Perez 1 Maria Perez Ms. Caruso English 1102 19 July 2012 Why Natural Childbirth?

Imagine that one thing that you have always wanted, that one thing that you dream about having, that one thing that inspires you. Now, imagine someone pushing you around telling you what you have to do with that one thing, knowing that there was nothing that you could do to prevent this; the only thing you could do was watch as someone else dictated your behavior. This thought is almost insulting, yet this is what is happening on a daily basis here in the United States with pregnant women. As we all know in America the number one way women give birth is in a hospital. Yet, we are practically the only nation where this is the case. As the film Born in the U.S.A. explains before the 1900s natural childbirth was common and midwives were the number one way that women gave birth. Aside from the fact that the majority of the population could not afford doctors; in addition, there was also a lack of hospitals and obstetricians. This method of having children was very practical and millions of children were born in this way; however, around this time obstetrician practices began to emerge, and they began to give negative connotations to midwives. In the US unlike other western countries, midwives were virtually banned (Born in the U.S.A.). This eradication of midwives lead to a huge dependence on hospitalized births; however, during that time and even now very few doctors have observed a natural birth in medical school and in the hospital (The Business of Being Born).
Beth Caruso 8/2/12 11:14 PM Comment: Idecidedtofollowyourideasandmakemy introductionusemoredirectstatements.I alsotookouttheexclamationpointsto makemytonemoreformalthroughoutmy paper.

Perez 2 If you look at obstetrics for the last 50 years, what do you find? In the 1930s they were giving x-rays on every pregnant woman to measure her pelvis. And then in the 1940s they discovered that that caused the baby to have cancer, so they had to stop it. And then in the 1950s and 60s they had another drug called Thalidomide, which caused babies to be born with out arms and legs, and then they had to stop that. But you see in every case it was after the fact in the fact 1990s they were giving cytotec to induce labor in women who had had a previous cesarean. And they ended up with hundreds and hundreds of ruptured uteruses and many, many, many dead babies before they found out finally in 1999 that they shouldnt do that. But you see theres not a good history in obstetric practice of careful study of the long- term effects of all these interventions. This is why, if you really want a humanize birth, the best thing to do is to get the hell out of the hospital. (The Business of Being Born) Thus, without even realizing it, women have erroneously placed their trust in the hands of those they consider more experienced. Furthermore, one would believe that this movement towards hospitalized births would result in decreased infant mortalities and happy mothers; unfortunately, this is not the case. In fact, the United States is ranked poorly in terms of infant mortality (The Business of Being Born). This is an indication that new delivery methods should be considered. There are several routes that a woman giving birth with no complications can take. Among these are natural childbirth, induced labor, and cesarean sections. In the following paragraphs you will be introduced to these methods to enable you a better understanding of how women in the United States give birth.
Beth Caruso 8/2/12 11:30 PM Comment: Irevisedthisparttomakeitall flowtogether.Ialsoaddedatransition.I addedthereasonswhymidwifeswereso prominentbeforethe1900s.

Perez 3 When a woman is ready to give birth her body naturally adapts and adjusts to help her give birth. The article, Why Natural Childbirth? does a great job in describing the birthing process. In the last months of pregnancy a womans cervix softens and begins to prepare for labor. The baby moves to the pelvis, this is when contractions begin to get stronger. These contractions lead to the release of oxytocin (which is the bodys natural pain reliever). The woman will naturally move and position herself in whatever way she feels most comfortable. To help induce her birth a woman can walk, use nipple stimulation, use castor oil, or even have intercourse (if her bag of water is not intact); to help augment labor a woman can walk, change positions, and use a midwife (the midwife would support her, and make her as comfortable as possible throughout the entire delivery process) (Pitocin FAQ). She can give birth wherever she feels comfortable- whether that be in a bedroom or in a tub full of water. Midwifes are well prepared and in many cases they have worked in hospitals assisting with deliveries. However, as with anything there are risks involved. In the case of medical emergencies a midwife will not hesitate in taking a woman to the hospital if complications beyond her control arise. Other risks associated with natural birth include: painful vaginal area, and urinary and bowl leakage; for babies the main risk is nerve injuries to the shoulder, arm, or hands- these risk are somewhat negative, but they do not compare to those that you will read about shortly (Best Evidence: CSection). Sadly, birth is often portrayed as agonizing, life threatening, and far from a normal event in the media (Born in the U.S.A.). This has lead women to believe that the place to give birth is a hospital, and not their home because women do not know how to give birth and should be dependent on an obstetrician. Therefore, the majority of women giving birth prefer to do so in the hospital. This decision increases the possibilities that a pregnant women will become induced if she does not
Beth Caruso 8/2/12 11:53 PM Comment: Connectedbothparagraphsfor readingpurposes.Ialsochangedtheending sentencestomakeonecompleteidea. Beth Caruso 8/2/12 11:29 PM Comment: Addedsomemoredescription astowhattheroleofamidwifeis. Maria Perez 8/2/12 11:18 PM Comment: Tookoutyouseetomake statementmoreformal. Flippedthefirstandsecondsentenceto helpmaketheparagraphsflowsmoothly.I alsotriedtoformalizetheparagraphby takingoutsomewords.(Her)

Perez 4 deliver within the time frame hospitals have. Induced labor has become more and more prevalent in the United States. According to the American College of Obstetricians and Gynecologist (ACOG) labor should be induced only when it is more risky for the baby to remain inside the mothers uterus than to be born (American Pregnancy Association). Yet this is not always the case, with the availability of medicine many women prefer not to stay in pain. Medication has enabled women to avoid going through the pain of giving birth. In hospitals, obstetricians are trained to minimize the pain a patient goes through. Therefore, when they see a patient in pain they tend to suggest or even push the use of medication. This alone is one of the fundamental reasons why the use of pitocin- a synthetic form of oxytocin-has increased so much even when its usefulness and safety are still questioned (Pitocin FAQ). Many believe that this is augmented by the position in which women are laid. The lithotomic position is the most physiologically dysfunctional position ever invented for birth (The Business of Being Born). This is not the best position because it makes the pelvis smaller and makes the woman giving birth have to work harder to push the baby out. Rarely any nations worldwide use this position to give birth. In fact, many countries criticize the United States for using this pose. Perhaps the worse thing about all of this is that in many cases medical decisions are being made for monetary and legal reasons (The Business of Being Born). Not because a woman wants to, but because they are made to believe that they need to give birth within a certain time frame to fit a doctors schedule. Making the decision to give birth in a hospital will also typically lead to medication. The most common type of medication used to induce labor is usually pitocin. Patients on pitocin are usually placed on regulated intravenous pumps. Pitocin is usually injected to a patients IV, and it begins to take effect immediately. Pitocin helps accelerate the contractions a woman gets making
Beth Caruso 8/3/12 8:31 AM Comment: Insertedatransition.

Perez 5 it easier for her to give birth. Oddly enough, it believed that pitocin reduces the amount of oxygen a baby receives, that is why women are placed on electronic fetal monitoring systems. The use of pitocin usually debilitates the mothers to be causing them to lose control, making them unable to push or have any type of feelings in her uterus, while at the same time augmenting the pain they feel. This is why many women end out needing epidural anesthesia. Epidural anesthesia is injected in a womans lower spine. This anesthesia is very powerful and will cause a woman to lose feeling in her lower body. This pain reliving method is very useful in terms of eliminating pain; however, with loss of control comes a greater chance of a woman needing a cesarean section. We have also witness that pitocin can be the beginning domino in the domino effect. The IV, the infusion pump, and the continuous monitoring will confine most mothers to bed, decreasing her ability to deal with the contractions naturally. With the more painful contractions a mother is more likely to need pain medication, such as an epidural anesthesia. The risk of this is that pitocin can lead to tumultuous labor, and tetanic contractions, which may cause premature separation of the placenta, rupture of the uterus, laceration of the cervix or post birth hemorrhage. Fetal hazards include: fetal asphyxia and neonatal hypoxia from too frequent and prolonged uterine contractions, physical injury and prematurity if the due date is not accurate. (Pitocin FAQ) All of these risks are taken by thousands of women on a daily basis by giving birth in hospitals in the United States; risks that are not necessary and can be avoided through natural birth. The Department of Health and Human Services National Center for Health Statistics on cesarean sections indicate, Cesarean rates rose significantly in each state from 1996 to 2007

Perez 6 (see table). The magnitude of the increases varied. Six states (Colorado, Connecticut, Florida, Nevada, Rhode Island, and Washington) had increases of over 70%. In 34 states, cesarean delivery rates increased by 50% or more. All of this is unfortunate, considering that in the majority of these cases a cesarean section is not necessary. However, with the medications that these women are given it is typical that complications will arise. Thus, leading to a cesarean section. As the Center for Disease Control indicates, In addition to clinical reasons, nonmedical factors suggested for the widespread and continuing rise of the cesarean rate may include maternal demographic characteristics (e.g., older maternal age), physician practice patterns, maternal choice, more conservative practice guidelines, and legal pressures. Some of these reasons are completely acceptable, but others are not. The fact that legal pressures are making physician practices patterns change, and that they are also making practice guidelines more conservative is not an excuse to put a woman through the risks, and complications of a cesarean section. The Childbirth Connections online page does a magnificent job in talking about the risk of cesarean sections. These risks include but are not limited to: Physical problems in mothers including, hemorrhage, blood clots, infections, and bowel obstruction. Poorer overall mental health and emotional problems that can lead to depression. More likely to rate her birth experience poorer than a woman who has had a vaginal birth. Less early contact with her baby and is more likely to have initial negative feelings about her baby. Recovery from surgery poses challenges for getting breastfeeding under way, and a baby who was born by cesarean is less likely to be breastfed and get the

Perez 7 benefits of breastfeeding. Higher risk than other mothers of having traumatic symptoms (such as fear and anxiety) and for meeting criteria of Post-Traumatic Stress Disorder (PTSD). Emergency hysterectomy. Injury from accidental cuts to nearby organs such as the bladder or bowel or ureter (the tube that carries urine from the kidney to the bladder), especially if the surgery is done in haste. Reduced fertility or even infertility. Maternal or fetal death.

The risks associated with cesarean sections are an eye opener to the risks a woman undertakes when she has a cesarean section. It is not fair that they are made to miss that once in a lifetime event, the birth of their children. Why should a woman be made to feel useless, or even unaware in that one event that she does have control over? Why should a woman have to become exposed to the risks mentioned above when she does not really have to? There is no reason. It is true medication has brought about magnificent changes in the lives of millions of women who are truly at risk during their pregnancies. But, no doctors schedule, or hospital bills should determine the course of a womans birthing decisions and experiences. The only way that this unfortunate trend will change is if we are more informed of the resources and opportunities available for women that are pregnant. Do not put yourself or a loved one in a position that you would not want to be. Become informed and help make a change.
Beth Caruso 8/3/12 2:33 PM Comment: Maria, Revisingthispaperhashelpedmeseesome mistakesthatIhadmissedthefirsttime.I havetosaythatthisrevisionstuffis actuallyveryhelpful.Itiseasytogetcaught upwhenyouarewritingandmissouton thebigpicture.Oratleastformeitis.Iliked thefactthatwerevisedoverseveraldays,it mademeseemypaperfromdifferentangles ondifferentdays..Thishelpedme understandwhatmypurposewas.

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Works Cited Best Evidence: C-Section. Childbirth Connection. Childbirth Connection., 2012. Web. 20 July 2012. Born in the U.S.A. Dir. Ken Schneider and Marcia Jarmel. Perf. N.perf. PatchWorks Productions, 2007. DVD. The Business of Being Born. Dir. Abby Epstein. Perf. Ricki Lake, Abby Epstein. New Line Entertainment, Inc., 2008. DVD. Inducing Labor. American Pregnancy Association. American Pregnancy Association., 2007. Web. 12 July 2012. Lothian, Judith A. Why Natural Childbirth? The Journal of Perinatal Education 9.4 (2000) : 44-46. Web. 12 July 2012. Menacker, Fay, and Brady E. Hamilton. Recent Trends in Cesarean Delivery in the United States. No. 35. U.S. Department of Health and Human Services National Center for Health Statistics. 2010 March. Web. 22 July 2012. Pitocin FAQ. Childbirth.org. Childbirth.org., 1996-1998. Web. 12 July 2012.