Up until the 1920s, most mothers gave birth to their children at home surrounded by loved ones and assisted, perhaps, by a midwife. By the 1940s, a new standard of hospital childbirth was set, thought to be the ideal because the doctor at the hospital had all of the right tools beside him when he needed them. The tools of the trade thought to be so beneficial back then, though, could be the reason hospitals get such a reputation of forcing medical interventions on laboring women today. With tools like forceps, surgical instruments, and medications readily available, why wouldn’t a woman accept them at the doctor’s request?
In the beginning, hospitals were unsanitary and not sterile, causing women and their babies to die from infection. Antibiotics were introduced in the 1930s and 1940s, followed by cesarean section surgeries as a safer option for women who had difficult labors and deliveries. Mothers were often put to sleep with heavy anesthesia during childbirth and doctors recommended bottle feeding instead of breastfeeding the newborn. In the 1960s epidurals were introduced to control pain, with more than 97% of births in the United States taking place at hospitals by the 1970s. Amazingly, a quarter of all births in the U.S. were by C-section by the year 1990.
Interestingly enough, fathers weren’t allowed to attend their wife’s labor until around the 1960s, when they were welcomed into the delivery room as coaches to help their wife through labor with the rise of the Lamaze Method in the 1950s. Today, the debate lives on to whether hospital births or births at home or freestanding birth centers are better for mother and baby, followed closely by controversy on natural childbirth versus medicated childbirth.
A typical birth at a hospital starts at the admissions desk with check-in, where moms will be taken to a room in the labor and delivery ward and given a hospital gown to wear. Next, a nurse will ask for details on the labor process so far to assess the situation, then will take the mother’s pulse, temperature, blood pressure, and urine sample. Along with an internal examination and cervix check, the nurse will feel the mother’s abdomen to check the baby’s position, listen to the baby’s heart, and find out about the birth plan, like whether the labor will be with or without an epidural.
Some hospitals have a bath or shower available in case the mother wants to labor in water to ease pain and discomfort, while others have birthing pools. Others have rooms that are more like labor and delivery suites with couches, chairs, and birthing balls to allow laboring mothers to have more room to move around. Generally a woman is in labor as long as 12 hours, so hospitals try to make the stay as comfortable as possible.
There are hundreds upon hundreds of women detailing their cases that giving birth in a hospital is more like being treated for an illness than a natural, normal experience that women have been doing for years upon years. Confusion, unhappiness, and out of control is how they describe their hospital birthing experiences, when the experience is supposed to make her feel safer.
In most cases, a woman can expect to be hooked up to an IV to pump in fluids so she will stay hydrated, as most hospitals won’t allow eating or drinking during labor, and attached to machines that will monitor her heart rate and blood pressure as well as the baby’s heart rate, oxygen level, and the way contractions are affecting them both. Most of the time, hospitals require women to stay in bed instead of letting her get up and walk around.
If a woman goes past her due date or has pregnancy induced hypertension (PIH), gestational diabetes, pre-eclampsia, or other similar high risk conditions, she is likely to be induced. Some doctors perform routine episiotomies and are quick to turn to a C-section if the baby’s heart rate decelerates during a contraction. Pitocin is usually given if the mother’s contractions aren’t strong enough, which can cause them to be so intense and painful that an epidural anesthetic usually follows shortly afterward. And if there is trouble during the pushing stage, sometimes forceps or vacuums are used to get the baby out.