labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Thursday, September 6, 2007

Birth as an American Rite of Passage

Birth as an American Rite of Passage, Second Edition, by Robbie E. Davis-Floyd has been hyped as feminist propaganda and an eye opening must read for childbearing women. This book was first published in 1992 with the second edition following in 2004. Outside of the preface to the new edition, the book was not changed or updated. This is much to its downfall.

Davis-Floyd is an anthropologist whose life work surrounds human childbirth. She views our current system of childbirth as technology driven, under a technocratic and paternalistic model. She analyzes the need for societies and groups to have rites of passage, birth being one of these rites. She examines the history of childbirth through conceptual frameworks that changed through generations. The underlying theme in most of these frameworks is that women’s bodies are flawed. During the industrial revolution and scientific awakening, mankind began to view the body as machine. The ultimate machine is the male machine, and the female machine is the flawed or continuously faulty body. It is under this belief that drives current trends and medical approaches to childbirth.

Davis-Floyd interviewed many women during and after their pregnancies. She analyzed these interviews for underlying themes in how women view childbirth under the current medical paradigm. Surprisingly, the majority of the women wanted or at least accepted the medical approach to birth. Drat!

However, the question must be asked: is this because we are products of our culture? Are we as a society bred to believe that birth in a hospital with all the latest gadgets and procedures (of which many have no scientific evidence basis) is the best and only way? I’d say yes. How often do we hear the dogma of the medical approach to birth because it is inheritantly dangerous? Why are we ignoring the evidence that many of the dangers are technologically grounded?

Outside of this discussion, the author includes her interpretation of the medical and hospital procedures performed during childbirth starting from the wheelchair into the labor room. Because this book was originally published in 1992 many of the procedures discussed are out dated. It is still interesting to read why such things (enemas, shaves, ritual separation of mother and baby) occurred.

Because some out dated procedures remain in the book, many discredit this work as foolish drivel. I agree that the author should have updated her references and ritual analysis of hospital childbirth procedures. There certainly is enough evidence out there to continue to support her theories and analysis.

This book will not tell moms-to-be “what to expect”, but it may help in making informed choices. If you are looking for a book chock full of birth stories with benign messages, look elsewhere. There are birth stories in this book, which I found interesting, but will likely leave The Baby Story crowd unfulfilled.


Wabi said...

Regarding your "women are enculturated to accept medicalization" thoughts ... Yeah, I think many women are extremely passive when it comes to labor and are encouraged to learn only the most cursory facts about what will happen when they have a baby. To be an informed pregnant woman today can lead to friction or being labeled a bad/annoying patient much more often than it will win you compliments. The system definitely reinforces itself.

That said, I also think there is more going on with women embracing medicalization than just the culture making people think they can't do labor on their own. Technology is just very soothing. Sure, most of the time labor goes fine if left alone. But sometimes it can go catastrophically wrong, and the mere chance of that looms large in your mind when you aren't talking about averages anymore, but about YOUR individual situation and baby. Then stats aren't reassuring at all. You crave more than that.

I guess my point here is that you can't discount the benefit women get from just believing in advance of labor that certain aspects of delivery (like pain) can be eliminated via technology. If you are afraid of pain in particular, the anti-interventionist crowd tends to tell people "pain won't kill you, you can get through it with a variety of non-medication measures." And while that's true, it's also really cold comfort if you are nervous about labor. So technology, even with strings attached, can be very seductive.

Labor Nurse said...

wabi, well said.

Real said...

Yeah, what I find is that it's not just about pain relief though. Women really believe that it's actually SAFER to have an epidural--for mom and baby. And of course, in the grand majority of cases, that's ridiculous. But it's all about fear. A woman having a natural labor is "in the zone" and making noises and moving around and even struggling or panicking.

That can look scary, like something's going wrong. What can you do?!?! Whereas a woman with an epidural is calmly lying there, not freaking out, not making noises, not moving around, even SLEEPING!

It sure *looks* like there is less going wrong with the woman with the epidural than the naturally laboring one.

It's very seductive.

Alot of the time all women know about labor is that it's painful and all they know about epidurals is that it takes away the pain. And if they actually do hear the side effects of the epidural (let alone side effects of like monitoring or something else "benign" like that), they tend to kind of gloss over it as legal mumbo jumbo that someone HAS to tell them but really doesn't apply. Because, after all, if epidurals (or whatever) were really dangerous at all, the hospitals wouldn't be doing them, would they? I mean, not just for convenience and pain relief when there's no medical indication for them? Right?

Anonymous said...

I think what keeps me going to the hospital is the after care for baby in case of emergency. I have had 5 and now am about to have my 6th. I want my baby in my arms, no eye ointment and the like...but if my baby had a real problem, I want the best I can get medically right away. It's the "brain damage" fear, or death itself. I'm one who labors with no IV, and pretty much goes in with about 2 hours left of labor...and has had no OB the last two times because I dilated very quickly in the last stage (just as many more than 3 multiparas might) it was just nurses and my husband in the room when the wee one arrived. I believe it's safer in that we have a great NICU I've only had to use once for 6 hours. So, it's not about my experience which I can do my best to stand up for, it's about those first critical moments if baby is doing poorly. This time I did screen positive for trisomy 18, which is most generally fatal. I didn't get amnio, so we don't know for sure...and so being in the hospital seems prudent.