Monday, May 26, 2008

Midwives, in thrall to ideology, discourage pain relief

Natural childbirth: whose birth plan is it anyway? in the Sunday Telegraph is a fascinating exposition of the rise and tyranny of the philosophy and fabricated claims of Grantly Dick-Read":
As any woman with children knows, the politics of childbirth are so highly charged they make infighting between Labour and the Tories look like a teddy bears' picnic...

Maureen Treadwell of the Birth Trauma Association ... says that far too often ideology takes precedence over individuals' needs. 'The consequences can be unbelievably cruel...'

At the heart of much of the argument are the philosophies of Grantly Dick-Read, a British obstetrician who was convinced that much of labour pain came from society conditioning women to expect it. His 1942 classic Childbirth Without Fear expounded his belief that women educated to be free of fear and tension would experience birth as a 'normal and natural defecation'...

Dick-Read became the first president of the Natural Childbirth Trust ... [which] later became the National Childbirth Trust ... Yet Treadwell believes they may also encourage an unnecessarily stoic attitude. '... I have noticed that several midwives who have gone down its route believe pain relief leads to a cascade of interventions, when with modern techniques there is little evidence to back this.'
Belinda Phipps not only acknowledges the stance of the these midwives, but supports it:
... Belinda Phipps, the NCT's chief executive, defends such a stance. 'A lot of women who feel they are denied an epidural are on the verge of starting to push the baby out and don't actually need one any more... [A]n experienced midwife will know she's actually getting ready to push and persuade her to wait a few more minutes... Afterwards most women are very pleased they were coaxed into holding out.'
Not suprisingly, many women are outraged that their wishes are being ignored in favor of the midwives' ideology:
... 'I talk to women who have been left screaming in agony because they were either not offered or were refused pain relief,' Treadwell says. 'Afterwards, they've needed psychological help, their relationships have been scarred, they've been afraid of getting pregnant again, they don't bond with their babies.' Figures compiled recently by The Sunday Telegraph showed epidural rates vary hugely between hospitals; medical experts said the low use of epidurals at dozens of hospitals was 'extremely disturbing'.
The government, in a transparent attempt to save money, is encouraging homebirths and discouraging pain relief:
In Britain the number of home births has risen from a low of one per cent in the 1980s to nearly three per cent today, a trend that the government seems eager to assist. Last year it announced a target of ten per cent home births by 2009. Yet Treadwell is dubious that such initiatives correspond with actual demand: 'In Wales they've had a ten per cent target for home births for a while, but the figure sticks at less than four per cent, which probably reflects the number of women who actually want them...'

The result, Treadwell says, is that the government is discouraging pain relief when more and more women need it... I talked recently to an American obstetrician who was appalled at how our hospitals are praised for their low rates of pain relief. What about the suffering women? This is the 21st century, for heaven's sake.'
The ultimate irony, as I've pointed out many times, is that Grantly Dick-Read was a racist and a sexist who made up his claim of painless childbirth in order to encourage women of the "better" classes to have more children. Dick-Read, deeply influenced by the eugenicists of the early 20th century, was concerned about "race suicide" if the "inferior" races had more children than middle and upper middle class white people. Dick-Read's claims about primitive women and childbirth have their origin in sexist philosophies of labor pain as punishment for women who didn't know their place, and racist theories that "primitive" women were hypersexualized, understood their "place" in relation to men, and therefore had painless childbirth.

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