Book Review: Birth by Tina Cassidy
“The diary of the Reverend Ezra Stiles, president of Yale College in the late eighteenth century, noted that between 1760 and 1764 there were ten maternal deaths in Newport, Rhode Island, a rate of one-half of 1 percent. These were probably fairly pure births, in an age of simple midwifery, few tools, and no anesthesia. In natural and historical terms, a half of 1 percent is not a lot. Of course, no one would want to be one of the women who died, or her offspring.” This passage is near the end of Tina Cassidy’s book on the history of birth and, while it’s a good book altogether, this bit would have been better at the beginning. In so many ways, this is less a history of birth and more a history of the way people have tried to reduce this percentage of maternal and fetal mortality. Some of these measures were extreme and many are brutal sounding to our modern ears; it is easy to read them and be tempted to think of them as normative for their time periods, when they might simply have been desperate attempts to fix a desperate situation.
Reading about these desperate attempts makes for emotionally difficult chapters; how do you deliver a baby who is truly stuck before the advent of safe caesarean sections? Not in a way that makes baby’s safety a guaranteed thing, that’s for sure, and will probably involve trauma for the whole family.
And despite the relatively good statistic in the paragraph opening this blog post, there are SO many things in the modern world that I am thankful for and hadn’t quite connected to what they would have meant for childbirth in the past. Rickets, y’all. I am mainly talking about rickets here. Malformation of the bones, of course; this includes malformation of pelvic bones, duh, doula Nicole! And a malformed pelvis makes for awful childbirth conditions. So, yes, completely and totally grateful for modern health improvements… although I’d also like to take this time to shout out that the rickets cases have surged in recent years, so please be mindful!
To return to the book at hand, as time went on, some of the extreme safety measures taken by medical professionals became standard ~ also for safety reasons, but somewhat misguided. Keeping fathers out of the delivery rooms, for instance, had a great deal to do with germ prevention. You might say this is a case of tossing the daddy out with the bath water, trying to keep the baby safe. Eventually, although after much drama and an arrest or two, people realized that there were other precautions that could be taken for safety and that still kept the greater good of the family together. This is how much of birth history (and, well, all history) has worked out: we are reactionary beings, and it takes us a while to find balance. For far too long, for instance, strong religious conservatives argued misguidedly that it was wrong to alleviate a woman’s labor pain because of the curse given to Eve in Genesis. Women reacted to this (of course!) by demanding the removal of all pain. I always thought of the “twilight sleep” for women giving birth as some barbaric thing done by medical professionals; but imagine my surprise when I read that early feminists pushed for it too - demanding to be freed from the pain of birth and Just Put To Sleep. See what I mean about finding balance?
One thing seems to remain constant with women, babies, and birth, though: outcomes are always better when women feel supported. Not surprisingly, I loved the chapter discussing how the modern doula came about. Two researchers observed some anecdotal evidence that seemed to indicate non-medical, continuous support could make a difference for women. They decided to do serious research on it and, as Cassidy writes, the results were telling. “Klaus & Kennell launched their first real doula study in 1975. The research team hoped to have twenty normal vaginal deliveries in the doula group and another twenty deliveries in a non-doula group to examine how having support during labor affected mother-child relations right after birth. However, the nondoula group was producing far more complicated deliveries, including a high rate of caesereans. In fact, it took 103 women in the non-doula group to produce just twenty normal vaginal deliveries, compared with only 33 women in the doula group to reach the same target.”
Wow. I’m a doula and I’ve seen the way this support can help a women process labor better, but these numbers still made me gape a bit. A woman’s need for encouragement in birth is real and is connected with her physiological wellness too; well, as research seems to be showing, this is actually a human condition… here’s to a future with more support for people everywhere!