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On Being Strapped Down In Labor (Lessons From A Women's Prison)

Prison controversy highlights importance of movement in labor.

The practice of restraining pregnant inmates during labor has been the topic of controversy for some time now: Finally, states are passing laws banning the practice which can pose serious health risks to mom and baby. Today The Daily Beast looks into the shacking and cuffing of laboring women and it’s pretty interesting to read for several reasons. The controversial restraints are used to prevent a jailbreak attempt which is unlikely under these circumstances– a woman at 8 centimeters is not going to get far…The descriptions of how prisoners are treated during labor and postpartum are chilling: the word “cattle” is used

But what stuck me most about this piece is the emphasis, by doctors and women’s health advocates, on the importance of movement during labor:

“The challenges of shackling become more urgent in the delivery room, where it’s vital for a woman to move around early in labor, to appease pain and expedite delivery…’Anyone who has had a baby knows it’s almost impossible to sit still. So, depending on how the woman is shackled, it’s incredibly debilitating. If her feet are shackled—if she’s forced to stay on her back, it can put stress on  the baby’s heart,’ said Tina Cassidy, a maternal health advocate and author of Birth: The Surprising History of How We Are Born.”

In a standard US hospital birth women are often told to lie on their backs and be monitored, with two large belts around their bellies, sometimes for most of labor. I don’t want to get too heavy-handed comparing the shackling of prisoners in labor to the standard hospital birth–the situation is clearly much more dehumanizing for the incarcerated set–but I do wish that the standard medical treatment of women in labor included more emphasis on movement.

The fetal monitors used in most US hospitals are distressingly lo-fi. In some places in Europe, women are monitored with ambient (wireless) monitors, so they can move around while having the fetal heart rate tracked. But you go into any hospital in New York City and women are strapped in on their backs and tethered to a machine for at least 20 minutes of every hour. Ways to avoid this include staying home in early labor and hiring a doctor or midwife whose philosophy leans towards fewer interventions–these are also care-givers are more likely to monitor with dopplers, a hand held device that can be used when a women is in any position or even in the water.

I wish we didn’t have to be quite so proactive about getting off our butts in labor.  There’s clearly medical evidence supporting movement and mobility in labor, maybe we need to get the word out for all mothers?

 

 

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