Is the fact that midwives cut far fewer episiotomies than
doctors important? Scientific evidence shows that having an
episiotomy means more bleeding, more pain, more permanent
deformity of the vagina, more painful sexual intercourse for
months or even years. As well, unnecessary episiotomy is a
form of sexual abuse. Some women's groups in America are
rightly concerned about the practice of female genital
mutilation in parts of Africa. They need to be equally
concerned about the millions of American women who have
suffered female genital mutilation--unnecessary cutting of
the genitals at birth at the hands of doctors.
While midwives trust women's bodies, use low tech assistance
such as the skilled use of their hands, and understand the
importance of preserving normalcy, doctors in general do not
trust women but trust drugs and machines, use high tech
assistance and focus on the pursuit of abnormality. So
having a highly trained surgeon obstetrician assist at your
birth is about as sensible as hiring a pediatric surgeon as
a baby sitter for your healthy two year old when you go out
in the evening. Like the obstetric surgeon who gives the
normal woman a shot to hurry her labor, the pediatric
surgeon babysitting your normal child will focus on medical
management: When your robust two year old gets tired and
fussy, the pediatric surgeon will give him or her a shot to
hurry the child to sleep. The result? In the one case the
medicalization of birth (remember, birth is not an illness)
with a lot of unnecessary risky interventions and very
expensive medical care, and in the other case the
medicalization of childhood (being two years old is also not
an illness) with unnecessary risky interventions and very
expensive babysitting. When deciding on your primary
maternity care provider, it is important to ask midwives or
doctors about their practices: find out if they prefer to
put you on your back during birth, how often they do
episiotomy, forceps or vacuum extraction, and cesarean
section. If they don't know their rates of surgical
interventions or refuse to tell you what their rates are,
look out! Beware of any tendency to patronize you, to
suggest that you cannot possibly understand all this
technical stuff, or that you should just "trust me, I'm the
doctor." -Marsden Wagner, MD, Technology in Birth
Reprinted from Midwifery Today E-News (Vol 2 Issue 26 June 28, 2000)
To subscribe to the E-News write: enews@midwiferytoday.com
For all other matters contact Midwifery Today:
PO Box 2672-940, Eugene OR 97402
541-344-7438, midwifery@aol.com, Midwifery Today
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