Promoting Normal Birth

We want to lend our voices in support of the growing movement of women, families, caregivers, and advocacy coalitions who are dedicated to reestablishing normal birth as the standard of care. 

This movement seeks to reclaim the meaning and wonder of a normal, healthy birth and to inspire both women and caregivers to reincorporate normal birth as part of society’s overall policies and standards for reproductive health.

Based on our many years of clinical and research experience, we share a vision of how birth can be optimized and how a natural birth can be both safe and powerfully transformative.

There is a proliferation of information about all aspects of care in labor. Recently, many experts have harshly criticized the “medicalizing” of childbirth. 

Scientific reasons that a natural birth is preferable, if at all possible

We present the case that science is on the side of normal birth: undisturbed, noninvasive, non-coercive, and noninterventionist. This is at odds with the typical practices and protocols found in many medical institutions. 
From: Childbirth Connection 
Evidence-Based Maternity Care: What It Is and What It Can Achieve
by Carol Sakala and Maureen P. Corry
©2008 Milbank Memorial Fund 
evidence-based_maternity_care.pdf
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Mother-Friendly Childbirth Initiative
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

A Look Back

Prior to mother-centered birth, particularly from the 1930s to the 1960s, standard delivery methods were based on a false concept of “progress”. This was the era of “backwards and helpless”, mothers lying supine with legs up in foot stirrups, sterile rooms with fluorescent lights, the common use of forceps, and medical residents observing the birth on their rounds, without regard to the mother’s privacy. Loved ones and partner were kept out of the delivery room. The newborn was taken away immediately from the mother, washed and placed in an incubator room. The mother surrendered herself into the hands of her physician and was often left feeling patronized and disempowered.

We witnessed and participated in the burgeoning of mother-centered birth in the 1960s and 1970s, and helped encourage physicians and nurses to implement advances in public health, reproductive rights, and evidence-based medicine, as well as emerging research findings on the importance of nurturing parent-child interactions. Policies and protocols in hospitals, medical schools, and birth clinics, went through significant changes during this time.

Women became more fully engaged in the birth process, from making decisions on when to start a family, to choosing who would be present at birth, to facilitating the type of birth and aftercare they received. Women were less likely to view the doctor as an infallible authority and took back reproductive control over their bodies, creating a whole new climate for birth.

Women’s growing enablement to make decisions, to educate themselves and each other, rested on broad changes in social attitudes toward women, reinforced by a confluence of legal and educational advances and changing gender roles, cultural values and priorities. Improvement in the status, rights, and independence of women also benefitted other groups struggling for respect and self-determination, enhancing movements for consumer and patient rights, and influenced family policies, such as maternal leave and government-funded prenatal care.

For a few short decades, a plethora of options were available for many mothers in the United States and elsewhere. We saw an enormous rise in breastfeeding (instead of formula), rooming-in, non-supine positions, the use of birth centers, natural childbirth, midwifery, home birth, Lamaze techniques, lactation support, and a much greater understanding on the importance of enhancing early attachment and helping parents learn to attune to a child’s individual temperament and developmental stages.

And then, at some point in the late 1980s and 1990s, the situation began to change.

We watched in dismay as the rising tide of medical, surgical, and instrumental interventions served to make childbirth treated almost as an illness, rather than a normal function of our bodies. Childbirth in many American hospitals and medical schools appears to be “hijacked” away from normal and mother-centered birth. We feel shocked and worried by these trends.

The crux of our concern is that, under the assurances of the medical community, so many women have been convinced to ignore their own wellbeing. We have seen both mothers and caregivers swept up in a false premise: that “new” interventions are better and that the use of them is almost always well-founded. By assuming that an intervention-laden birth is “normal”, women are more likely to miss the benefits that a natural birth could give them. 

The concept of a “normal” birth has become distorted

A documentable generational shift in obstetrics care has occurred over the past 15–20 years, in response to many social and economic changes, including the increasingly bottom-line approach to managed health care. Physician’s fear of malpractice suits, corporatism, regulatory agencies favoring industry over consumers, and even the way medical equipment is marketed to doctors, have all added fuel to these changes.

We argue that these trends are having dire consequences on maternal and infant health, as well as on society as a whole. An increasingly interventionist approach toward birth has led to high rates of unwarranted procedures, but has not produced measurable improvement in healthy outcomes for mothers and babies.