Based on location, giving birth happen at home surrounded by friends, family and a midwife, or it can happen at a hospital; either with family or alone in an unfamiliar environment. Based on location and cultural normalities, ideas of how and where a birth should be carried out vary greatly. In the Netherlands, policies are more relaxed and women have a choice as to whether they give birth at home or at a hospital. Somewhere between 30-60% of woman give birth at home. Studies here show that there are no greater risks giving birth at home compared to in a hospital (de Jonge., et al., 2009). In Vietnam policies are also relaxed but at home births often pose certain risks, especially when they are lacking a trained midwife. Families may cut the umbilical cord with dirty scissors or wipe the baby with a dirty towel. If the baby enters the world into an unsanitary environment, the risk of contracting a deadly bacteria infection greatly increases. For the Hmong women, getting to the hospital through the northern mountains in Vietnam poses other risks. The journey can take several hours which is very hard on a 9-month pregnant woman. Also, there is always a chance of going into labor on the way, and some areas of the trek can be dangerous – including the Vietnam-China border where sex trafficking is known to occur at times (Ahlmark and Precel 2011).
In the United States, it is also legal to have a home birth though still quite uncommon. According to the CDC, in 2012 less than 1.5% of births took place at home (MacDorman, and Mathews, and Declercq, 2014). Hospitalization in America is so common that there seems to be a stigma around home births that they are unsafe and therefor frowned upon. According to lecture, in the early 1900s, nearly all births in America took place at home surrounded by family and a midwife. Today the exact opposite is true. At home births in America may or may not be covered by insurance based on provider, but choosing a midwife is often much cheaper, under $5000 compared to tens of thousands for a hospitalized birth (Renter, 2015).
The policies in these countries are much more relaxed compared to those imposed on Northern Canada’s Inuit. For thousands of years, cultural significance was placed on home births seen as a community, social and spiritual act by the Inuit (Heeding warnings). During the relocating fiasco in the 1950’s, Canada wanted the Inuit to stop migrating and to settle in one place; allowing for improved modern education, health care and developed permanent housing. This led to women being flown to southern Canada to give birth. Due to the expenses involved with airfare and stay, this was done alone without family, friends, or children who were in special need of their mothers care. Prior to this, birthing was done in special huts where elders helped to deliver the child and decide which recently deceased elder had passed on their soul to the newborn child (Pauktuutit Inuit Women of Canada, 2006). Although it is likely Canada started this for what seemed like good reason, there are often many consequences of medicalized birth for the Inuit. To start, mothers are away from home and not able to adequately care for their young who need attention and sometimes breastfeeding and are unable to participate in their community. They are forced to leave a month before they are due and sit for weeks in Southern Canada eating foreign food, with little exercise and no family support. This alone can lead to psychological problems for the mother. Although evacuation has helped high-risk pregnancies to successfully deliver healthy children, it has created more problems for healthy mothers and their culture than it has solved (Daviss, 1997).
Another interesting contrast between American and Inuit women was how post birth, Inuit women generally have their babies held in their fur coats or breastfeeding at all times (Pauktuutit Inuit Women of Canada, 2006). American women on the other had often hire a nanny or send their child to daycare at least a few days per week only a month or several after birth so they can return to work or social obligations.
This is a photo of a woman named Ellen Fisher and her husband holding their baby girl who Ellen has just given birth to at home in a tub (Fisher, 2018). This photo challenges dominant ideas of birthing in America because as stated above, less than 2% of births happen at home. I remember showing this photo to my mom when she posted it and my mom commented on how dangerous that was. Our birth culture in America is dominantly focused around hospitalization due to the fact that nearly all births occur here. The stigma leads us all to believe this is the only safe way. It is not until we look more into the statistics, similar to the Netherlands statistics that show us that for low risk births, at-home births with a midwife are just as safe as hospitalized births (de Jonge, et al., 2009), with the benefit that they are much more personal and comfortable.
Ahlmark, N., Precel, N., [UNFPAsia]. (2011, April 27). The Mountain Midwives of Vietnam. Retrieved from https://www.youtube.com/watch?v=1F1dmcJTd9U
Daviss, B. A., (1997). Heeding Warnings from the Canary, the Whale, and the Inuit: A Framework for Analyzing Competing Types of Knowledge about Birth. In Childbirth and Authoritative Knowledge: Cross-Cultural Perspective, edited by Robbie Davis-Floyd and Carolyn Sargent, pp. 441-473. Berkeley: University of California Press.
de Jonge, A., van der Goes, B., Ravelli, A., Amelink-Verburg, M., Mol, B., Nijhuis, J., . . . Buitendijk, S. (2009). Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births: Perinatal mortality and morbidity in planned home and hospital births. BJOG: An International Journal of Obstetrics & Gynaecology, 116(9), 1177-1184. doi:10.1111/j.1471-0528.2009.02175.x
Fisher, E. [ellenfisher]. (2018, March 7). [It’s a GIRL!! Her name is Scout Hannah and she was born in the birthing tub in the comfort and safety of our home]. Retrieved from https://www.instagram.com/p/BgB8h_aFu5Q/?taken-by=ellenfisher
MacDorman, M. F., Mathews, T. J., Declercq, E. (2014, March). Trends in Out-of-Hospital Births in the United States, 1990–2012. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db144.htm
Pauktuutit Inuit Women of Canada, (2006). The Inuit Way a Guide to Inuit Culture. Retrieved from http://anthropology.msu.edu/anp270-us18/files/2016/06/3.1-inuit-way.pdf
Renter, E. (2015, July 3). How much do home births actually cost? Retrieved from http://www.foxnews.com/health/2015/07/03/how-much-do-home-births-actually-cost.html