Rethinking Childbirth

Posted By on August 31, 2011

Andrea Schwartz has a fantastic two-part series up on His Heartbeat for Women. Here are samples from each:

Far from being a neutral area of life, the issues of labor and delivery, and the customary practices routinely followed, will either reflect the wisdom of God’s created order or they will reflect a humanistic makeover of that order. Too few prospective parents have examined these issues from the Word of God and have uncritically assumed the validity of letting modern medical science practitioners make decisions for them, usually within a framework that sees childbirth as pathology rather than a reflection of God’s creative wisdom. To fully bring all areas of life and thought under the dominion of Jesus Christ, we need to recover a better-informed Biblical mindset concerning childbirth so that family prerogatives aren’t surrendered to approaches that may be inconsistent with God’s Word….

It appears that many women continue to be deceived by humanistic medical criteria in the very midst of fulfilling their respective callings to be mothers. Many mothers-to-be today buy into modern medicine’s disdain for God’s natural, physiological processes, and in essence agree that God’s design is inherently defective. Systematic deceptions under color of medical authority include its glowing characterization of the travesty of abortion. So many women are grossly deceived when it comes to believing the lie that abortion is safe, easy, and will allow them to get on with the rest of their lives without any negative consequences. The medical profession has made a practice of telling women what they wish to hear.

Read all of Part I HERE.

From Part II:

Why have Western women seemingly lost the ability to proceed through labor and delivery without medical interventions when women from less medically advanced cultures seem to glide through the process? Could it be that with the humanistic thrust that has dominated the West, with science determining there is no longer any need for God and His Word, that women have become convinced that their bodies are incapable of doing precisely that task God has designed them to do? From a Biblical point of view, childbirth cannot as a rule be seen as a pathology that demands massive intervention, but rather as a God-ordained process through which the command to be fruitful and multiply is to be fulfilled.

When people put their trust in materialistic philosophies in opposition to the triune God and fail to acknowledge the supremacy of Scripture over every activity and segment of life, the results are sure to be detrimental.

Read the rest HERE. As someone who has been blessed to enjoy the midwifery model of care for all my children’s births, I am extremely thankful for a mother who brought me up to approach childbirth with joy and to study the God-designed biology of birth from age 14 on. It is an incredible gift to grow up with a positive understanding of the birth process and head into delivery armed with this knowledge. Emergency interventions are just that–for emergencies. We can thank God for skilled doctors and hospitals for the difficult births. But it’s so important not to anticipate trouble when there isn’t any. Moms, equip your daughters to understand and welcome pregnancy and birth. Make it a point to collect resources like Shonda Parker’s Naturally Healthy Pregnancy and Doran Richards’s Celebration of Pregnancy and Maidens by His Design. Talk to other Christian women who have a positive, healthy outlook on birth and glean their wisdom. You will be so glad you did.

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About The Author

Jennie is the wife of Matthew and mother of ten children, all of whom keep the household bubbling with life, learning, and levity. Jennie co-founded LAF in 2002 with Lydia Sherman and has been delighted to hear from women all over the world who enjoy their femininity and love to cultivate womanly virtues.

Comments

14 Responses to “Rethinking Childbirth”

  1. Erin says:

    As one whose latest blessing included a complete placenta previa, “natural” childbirth would have been dangerous, most likely fatal, to our baby and potentially myself.

    After four textbook perfect deliveries I was leaning towards a home birth, but having found myself on the other side I am very grateful for modern medical intervention.

    It was strange, however, to have so many people who lack knowledge about previas push me to reconsider my scheduled c-section. My mother-in-law had a VERY difficult time believing that my prescription of total bedrest was necessary. My sister in-law was convinced that if I prayed hard enough, God would move the placenta. I agree that he could if he chose to, but I firmly believe that testing him over this would have been foolish and needlessly placed our precious baby at risk.

    I agree that we shouldn’t look at pregnancy and childbirth as a disease, but would caution those of us who have complication free pregnancies to not treat those who face serious difficulties as if they are weak, faithless or lazy when they follow the advice of their doctors.

    I appreciate that you didn’t do any of that in your post, you allowed for emergency intervention in your opinion. I think you would be surprised at how disdainfully some “home birthers” treat those of us who don’t have that option.

  2. LVH says:

    I’m not exactly sure where Ms. Schwartz was going with her articles. Was she arguing against (elective) medical interventions and for natural vaginal birth? Her articles lack citation for the number or percentage of elective interventions. She doesn’t go too much into detail why women/doctors may choose “non-emergency” interventions.

    Do medical interventions have to be only in emergencies? For example, my friend was in excruciating back labor for 26 hours before she decided to have a C-section. Her water also had broken naturally and she tested positive for Group B Strep. Depending on what Ms. Schwartz’s definition of an emergency is, there was a risk that the infant could have contracted the Group B strep infection, so therefore my friend had the surgery (after a certain amount of time passed).

    Living in a military town, I have many, many friends who have either induced or scheduled a C-section so their husbands could witness the birth of their children. Was this wrong of them?

    What about in the case of twins and high order multiples?

    “Why have Western women seemingly lost the ability to proceed through labor and delivery without medical interventions when women from less medically advanced cultures seem to glide through the process?”

    Glide through the process?? Childbirth is one of the top reasons for mortality of women around the world. The World Health Organization estimates that over half a million women die each year from childbirth and resulting complications. That is not exactly gliding through the process. Childbirth is still very dangerous for women. Ms. Schwartz’s lack of acknowledgement on this matter along with her credibility is great cause for concern.

    Source: http://whqlibdoc.who.int/publications/2006/strategic_approach_eng.pdf

    “But it’s so important not to anticipate trouble when there isn’t any.”

    I think one can find a middle ground between anticipate and expectation of trouble. When I went to the hospital to deliver my daughter, I did not want, anticipate or expect any danger. However, I believed that by going to the hospital that I was prepared in the likelihood that something did. I labored normally for 6 hours. I was ready to push, but suddenly my daughter’s heart rate became abnormal. Even after a normal & healthy pregnancy, and a normal labor, there was a last-minute emergency. Continual fetal monitoring and a forceps delivery saved my daughter’s life.

    If pregnancy is considered a natural process designed by God, should women seek pre-natal care at all? Assuming they are young and healthy, is there any need for women to see mid-wives or doctors for routine check-ups? Are women anticipating trouble when they visit the doctor?

    I had a friend’s mother who went through the exact same scenario. However, they did not have the fetal monitoring system when she was laboring. Even though my friend had a heartbeat, nobody knew that the heart rate was abnormal and that she was losing oxygen. My friend was born with Cerebral Palsy. Thankfully, it wasn’t as severe as it could have been. She had to go through extensive physical therapy when she was a child and had a difficult birthing process to have her son.

    “So many women are grossly deceived when it comes to believing the lie that abortion is safe, easy, and will allow them to get on with the rest of their lives without any negative consequences. ”

    Couldn’t we say the same about childbirth though? Assuming that Ms. Schwartz is pro-life, many pro-lifers express and defend the same sentiment above, and yet gloss over or even ignore the real risks and complications that come with the childbirth process; like hemorrhaging, infection, sepsis, obstructed labor, eclampsia, loss of oxygen for the baby, fistula, incontinence, tearing of the vagina, and lingering mental effects such as Postpartum depression. Let’s also not forget about death.

    “Letting modern medical science practitioners make decisions for them, usually within a framework that sees childbirth as pathology rather than a reflection of God’s creative wisdom.”

    In which ways are practitioners making decisions for conscious women? In most circumstances (if not all) no medical professional (at least in the US) is allowed to make decisions for women. They can give choices to women, but it is up to the woman to decide what she wants to do.

    Second, treating pregnancy and childbirth within the scope of modern medicine is not a bad thing. Pregnancy and childbirth may be a natural human process, but natural in a medical sense. The woman goes through many bodily changes and can experience risks and complications due to the “natural process.”

    Ms. Schwartz lacks to fully acknowledge the science, evidence and reasons behind modern medicine’s involvement in childbirth. She lacks to acknowledge risks and complications associated with childbirth (even if the mother had a completely healthy pregnancy). She quotes from a man who travels to Africa in the 1950′s who observes “normal natural births”, yet fails to acknowledge that currently Africa also ranks as the continent with the second highest maternal death rate (see WHO link above). She lacks to fully discuss “non-emergency” procedures, what they entail and reasons women may choose them (my mother went through 32 hours of labor, with no pain medication and then had a c-section. She didn’t do this for fun or because she was scared of vaginal childbirth).

    Personally, I believe that one can see pregnancy and childbirth as an incredible, beautiful, loving, and life-changing event. I believe that wives, husbands, women, men and families can appreciate God and scripture and still resort to medicine for childbirth needs. I believe a woman can receive an epidural to let her body and mind rest until she delivers her child. Somewhere between the natural birth crowd and the modern medicine crowd, there can be a very happy medium. Just from personal observation, more and more hospitals are listening to women and forming their birth centers around a more natural birth mindset. This can be viewed as a win-win situation for both crowds!

  3. Erin, that’s exactly why I included my comment on the blessing of having skilled physicians and hospitals for complications like yours. There are, indeed, very good reasons to use a hospital for birth. What Mrs. Schwartz was talking about was how so many so-called “complications” today are the direct result of unnecessary medical intervention (like the routine use of pitocin to push labor along). I’ve been amazed to hear some of the nonsensical ideas pushed by OBs who are committed to speeding up the birthing process. It is these kinds of practices that Mrs. Schwartz (and I!) hope to see changed as women learn more about birth and how God has designed the body to work. Thanks!

  4. LVH, see my reply above to Erin’s comment. Mrs. Schwartz has a long history of research and writing behind her positions on birth, so she’s not writing out of an ignorance of medical science or the need for good doctors in this area of medical care. The article was not meant to incite a war between home-birthers and hospital birthers at all. I’ve birthed at home and in hospitals and have had good experiences in both places. Delivering twins is considered high-risk by midwives, so I delivered with a good OB who was totally on board with natural birth … but he had all the tools at hand in case something went wrong. This is wise and good.

    I think there’s a misconception here, though, that midwives are somehow not “medical” or well-trained. All the midwives I’ve used have made it clear that they are available only for births without complications or to mothers without any high-risk factors. This is for the safety of both mother and child. High-risk pregnancies are referred to good physicians. But for those who do choose the midwifery route, there is also plenty of good, careful medical backup. All of my midwives brought along oxygen, fetal monitors, and other life-saving equipment…even when delivering at home. Midwives are trained to use emergency procedures when an unexpected emergency arises. Now, there are extremes. I’ve seen websites dedicated to unassisted birth that scare the daylights out of me (including photos of women giving birth in the forest with no comforts around to receive the baby). To me, that points to a glorification of “nature” rather than God and is a weird offshoot of the return to natural childbirth — and definitely not one we endorse here at LAF!

    I live in Africa, and the midwifery model of care is embraced here even by OBs as the superior model for safe deliveries. My OB here trained as a midwife first and is appalled by the physician-induced complications in the West (including the extremely high C-section rate). Maternal deaths here in Africa occur mainly in remote areas where people are still living in mud tukels without access to any medical care whatsoever. Giving birth in areas with a very high malarial rate and little hygiene is definitely dangerous. Part of the solution has been to send in trained midwives and nurses who can teach women about proper pre-natal care and cleanliness. But it’s a long road, as there are millions of unreached women living far from good care.

    We need to be careful not to throw the baby out with the bathwater here, too. Arguing that it would be more consistent for women not to seek pre-natal care or any medical assistance if they embrace natural childbirth is taking things to an illogical extreme. No one advocating healthy, natural childbirth promotes skipping out on healthy eating, diet monitoring, exercise, or anything else that goes into forming a healthy child and a good delivery outcome. ;) Midwives are in the Bible, as are physicians. God has given us people gifted in these areas because we live in a fallen world where illness and death happen. In Eden, we wouldn’t even be having this discussion–LOL!

    So, yes, there is a need for balance on both sides. Mrs. Schwartz isn’t advocating tossing out the medical model at all…just demonstrating that it is important for women to come into pregnancy and birth fully informed and ready to make healthy choices from wisdom rather than be pressured into choices from fear. Being armed with knowledge is so incredibly helpful when meeting with a practitioner. One of my OBs when I was pregnant with twins was a young lady fresh out of medical school who had never had children but was very sure of her way of doing things. She blurted out several scary-sounding statistics about twin pregnancies and births, but when I was able to answer her knowledgeably with quiet assurance, she realized I had actually thoroughly researched my options and understood the choices I was making. After that, her attitude was far more respectful, and she ended up asking me some questions. Though she wasn’t the one to deliver my babies, I was happy for the opportunity to give her the other side of the coin when it came to twins and natural childbirth, and she came to my room to congratulate me after they were born, saying she was amazed I’d carried to term and birthed naturally. In turn, I told her I was thankful for the hospital’s excellent precautions in having me deliver in the C-section room “just in case” with four extra nurses on hand for my babies.

    Happy medium! It can be found. It’s just so important for women to read, research, and communicate with their health care providers…whatever choice they make. Thanks!

  5. LVH says:

    Hi Mrs. Chancey! Thank-you for responding. For what it’s worth, I agree with most of what you’ve said.

    It is also not my attention to incite a war between home-birthers and hospital-birthers. Personally, I can support home-births with the precautions you mentioned above along with a highly-trained mid-wife. Unfortunately, in the US, not all states have a set guideline for midwives and licensure. For example, the state of Oregon does not require midwives to be licensed in order to practice. To me, that is cause for great concern.

    (Source:http://www.oregon.gov/OHLA/DEM/docs/Publications/OHLA_DEM_Midwifery_in_Oregon_2008_07_09.pdf?ga=t)

    “Mrs. Schwartz has a long history of research and writing behind her positions on birth, so she’s not writing out of an ignorance of medical science or the need for good doctors in this area of medical care. ”
    …..
    “Just demonstrating that it is important for women to come into pregnancy and birth fully informed and ready to make healthy choices from wisdom rather than be pressured into choices from fear.”

    The point of my earlier post is that Mrs. Schwartz’s articles were very poorly written. If she is arguing that women should be informed of all the risks, complications and choices, than I fully and whole-heartedly agree with her. However, there is little indication of this in both of her articles. She makes claims like:

    “The so-called “experts” in the field of obstetrical practice desire that families do minimal thinking on their own and submit to the superior wisdom of modern medical science.”

    And

    “Too few prospective parents have examined these issues from the Word of God and have uncritically assumed the validity of letting modern medical science practitioners make decisions for them, usually within a framework that sees childbirth as pathology rather than a reflection of God’s creative wisdom.”

    And

    “There has been an increase in the number of women requesting non-emergency medical interventions during the process of laboring”

    She fails to demonstrate or prove that obstetricians want families to do minimal thinking? That is a rather bold claim to make, yet with no evidence or proof to back it up.

    She should have taken the time to address why women may choose certain procedures. Is fear the only reason? What percentage of women are choosing these procedures? Is she specifically talking about the epidural? Is she talking about Pitocin? What does she mean by non-emergency? What constitutes an emergency according to her? She explains none of this, and it leaves the reader confused.

    She continues with:

    “Because today there is an unrealistic expectation on the part of parents and medical personnel as to how long labor should take, especially a first labor, the many “helps” that are available from the hospital “pain reduction” menu often are the very factors that lead to eventual C-sections.”

    And

    Add to that the artificial time schedule assigned to “normal” labor that made it so birth had to occur at the convenience of the hospital staff, who would have a tendency to rush things along if a shift change were approaching, or to accommodate a doctor’s schedule, or should there be a need for the hospital bed.

    Unrealistic expectation and artificial time schedule? She yet again fails to discuss the current scientific reasons behind Dr. recommendations regarding length of labor. Here is a pretty lengthy article discussing the so called “unrealistic expectation” and “artificial time schedule” of prolonged labor: http://emedicine.medscape.com/article/273053-overview#a0101.

    Mrs. Schwartz also goes on to talk about Dr. Odent and his claims about bonding within a natural, drug-free birth. However, Dr. Odent has been long criticized for failure to substantiate his claims with scientific data.

    If Mrs. Schwartz wanted to write about how women must come to decisions regarding pregnancy and childbirth with wisdom, she should have. She could have taken the time to write more details about “non-emergency” procedures and what they entail. She could have spent time defending and proving her claims, instead to casually expect the reader to take it as factual information. She could have acknowledged that women in developing worlds do not go through the birth process easily and that childbirth is regarded as one of the top mortality rates for those women. Post-partum hemorrhage is one of the leading causes of maternal mortality (see WHO link above).

    Despite her “long history of research and writing”, Mrs. Schwarz ultimately fails to present this information in an accurate and engaging way to the reader and instead presents a very faulty one-sided perspective–one of maybe fear instead of knowledge.

  6. themomma says:

    Amen, amen, amen! I can’t wait to check out the resources you mentioned and I would also like to add Supernatural Childbirth by Jackie Mize. Although not necessarily a Christian resource I have been GREATLY encouraged by Ina May Gaskin’s Guide to Natural Childbirth. It really helped me gain confidence in how God created my body. That was something I allowed a few OB’s to steal from me when I was a very young mother.
    (4 children. 1 c-section, and 2 VBACs)

  7. I think the best thing to do is to take your comments directly to Mrs. Schwartz over on her blog, as she’ll be able to provide the resources and links she has used. It’s definitely a good idea to post resources for others to follow on their own. :) Just a quick note on direct-entry vs. certified nurse midwives: It’s not a black and white issue of “unqualified”/”untrained” vs. “qualified”/”trained.” A piece of paper doesn’t set one type of midwife above another. Direct-entry midwives in Virginia (my home state) received the exact same training as CNMs, but because home birth was illegal for a long time in VA, many women chose to practice as DEMs instead of going all the way through the state-certification route (which ended up costing a ton and still not letting them practice). I was attended by CNMs for my first two births and by a DEM for the third. The level of training and care was exactly the same. In fact, my most difficult birth was my third, and the DEM had all the same equipment on hand and the necessary skills to safely deliver that baby. I was never worried about her ability to handle an emergency situation. I had a CNM for the fourth birth and a DEM for the fifth, and, again, both women had gone through the exact same training courses and had the same abilities and emergency skills. After moving to an area with no midwives, I enjoyed the care of two OBs with a high regard for natural childbirth and a desire to support mothers through an unhurried labor for a more successful, less stressful delivery experience.

    Finally, just as a side note on the high infant mortality rate here in Africa, there was an article in our paper today on this very topic. It noted that the number one cause of death is a lack of basic hygiene in the first 28 days after birth. Mothers in rural areas aren’t dying from rare emergency complications in childbirth, but both mothers and children living in remote areas without clean water often succumb to very easily treatable illnesses or infections due to the lack of basic hygienic practices. Kenya and South Sudan both want to see more midwives trained in post-natal hygiene and sent into these areas to serve women who are giving birth in very primitive conditions. They estimate that could lower the infant mortality rate by at least 40% right off the bat. We sure take a lot for granted in the West! Just having clean water to bathe in and use for cooking is so vital. That’s part of what we are doing here — digging wells in Sudan so that the people do not have to rely on muddy “watering holes.” One step at a time, we can change things!

  8. LVH says:

    Thank-you Mrs. Chancey. I will be sure to direct my comments over to Mrs. Schwartz’s blog.

    I think a conversation on the discipline of midwifery would be an interesting one for the future. I’ve lived in Virginia almost my whole life, so I am familiar with the laws regarding midwives.

    I view licensure and state standards as a form of protection for both midwives and for patients. I see licensure for Doctors, and Lawyers and Psychologists the same way as well. Licensure is more than a paper. It tells us that people in these disciplines have reached a certain amount of education, testing and experience in order to practice. Yes, having a license doesn’t always guarantee a good provider but I believe it is a system that is much better than allowing anyone to practice the above disciplines without one.

    I’m not exactly sure why you brought up infant mortality, since the subject matter was women and childbirth. However, thank-you for the information.

    “Mothers in rural areas aren’t dying from rare emergency complications in childbirth”
    Everything that I’ve read has claimed that many women (in Kenya) are dying from childbirth complications that include post-partum hemorrhage and obstructed labor Again, the World Health Organization has researched and claimed this (please see link above) and also other organizations such as USAID. Source: http://pdf.usaid.gov/pdf_docs/PNACQ311.pdf

    If you can find evidence or information which dispute these organizations and their research, I would be interested in your sources.

    Thank-you again! :-D

  9. LVH, I added the comment about infant mortality because you had brought up birth complications and maternal death in your first comment…and newborn infant mortality is often connected to maternal death. Here are some of the sources I have here in Kenya (besides what I see with my own eyes and hear from the women in the slums with whom we interact):

    http://www.unicef.org/esaro/factsonchildren_5774.html – This piece from UNICEF highlights the high rate of maternal deaths due to AIDS and lack of basic care (thus the drive to provide birthing kits to women in rural areas — these kits, many of which are produced here in Nairobi, include sterile wipes, medical gloves, disposable birthing pads, alcohol swabs, suturing kits, and other supplies that help create a hygienic birth environment and provide for emergency treatment). Unfortunately, the AIDS deaths won’t be impacted as greatly by sending more skilled birth attendants or more hygiene kits into the rural areas. The best example of how to combat AIDS comes out of Zimbabwe, which has reduced its AIDS rate by heavily promoting abstinence and faithfulness within marriage (we posted a story about this a month or so ago on LAF). There is a very direct link between the high AIDS rate in Africa and the high maternal/infant mortality rate.

    http://www.wunrn.com/news/2010/07_10/07_12_10/071210_kenya2.htm – This piece demonstrates the devastation wrought by a lack of clean water. Water-borne diseases can decimate entire villages, and even women birthing in hospitals are susceptible when there is no source of clean water available.

    http://www.nationmw.net/index.php?option=com_content&view=article&id=21176:poor-hygiene-leading-to-maternal-deaths&catid=1:national-news&Itemid=3 – Poor hygiene a leading cause of maternal death.

    http://www.nap.edu/openbook.php?record_id=9800&page=1 – This is a link to a study published by the National Academies Press, highlighting the statistics on maternal death and the most prevalent causes. So much of what causes complications during birth involves disease (including malaria, HIV/AIDS, water-borne illnesses, etc.), malnutrition, lack of basic prenatal instruction in hygiene and vitamin deficiency, etc. Many of these things would be wiped out by ensuring access to clean water, adequate medical care for treatable diseases, and even simple things like mosquito nets. Unfortunately, it’s an uphill battle here. PPF distributes mosquito nets in high-malaria areas, but many people use them in their gardens for climbing plants or to shelter young trees so animals don’t eat the leaves. They are not used to cover people at night to prevent mosquito bites. Malaria has all but disappeared here in Nairobi due to extensive campaigns to educate people on the use of mosquito nets (especially for young children and the elderly), but when you go into the rural areas, people will use the nets for their most pressing need, and they see food production as far more pressing than malaria prevention. It’s going to be a long haul, but it’s worth it…one step at a time.

    We also have the added plot twist here in Kenya of women choosing to birth at home with midwives because of the outright abuse or neglect they experience in hospitals. I’ve heard quite a number of these stories from Kenyan women as I’ve visited my midwife during this pregnancy here. They talk not only about the skill level of midwives but about their model of nurturing care during labor. And two hospitals have been sued here this year for surgical mistakes after a C-section that have killed women. The latest was highlighted in yesterday’s paper. Here are a few stories from the past year:

    http://www.nation.co.ke/News/Hospitals+on+the+spot+over+deaths+/-/1056/1150786/-/enkqkyz/-/index.html
    http://www.nation.co.ke/News/Surgical+towel+left+in+woman+s+womb+caused+her+death+/-/1056/1201512/-/cxgmnk/-/index.html

    Horror stories like this go a long way to convincing women that they are better off avoiding the hospital. Complications occur both in the hospital and out of it, even when the hospital is an advanced medical facility by western standards. Most of the complications in-hospital here occur due to medical negligence or understaffing (meaning women are left alone in labor for hours at time). Most of the complications out of hospital occur in slums and rural areas with little to no clean water or skilled birth attendants. That’s why Kenya is calling for more trained midwives to assist in these areas. Building more hospitals might be ideal over the long haul, but it’s not going to happen quickly in the Third World. It’s much faster and less expensive to train midwives and provide them with well-stocked birthing kits that are easy to transport into the bush and purchase inexpensively in the slums.

    Finally, as an interesting side note, my husband was able to help deliver a baby in Sudan four years ago when three OB nurses who had come for a medical mission were stumped. A first-time expectant mother walked into the camp with her mother, complaining that she had been in labor for two days and that the baby was “stuck.” The OB nurses examined her and asked for a medivac, as they believed her only hope for living through the labor and delivery (and saving her child) was a C-section. Needless to say, there is no such thing as a medivac service on the Darfur border! So Matt called home to ask me if I had recommendations from any of my midwifery books for restarting a stalled labor and keeping it going. I ran through the list of natural labor stimulants and finally landed on the only thing they could get: capsicum (red pepper). He jumped a motor bike to the local market and woke the shopkeeper (it was now near midnight) and purchased dried red pepper. After crushing it up and putting it into water, he and the OB nurses took turns helping the young mother sip from the cup and then stood her up to help her walk. Labor kicked back in within 45 minutes, and she delivered her baby safely around 3am. The OB nurses were utterly floored that a man with no medical training could figure out a way through a serious birth complication with such amazing results. I was so proud of my husband for his level head and quick thinking. When there are no hospitals or emergency services around, it is absolutely vital that attendants are aware of other alternatives. This is where midwifery training comes in. It’s the only viable option for poor countries with no sound infrastructure (roads, vehicles for transport, etc.). You could build a multi-million dollar hospital in the middle of the bush and staff it with top OBs and nurses, but it would do no earthly good, as the lack of roads and transport would make it inaccessible for 95% of the population.

    So the solutions are neither simple (building hospitals and hiring OBs) nor quick (throwing money at the problem). Multiple levels of care and education are needed here, mainly on the prenatal side of things (disease prevention, hygiene, adequate nutrition, access to vitamin supplements, etc.)–long before women even get to the birthing end of things. PPF built its first medical clinic in Jaac, Sudan, in 2007. We fly in medical supplies every time a shipment comes in (one’s going in next week, in fact). We staff the center with a trained nurse who sees hundreds of people a day with only one assistant. It’s a start. Many women come to the clinic for prenatal care, but they have to walk through miles of bush to get there. PPF has also been digging wells all over South Sudan to make sure people have ready access to clean water. But even that doesn’t fix the problem, because people will still drink from muddy holes in the ground rather than walk five miles to a well to fill jerry cans. Years of living in a war zone have made people reluctant to build lifelong healthy habits (when going for clean water meant the possibility of being bombed, people naturally stayed hidden). We hope to change that a little bit at a time, and part of the vision is bringing in skilled midwifery care and well-stocked birthing kits so that South Sudanese women can see better maternal and infant outcomes. Please pray with us that God will open doors for this to happen and bring in the right people to teach the local population how to care for their families for long-term health and well-being. Thanks!

  10. LVH says:

    Hi Mrs. Chancey. Thank-you for your thoughtful response and your links & sources. I greatly admire writers and authors who provide this type of evidence when discussing facts, and not opinions. :-D

    I wanted to respond again, because I believe we’re starting to go in a bit of a circle.

    Everything that you’ve written about hygiene, infection, and diseases like malaria have been true, insightful and well researched. Also, having your personal perspective and observations has added a great deal of knowledge to this discussion. I don’t dispute at all what you have written. You are factually correct in that women die in childbirth or after childbirth because of poor sanitation, exposure to diseases that exasperate the pregnancy conditions, or infections that are acquired.

    My concern lies with this statement that you made:
    “Mothers in rural areas aren’t dying from rare emergency complications in childbirth”

    I strongly disagree. The World Health Organization has listed post-partum hemorrhage (PPH) to be the leading cause of maternal mortality. USAID (see above) and your source National Academies Press both state this. Post-partum hemorrhage is a childbirth complication. National Academies Press also has included a graph that visually describes the causes/reasons for maternal mortality. PPH is listed as the reason for 24% of deaths, indirect causes (anemia, malaria, heart disease ect) is listed at 20%, and infection is listed at 15%. Graph seen here: http://www.nap.edu/openbook.php?record_id=9800&page=5#p20003383mmm00002

    Also, the World Health Organization, National Academies Press (which is actually using data from WHO) and USAID all also state that obstructed labor as another reason for maternal death. Obstructed labor is also considered a childbirth complication (in the graph, obstructed labor is responsible for 8% of maternal deaths).

    Death from post-partum hemorrhage and obstruction of labor is rare in developed nations like the US. This is mainly due to advanced medical care & techniques and access to medications like Pitocin (which helps the uterus to contract after the placenta is delivered).

    Again, if you state that women are not dying from “emergency complications in childbirth”, than please post resources that dispute the above information.

    You and I agree on the matter that sanitation, access to clean water, and skilled birth attendants are greatly needed. I think training more midwives in prenatal health, pregnancy, childbirth and postnatal health is greatly needed. Having access to life-saving tools, techniques and equipment will also help midwives to effectively help pregnant and laboring mothers. Training more people and sending them to rural areas will help women access the care they need.

    There are many solutions to the dismal maternal mortality rate, and many organizations and people (like yourself) trying to help as much as they can. My concern lies in when statements are made that are not factually true. PPH and obstructed labor are just two examples of childbirth complications that can cause maternal death without proper medical care or help. Training more midwives and medical professionals is a step in the right direction. :-D

  11. Sorry, LVH, what I meant to type the first time around was “are not dying primarily from rare emergency complications in childbirth.” The vast majority are dying from very treatable conditions (malnutrition, unsanitary conditions, etc.). Are there emergency complications in these rural areas? Indeed. But the answer isn’t to go in and build big hospitals and hire expert doctors. The infrastructure isn’t there, and the majority of the women would never be able to get to those medical centers. A better use of money and time would be to train midwives and send them into communities where they can serve women by educating them, providing excellent prenatal care, etc. The other “arm” of this approach is, of course, for missionaries and NGOs to go in and help with digging wells for clean water, helping the people to better their farming practices so they can feed their families and villages, etc. PPF is the second arm in this case. Now we’re networking with medical professionals here in Kenya to see how we can support the drive for more competent midwifery care in both Kenya and Sudan. So I think we are on the same page. :)

  12. CaitKady says:

    Hi Mrs. Chancey,
    I read these articles and they caused a lot of thinking and discussion between my husband and I. I’m expecting our first baby in February and would love a natural birth (though intentional homebirths are illegal in the UAE, where we are currently!), but for my own and the baby’s health rather than for any philosophical reason. It’s a goal because I know women’s bodies were designed for this and that it’s a beautiful thing to not be afraid of, as well as the fact that for the baby’s sake I’d rather avoid all that is not necessary for the baby’s healthy delivery. So, I agree with these things and it is my desire, though out of my control in the event of an emergency, which will still be controlled by the Lord!
    Anyway, while these things do make sense to me, I felt that the article was a little unbalanced and could have been read as a discouragement of using any modern safety means and methods, instead of simply an encouragement to women to be educated, to not fear a natural process, and to avoid unneccesary intervention. I will take all of these things directly to Mrs. Schwartz, but I did have a question for you about the theology in her article.
    Do you personally believe that woman’s curse in Genesis indicates that any form of pain relief in childbirth is contrary to Scripture and wrong?

    This was the part of the article that surprised my husband and I the most. While I hope to give birth with no epidural, I believe that saying things like this are prohibited because of the curse indicates a remarkably narrow view of the curse. Living in a fallen world we do experience effects of the curse, but since Christ died taking the curse and its full punishment (far more extensive than Genesis 3) upon Himself, to say that we must live purposefully under that curse is saying that we must live under the curse as a whole, under sin and under condemnation. And it doesn’t account for the reversal of the curse which is part of the plan of the gospel, beginning with the resurrection of Christ, continuing through today, and having its completion at His return and final restoration of all things.

    I appreciate all of the replies you have written in the comments, and definitely think along the same lines. I simply found the tone, and more importantly, theology, of the articles themselves unhelpful and will write Mrs. Schwartz directly. I was just curious what your own convictions were on that other area, of the curse, as no one had asked that yet.
    Thank you!

    Cait

  13. Thanks for the note, Cait! Mrs. Schwartz has plans for a future podcast on this topic, so I know she’ll be fleshing out a lot of these areas. She definitely does believe there is a place for modern medicine, particularly when it comes to life-threatening complications. Her point is that much of what are labeled “complications” are actually created by modern hospital practices (routine use of pitocin to speed labor along, having women lie on their backs for labor and delivery, etc.). When women are well-informed and have learned as much as they can about the birthing process, they are able to ask wise questions and make better choices than if they just go along with whatever is presented “because the doctor said so.” I’m so thankful for my mother’s insistence that I learn all I could about pregnancy and childbirth before I was married so that I would go into that area of life prepared. When OB/GYNs throw around big words and scary-sounding statistics, it only takes a few respectful comments or questions for them to see that I know what they are talking about and have made my choices based upon knowledge rather than upon fads or fear. That’s Mrs. Schwartz’s goal for women — get past the fear and prepare. Know what questions to ask. Know what procedures really involve and make decisions well ahead of time rather than in the heat of the moment when the nurse is pressing you to take the drugs. ;)

    As for the theology, I know there are many streams of thought on this issue. I happen to believe that, while pain is part of the curse, it is not a sin to try to mitigate that pain. I don’t choose to do that through drugs, because I know those directly affect the baby and can cause difficulty with bonding right after birth (lethargic babies often have a hard time nursing immediately). However, I went through the Bradley Childbirth course with my husband while pregnant with my first to learn how to relax through the first stage of labor, breathe, stay calm, and recognize the stages of labor by my emotional state or what I was feeling. I’m totally on board with warm compresses, herbal teas, back massage, and using comfortable positions to make labor easier. God created our bodies to give birth, but there are things we can do (tensing up, worrying, hyperventilating) that can actually cause unnecessary pain. In studying natural childbirth, you will learn so much about optimum laboring and birthing positions and how to minimize the normal pains so that you can focus on bringing that baby into the world. And Scripture tells us (quite accurately!) that “as soon as [a woman] has given birth to the child, she no longer remembers the anguish, for joy that a human being has been born into the world” (John 16:21). Even in our fallen state, God has given us the wonderful gift of endorphins that rush to fill us with joy and a feeling of strength when we have made it through labor. Taking drugs can dull that amazing experience. Don’t get me wrong: there is a place for medication in labor. There are times when a woman will have to be quickly medicated to perform an emergency procedure. No one is condemning women for using medical technologies to save life. What is sad is that we have become so dependent upon interventions that we see them as normal and routine and forget that childbirth is not (in the majority of cases) a pathological experience. That is Mrs. Schwartz’s point, plain and simple.

    I hope this helps, and congrats on your expected blessing!

  14. LVH says:

    Thank-you Mrs. Chancey for clearing that up. We are in agreement. :-D

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