Saturday, May 8, 2010

Birthing Around the World

Last night I watched "The Business of Being Born" and found it fascinating. Living in Seattle, we have a lot of options for natural childbirth and medication-free, low intervention births. Doulas and midwives seem to be plentiful and home births aren't unheard of here either. Needless to say, much of the information in the movie was familiar to me.

Having said that, it was still an incredibly inspirational movie about the power of women to give birth on their own terms without medical interventions and without the need of specialists or doctors or hospitals. What I find myself pondering is the cultural implications raised in the movie. For example, the movie suggests that something like 80% of all births in Japan have a midwife in attendance. While I think that's admirable (keeping the tradition of midwifery alive and relevant even in hospital or clinic settings as opposed to what we have in the U.S. where midwives are often unwelcome in hospitals) I wonder how accurate or meaningful this fact really is.

I had the sense from a number of women (both Japanese and non-Japanese) that I've heard from who delivered babies in Japan, that labor and delivery generally involves the pregnant mother lying on a bed while a doctor runs the show. Sure a midwife may be in the room, but I've never gotten the sense that comfort measures or encouraging a less "medical" or standard hospital delivery was part of their job responsibilities. If this is the case, and the hospital stay accompanied by doctor delivery of the baby is truly standard in Japan, then I'd argue that the mere presence of a midwife isn't sufficient to make things different in a meaningful way. It may be true that maternal mortality and infant mortality rates in the U.S. are both worse than the rates in Japan, but isn't it possible that this is because epidurals aren't widely available? (And if epidurals aren't used then the labor is less complicated and "risky" for a variety of reasons.)

All of this just makes me wonder about cultural similarities and differences. Does the fact that doctors and hospitals are seen as "the" place to give birth transcend Japanese and American cultures? Are midwives in Japan truly more influential in Japan than they are in the U.S., or are they simply more visible without any real influence on birth outcomes?


  1. In Sweden for the typical birth I believe they really and truly rely on the midwife, but the details I don't know, and I believe it's mostly hospital births.

  2. Hi, I popped in from Kims blog.
    I've had three births in a public hospital here in Japan. At my hospital the policy was that no baby could be born without a doctor in attendence, as for my son well shh!! He popped out a few minutes too early! The midvives 'direct' the labour until a point then call the doctor. They don't really have control over the situation as there is a lot of protocol to adhere to but it was nice not having the doc around! I also liked that drugs are never even mentioned. No gas, no epidural and no painkillers afterwards.

    Stats can be read anyway you want to. Here all staff in maternity wards are midwifes so regardless of who is in the delivery ward with you it will still be a midwife. Are they influential? I don't think so there is really a sense of "I am the doc you aren't"

    The prefecture in which I live does not allow for midwives to deliver babies without support. 2 years ago a clinic opened near me but the midwife has to have a doctor from the local hospital be her guardian so to speak, and the clinic needs to be close enough to the hospital (hers is 500m) so I wonder how benefical the whole thing is.