This article is from one of Marsden Wagner's books. Marsden Wagner, MD serves on The Association for Wise Childbearing's Advisory Board. Your responses are welcome!

FISH CAN'T SEE WATER:

THE NEED TO HUMANIZE BIRTH

Marsden Wagner, MD, MSPH International Journal of Gynecology and Obstetrics, 75, supplements 25-37, 2001

INTRODUCTION Humanizing birth means understanding that the woman giving birth is ahuman being, not a machine and not just a container for making babies. Showing women---half of all people---that they are inferior and inadequate by taking away their power to give birth is a tragedy for all society. On the other hand, respecting the woman as an important and valuable human being and making certain that the woman's experience while giving birth is fulfilling and empowering is not just a nice extra, it is absolutely essential as it makes the woman strong and therefore makes society strong. Humanized birth means putting the woman giving birth in the center and in control so that she and not the doctors or anyone else makes allthe decisions about what will happen. Humanized birth means understanding that the focus of maternity services is community based primary care, not hospital based tertiary care with midwives, nurses and doctors all working together in harmony as equals. Humanized birth means maternity services which are based on good scientific evidenceincluding evidence based use of technology and drugs. But we do not have humanized birth in many places today. Why? Because fish can't see the water they swim in. Birth attendants, be they doctors, midwives or nurses, who have experienced only hospital based,high interventionist, medicalized birth cannot see the profound effecttheir interventions are having on the birth. These hospital birth attendants have no idea what a birth looks like without all the interventions, a birth which is not dehumanized.
This widespread inability to know what normal, humanized birth is has been summarized by the World Health Organization: By medicalizing birth, i.e. separating a woman from her own environment and surrounding her with strange people using strange machines to do strange things to her in an effort to assist her, the woman's state of mind and body is so altered that her way of carrying through this intimate act must also be altered and the state of the baby born must equally be altered. The result it that it is no longer possible to know what births would have been like before these manipulations. Most health care providers no longer know what non-medicalized birth is. The entire modern obstetric and neonatological literature is essentially based on observations of medicalized birth.

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