Issue 67

The Role of Fear in the U.S. Birthing Process

The once natural event of female-centered birth has effectively been medicalized. Power and control have been removed from midwives and women and shifted to science and the surgical specialization within medicine, today known as obstetrics. Read more…. The Role of Fear in the U.S. Birthing Process

Preventing Complications with Nutrition

Nutrition in pregnancy—a no-brainer, right? Who would think it was so controversial? Disagreement over a healthy diet during pregnancy continues to rage, with one side saying that what a woman eats will have no effect on her pregnancy and the other saying it has an enormous impact. So what’s a woman to eat? Read more…. Preventing Complications with Nutrition

Misplaced Fear

I find it fascinating that women are afraid of the wrong thing when it comes to birth. They are afraid of birth when it is what they are perfectly designed to do. The thing they should be afraid of is whom they put their trust in and where they birth. Read more…. Misplaced Fear

Cytotec Induction and Off-Label Use

Without adequate testing of Cytotec (misoprostol) for labor induction, obstetricians simply began to use it on their birthing women. They were taking advantage of a huge loophole in our drug regulatory system. Read more…. Cytotec Induction and Off-Label Use

Cytotec Induction And Off-Label Use

Editor’s note: This article first appeared in Midwifery Today, Issue 67, Autumn 2006.Join Midwifery Today Online Membership Without adequate testing of Cytotec (misoprostol) for labor induction, obstetricians simply began to use it on their birthing women. They were taking advantage of a huge loophole in our drug regulatory system. Once a drug is approved by the FDA for a specific medical indication and put on the market, there is absolutely nothing to prevent any doctor from using that drug for any indication, in any dose, for any patient he or she chooses. Since the label of the drug contains the indications approved by the FDA, this is called “off-label” use of a drug. When obstetricians using Cytotec induction are confronted about their willingness to use a drug “off-label,” they inevitably answer: “We use drugs off-label all the time.” There are several serious problems with this answer. First, in reality, using Cytotec for induction is not “off-label” at all—it is “on-label contraindicated.” On the Cytotec label it is explicitly written that this drug is contraindicated for use on pregnant women. Contraindication would not be on the label unless data exist suggesting possible serious risks from such use. “On-label contraindicated” is a whole different level of risk-taking than a use that is not mentioned one way or the other on the label. A second reason to be concerned with the offhand answer of some obstetricians is that all off-label use is lumped together as though there were equal risks involved. During a case I was involved in, I asked the obstetrician about the off-label use of Cytotec for labor induction. He replied with the same answer that I have heard from so many clinicians: “We use Cytotec off-label for induction just like we use other drugs off-label all the time.” Compare this… Read more…. Cytotec Induction And Off-Label Use

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Cruelty In The Maternity Wards Revisited

I based the title of my article on the title of a highly influential Ladies Home Journal article from the 1950s.    It began in the November, 1957 issue with a letter to the editor from a labor and delivery nurse who gave some examples of abusive treatment of laboring women where she worked. The editors published the letter, saying that they had never heard of such mistreatment, and invited readers to respond. The result was “Cruelty in the Maternity Wards,” an outpouring that Ladies Home Journal published as an article in the May issue the following year.

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The Role Of Fear In The U.S. Birthing Process

Birth is inherently a female activity. The choice, the ability, the power to give birth is innately female. Historically women were the sole possessors of birthing knowledge and technique, and in certain cultures and time periods men feared them as a result of this.

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Though I Walk Through The Valley …

When I first became interested in midwifery, I was pregnant with my fourth child. I came from a hospital background not only in my birthing style, but also in my chosen field of work.

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The Questions Are More Important Than The Answers

During the twentieth century, it had been commonplace to raise the main questions regarding childbirth in a negative way. How to give birth without pain? How to give birth without fear? How to be born without violence? As long as the questions are raised in this way, they will usually lead to sophisticated and sterile solutions.

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Fear, Society, And Birth

A friend reminded me in a recent e-mail of the world of risk we are now part of in the West. It was one of those circulating e-mails, and it took a look at the differences in the world we grew up in compared to the one our children are a part of now. According to the risk measures we apply to the life of our children it is clear many of us should not have survived! Children now have become more protected and cocooned than we ever were.

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Tokophobia

“Tokophobia” is an intense anxiety or fear of death that leads to some women dreading and avoiding childbirth despite desperately wanting a baby. So, can we call this yet another piece of iatrogenic morbidity? How many women had this a hundred years ago? What has the Western childbirth model done to women?

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Fear of Death During Labour*

Whatever the mother tongue, the reference to death is typical of a certain stage of labour. My own observation of births on both sides of the Channel, both in a home-like hospital (Pithiviers, France) and at home, are confirmed by detailed reports of births throughout the world, in the past and at present. However, the expression of a fear of death has rarely been studied, even by such acute observers as Grantly Dick-Read, the author of Childbirth Without Fear (1955).

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