to understand birth in a cultural context, or any context—until they are in their third trimester! We all know that “passive” childbirth education begins long before a woman/couple becomes pregnant—and too often that education is rendered from television and birth stories which may entertain or arouse emotionally-charged imagery—but may not challenge youth to think about childbirth in a broad context of history and culture.

History courses usually focus on politically and economically relevant events such as wars, inventions, revolutions, but rarely touch on how “mundane,” peripheral events, such as birth and medicine, were influenced by, and influential in, those events.

I prepared a brief power point presentation with images of ancient and modern birth, and interesting characters such as Ignaz Semmelweis (who is famous for observing the difference in death rates between doctors’ and midwives’ patients in a Vienna hospital and made the connection between childbed fever and germs being introduced from unwashed hands—because doctors came from autopsies to births without washing their hands in the good ol’ days), William Smellie (who in the mid-1700’s went to births in drag to make the ladies feel more comfortable with a man in their birth room) and Mary Breckinridge and the midwives on horse back in rural Kentucky....(How did the midwives arriving at home births on horseback with just a pair of scissors and herbs in saddle bags achieve remarkable results in home births in the late 1920’s? They had no drugs, no IV’s (not invented until late 1930’s), no drugs to induce labor or kill pain, no forceps or means of performing cesareans—and yet no mothers died and the neonatal mortality rate dropped dramatically after the midwives came, and remained well below the national (hospital) averages. They taught mothers good prenatal nutrition, and they did not interfere with the natural process

I actually had a few learning moment of my own while presenting. In 1600, an English physician, Chamberlin invented forceps. In that era, many children were orphaned and poor, and made their living in factories. There were no child labor laws, and children were exploited; they worked long hours in dark factories and had little food—which affected normal bone development causing rickets. Rickets contracted the pelvic opening; women with rickets had more difficulty birthing normally. It would be three more centuries before there was anesthesia, antibiotics, IVs, suture, or surgical skill to perform safe cesareans. So Chamberlin must have seen women suffer and die, and he invented a way to intervene—the only way he could think of at the time.

For almost four decades, I have been stuck in an absolute, unyielding belief that Chamberlin and his invention, forceps, were barbaric. This is because I was a very young nurse and midwife when I first saw forceps used; I did not have a historical perspective—until Friday. In a singular moment in the high school classroom I felt a wave of understanding and compassion expand my understanding (which is not to say that forceps should not be used with caution and skill).

In one of Sky’s classes he showed his students a very cool video of an “animated” line graph that showed when the average of death rates in various countries increased from the turn of the century to present. From 1900 to 1940, life expectancy was about the same everywhere (30-40 years). Around the mid-1940’s, the life span in developed countries began to rise rapidly, by 1950, it was 68 years!

What happened in the 1940’s?
Penicillin was discovered in 1929 but not developed into a pharmaceutical until the early 1940’s; other antibiotics followed. IV’s were invented in 1935, and improved and made available after 1940. Those two changes alone saved many lives on the battlefield and in hospitals. These important contributions simultaneously coincided with the ongoing campaign to eradicate midwifery and move birth to the hospitals. But it was not the “hospital” or the absence of midwifery that made birth safer: it was primarily attributed to antibiotics, IV’s and blood transfusions.

The students were completely present and asked great questions from a place of innocence and wisdom. Every class raised the questions: Why are there so many cesareans?, Why did they bottle feed babies?, How could they think that formula was better for the baby than what mothers' own bodies made?, Why did they give mothers Scopolamine? (Why indeed?!), and What about home birth?

I wanted to show you photos of Sky and I in his classroom... but the student photographer took blurry photos (maybe it’s my camera because a lot of my photos turn out the same way!). Nonetheless, the image of these youth considering the history of childbirth will be remembered by me and, I imagine, all of the students as well.

Please, find an opportunity to teach youth about the history and evolution of childbirth in our culture.

Good Night,

Pam

3 comments:

  1. Thank you for the realization that the invention of forceps coincided with the prevalence of rickets. Lots of women did die during this time period. Chamberlain really, probably was not the mysogonist many (myself included) thought he was.

    years ago I was at a birth (as a doula) with a CNM I respected immensely. I don't recall all the details of the birth, but it became clear that the attending physician had taken over care during 2nd stage and was leaning towards a cesaren for ftp, but wanted to use forceps first. The CNM leaned into the mother and said very calmly and confidently "Dr. Wagner is artfully skilled with forceps. Listen closely to her and if anything will help you your baby come out, this will." The doctor showed her the forceps, told her how she would use them and asked for her consent - which the mother breathlessly gave.

    She rotated the baby and brought him down and the mother pushed him out the rest of the way.

    It is a skill that is being lost. It is a skill I wish more OB's were trained well in. But that is neither here nor there, what the midwife said made that birth a sweeter one. They were healing words.

    Not only to that mother, but to me as a doula seeing my first forceps birth.

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  2. Excellent-would you be willing to share your power point slides with us?

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  3. I really enjoyed this post. You write about this topic very well. There are many cherished moments in life, why not wear a beautiful dress! When looking back on special memories of your child wearing a gorgeous dress, it will make a fond memory.

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