When Alice Dreger, professor of clinical medical humanities and bioethics at Northwestern University, got pregnant she researched her options and decided that a low-tech birth would be the most scientifically sound approach for her pregnancy.
She ditched her OB, got a midwife, and gave birth without much in the way of medications, monitoring and other medical technology. In her article about this experience in The Atlantic Monthly, she says that most people, and most doctors, don’t get that when it comes to birth, too much technology can be a bad thing.
“Many medical students, like most American patients, confuse science and technology. They think that what it means to be a scientific doctor is to bring to bear the maximum amount of technology on any given patient. And this makes them dangerous. In fact, if you look at scientific studies of birth, you find over and over again that many technological interventions increase risk to the mother and child rather than decreasing it….. In other words, if the regular low-tech tests kept indicating I was having a medically uninteresting pregnancy, and if I wanted to scientifically maximize safety, I should give birth pretty much like my great-grandmothers would have: with the attention of a couple of experienced women mostly waiting it out, while I did the work. (They called it labor for a reason.) The only real notable difference was that my midwife would intermittently use a fetal heart monitor — just every now and then — to make sure the baby was doing okay.”
Dreger’s post has gotten 463 comments so far, and no shortage of controversy. There are finer points to be made: When to avoid interventions, when not to, what are the precise risks of epidurals? But the core argument of her article is absolutely true: Go overboard with technology and nature suffers.
We know this in all aspects of human life on earth. It should not come as a surprise that this applies to giving birth. But when we go the other way, we suffer, too. The conversation always has to come back around to the balance between nature and technology. It’s when we start debating nature VS technology, we get into trouble. “Nature”? If you really go down this road, you’re going to be naked in the woods, no tools for skinning hides. If the cow’s milk is infected by a poison berry, you die. Nature is ruthless. But also kind: Evolution provided us with big brains so that we could tool our way out of this mess. We invent knives to skin bears to make hides, we have c-sections for pre-eclamptic moms.
The issue right now, with birth, is that we’ve tipped the balance a little too far towards technology and now we’re seeing harm done. (Here’s a fantastic video explaining precisely how and why this has happened.) Barbara Katz Rothman, professor of sociology at City University of New York says In Labor: Women and Power In the Birthplace, “In medicine, as in much else in technological society, even action with very little chance of success if preferable to no action at all, on he the spurious assumption that doing something is better than doing nothing.” In America, when it comes to birth, it can take a lot of effort to do nothing.
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