American Birthing: Part II

Approximately one in three women in the United States who give birth this year will end up with a major abdominal surgery.  The caesarian section (c-section) will leave many women with outcomes that are often not disclosed to them before, during, or after their pregnancy.  Some of these outcomes include (but are not limited to not limited to) hemorrhage, infection, decreased fertility, difficulty with breastfeeding, complications with future pregnancies, reduced early contact with baby, longer hospital stay, increased pain, and long recovery (1).

In a previous article, I discussed the model of birthing in The Netherlands where midwives possess most of the power and influence in obstetrics and one-third of women give birth in their homes.  The basic premise of birthing as a natural process seems to be a foreign concept to many Americans.  Our hospitals are deliberately modeled to promote unnecessary and often risky interventions to the birthing woman and her baby.  Fetal monitors limit movement and are often inaccurate, IV fluids provide women with little control over their own body’s cues, epidurals numb the body and increase the risk of other harmful interventions, and artificial oxytocin (i.e., pitocin) leave women with contractions that are extremely painful and difficult to bear.  Women are often pressured to have the baby within a certain time frame, otherwise, they are threatened with interventions due to “failure to progress.”  Then, because women are connected to machines, their mobility is restricted, and they are forced to lie down on their backs to give birth.  This position is not only the most painful position in which to give birth, but it is also the most ineffective and restrictive to oxygen and blood flow (2).

These countless interventions given to women in birth are not without their risks.  For example, women who receive an epidural are more likely to develop a fever during labor (3).  As a result, newborns are sometimes given antibiotics as a “precautionary” measure since a fever in the mother could indicate an infection.  Even if antibiotics are not given, maternal and child separation almost always occurs as a result of the fever.  Epidurals can also cause low blood pressure in the laboring woman, which can decrease the oxygen supply to the baby (4).  The side effects of all interventions can potentially be harmful, but the most disturbing aspect of medical interventions is the cascading effect.  Once a single intervention is begun, the likelihood of receiving multiple interventions is inevitable.  For example, a woman given an epidural must also receive an IV drip and continuous fetal monitoring.  These interventions all increase the likelihood of cesarian section and the combination of so many medical and chemical interventions can be harmful for both the mother and the baby.  However, I do not have the space to describe in detail every intervention and the corresponding side effects.  Several books provide in-depth information about this topic, including (but certainly not limited to) The Thinking Woman’s Guide to a Better Birth, Gentle Birth Choices, and Ina May’s Guide to Childbirth.

As a new mother, the most troubling facet of the effects of interventions during birthing is how it can possibly affect maternal and child bonding.  Michel Odent, a famous French doctor and birth activist, describes the importance of hormones during the birthing process.  He writes in his book The Scientification of Love, that when a woman gives birth, she releases the most oxytocin she will ever release in her lifetime (5).  Oxytocin is often called the “hormone of love” and is needed in humans and animals to initiate the process of bonding.  Artificial interventions can often hinder, block, or interrupt the natural release of oxytocin and other hormones in the process of birthing.  Studies have shown that lamb and sheep who are given c-sections and epidurals often have no interest in caring for their offspring (i.e., they refuse to care for their babies) because of this hormonal disruption.  Human beings are undoubtedly more complex and will not refuse to care for their newborn babies due to an epidural.  However, the studies are worth considering and the results still fascinating with respect to the implications for humans.  For example, studies have shown that women who have vaginal births consistently release more oxytocin while breastfeeding than women who have cesarian sections days after delivery (5).

The hour after birth is critical for mothers and babies to bond, and hospital practices have disrupted this process.  Not only do medical interventions have the potential to disrupt hormonal processes in mothers and their babies, but they also increase the possibility of separation immediately after birth.  Studies have shown that the period right after birth is critical to establish the bond between mother and child.  A recent Cochrane review, based on scientific evidence, shows that babies who were not separated from their mother for the first hour after birth and participated in skin-to-skin contact were more likely to breastfeed and be shown more affection while breastfeeding.  Similarly, mothers were more responsive to their babies (6).  The first hour after birth is so significant in establishing a secure relationship that Michel Odent believes it to be one of the most important moments in a human being’s life (5).

As a Muslim woman, I believe that God has given me the innate ability to birth.  I also believe that He, in His infinite wisdom, has made the process perfect in all its pain and hardship.  The Quran states in the 94th chapter: With hardship, there is ease.  Imam Sadiq (upon him be peace), a descendant of the Prophet Muhammad (peace be upon him), stated: “Allāh (swt) has given every woman the patience of 10 men, and during pregnancy Allāh (swt) grants her the ability of 10 more men.” (7)  It seems peculiar to me that we treat birthing in the same way that we treat major surgery in this country.  Birthing seems to be the most natural process in all of His beautiful creation, and we have turned it into a sickness.

In my next article, I will review the history of the U.S. birthing system, and the subtle messages given to women about birthing in this country.

(2) Enkin, M, Keirse, M., Neilson, J., Crowther, C., Duley, L., Hodnett, E., Hofmeyr, J. A Guide to Effective Care in Pregnancy and Childbirth. Oxford University Press, 2000.
(3) Segal, S. (2010). Review article: labor epidural analgesia and maternal fever. Anesth Analg, 111(6): 1467-1475.
(5) Odent, M. The Scientification of Love. Free Association Books Limited, 1999.
(6) Moore ER, Anderson GC, Bergman N. (2007). Early skin to skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev, 18(3): CD003519


About The Author

Hanieh Razzaghi

Hanieh Razzaghi was born in Tehran, Iran and moved to the United States with her family when she was two years old. She grew up in Pennsylvania and attended Penn State University where she received a Bachelors Degree in Biobehavioral Health. She then went on to receive a Masters in Public Health at Yale University. Most of her work since graduation has been focused on research related to health care in the United States. Hanieh is currently a stay-at-home mom to her daughter recently born in November of 2009 and her research and blogging interests have expanded to include child health and development. She works part-time from home as a Research Project Manager and she is also studying to become a birth educator and breastfeeding counselor.

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12 2010

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  1. Samira Rizvi #

    MashAllah sister, great piece! As a new mother who had a c-section, I often felt quite disappointed that I had to end up on that route… it was a combination of issues, but I think I lacked preparation and I really do think, like you mentioned, hospitals in the U.S. are only out there to deliver and get you out. Alhamdulillah, my experience nursing and bonding went well, so I am glad for that. I just wished that I could have done things differently… inshAllah, maybe next time!

    I will keep reading your series.


  2. Hanieh #

    Glad you liked it, Narges :)


  3. 3

    Very interesting piece … contained many points I had never thought about. Jazakallah Kheir Hanieh!


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