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A History of Childbirth

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Childbirth isn’t anything new, of course. It’s been around for as long as we have. What has changed is our response to it.

Medical procedures are constantly adapting and attitudes are always in flux. From midwives and home births to male doctors and hospitals, from no drugs to drugs, to our modern-day smorgasbord of birthing options, there’s always some new thing.

But how far have we really come, and what have we learned? Doctor and journalist Randi Hutter Epstein has written the book on it.

This hour, On Point: Childbirth through the ages.

Guest:

Randi Hutter Epstein joins us from New York.  A medical journalist and trained doctor, she’s written for The New York Times, The Washington Post, and other publications. Her new book is “Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank.”

Read an excerpt from “Get Me Out” at NPR.org.

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  • Isabel

    Giving birth to my son was the most empowering experience of my life. I was very well prepared and I chose natural childbirth. I refused drugs of any kind and there were no interventions, such as forceps, of course. Could you talk about how more and more women are choosing natural childbirth. I’m writing quickly because I’d like to get my question on the air.

  • Jennifer G

    I wanted to share my experience of childbirth–with my first (and only) child, I was committed to having a natural home birth with midwives. I went to a childbirth preparation class and felt skeptical of medication and epidurals–I said to my husband, “I do NOT want an epidural.”

    Then I went into labor, at home, and everything went fine until I could not push my baby out. She just got stuck. And I was in the most incredible pain.

    So we went to the hospital (it was not an emergency, the baby and I were fine), and I had to eat humble pie. By the time I got there, I was begging for an epidural, which ended up being the best thing that’s ever happened to me.

    The medication allowed me to give birth naturally instead of having a c-section, and on top of that, the hospital staff was incredible.

    So ultimately I am so grateful for current medical technology. Although I think it’s great that women can also choose natural childbirth.

  • frances

    Hi Jane, I’m hoping you can ask your guest to comment on the current trend of women being present only at their own deliveries. Are we less prepared for our own by not observing/helping with our sisters’ and friends’ deliveries?

  • Courtney

    It’s interesting that Dr. Epstein remarks on the quantity of advice floating around for pregnant women…it seems to me that the realities of pregnancy are largely unspoken, like secrets that no one tells you about–and that there is a dearth of knowledge about these things rather than an abundance.

  • Lisa Dwyer

    I have 3 children and gave birth to my first 2 at home. I had planned to deliver via hospital for my first baby, then I got spooked when the doctor kept changing during all of the ob appointments. Who was going to deliver this baby? They seemed unconcerned, but I was very concerned. So I found a reputable midwife with whom I established a wonderful relationship. She went on to deliver my second child. My third was problematic, he needed surgury after birth, so I had little choice. But I had as much control as I felt I could have. And I would do it all again.

  • Edward Warner

    At the beginning of the interview your guest said that in the 1800′s a woman, upon learning that she was pregnant, was ‘literally scared to death’. If this was ‘literally’ true it would have ‘literally’ meant the end of the human race.
    Just saying.

  • LEANNE

    My Grandmother had told me that my father was a c-section in 1938.. no other reason but because she was a small women, he didn’t think it would be good for the marriage to stretch her all out.. said he would ‘put a zipper’ in her. Weird? or common for that time?
    Thanks

  • Katie Ferreira

    In my pregnancy, I had a wonderful midwife. I planned to have a natural waterbirth, but at a hospital (Jordan in Plymouth) instead of at home. There was only one hospital in my area that offered waterbirth. I was lucky to have chosen this hospital, since I had complications that resulted in an emergency C-section. In the future I will again plan on having a waterbirth. I hope that in the future, hospitals would be more open to the natural/alternative births. Do you think that is a likely path?

  • Gwen

    Hi Jane,
    Like a previous caller, I have three children. The first was a hopsital birth and the last two were home births under the care of a midwife and her apprentices.

    Also, like one of your callers my hospital birth was traumatic, but uinlike her (she chose an elective c-sect), I chose to abandon the hopsital and OB model of care. This is one of the best choices I have ever made.

    I don’t believe that home birth would be appropriate for every woman or every pregnancy, but I do feel that every family ought to have the right to make the choice that is best for them.

    I would like to see birth choice as a topic for discussion as we move towards healthcare reform. I would like to see home birth and the midwife model of care regulated and covered so that is will be a choice for everyone, not just us ‘pioneers’.

  • Marie Ricketts

    When I was pregnant with my first child in 1979, the caesarian rate at the local hospital was 30%. That scared me to death. I used lay midwives
    As it turned out my blood pressure got a little high during labor and if I had been in the hospital, I’m sure that I would have had a caesarian to protect the physician from a mal-practice suit.

    I went on to have 3 more children, at home, with lay midwives. It is my understanding that the caesarian rate has not changed much in the last 30 years.

  • Yael

    As an obstetrician, I have seen many women with uncomplicated pregnancies have childbirth experiences that unexpectedly go awry. I have seen massive hemorrhage, where access to medications and ultimately blood products enabled them to live through the experience. I have seen babies born full term to healthy women who unexpectedly have difficulties breathing at birth, or aspirate in the first few minutes of life. I would remind women who choose to have deliveries at home that there are serious risks for not only them, but for their child who is not making this choice to deliver at home. We spend 9 months doing everything to protect our baby, but then delivering far from access to neonatal care is made out to be “natural” rather than potentially unsafe.

  • Barbara Bashevkin

    I am struck by the assumption that women must choose between a midwife and a doctor. Our local hospital in northwestern Massachusetts uses team practice by obstetricians and midwives, giving our mothers the best of both worlds.

  • Brian McPhillips

    I am a male family physician and delivered hundreds of babies over 15 years in a hospital near Boston that has midwives and many Obs. My 3 partners (all Male) had to stop deliveries 2 years ago due to the absence of first time mothers coming to our practice. Our repeat patients almost always returned but young women stopped coming to males for their first babies and it became unaffordable due to malpractice. Ironically, we delivered all of our own patients, ie you didn’t get the on call physician / midwife as you do with all the other options and our patients loved this.

  • Randall

    I’m concerned about the medicalization of everything in society today (where even weather reports include pollen count/allergy predictions), particularly the oldest and most natural process in the world, child birth.

    It seems pretty obvious how fear and nervousness contribute to complications, both during pregnancy and during the birthing process itself — Dr. Epstein has alluded to this several times, including the fear/defensive mode that doctors are in and pass that along to their patients.

    I’m interested in how parents’ faith in God assists in this most natural process (although I doubt there are many studies, as most of the medical establishment denies significant connections between spirituality and health). Dr. Epstein, did your research uncover anything in this area?

  • Polly Pierce

    When I had my daughter 14 years ago, she was breech and born vaginally. I was told at the time that my OB was just about the only one in the area who would attempt a vaginal breech delivery. In my case the delivery was smooth and it went quite quickly once I was ready to deliver. I think it would have been such a shame to have been required to have a c-section when in the end the delivery was uncomplicated. Are doctors refusing to attempt vaginal deliveries when the baby is breech due to liability reasons?

  • James A. Sieks

    Your guest on the ‘Women and Childbirth’ really didn’t add much to anyones knowledge. She obviously was a person interested in trumpeting women and belittling men in the whole process. The last question you asked regarding her own choices, given all she knows now, was unsatisfactory. She wants to give women the feeling of power to make the decision but ends with cheering on the neo-natal room down the hall. The moderator should have asked some harder questions. All in all, there was very little educational value here.

  • Barbara Miller

    Hi, I was glued to your program this morning as my 1st child was born in 1966 Hempstead, Long Island. To my great surprise I was torn away from my husband at the elevator, left alone during labor, and given drugs which I didn’t want. I was told “dr.’s orders”. “Let me talk to the dr.” He’s not here.” “Let me talk to someone.” I got the drugs. I was so drugged I didn’t know I had given birth until hours later when I woke up and had to feel my abdomen to realize I had given birth. No encouragement to breastfeed. 1976, ANN ARBOR, MI. I HAD NATURAL CHILDBIRTH, TOOK PG EXERCISE & LAMAZE CLASSES, HUSBAND PRESENT, IN FACT MY HUSBAND WAS ALLOWED TO DELIVER THE BABY. BREASTFEEDING ENCOURAGED.

  • Charlene Kealey

    The author’s contribution will undoubtedly empower more women as they consider their options for this incredibly common and totally unique experience. In 1970, I prepared for a home delivery by reading the entire list of recommended publications in the Whole Earth Catalog. The one that stands out to this day in my memory was the St. Louis Police Department’s manual for Emergency Childbirth Delivery. It ended with a comment to officers who would find themselves in such an ‘emergency;’ “….and when the mother thanks you for your assistance, just smile and tell her you just did what any 8 year old could do.” I was truly inspired by the humility of that comment from those we think of as truly having the power of life and death over others. My first child was born at home with just my husband and I in attendance. Later in life I would look back and marvel at my sense of empowerment to even attempt such a thing and always gave credit to that humble comment. By the time I decided to have another child 18 years later, birthing rooms were in full sway and so I decided to try it. I had the most wonderful L&D nurse who was also a midwife from the Philippines. My own fabulous, Iranian doctor, a woman, was out of town and her Egyptian partner, a man, had to fill in. He was lost somewhere during my labor and couldn’t be found. The midwife could have delivered the baby effortlessly but was not allowed to because of insurance liability. In the meantime, although I didn’t have my legs tied shut, I employed all my breathing techniques to hold back from pushing for 45 minutes as we waited for the doctor to be found and to appear! Just as the midwife/nurse was running out the door to get an emergency doctor, the doctor showed up. He immediately started giving orders and I responded by announcing what I would and would not do, thank you very much! My daughter was the first 10-10 baby born in that hospital that anybody could remember in modern times apparently. The doctor congratulated himself, shockingly, while everyone knew that it was by the combined efforts of my wonderful nurse/midwife/coach, a woman I shall never forget, and my previous experience that secured a common but rather fantastic outcome. My third child was born in Scotland, where the midwives do all the work and the doctors show up 15 minutes later to congratulate the new ‘mums’ and their midwives on a job well done. I can’t say enough about the British Health Service of 1989, as they offered terrific ‘ante-natal’ classes to all new ‘mums’-to-be and gave the most practical advise I’d ever had about the most basic things, for instance: only have three of everything for the new baby, one on the shelf, one on the baby, and one in the laundry. Simple and obvious except to American over consumers. I had a closet full of clothes my daughter grew out of before she ever wore them. Embarrassing but true. At that time they encouraged all new ‘mums’ to stay six days in the hospital where they pampered us with tea and toast five times a day. It was great. Then they sent a home visiting nurse to see us at home for ten straight days and then once a week for six weeks. It was a total support system that truly honored women and children! What a contrast to the current experience of most American women. Thanks again to the author for her work on this all important topic, congratulations!

  • Beverly

    Your guest on the ‘Women and Childbirth’ did add to the conversation about women’s mental, emotional, and physical health and birthright to determine how they want their labor and delivery to happen. She did add to listener’s knowledge in that the very act of talking about this keeps the importance of effective and safe labor and delivery top of mind. She obviously is a person interested in advocating for women and children and the men who support these women and children – medically or as a loving partner. Not one moment did I sense that your guest attempted to belittle men – on the contrary, one definition of obstetrics is, “the branch of medicine dealing with childbirth and care of the mother” – so, the focus is properly on women and the babies in their bellies – not on the men who may feel left out of the conversation.

  • Greta Kreider

    Around here, we call people like me a “birth junkie”, so thanks for your topic! Ms. Epstien seems to imply that a mother/family can get the same care from a midwife or doctor. It seems to me that the training of each determines the kind of care they can offer. On the whole, a doctor is trained to look for the worst case senario, and is familiar with instruments, monitors and surgery to solve the problems that are perceived or presented. A midwife trained outside the medical system is trained to assist the labor and to watch the vital signs of mother and baby. The support and applied techniques actively avoid problems.

    We absolutely need both. Doctors save lives in actual emergencies in ways midwives cannot. Midwives can help avoid emergencies, unnecessary procedures that cause morbidity, and help connect women with their bodies and their babies in ways are beyond the medical model. They do different jobs, and I feel strongly that the ideal would be for greater collaboration between the two so families can get all the care they need at the right time, when each is appropriate.

    Currently, doctors practice in a culture (and in the hospital business with layers of people and interests) that value efficient, controllable and known processes.
    The culture midwives practice in encourages them to accommodate a wider range of variables in labor. Midwives are overseen and guided by far fewer interests. The mistrust and misunderstanding of each for the other is unfortunate. But until doctors have more autonomy from the systems and culture they work under, it cannot change. Until the recognize the need for this, the doctor/patient relationship is limited.

  • Joshua bigley

    She apologetically says that this was the way thing was–they wanted the ptents (of male midwives and their tools)–nothing has chnaged–corporations claim patents on ediacla treatment, medicine, and drugs everyday–denying helath-care to the poor, condeming billions to death–not in the spirti of medicine or humanity–but profit, greed, wickedness.

    She says Eve didnt have brothers and sisters–ABSURD! WHy does NPR broadcast such insanity-its time to start a new abolition movement–free people from ignorant dogma such as Christianity that is so harmful to the world.

  • http://NPR Maureen Holme

    After 3 children natural and no meds, I believe informed women are not in fear of their ob/gyn, they are in fear of the hospital, and hospital procedures, or should be. With my husband’s assistance, we played hide and seek with hospital personnel right through almost all of labor, walking, showering, hiding, talking on the phone, etc. We avoided all interventions that hospital people were trained to attempt to talk us into. Our fine midwife got a great kick out of it all. Our ob/gyn arrived from golf or whatever in time to help catch the babies, nothing more, although obviously would have been of service if complications had arisen. Check Bradley method of childbirth if you wish to learn of a comprehensive philosophy of natural childbirth.

  • Bruno

    This really did not inform me in the slightest. All her comments were “I think…”, no talk about her scientific approach, who did she research? what were the percentages of pro-homebirth vs pro-hospital?
    I got the impression that she made a book about how childbirth has been at different years but did not do credible research into topics such as which method is “best” or “safer”, and she was trying to answer those questions without having done sound research. Statistics.

    In my opinion, this served more for misinforming people rather than informing.

  • Adele

    I was born while my mom was under anesthesia, and was delivered with forceps. When I was growing up, my mom made childbirth sound like the worst imaginable situation. Not only did I feel I never wanted to give birth myself, but I developed a fear of medical procedures.

    When I got pregnant unexpectedly, I asked about having a c-section because it seemed to me the easiest way to get the baby out. Fortunately the doctors talked me out of it. I learned relaxation techniques to deal with my fears, and yet I hoped to go without an epidural because of my fear of needles.

    As it happened, my first child took forever to be born; the stage of labor that was supposed to take 1/2 hour according to the books my husband and I read took several hours. I was in the birthing room for over 18 hours, and just managed to avoid a c-section. But to my amazement, the contractions that I’d feared so much felt like very powerful menstrual cramps, not a new kind of pain, and I felt “I can do this!” (I don’t know why none of the childbirth books point out this similarity.) I managed to get through without the epidural, and the whole experience gave me such a boost in facing my fears afterward. It was a totally unexpected experience for me.

    When I had my next child, my labor was faster and more intense, but I was able to use a midwife for the birth. What a difference! She was with me the entire labor and delivery, and she gave me advice that helped ease the pain, rather than just popping in and out to check on me, as the doctors did when my son was born.

    I feel very lucky to have avoided any complications, but I also wanted to share with other women the idea that I went into my first pregnancy with a HUGE fear of childbirth (my feeling was: Get it out of me!)– and yet I was surprised to find myself able to handle it without drugs. I don’t mean that every woman should aim for this; I just want to reassure anyone out there who might be feeling the same fear I had, that a normal childbirth is not at all the way it’s depicted in movies, as an overwhelming constant pain from beginning to end. On the other hand, I have a friend who overcame her fear of needles by asking for an epidural during childbirth, and that seems a common occurrence as well.

  • sheila wright

    Why does a hospital charge 10K-12K for just using the hospital for vaginal birth? Then don’t forget the doctor who just comes and does the catching charges 4-5 thousand for his/her service. The only doctor who really does something is the Pediatric doctor and that service is for the baby.

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