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Why Do Most Births Take Place in Hospitals? An Honest History

Most of us are familiar with the hospital as a place to give birth. In fact, in America, it’s the norm. 98% of all US births took place in hospitals in 2017. The dramatic shift to giving birth in hospitals is a rather new concept, starting when men began taking over the obstertic scene and offering promises of shiny new technology in hospitals. By the early to mid 1900s, almost everyone was opting for a hospital birth.

Under Dr. Joseph DeLee, a well renowned obstetrician at the time, birth became viewed as a pathological condition and something that needed to be heavily controlled and monitored with interventions in order to save women from "the evils of natural labor". Routine forceps delivery, anesthesia, and espisiotomies became the norm for all women, whether there was a complication or not. Unfortunately many of these practices proved more harmful than good, and it was during this time that the "twilight sleep" was introduced (worth a google search if you're unfamiliar!!). Many doctors adopted his textbooks and ideology, which still influence many of our ideas of birth today.

A lot of the history speaks for itself, and I think its important to know how we got here. In order to talk about the good that can (and does) come from birth in the hospital, we can't ignore some of the ugly. And we can't ignore that America has the highest maternal death rate in the developed world. We can't ignore that black women are dying at rates 2.5 higher than white women. We can't ignore that our C-section rate is 32% when it should stay between 5%-15% according to WHO statements. (And its not the 2% of out-of-hospital births to blame for these numbers.)

How can we call for systemic change if we don't start from the very beginning-- literally when you bring life into the world.

I promise this series isn't all doom and gloom. Next we'll be talking about why the hospital can be a wonderful and safe option for birth and some of the reasons you might choose to birth there. Stay tuned!

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