COMMENTARY | When I was in my late teens, I was set on dedicating my career to improving the health and birth experiences of women and newborns. I wanted to become a direct-entry midwife. Two factors steered me away from that direction. One was the realization that -- like any obstetrician or pediatrician -- I would eventually witness (and possibly even cause) the death of a newborn, and the understanding that I could not emotionally cope with that possibility. The other factor was a frustration with the polarization of birth attendants -- with obstetricians often feeling very distrusting of midwives, and vice versa.
This distrust and polarization remains rampant among both types of practitioner, as has been demonstrated recently in Idaho, where many midwife-attended newborns have died or suffered permanent damage. Physicians largely feel that midwives -- and their clients, who often view hospital transport as a completely unacceptable failure -- are responsible for these preventable catastrophes.
I think it's important to note that, just as horrible accidents happen in the hands of midwives, horrible accidents also happen in the hands of physicians. In the highly medicalized setting of hospital childbirth, unnecessary interventions such as epidurals, episiotomies, IVs, and cesarean sections are commonplace. Because of these interventions, it is often safer for women with low-risk pregnancies to give birth at home attended by midwives, instead of in a high-intervention hospital setting. The American College of Obstetrics and Gynecologists even acknowledges the benefits of midwife-attended home birth for women with low-risk pregnancies.
The issue at hand isn't that home births or hospital births are inherently unsafe, but that moms, obstetricians, and midwives all need to shift their focus of the discussion. The utmost priority during childbirth should not be to eliminate all pain or make it through childbirth drug-free. Nor should the priority be to give birth only in the security of a high-tech hospital or the warmth and comfort of home. The priority for everyone involved should be to produce a healthy baby and a healthy mother, with as few complications as possible.
Doctors and midwives need to stop quarreling over which practitioner is superior. There will always be women who need physician-assisted childbirths and there will always be women who are safer and happier in a natural setting aided by a midwife. Instead of perpetuating the childbirth wars, practitioners must unite in common goals: to provide comfort to women, to enable the birth of healthy babies, and to admit when something has gone wrong and needs further intervention. There is nothing inherently wrong with midwifery or obstetrics, but something is amiss when life-saving care providers can't look past their philosophical differences to save the lives of women and children.
Juniper Russo is a health advocate, freelance writer, and dedicated mom living in Chattanooga, Tenn.
