By Leila Muse
A month before my paternal grandmother died, I spent treasured time with her just talking. She was an
amazing lady. Memories of early childhood are filled with the comfort I always felt around her. During
our conversation about the past and present and future, she spoke to me about how my father was born.
Sixty years after her birth experience, the memory was strong for her.
I never had the chance to tell my grandmother I was pregnant. I did not know until shortly after our
final conversation. I did talk to her about the first human birth I witnessed in person, a woman attended
by a midwife at a birthing center, and how that birth left me in awe of birthing women and the creation
of a family. My grandmother’s birth story came after my story. She had not felt awesome like the
mother I had recently assisted. She was afraid of her body. My grandmother’s body was dysfunctional.
My grandmother was a small, slight woman. My grandfather was a large, impressive man. They were
an adorable couple throughout their lives. Their love for each other was evident and inspirational. She
told me my father was born by cesarean surgery. Cesarean surgery had earned greater popularity by the
1940′s1, as physicians had learned greater skill, and effective antibiotics became readily available.
Cesarean surgery was a ready fix for a tiny, frail woman having what would be her only baby.
Through the years, I have spoken to many women about their birth experiences, from new mothers to
octegenarians. Some have allowed me the privilage of being with them as their doula during their
births. There is a helplessness many mothers express; their births just happened, their bodies were
simply there and these mothers relied on someone else, usually their physician, to make the birth
happen. These women say, “I can’t!” Some mothers feel more powerful; they made decisions, worked
with their bodies’ urges. They birthed their babies, with the loving support of someone else watchfully
waiting to assist if needed. These women say, “I can!” Some women start out with “I can’t,” and learn
to say “I can!”
Every mother is affected by the births of her children2. No matter how birth happens, the experience is
deeply moving and profoundly important to the mother. She remembers her births when she plays with
her great grandchildren. Her birth experience can shape her psyche, her mothering, her relationships.
The resounding theme- how confident a mother is in her self and in her mothering- revolves around her
feelings about the care she received during her pregnancies and the births of her children. Mothers who
are supported on all levels- emotionally, physically, and medically if necessary- have a more positive
experience regardless of how the birth happens. Mothers tend to find this whole-woman care through
midwives, not the standard obstetric care.
There are two basic models of care in pregnancy and childbirth: medical and midwifery3. Midwifery is
the centuries old women-centered way of caring for a pregnant mother and supporting her through birth
and postpartum. The medical model started gestating over three-hundred years ago, when men started
learning midwifery. By the twentieth century, the medical model birthed into a seemingly better, safer
care that relieved women of responsibilty. Interestingly, death rates were not dropping with increased
medical intervention.4
Physicians had the better answers by the mid-twentieth century, much to the relief of mothers. Use
heavy anesthesia to knock a mother out. Save her from the agony of childbirth. More birth
interventions were necessary- drugs to force labor contractions, episiotomies, forceps, surgery- because
mothers became passive, uninvolved, and immobile during the birth process. Newborns kept far away
from their mothers, partly because mom was too drugged to be safe around her baby and partly to save
her from the tiring responsibility of mothering.
Now, more women are questioning the medical model and seeking a return to the ancient midwifery
practices. The United States’ maternity care statistics are not improving under medical management.5, 6
Some mothers are questioning handing over their bodies and their babies to an impersonal professional.
Out of hospital births have increased in the United States7. Many hospital based practices recognize
women want the more personal touch and have added midwives to their staff.
The most ideal care involves collaboration between midwives and physicians. When physicians refuse
to work with midwifery, mothers have difficult choices: have their babies in a hospital under medical
management- risk of unnecessary interventions; have their babies with a midwife who does not have
back-up- risk of complications if a transfer is needed; or birthing unassisted- risk of not being aware of
or able to do something about a life-threatening complication.
When I look at my extended family tree, I can see this midwifery to obstetrics and back to midwifery
phenomenom. My mother had hospital births with physicians. My mother’s father was born at home.
My grand-aunt and namesake, Lela, had her children on her farm. Their family physician acted more as
a midwife than what is seen in our modern days. One of Lela’s children was premature and she writes
about that child’s birth and loving care that helped her baby survive and thrive:
…1916, we were surprised with a visit from the stork with a 2 months premature baby…
The tiny baby arrived ahead of the doctor and weighed in at 2-1/2 lbs. For the next 2
months (it) was a nightmare but with the help of mother Nedrow and Dr. Hargis, she lived…
We carried Forence on a pillow until she was three months old8.
My daughter’s father and siblings were all born through cesarean surgery. My daughter’s paternal
grandfather was one of thirteen born at home. Twentieth century mothers had fewer children. Before
1900, families were full of children. In my extensive family tree, there have been few perinatal deaths.
Those that I have found in the history seem to be related to outbreaks of disease, a teenage mother,
potential genetic disorders in one family line, and a case of maternal disease.
A mere two generations ago, most of my relatives birthed at home. Now, most of my family have their
babies in a hospital under the medical model of care. My sisters and I began to change that pattern. My
older sister had a hospital birth followed by a homebirth. I used a homebirth midwife and experienced a
supportive transfer to hospital birth during labor. My younger sister had a highly medicalized hospital
birth followed by a hospital birth under the care of midwives.
Sometimes, I think about my grandmother and what our conversation might be today.
1. Melissa Jeffries. C-Section Overview. 03 January 2008. HowStuffWorks.com
<http://health.howstuffworks.com/pregnancy-and-parenting/pregnancy/labor-delivery/c-section.htm>
13 Feb 2013
2. Sarah Barre Clark. Why the Birth Experience Matters. Midwife International 13 Feb 2013
3. Choosing a Caregiver. Options: Midwives for Maternity Care. 17 January 2008. Childbirth
Connection < http://www.childbirthconnection.org/article.asp?ck=10163> 16 February 2013
4. Drife, J. The start of life: a history of obstetrics. 6 February 2002. Postgrad Med J 2002; 78:311-
315 <http://pmj.bmj.com/content/78/919/311.full> 16 Feb 2013
5. United States Maternity Care Facts and Figures. Transforming Maternity Care.
<http://transform.childbirthconnection.org/resources/datacenter/factsandfigures/> 16 Feb 2013
6. Deadly Delivery: The Maternal Health Care Crisis in the USA. Amnesty International, London:2010
7. MacDorman MF, Mathews TJ, Declerq E. Home births in the United States, 1990-2009. NCHS data
brief, no 84. Hyattsville, MD: National Center for Health Statistics. 2012
8. Nedrow, Lela Waugh. Covered Wagons to Jets: The Life History of Lela Waugh Nedrow of Ashton,
Idaho. First Edition, December 1983
What an amazing day we had today! We got to meet a bunch of awesome moms, dads, kids, grandmas and grandpas who love birth and love midwives! The rain held off, we even saw the sun shine. It was exciting to see so many supportive friends in one place. And we got some wonderful pictures. Thanks to all the people who made today happen, especially Maryland Families for Safe Birth! On to the hearing on March 5. We plan to attend and take notes. So, expect an update very soon. We will also be introducing our new blogger to you in March, so look for that as well!
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