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Birth Industry A Huge System

July 13, 2011

Taking On the Establishment -- Phillip White

Birth Industry A Huge System

Phillip White

Long ago I took a  management course which discussed Deming “Win-win” type of organization management strategy.  Deming’s (a Stanford genius) view was radically different from the authoritarian management practices used in corporate America.   One of its pertinent principles was the idea that problems were caused not by the people but by the organization’s systems of operation.  Well the birth industry is one huge system, that employs some very well trained and excellent people.  But the organizational structures do not follow evidence-based policies and procedures, and this has become the dominant Goliath-sized  issue for women’s health care in the second half of the 20th century and the early 21st century.

But like David found, having trained to kill bears and lions with a simple sling, the bigger the target the harder it falls.   What seems insurmountable can actually be overcome with excellent strategy and a honed knowledge of the enemy.  Peebles can take down Goliath.

It is exciting to me to see women arming themselves to the teeth with information and statistics.  But, the peebles may come from a strange and foreign place, and that is a secret waiting to be unleashed, for women only need to tell men that they are being violated and abused by the system, and men will willingly stand up for this cause.  Men just need to understand how the over medicalization of birth has caused unnecessary harm to their children, partners and wives.

Many intelligent and astute women overlook how the vast ignorance of the male species benefits the  medical community.  Dumb men are manipulated by the male ” protection instinct” by doctors and their medical staff to control birth.  Male fear and lack of knowledge  is the medical establishments number one ally.  Each intervention and each step of a hospital birth are orchestrated to generate a dramatic surgical ending where the doctor rides in his white limo to save the mother and child.  Men who believe that they are in the safest place for birth, smile when signing off on each and every intervention, thinking they are helping to save their partners from pain and harm.  Little do they understand that the established birth procedures are built to maximize the profitability of hospital facilities and optimize the doctor’s time use.  Like much in American society, convenience is valued higher than truth.

Rarely are any of the backroom candid conversations between doctors and their staff overheard by the birthing couples.  The doctors are often miles away while the couple go through the early stages of labor.  The call for offering the couples their first interventions is almost set to scripts, that lead to the next and the next interventions.  Especially telling is the use of “pit” (Pitocin) to ramp up a slow labor.  Next comes the suggestion of drugs or epidurals to take away the edge of those more powerful than natural contractions.  Birth is prodded along a beaten path with poles and whips, all managed by chemicals and intrusive hands, assembly line like.

The problem here is that medicine does not look at birth as a healthy ordinary human bodily process, they actually believe  the script’s theme, that birth is an emergency,  a disaster ready to happen.  Defensive  medicine – like that done at a crash site — is the common factor in American birth.  Surgeons now control over 90%of births in the USA while the healthiest places to birth internationally have the vast majority of their births attended by midwives (women).

As everyone knows to take on the establishment, you need some political force behind your message.  Mothers who find themselves at conflict with the way medical/technological birth is handled often find it easier to either to succumb to the established pattern and even schedule a c-section to avoid the terror of the emergency c-section believe it is better to assimilate.  Some mothers stop having children.  Others are oblivious and just don’t understand.  But a small group of radicals withdrawal, or take a detour by hiring a doula  perhaps thinking”bodyguard,”  or more radically  return to the ancient path of midwifery.  HMOs, like Kaiser, have found that they have reduced insurance costs of birth by managing most of their births with midwives.

For the mothers who have felt robbed of quality health care services, they have tried to raise the issues, and they have many strong advocates internationally which write about this subject.  But the system is continuing to move further and further away from natural birth practices, favoring higher surgical interventions which promote physician’s schedules and wallets, while also protecting them from medical malpractice and generating facilities fees.

Women’s health care issues are overlooked by the patriarchal world of medicine, which is still predominantly male.  Only 30 percent of doctors are women.  Women doctors, according to studies, also make only 65% of what male doctors make as well.  This means men dominate the topic of birth in the medical world, and devalue the females in their midst by underpaying them.  It is no wonder women feel disemboweled politically in the U.S.A  No woman has been president.  Hardly any women run Forbes top 500 corporations.  About the only powerful women’s group I’ve seen in action  is MADD.  It shouldn’t take the death of one’s child to make one stand up for what is right.  It’s time for women to take back birth as a woman’s right!

In order to turn the tide, women are going to have to teach men more effectively on what is safe and what is not safe.  Women must teach men to fear the medical unnecessary interventions, and put stones in those men’s hands.  Men need to be armed with both knowledge and sense to take up the cry of “foul.”

Then Goliath will fall.  The ground will shake, and the head of this beast can be lopped off.

Ladies turn that fear driven, protection instinct of these men in your favor, and the 32% cesarean section rate will come down.  Men will stand with you in the lobbies on the Health and Human Services Agency, they will take on the Surgeon General, and they will throw enough peebles at the AMA to get their attention.

How insurance coverage handles birth may be the best strategy for making a dent.  This is the kingpin to the power base of the AMA, the doctors and the hospitals.  Once the insurance coverage for birth options happens, where people actually have real choice, then change will occur.  If the money changes hands, then the power will shift.  When the purse holders decide to pay for better care for less money, the tide will change but not on force of principle.  The stone that takes down Goliath is  money.

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