In comparison to birth in the Netherlands, among the Inuit and in Vietnam, the United States has a highly medicalized birth system that is relatively unchallenged. In the U.S., as one of the videos mentioned, until the mid 1900’s there was a relatively low hospital birthrate, however with increasing medicalization, by the 1980s, 98% of U.S. births were in hospitals. That is much different from the Netherlands where, in the article by de Jonge A., et al., a study showed that more than half of women from the Netherlands, 60.7%, “planned to give birth at home” (de Gonge A, 2010). Based on this figure, it is easy to see that birth in the Netherlands has not been nearly as medicalized as birth in the U.S. as most women would prefer to give birth at home if they have the means to do so.
Medicalization of birth among the Inuit is a bit different from both the U.S. and the Netherlands. Similar to the Netherlands, in the past the Inuit preferred to have home births surrounded by their families, making it a very social occasion. However, due to the pressure of white Canadians physicians living in the cities and the mainstream medical system, “evacuation was introduced… where women must sit for weeks in southern cities waiting to go into labor” (Daviss 1997). Due to this, pregnant Inuit women were forced to leave their homes and travel to hospitals where they had to give birth alone, as opposed to being surrounded by family. This is similar to the U.S. in the fact that Inuit birth became much more medicalized, but it was much different from the U.S. in the fact that this medicalization was essentially forced, while medicalization in the U.S. was the choice of many families.
Similar to the Inuit, the medicalization of birth in Vietnam for Hmong families was also somewhat forced by outsiders. However, a little bit differently, as seen in the film by Nick Ahlmark and Nicole Precel, Hmong midwives are the ones who ask the women to come to the birthing center. This is different than the Inuit in that the people who are asking the Hmong to medicalize birth are from inside their ethnic group, as opposed to outside. In the United States midwives are relatively uncommon and families go to the hospital on their own accord because they want to and they feel the safest giving birth there. Also, many Americans do not have the same sort of rituals that the Hmong people do surrounding birth, so it is much easier for them to go to the hospital.
In the film my Merilynne Rush about Home Funerals, Rush also makes a point about the medicalization of death being very recent. She discusses how until the mid 1900s, death was a very social event where the individual was cared for in their own home by their family and many funerals were held in the home. However, more recently she says that we have handed death care off to others to take care of, including hospitals and funeral homes. In this way, the U.S. has medicalized death in the same way it has medicalized birth.
These kinds of different ways of looking at and going about birth reflect very different ideas about women and how much they know about themselves and their maternal care. In cultures where home births are more prominent, it illustrates that there is a confidence in women and mothers that they are able to take care of themselves and their babies by themselves with the help of a few family members. It also illustrates a trust in the women that they are responsible enough and competent enough to be able to seek medical care when they believe they need it. This can especially be seen in the case of the Netherlands where babies born from home births were as “equally likely to be admitted in to a neonatal intensive care unit” compared to babies born from hospital births (de Gonge A, 2010). The home births also reflect a stronger emphasis on family who are often there to help out with the birth itself and care for the baby afterwards. The opposite can be seen when women are forced into hospital births, such as in the case of the Inuit. This reflects the view that women cannot take care of themselves or their families by themselves and they do not know what is best for them or their children.
This image is the cover of a magazine called Pregnancy. This image does reinforce dominant ideas about pregnancy and birth in the America, especially because it references a C-section on the cover. As mentioned in the Birth and Death Cross-culturally video, the U.S. has seen a very large increase in the rate of C-sections over the past few decades and the fact that this magazine advertises about it on the front cover shows how popular they have become. The image communicates that having a very medicalized birth, like a C-section, is not uncommon and that it is a normal part of pregnancy.
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.
“Pregnancy Magazine.” Facebook, www.facebook.com/pregnancymag/photos/a.434700834249.229869.5903849249/10150825386444250/?type=1&theater.
Rush, Merilynne. YouTube, YouTube, 25 Sept. 2012, www.youtube.com/watch?v=XaVJfJsflP0.