Friday, 15 August 2014

Why Birth was Hospitalized

Childbirth is not a disease. On the contrary, it is a process of enhancing and furthering life. So it seems strange that it became part of hospital life - hospitals invented for the sake of curing ill people. Homebirth became a rare exception in modern countries, and in developing countries, everyone who can afford it, goes to hospitals for birth.

To understand this process, we should keep three aspects in mind, which obviously work together in squeezing birth into hospitals throughout the world in the last decades.

One viewpoint: The medical establishment has gained more influence in society since it started to cooperate with modern science. Preventing risks for individuals became a major goal in politics and society, and science based medicine offered its services for this purpose. Due to great successes in conquering many diseases, modern medicine proved its power in helping people to improve their lives and keeping risks at distance. Finally, it also took over the role of providing the best care for mother and child at birth - what should be a risk, when you had all the experts with their instruments and machines around while giving birth to a child?

Second viewpoint: The growth of stress in modern society especially affected birth as a very sensitive phase in life. In addition to that, insecure attachment patterns created an atmosphere of unsafety around birth, so pregnant women started to distrust their instincts and to entrust doctors to better know what is needed when a baby is born. 

Third viewpoint: The economic system of capitalism is based on the exploitation of human (and natural) resources. It requires individuals who are used to stress. So it is in the interest of this system, that individual life starts under stressful circumstances.

Patriachalism and the Alienation of Childbirth

Midwives lost their independent role as experts of childbirth and were placed between doctors and mothers, as part of the medical establishment, subordinated under the regiment of doctors educated at universities.

It is a strange development that male doctors became the experts in childbirth, dismissing the emotional and intuitive female expertise of mothers and midwives which had worked good enough to keep up human life for millions of years. This can be seen as a late victory of patriarchalism not only over the traditional female knowledge about birth, but also about nature. Birth was transferred from a natural environment to an artificial one in hospitals. New life is created in maximum distance to nature. (You only need to walk into a modern hospital to experience this distance, e.g. in Vienna's biggest and best equipped hospital almost all rooms do not have any access to natural light.)

These doctors are not trained in emotional and intuitive knowledge, but only in montoring scientific data and applying "proven" methods designed for avoiding or managing situations of danger. Although by far the most procedures in hospitals have never been scientifically proven, the magical power of the white coat works in entrusting the doctors with a leading role in childbirth, attributed equally from the mothers and from the society as a whole. Pregnant mothers relinquish their intuition and their experience from nine months of pregnancy to the superior knowledge of studied medicins. So childbirth tends to become unemotional, unempathic and unintuitive, standardised and mechanised, resembling more a birthing factory or a highly risky operation than a mystical process as a wonder of nature.

As consequences, cesarian births have multiplied by ten or more in the recent decades, and medication and surgery became regular procedures in the birth process. New risks arise because of the mechanised and sterilised environment of the hospitals. Children are born into a world of machines, artificial light and stressed professionals. Anxiety is the only emotion allowed in the sterile birthing rooms. Every trace of nature is carefully eliminated, is kept outside, so that in this germfree environment the baby has no chance to interact with nature.

Stress and Unsecure Attachment

Under these circumstances it is extremely difficult for the mother and the father to establish a loving bond with the newborn being, as emotions are excluded as much as possible. The whole apparatus is not interested in fulfilling emotional needs but only in taking care of the risks which can be externally witnessed and measured.

The historical trend behind this development has to do with the emancipation of women out of their traditional role as housewives and childreerers. By entering the world of paid labour, women took over the external stress ruling capitalsm. They had to make this step out of the general need to leave behind the confinements of fate in a hopeless class of poverty administered by birth. For a family to escape this fate, the industrialized society of the 19th century (in Europe) and later in other parts of the world offered the possibility of paid work in factories. The income of the family father alone was not sufficient to provide for  the needs for survival and sustainance. So mothers start to work to afford a better life and find an escape from poverty. The price was that women adopt the stress of modern labour which was added to the stress produced by child raising. It is a stress different to the stress in agricultural societies. 

This means that children are born into an environment imprinted with industrialised stress. They receive stress from very early on and chronify it unconsciously, passing it on to the next generation. Babys who have already become used to stress in their prenatal phase are then born under stress. Mothers whose own prenatal time and birth was stressful will again have stressful births of their children. 

As a consequence of stressful births, the bonding between mother and child becomes a problem. Medication, surgery and cesarian section have massive influences on the mother and the child. The emotional energy needed for coping with these hardships reduces the possibilities of establishing a secure relationship on both sides. So the hospitalisation of the birth process can also contribute to the development of insecure attachment patterns which produce habitual ways of avoidant or ambivalent relationships throughout the life of an individual and transferring these patterns to the next generation. These patterns reduce the ability to relate empathically and to feel the needs of others and of oneself. The focus stays on the outside and so help is generally expected from outside. Mothers, who have experienced a lot of stress during their lives and especially during their own birth, feel incompetent about giving birth. So they seek support by external professional helpers, by experts, namely doctors in their white coats. 

Internalising Stress From the Start

Seen from the other side, a society dominated by the economic values of capitalism requires working people who can tolerate a maximum amount of stress and are willing to give their life substance up to the point of exhaustion. Capitalism, fuelled by the urge to maximise profit, has the indispensible tendency to exploit all resources, including human life energy. Exploitation causes stress, and the world of capitalism only tolerates people who are ready to give it all and who are tough enough to cope with excessive demands and can live with the compensations offered by the system.

So capitalism needs people who are used to stress, so they do not notice when they transgress their limits of health. Such people are created by starting their lives in stress and emotional hardship. Thus stress becomes internalised. This is the optimal setup of humans for a world of exploitation and excessive demands. 

By internalisation of stress we mean: When external source do not longer exist, like the whip in slavery, stress becomes internalised. The internal whip is created: You are not good enough, you have to work more, you have to perform better.A child born in the sterile circumstances of a hospital has to quickly give up all expectations of what he or she considers as essential and as normal: A mother full of wonder and joy about her child, people around her who support her needs and the needs of the baby, in a loving and caring atmosphere. Instead, stress reigns, and the baby has to cope with this stress by taking up the assumption about him- or herself: I am not good enough for this world to receive what I need and deserve. I have to improve, I have to become better. If capitalism were a person it would exclaim: "Yes, this way I want you, you are welcome to the world of exploitation."

Back to Nature in Birth

So two sides work together in hospitalising birth: The social dynamics of the age of modern industrialisation as an objective force and the drive of individuals to create a safer and better life in the framework of this economical system, contributing the subjective side of this process. Science plays the seemingly innocent role of supporting this development with facts to prove the necessity of medical control of childbirth. But by suppressing the emotional and relational impact of this development, it just serves the needs of the capitalistic society. Science becomes the cognitive reassurement and affirmation of the instrumentalisation of childbirth, thus transforming into an ideology with pseudo-religious influence.

It has to be mentioned that scientific medicine helped to reduce mother's and children's mortality rate and other dangers involved in birth, but that it also contributed to an increase in emotional stress causing other impacts on physical and emotional health with lasting consequences.  

To escape the vicious circles created by the institutionalising of birth, "nature" has to return to childbirth as much as possible: Nature in form of the emotional intelligence and ancient expertise of women and in the form of friendly and relaxed environments so that the normal birth becomes a norm again, which is a birth without need for institutionalised help but just a wonder of nature creating a beautiful new being, celebrated by openhearted people.