Parallels in obstetrics and psychiatry

flowerpBy 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 20th 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.

8 thoughts on “Parallels in obstetrics and psychiatry

  1. This piece brought me to tears, recognizing the parallels in my own life, particularly, my first diagnosis of postpartum depression, following the premature birth and almost immediate infant death of my second child. It seems from that time on, I moved through a fog of disconnect, following the mind/body disconnect, instructed that most of my distress was all in my head, while at the same time told to keep my legs and mouth closed. I babbled on incoherently about my sense of calling to recreate rituals of birthing and death, evoking the goddesses of old, heartened by the stories of temple priestesses when women who exhibited sexuality were reverred as holy, rather than trashed as whores, or morally loose. More and more, I see all this crazy-making as part of making-humans-into-consumers, addicts to an unnatural compliance that serves profit margins rather than the natural remedies that come instinctually . . . rest, loving kindness, tender rebuke, and mirrored self-awareness, and the proper kind of care for mind, body, spirit and the communal ground of others, with whom one can celebrate, play, work, hope for the future, and grieve for what was lost to the past. With thanks for the courage to stand for the pain to see things through. karenkel


  2. Natural gal – a very important point that often home births are not covered by insurance. They weren’t covered by mine and I paid $2000 out of pocket. I am very aware that this is out of the realm of possibility for many people. There is a lot of advocacy in the birth community to get home birth and birth center births covered by insurance. There also may be a lot of midwives who would be willing to work out something with people who can’t afford. There is a birth center in Washington, DC where I live that actually caters to low-income women, which is awesome.

    I do understand that in some cases it’s just not possible to have a home birth – so please know that I am not in any way standing in judgment of those who need to birth in a hospital due to high risk or other issues. In the end it’s about labor where the mother feels safest – for me it was home, and for some it just may be the hospital. I want people to have more choices -whether it is home, birth center, or hospital – and informed consent with any procedures.

    Bonnie – so cool! Thanks for sharing your experience with me. You remind me of when I watch those childbirth shows on TV – it really does make me grateful to have had such a different experience. But it is somewhat heartening that more and more hospitals are having birth centers attached to them, which at least have a more home-y atmosphere and do allow for women to birth at their own pace.

    Ted – thank you. Good point that modern medicine, no matter what the discipline, really works in essentially the same way at this point in our history. Really I could have compared psychiatry to any other medical industry – oncology, you name it. I just happen to know a bit more about the obstetrics/birth industry. 🙂 Glad you found it helpful.

    Val – sorry it was painful to read for you. Birth, like so many things in life, may unfold contrary to our expectations. I hope you know that you did the best you could and do celebrate that sweet son of yours!!! And yourself for bringing him into the world.

    Nicole, thank you for bringing up the Mother’s Act. I wanted to in this piece but just plain ran out of time and wanted to keep it short. Amy Philo Evelyn Pringle and others have written about it too. I didn’t get to go a lot into Suzanne Arm’s perspective but she does believe that a lot of autoimmune issues that we see cropping up today may be traced to the decline in natural births. Also she does tie a lot of emotional distress to this as well but those kind of analyses tend to worry me. I think usually people’s emotional distress has to do with what happens to us after birth, although I get that birth trauma could be deep seated in an individual.

    Gianna thanks for encouraging me to write this piece! I had the exact same reaction to the Business of Being Born. And thanks for driving home those points about oxytocin and so called PPD. Being a natural childbirth supporter is a loving/affirming thing, but you do bump up against the state and its witch-hunting behavior on trying to criminalize midwives (not “medwives”/CNMs) but CPMs, the ones who are really coming at birth from a non medical model approach. Scary stuff. I get tired of being angry too…my little one reminds me to laugh loudly and often, which helps.


  3. I wanted to have a midwife but my insurance would not cover it. And I was scared that if anything went wrong we would be strapped with high bills.

    I got to sit in a whirlpool during labor. It was great. The hospital had lost my records but as soon as they found the records and saw that I was high risk they made me get out of the whirlpool.

    I found that the staff was very respectful of me. I got to have my baby’s father and my cousin hold my hands and kinda lift me up to a squatting position and push. And the labor pain and the push I would lay back down and fall asleep. My husband and cousin were amazed that I could be in pain one second and sleeping the next.

    I must admit I am terrified of pain. My husband said I practically jumped three feet high above the bed when the pain finally kicked in…and I begged the doctor for drugs….I was so scared.

    I have a friend who just had a baby last spring. She lives out in the country and had planned a homebirth at a midwife/doula’s home in the city. She wanted to be close to a hospital if something went wrong. Things did not go well and she ended up going to the hospital.

    I have a cousin my age who is mentally retarded because the doctor let the mother labor for three days. His head had been in the birth canal too long. I know some other horror stories like this so I was very scared of something going wrong.

    I wrote a huge research paper about this subject while I was in college. I had wanted to do things naturally, but it didn’t work out that way.

    I am so happy about the supportive people I had around me during the labor and delivery. But I was high risk so I was grateful for the medical support.


  4. —“we view people as the experts on their own lives” Amen!! I loved this post. I birthed both of my children at home in the early 80’s when there was also a resurgence of natural home-birth movement. I thought about going in the direction of midwifery while in nursing school, then I did an Ob/Gyn rotation in the hospital. Having had my children at home, not one second of the hospital experience made any sense to me. It was overwhelmingly saddening to see the
    Sacredness of these events totally removed in the hospital setting. I was, and still am, filled with gratitude for the experience that I was gifted.
    Thanks Leah


  5. Leah, I appreciate very much the talent you have for writing so clearly and with such insight about difficult issues. This post made me realize more clearly how the whole medical industry, not just psychiatry, is basically completely disrespectful of the people it claims to help. And as a man who tries to understand women’s experience, it taught me a lot about that as well.


  6. This was painful for me to read, in a different way…
    I would have been ecstatic to stage my own version of a home birth, but nothing unfolded neither as it SHOULD have, nor as I wished it to – so finally, my one n’ only successful Live Birth would be a day of infamy, if it weren’t also what I try to celebrate joyously as the birthday of my son.
    Sorry for rambling off obtusely there, but what a great post Leah!


  7. THIS is a WONDERFUL post so full of peace and love. I can feel it and enjoyed reading it. I wrote a piece a few weeks back talking about the link between c/sections and depression and how the Mother’s Act threatens to be another way pharmaceutical companies and the government will try to control women’s lives. This is such a good comparison and I am very happy for you that you found your way to freedom and that you were able to experience the real joy of birthing. There is so much out there about the connection to natural birth hormones and mental wellbeing for both mother and infant. Its a shame that we ruin it with inductions and drugs.

    I am currently reading Suzanne Arms orginal Immaculate Deception and as I read it I shake my head and say “My God…the more things change…the more they really do stay the same”

    I completely agree when you say… “I believe there may be long-term societal repercussions to the c-section epidemic that we may not understand fully for years to come.” In fact I belive that we are already seeing some of those ramifications. It is a sad state of affairs. I am so happy to be a part of this movement helping to spread the word about childbirth the way it should be. Thanks for sharing your story.

    In Birth and Love


  8. I’ve been very interested in the loss of natural childbirth being a big part of the escalating mental health crisis for a long time…in fact I talk about the movie Leah mentions in this piece The Business of Being Born all the time all over the place….it’s so totally worth watching!!!

    …so when Leah suggested writing this piece I was thrilled!

    I believe if mothers give natural childbirth and didn’t get loaded up with
    SYNTHETIC hormones the natural hormone Oxytocin is released flooding the mom and allows for normal bonding and makes the mother feel HIGH!! And HAPPY

    …we mess with nature it messes with us. this is part of why we see the incidence of “post-partum depression,” in my opinion. No natural love hormone release…then the opposite happens…

    This is something I’ve only been able to comment on as an outsider. Here Leah speaks from the perspective of having given birth. She is a mother. She knows.

    Thank you so much Leah because as important an this issue is to me I can never speak about it credibly not having given birth.

    It’s a pet interest though.

    Sometimes I think about becoming a midwife or doula!!

    seriously, because this shit gets heavy and helping healthy women who reject drugs give birth sounds like fun and a way to fight this from a whole different place!! A life affirming and loving place. I get tired of being angry.

    Helping mothers bond naturally with their children and avoiding post-partum from the get go. It seems like a no brainer.

    I’m kinda rambling here…

    the last thing I wanted to say is when I watched the Business of Being Born (twice) I cried through most of it AND continually though, “my god, this is psychiatry playing out in OB/GYN—complete with coercion and no informed consent!!”

    …so again…thanks so much for bringing an experienced voice to the matter!!


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