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From:
Chris Mulford RN IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 20 Nov 1998 08:40:19 EST
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I'm late picking up this thread---sorry!

Remember how we once heard that formula companies had supplied hospitals with
architectural design advice for maternity units, making sure to include a
central nursery with nice big cupboards for storing all the formula?  (I would
love to have documentation of this factoid, by the way.)

Well, has it ever occurred to you that the lovely "LDRP" concept, in which a
woman Labors, Delivers, Recovers, and spends her Postpartum stay all in the
same room, will only work under one of the following three conditions?  Either
a) There is mega soundproofing between the rooms. or
b)  Everyone understands and welcomes the natural noises women make when
laboring and birthing their babies.  or
c)  The women are all mouse-y quiet during labor and birth because they are
drugged.  Epidurals work SO well for this.  Much better than Scopolamine
(which was still being used at the hospital where I started working as a nurse
in 1974).  "Scope" removes inhibitions, and then you get mommies swearing and
taking a swing at people who upset them.

I know that LDRPs are supposed to be more "home-like."  But I think there's a
certain falseness in the promise that giving birth is all sweetness and light.
It is hard work.  It is the real Nitty Gritty, where inhibitions get lost
because there's a job to be done.  People scream and pray and curse and grunt
and groan, even in well-conducted births, and even more so in births where
women are not helped to feel safe and strong, and not helped to get into the
most comfortable positions, and not "allowed" to have a doula with them.

There has long been a feeling in Western medicine that birth was a dirty,
noisy, dangerous, shameful activity that was best hidden away.  Those inner
sanctum delivery rooms were protected by the need to keep things Very Clean,
of course, and that does protect the mothers and babies from infection.  And I
do agree that new mothers and babies need protection---but just as much
because they need privacy for an intimate event as because they need safety
from germs.  For many Western women, the most germ-free place, after all,
would be the mother's own home.

When I went to Swaziland in 1992 we visited both of the country's big
hospitals on field trips.  At RFM Hospital we arrived in the maternity ward
just as a mother was giving birth.  While we were being greeted by the nurse
in charge, we could hear the sounds of a newborn crying.  So the first thing
we saw as we came around the corner was a bed in the hallway with a blanket
hung up over the bedframe at one end for a little privacy screen, and in the
bed a 17-year old first time mom with her baby already at the breast.  She was
right across from the triage/admission area, and if there was a separate
"delivery" area we didn't see it.  The birth seemed to have happened with
little fuss---certainly without drugs.  I would say that "Condition B" from my
list above was the prevailing philosophy----birth happens; it's part of life;
let's keep it safe and get on with it.

It's always fascinating to me the degree to which culture and attitude affect
our perceptions of body functions.  And I'm troubled by the "sanitized" image
of birth that I think is promoted by the LDRP concept.  The doctor who was
quoted as saying he likes to keep his women "quiet" was really disclosing the
truth about his attitude---he thinks that birth can be a noisy and unpleasant
spectacle.  Epidurals seem like a good thing because they let women keep their
dignity---and they let onlookers keep their detachment.

We had lots of epidural births at the hospital where I worked.  (And we got
rid of the Scopolamine very soon after I came.)  More than once I was appalled
to see the television on in the corner, the male doctor and the husband
watching a football or baseball game between contractions, and the
epiduralized mother lying there between the men being a nice hostess.   That
is NOT a birth scene that honors the woman for what she is doing, that
respects the process that brings a new human into the world.  If the men
aren't helping the mother, I say send them and the TV out into another room
and give her a doula who will focus on her.

Climbing down now.

Chris near Philadelphia---a cradle of the prepared childbirth movement of the
1960s.  Where are the strong women of yesteryear?

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