The introduction of male doctors into the world of birth happened in the 1700s, but the college of obstetrics was not founded until 1929.
It can be hard to control the subconscious mind. There are things we learn that we aren't even fully aware of. Ever heard of "accidental sexism"?
I had a teacher growing up that told me women couldn't be in the army because men couldn't help but try and save them. Men couldn't let a female get hurt so these army men were less focused on what they were doing and more focused on protecting the females of their troop. I'm not sure where his theory came from exactly, but it made me think about the world of birth, that is my specialty after all.
Someone once told me that obstetricians are trained in how to get a baby out fast, while midwives are trained in how birth acts and how to support that.
If women are to be protected by men, wouldn't men want the baby out fast? In order to get that damsel in distress out of distress. Baby out, pain over...right?
In "Call The Midwife" there is a scene where a male doctor gives an unconsented episiotomy. He was going through some ptsd from the losses he witnessed, but the trigger for him was seeing this patient in pain. He wanted things over quickly.
I am not going off on a "blame men for everything" tangent. The tools they introduced into the birth field, such as forceps, have helped many people give birth to healthy babies.
The issue is who they tested these tools on and how they choose to use them now.
When men began to enter the birth world they were turned off by the low payments and long hours, but soon richer families, who wanted a highly experienced physician, began paying higher rates to have doctors instead of midwives. The appeal? Patients thought these doctors could help them have a painless labor through all of the tools they used to assist. Unfortunately that wasn't the case. We know now that it is better to heal from a natural tear than an episiotomy and don't even get me started on twilight sleep.
When you look at the United States maternal mortality rate in comparison to other developed countries, ours is extremely high. At one point in recent years our rate was higher than Turkeys. Black women are 3-4 times more likely than white women to die in childbirth in the US.
The reason for the high maternal mortality rate? Sexism, racism, and lack of midwifery care.
Obstetrics was created on a foundation of racism and sexism. Men didn't want women in pain so instead of learning how to support labor, they looked for ways to shorten it. They tested their new devices on women of color. They strapped women down, tried to make them not remember birth, used vacuums and forceps, and eventually pushed for unnecessary cesarean sections.
It is nearly 2021 and we may think we have moved past all of this, but why is the mortality rate still so high?
This is still stored in the subconscious mind. We pick up patterns from the people training us, who picked the patterns up from people who trained them. It is passed down in ways we don't blatantly see.
Even if someone magically wiped out racism and sexism the rate would still be high because even if doctors weren't being subconsciously racist and sexist they would still be stuck in the pattern of getting the baby out fast. Removing sexism and racism would bring the rate to a steadier number across groups of different races, but the thing that is really necessary in lowering this rate is the return to midwifery care.
If you compare the US to Canada, Finland, Norway, the UK the biggest contrast is our country's policies. We aren't encouraging women to see midwives for their overall health. They are viewed as an option for the hippy dippy moms who want to go all natural. In reality, your sixteen year old who wants to go on birth control could go to a midwife for that.
A yeast infection? Go to a midwife. STD testing? Midwife. Postpartum depression and wanting to try a SSRI? Midwife.
Obstetricians in other countries work with families who are high risk, but even then they still consult with midwives. Families who know they are going to have to have a cesarean are the ones seeing obstetricians.
In America the midwives and obstetricians seem turned against each other. Homebirth midwives usually do not have privilege to deliver babies at a hospital. Who would have thought? Giving birth is a privilege? Having the provider of your choice no matter where you end up birthing is a privilege?
Women in labor are not damsels in distress.
Birth choice is not a privilege, it is a right.
The medicalization of birth, the racism, the sexism, and the elitism displayed in rich communities has all contributed to where we are now in 2021.
It isn't just going to go away.
We keep fighting for movements like BLM and women's rights, but we also push for basic birth rights.
Whether you have a doula advocating for you, friends and family, or just an amazing provider who knows your birth goals.
People are so focused on making money off of birth, and the medical industry as a whole, that they leave people behind. People are thrown in the trash like leftovers.
If you are white and have money in America you will probably have an okay birth experience, probably.
Putting funding into midwifery care is an investment with a higher pay off. We keep stressing about putting money into early childhood ed, but how about putting money in doulas and midwives? How about we start families off on the very best foot in their parenting journey. We make them feel confident, empowered, educated on their choices. We train doctors to be more like James McKenna, presenting families with all the options and then letting them trust their gut.
The choice should be there if you do want an obstetrician, but it shouldn't be the normal.
85% of deaths labeled "maternal mortality" could be avoided by an increase in midwifery style of care.