word, I am only saying that in truth, that is what these things actually are. And that’s OK to call them that. I am not saying there is never occasion for intervention – there definitely are times when intervention is absolutely necessary to reduce a definite danger or save a life. But too early intervention, or blindly routine intervention, is just plain ignorant and arrogant interference with nature and a woman’s right to birth in her own particular way. Some might say, well, that is what you get when you walk in the door and accept the “hospital package”. Not necessarily. Even within the “system” there are opportunities for flexibility and natural birthing – it mainly depends on how the woman approaches pregnancy and birth.
In a Labour Ward
Currently, there is much debate about the increasing rate of intervention in childbirth, especially at the most expensive end of the health insurance options where the number of caesarean sections being performed averages 25% of births nationally (up to 50% in some hospitals and some regions). Even some doctors are beginning to question the need for specialist medical care of perfectly healthy mothers during pregnancy, labour and birth. There are two main considerations to this matter: how much is the increase due to a general worsening of women’s health and their ability to handle a natural labour and therefore their need for such things; and how much is due to routine hospital procedure, professional caution, expectant management and the ideology that this is a desirable direction for the future of birthing?
Today, if you opt for a hospital birth there is a very strong chance that you will have interven-tion in your labour in some way. The following figures are nationwide averages. In some private hospitals the rates of interventions are even higher than mentioned below(17)(19).
• Induction of Labour Onset – 22.2%
• Acceleration of Spontaneous Onset Labour – 21.5%
• Epidural – 38.5% public patients, 62% private patients
• Forceps and Vacuum Assisted Deliveries – 13.5%
• Episiotomy – 22%
• Caesareans – 18% public patients, 23% private patients
All these procedures are remnants of the philosophy of Actively Managed Birth(See “The Hospitalisation of Birth” page 228). According to this school of thought, which predominantly guides mainstream birthing today, there is no mind for just letting nature take its course. The AMB
approach is relatively new (40 years or so), and whilst the popular reasons given for its introduction and continued use are “to make childbirth safer” and “to relieve the suffering and trauma of women giving birth”, the other motivations (but which are not made so public) are time management, dollar management, staff management and patient management – all of which comes back to control over the process of birthing.
The implementation of such policies origi-nated from, and to this day continues to proliferate, the concept that women need obstetric “help” to have a baby – that they are unable to manage through their own resources. Simply by going to a hospital for childbirth, a woman is tacitly condoning that very premise, thereby subtly encouraging the offers of “help” or intervention hospital staff may offer.
When a woman is in labour her perceptions and rational thinking capabilities are not readily focussed outward. If she is tired, in pain or anxious, the offer of intervention may seem attractive, especially if all its ramifications are not understood. Often, on reflection after the birth, women comment they felt they lost control because of the environment, the procedures, the subtle pressures and unspoken anxieties within the room. There is not only loss of control, but also loss of self-value. Women say that they no longer felt relevant – that they were merely birthing machines to be managed.
Many women have felt that medicalised interventionist births destroyed the potential intimacy of the process. Their relationship with the inner person and events they have been enjoying during her pregnancy (the baby) has been intruded upon by all the outer people and events of labour. The baby seemed like a prize to be retrieved rather than an emerging friend. Even after the birth, in those precious first days when intimacy between mother and child is paramount, interruptions and impositions are made upon her by hospital schedules which are definitely not organised in a way which most serves them best.
The moment interventions are offered, a woman can feel like her body has failed her and that she has failed in herself. So often, a little more personal support rather than medical support would encourage the woman to find that help she needs within herself. Interventionist birthing takes away this potential for self transformation for incredibly short term gain, whereas real support is empowering, and provides real long term gains. Interventions in a labour ward can best be avoided by: