Parallels in obstetrics and psychiatry

By Leah Harris (mamadharma)

It often strikes me as to how my experiences as a psychiatric survivor color most facets of my life, informing my perspectives and my choices in so many ways.

When I became pregnant, I immediately knew that I did not wish to give birth in a hospital setting.  Given my past history with involuntary hospitalization and drugging, hospitals are traumatizing places for me and I avoid them at all costs.

Yet, in early pregnancy, I honestly didn’t know of the other options available to me.  Even for someone like me, who was already skeptical of mainstream medical approaches, it took a lot of research to uncover the truth about birth.  Luckily, there is a growing movement out there of dedicated natural birth activists who seek to educate mothers and families about the birth options available to them.  Ina May Gaskin is considered one of the gurus of this movement, which has attracted celebrities like Ricki Lake (who made a great documentary called The Business of Being Born).

As I got deeper into the research about childbirth options, I began to notice the commonalities between the natural birth movement and our movement of users and survivors of psychiatry.  The first commonality is that we are confronting industries – the birth/obstetric and psychiatric industries, respectively.  In both cases, the trend is toward the most invasive medical technologies, which also just happen to make a lot more money for these industries.  When it comes to mental health – as we all know, it’s institutionalization, shock, and expensive psych drugs.

When it comes to birth, the parallel is in unnecessary Cesarean sections.  While I do believe that in some cases, c-sections are truly necessary, life-saving procedures, they are performed far too often. The U.S. happens to have one of the highest c-section rates in the world, yet maternal mortality rates have not declined since 1982. Basically how it works is that through a cascade of medical interventions – electronic fetal monitors, epidurals, labor-inducing synthetic hormones like pitocin, etc – many mothers end up with c-sections that could have, in the vast majority of cases, been avoided without the interventions.

On this subject, I highly recommend Suzanne Arms‘ book Immaculate Deception II: Myth, Magic, and Birth, which provides a little-known historical perspective on the birth industry.  Among the frightening practices of obstetrics in the 20^th century was “twilight sleep” – the administration of a powerful narcotic and drug which would literally knock mothers out to the extent they had no recollection of the birth experience.  The use of twilight sleep was common well into the 1970s.

Same story that you may recognize when it comes to mental health: a history of brutal “treatments,” expensive technologies, lots of medical experts, disempowered “patients,” and unimpressive outcomes.  Another commonality is that the truth about natural alternatives is suppressed.  There is a growing body of evidence, for example, that home birth is as safe, if not safer, than hospital birth, yet this information is not known to the general public. Most childbirth classes are run by hospitals themselves, so parents are not typically exposed to any alternate viewpoints.

By the time I got to the beginning of the third trimester of my pregnancy, and was assured by my midwife that there were no complications, I began to seriously consider having a home birth.  I knew that the only place I’d truly feel comfortable giving birth to my baby was at home; and since I knew I didn’t want epidurals or other drugs, there was no reason not to have a home birth.  I lived within a 10 minutes’ drive of several hospitals, so if something were to go wrong, I would have that option open to me.

In the end, I am ecstatic that I chose a home birth. While childbirth was by far the most physical pain I had ever experienced, I benefited from natural pain relieving methods – a birth tub filled with warm water (which I stayed in for hours), meditative breathing techniques, vocalization, and the application of pressure on my lower back.

At home, I was allowed to labor at my own pace, in my own way, to move around freely (rather than be stuck on a bed with a fetal monitor on my stomach), to make any noise I wanted, to eat and drink as I pleased.  Best of all, I was surrounded with the people I chose to have around me – my partner, an experienced midwife, a caring doula. All were there to make sure I had the best possible birth experience. Having a home birth was the most empowering experience of my life.

I had a relatively long labor, because my son was in a bit malpositioned in the birth canal, which made it harder to push him out.  My midwife said that if I had been in the hospital I would have for sure ended up with a c-section. Hospitals tend to have an unspoken 12-hour rule for labor, as they want to process mothers in and out as quickly as possible. I had an 18-hour labor so I would have surely been out of their time frame, and in line for a section.

Another interesting thread that winds through the birth and psychiatric industries is the way that these industries manipulate our culture’s fear of pain.  Women in the modern era are incredibly fearful of the pain of childbirth, as we typically never witness a childbirth before our own. The attitude of most women today is “why would I want to put myself through that, when there are perfectly good drugs out there that block the pain?”

Yet few seem to consider the implications of the wide-scale disruption of the natural birth process, or the long-term effects of drugs and other interventions during birth on babies. We do know that post-partum emotional distress can often be triggered by a mother’s profound disappointment in her birth experience. I believe there may be long-term societal repercussions to the c-section epidemic that we may not understand fully for years to come.

Suzanne Arms, author of Immaculate Deception II, says it best:

Drugs, technology, and surgery should be used in service of the whole person and the whole relationship of mother, child, and the entire family. Not to do so creates human beings who are disconnected from their bodies and from the earth…then we begin to behave in ways that do damage to both.  It is by being intimately connected to one another that we can learn what it is to be connected to life as a whole.  We must pay attention to what is natural…and follow that course, or the long term price we pay will be dear.

In our culture, we are taught to fear and avoid any kind of pain.  We are taught to eradicate it by any means possible.  Of course, we are all human, and most of the time we do prefer to live without pain and suffering. But there are some kinds of pain that serve a purpose.  Labor is certainly pain with a purpose, and much of our emotional distress also serves important purposes, as Al Galves recently wrote about here.

I think about the home birth process, and how it is a wonderful example of the power of self-determination: from start to finish, the mother chooses.  She chooses her support people and she chooses how she wishes to labor. She is seen as the expert in her process, she is empowered to trust her body to do what it is supposed to do, and she has the emotional support to endure the experience of childbirth without medical interventions.

These are the aims of our movement as well – we view people as the experts on their own lives. We advocate for letting people move through distress in the way they see fit, with the supports (if any) that they choose – not to have their experience shut down prematurely by forced drugging or hospitalization.

I will always be grateful to have birthed a healthy baby with no drugs, no doctors and nurses and random people running around, no bright fluorescent lights, no invasive procedures performed on my baby after birth, just quiet and peace and tears of joy and relief as my newly born baby was laid on my chest. The memories of this experience are among the dearest of my life.

What I wish is for our movement, and the natural birth movement, to make deeper inroads into spreading awareness about alternatives and choices – to make the truth known about the industries that profit from our fear and pain and disrupt the natural flow of life. I wish for a world in which babies are born peacefully, and in which people in emotional pain can move naturally through their experiences with whatever sort of “midwife” they choose. In this way, I hope that we can build a future where, as Suzanne Arms so eloquently puts it, we are all increasingly connected to our bodies, to our spirits, to the earth, and to each other.