Hospital Vs. Homebirth
Characteristics of the Technocratic Model of Care
(HOSPITAL BIRTH)
Basic Principle = Separation
- Mechanization of the body
- Isolation and objectification of the patient
- A focus on curing diseases, repairing dysfunction
- Aggressive, interventionist approach to diagnosis and treatment
- Alienation of practitioner from patient
- Reliance on external diagnosis
- Supervaluation of technology
- Hierarchical organization, the patient as subordinate to practitioner and institution
- Authority and responsibility inherent in the practitioner
Characteristics of the Holistic Model of Care
(HOME BIRTH CARE)
Basic Principle = Connection
- Views the body as an energy system interlinked with other energy systems
- Insistence that total healing requires attention to the body-mind-spirit-emotions-family-community-environment
- A focus on creating and maintaining health and well-being
- Nurturant, relational approach to diagnosis and treatment
- Essential unity of practitioner and client
- Respect for the value of inner knowing
- Technology at the service of the individual
- Lateral, webbed organization-networking
- Authority and responsibility inherent in the individual
Thanks to Anne Frye, Holistic Midwifery, Volume 1: Care during Pregnancy. Labrys Press, 1995.
How Safe Is Hospital Birth?
“Doctors argue that the decrease in mortality and morbidity rates as birth moved into the hospital proves that the hospital is safer. Even if that statement were true, it would not mean hospital birth was responsible for the decline, but the claim is false. In the 1920s middle-class women began having babies in hospitals partly on grounds of safety. By the mid-1920s half of urban births took place there, and by 1939, half of all women and 75 percent of all urban women gave birth in hospitals. Despite this shift, maternal mortality did not drop below the 1915 levels of 63 maternal deaths per 10,000 births until the late 1930s, when sulfa drugs and antibiotics to treat infection were introduced and more stringent controls were placed on obstetric practices. During that same time period, urban maternal mortality rates, where hospitalization for birth was more common, were considerably higher than overall rates. Infant deaths from birth injuries actually increased by 40 percent to 50 percent between 1915 and 1929.
“…One of the more potent myths of obstetrics is that women and babies died in huge numbers until obstetricians saved them from the ravages of the natural process and the ignorance of midwives. Quite the contrary is true. The endless parade of procedures and drugs that obstetricians have inflicted on women and babies since that time, including the much-lauded forceps, have maimed and killed more women and babies than ever have been saved by their use.”
Excerpted from Obstetric Myths Versus Research Realities: A Guide to the Medical Literature, by Henci Goer, Bergin & Garvey, 1995
“Do doctors deserve the credit for the fall in infant mortality over the past 70–80 years? Or perhaps, infant mortality was very low centuries ago when midwives delivered babies at home. When the female healer, including the midwife, was eliminated through the witch hunts of the 17th and 18th centuries, male doctors took over. They had one characteristic that midwives did not possess—they performed autopsies. And they had a nasty habit of going from the autopsy table to the mother in labor without washing their hands or…even changing their bloody gowns. Is it any wonder that childbirth fever-puerperal sepsis-became the great killer of these times?
“Finally…toward the end of the 19th century, Ignacz Semmelweiss told the doctors “wash your hands…” and as [they] began to wash their hands, childbirth fever began to disappear. Now, my concern is that modern medicine has taken credit for the decline in infant mortality, but understandably enough, has never considered assuming blame for its previous rise.”
Excerpted from “Childbirth Alternatives and Infant Outcome: A Pediatric View,” by Robert S. Mendelsohn, MD, in Safe Alternatives in Childbirth, NAPSAC 1977