Sexism, Men, and Stupid Obstetrics

I am routinely amazed by the ridiculous things done in obstetrics. So much of what is practiced is obviously not natural or normal, and yet has been normalized by years and years of use. Some examples:
Vaginal Exams
Continuous Fetal Monitoring
Labor and Birth in the Supine Position
Medication For Labor and Birth
Routine Immediate Cord Clamping
The Overused C-Section

These are just a few things that upon even gentle examination make no sense, harm the birth experience, and ultimately harm the mother and baby.

We are starting to see some progress in obstetrics as research shows just how STUPID so many of the above things are. They are not supported by better outcomes or better experiences. And yet research backed by the almighty dollar seems to be the only thing that can change ridiculous practices that never should have started in the first place.

Why the prevalence of STUPID obstetrics?

The answer is simple- MEN.

When women give birth with other women, particularly generations of women who have given birth themselves and have seen many other women give birth, they are led by instinct and fact based wisdom of what works. They birth in positions that they FEEL like giving birth in. They listen to baby or simply FEEL it move. They would not think of cutting the private parts of one of their own sisters. They know she can do it because they have done it themselves. There is nothing more natural and sacred, and there is nothing scary about it.

When birth became the subject matter of men, everything changed.

A man literally has NO IDEA that it is uncomfortable to lie on your back when full term with an eight pound baby. He of course has never even been pregnant. He might believe it- if you can prove it.

He has no idea that a vaginal exam is humiliating, uncomfortable and tells you nothing about the time of birth. He looks at the female body as a mysterious machine, that can and should work in a predictable manner.

When he sees a woman moaning and moving in labor, he is in awe of her power. But awe turns to fear and doubt because he does not understand how these primal rituals can influence something that seems to be only a physical process that should be kept as controlled as possible. He also thinks her noises mean she is in pain, when they are in fact a way to deal with the overwhelming sensations of birth.

When he sees the miracle of the baby emerging from the "tiny" vagina, he thinks- "That must hurt, I can help her by numbing her or making the opening larger." He doesn't know that the moment of birth is more climactic than painful. He doesn't know that her body is meant to do this. He doesn't know that that "tiny hole" can both make love and birth babies with equal skill. It looks incomprehensible, and because he has never done it, it is incomprehensible to him.

Forcing the woman to be conveniently still and medicated to the gills on her back of course increase the "need" for instrumental and surgical delivery. He sees the female body as flawed and failing rather than powerful and amazing. After all, the woman probably needs and even wants to be "saved" from pushing that huge thing out of that tiny hole. The c-section is more and more necessary the less we understand the female body and her abilities.

When the baby is finally ripped from the malfunctioning body of it's mother, it is important to cut the ties that bind and pass the baby to another penis yielding expert who can handle things. The cord is cut, the baby is passed. Does it need anything more from that placenta and that mother? Of course not! Missed is the miracle of the placenta, the need for the precious cord blood, and the common sense of thousands of years of evolution and divine design. The wisdom of ages is replaced with cold hands and steel instruments.

We should not have to "prove" what is obvious. The female body is made to give birth. This is the RULE. The exception are the rare cases where something else is needed. With modern health and sanitation, the exception (the woman who can't give birth without help) is even more rare than ever. And yet, we seem to be surrounded by women who "needed" intervention, now more than ever before.

The sad fact is that the introduction of men to the art of birth has changed it, probably forever. It introduced so many foreign, silly, and yes, STUPID practices that never would have been there had birth stayed within the realm of wise women, intuition, and sisterhood.

I want to close with a quote from Ina May Gaskin, found in the movie, Orgasmic Birth (my emphasis added).

"The United States has a peculiar history about childbirth. There is a higher level of fear of birth in this country than we see in so many cultures around the world. I think it has to do with our own peculiar history of absolutely destroying the profession of midwifery in the early twentieth century. When you destroy midwives, you also destroy a body of knowledge that is shared by women, that can’t be put together by a bunch of surgeons or a bunch of male obstetricians, because physiologically, birth doesn’t happen the same way around surgeons, medically trained doctors, as it does around sympathetic women."

Give birth on your terms with others who believe in birth. We have moved so far from this sisterly knowledge that now even female midwives and practitioners sometimes doubt the power of the female. Surround yourself with people who trust birth.


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"They would not think of cutting the private parts of one of their own sisters."

It's interesting that you should say this in the context of birth while the fact is that the practice of female genital mutilation of young girls outside birth is largely perpetuated by the insistence of women. Though of course the grounds for it is that the men will not accept an intact woman as a wife, and since men are in charge and women are at their mercy, they must obey. Still, these women perpetuate the same myths about FGM as are circulated in the United States about MGM - it's cleaner, protects from disease, etc.
Mama Birth said…
I had never thought of that Carla, and I admit to knowing pretty much nothing of that subject.
I am sure that women hurt each other all the time. But as somebody who has healed from an episiotomy and a tear, I can not imagine inflicting that on another woman, but you still hear the argument (usually from male ob's) that a cut heals better than a "jagged tear". So many of these practices continue (in my opinion) because of a deep belief in the inability of the female body to give birth. In our country it is perpetuated by men and women- but I believe it began with the introduction of men into the birthing scene.
Thanks for your insight.
Oh yes, I absolutely agree with everything else you said. All these interventions spring from the belief that the female body has no power (a belief left over from the 19th century, the age of the "rest cure" and "hysteria"), and that control needs to be forfeited to the male authority figure.

Reminds me very much of the story, The Yellow Wallpaper, the whole idea of hysteria and the rest cure. Women were literally thought to be made sick from using their brains too much, and from just being a woman - because they thought the uterus "came loose" and made you crazy!!

I wrote a paper about that for my Biology of Women class last year, I think I might post it on my blog.
January said…
Wow! I've had the same thing on my mind...things that aren't necessary in pregnancy or birth. I never saw it like this though.

I do have to say though that many women (midwives) do these unnecessary interventions as well and that frustrates me!
Mama Birth said…
I think you are right January that so many women do these same things, both female midwives and OB's- I do think it all started though when birth moved from lay midwifery (instinct, home, tradition, non-science) into the male dominated hospital (pathology based). I didn't know that so many of these things were unnecessary until my last home birth where I had a midwife who I had to ask for a VE if I wanted one. I was blown away at the difference, when I had already had 2 great midwife assisted natural births. I will never look down on the CPM again-
UmmAlice said…
This post is in itself a bit sexist and i think this is a cruel generalization. My husband was totally into the idea of an unassisted home birth, infect I think it was his idea in the first place. Throughout my entire pregnancy, and still to this day as I breastfeed our daughter, he has reverence for the female form and what it's capable of doing,
. It's the introduction of DOCTORS that has forever changed the art of birth. While I was pregnant and researching different birthing options, I seen videos of births with men in the birthing tub, holding their women. I seen fathers catching their children in "home births" in other, less developed countries. We begin to see idiotic practices present at births when doctors began attending these births. And since, most of the doctors were always MEN, well there you go. Since they were both MAN and DOCTOR they did not know, understand, appreciate or respect the power of the female form. We, as women are in control of our bodies and choices. As doctors began to beacon pregnant mothers, they made the choice to give a doctor that control, instead of reaching inside themselves to find the strong Mother within, who comes alive at birth. When women stopped believing in their own ability to birth, doctors took over.
And of course they see no problem with cutting the genitals of a birthing mother when chances are his own mother opted to have him circumcised at his own birth. Performing an episiotomy on a birthing woman is just as absurd as circumcising a newborn.
Most women, let alone men, understand that the vagina is designed to expand during childbirth, then shrink to pre-birth size, or pretty damn close. Just like a man's penis can double it's flaccid size when need be.
I'm like the most hardcore feminist I know, but blaming men for everryyything isn't going to give us back control of birthing, or other aspects of our lives. Knowledge is, for women just ad much as men.
Amanda said…
I have to agree with UmmAlice's assessment. Most of the doctors with whom I have had problems have actually been women (my own OB was a man and dissatisfactory, but that had more to do with my status as a Medicaid patient and my limited options than his masculinity). But my son's first pediatrician was female, and all about the over-application of medical interference (and ignoring parental feelings). I have had female Ob/Gyn's who treated me far more roughly and with far less respect than some male Ob/Gyn's I have seen, possibly because they feel they dealt with it, so should I? I think the problem with "female-ness as disease" has more to do with our attitude in society that education/ medicine/ money solves all problems, and that anything that makes us a bit uncomfortable is a problem. Let's look at the root of the problem-- we abuse animals in CAFOs so that we don't have to deal with where food comes from; we buy products made in third world countries so that we don't have to see the slavery that our desire for cheap Snuggies and soap dishes creates; we overprescribe ADHD drugs so that we don't have to exercise with our kids... Our whole society is about easing pain. That's not caused only by men.
Sober Woman said…
I think this is so well written. As I was reading and researching birth practices in different cultures and how birth moved into hospitals it became obvious the choices were made by men. Woman as doctors are seen only recently, since in the begging of the 20century few woman were even admitted to universities. So even if some of you now think about female doctors who are "worse" than male OBs, that is not the point of this post. It is the history we should look at and Sara has it nailed down to the bare essentials.I love this post, so powerful! It is one of your best- best one I've read so far :-) way to go mama!
Em Hamzah said…
Hello! I have come across your article and I just wanted to say that I think its great! I agree with you in a lot of ways. I don't think men should be involved in this practice at all. I had my baby son at home and with a midwife in attendance. I feel very blessed to have had that opportunity since when I went for the beginning prenatal check ups at the hospital, I really felt very uncomfortable.

Also I am muslim and I just wanted to share some things, that muslims give very high status to the mother and especially the mother during labor. We believe that when a women is in labor, this is the best time to ask God and know that our prayers will be accepted. For us, this is very big.

Also since the women goes through much pain during labor also gains many rewards for the day of judgement.

In addition to this, if a women happens to die in labor due to complications, she gets a higher status in paradise.
Mama Birth said…
Thanks for all your feedback-
I guess you could say that it was doctors or medicine that changed birth- but those doctors were largely men (not till recently have there been female docs and even now they are relatively rare) and that the profession itself is most certainly masculine in its approach to human life.
Of course many men have made a fantastic contribution to making birth better (I am a Bradley teacher! I train partners, usually male!) Dr Bradley, Dr Grantley Dick Read, Dr Lamaze, etc.
I am not blaming men for the state of childbirth, I think accepting that intervention and dehumanization lies squarely on the shoulders of women who allow themselves to be treated that way. But- I do think the influence of garbage medicine and care provider convenience and lack of evidence based practices most surely started with the introduction and take over of MEN who happened to be doctors.
yorgisali said…
I am male, my latest child was home born, am founding member of the Natural Childbirth Association Since the end of the last ice age women have become men's POWs in most cultures. Yet Nature--or the Great Spirit--bestows on every woman a natural birthright of great Female Power. POWomen have largely relinquished that power to the perks of male culture. Most women who would like to pursue alternatives to male obstetrics need to undertake a major overhaul of their deeper identity until they restore within themselves that level of Female Power that is necessary for natural childbirth. Today a woman also needs an accepting and supportive male partner, which is the reason i have been animating expectant father's groups.
Anonymous said…
I agree with your thoughts about sexism and mean entering the realm of birth.

But I do not understand why some birthactivists constantly try to deny the fact, that childbirth can be painful.

Life is not black and white - just as breech is a veriety of normal, childbirth may hurt or not. It is not up to the women, try as she might, to "reach painfree birth" as ultimate goal.

After all, pain during childbirth is one of the very things, that force us to grow as a person. Reaching inside our hearts and find, in spite of the pain, courage, faith and strength to surrender to birth is a great achievement. One thing, that prepares us for motherhood and can heal damage in ourselves.

Why deny it, because it is scary? I don't like to tag feelings as bad or good. Pain is simply it, pain. It might be hard to endure, it might be scary, it might be daunting and it can seem like a force of nature. But it is nothing bad.

So, please stop denying childbirth can be painful. It says nothing about the pureness of the woman, who feels it (or doesn't feel it) during childbirth.
Anonymous said…
I cannot believe the reverse sexism that your article demonstrates towards men. I feel sorry for your husband and children.

By the way, "gentle" examination of the usefulness of medical interventions is not enough. You have to have chemistry/biology/physiology/anatomy coursework, great GPA, 4 years of medical school, internship and residency, and specialty work just to START as an OBGYN. You must think they're just smoking pot for 8 hours a day, if your average lay person can "gently" sift through the data with an equivalent mind/educational analysis as they can. But I guess ignorance is bliss when it comes to not knowing what you don't know. *Though come to think of it, it was in HIGH SCHOOL that I learned, that the more you know, the more you realize how little you know. In reverse application, It has been scientifically proven that the less you know, the more you think you know. This is known as the Dunning-Kruger effect - lol.

Jaimie said…
What an irresponsible post. If this blogger wants to go back to the day when infant mortality rates were in the hundreds (out of a thousand births) by ignoring medical science, then be my guest.

And she doesn't even get the numbers correct. 99.4% of all midwives in the US are women. 75% of all OBGYN residents are women.