Questionable Ethics of Hospital Birth Practices

For all of history, until relatively recently, women have traditionally given birth using positions that are instinctively beneficial and allow for gravity to aide in the birthing process. Currently, however, a more technological approach is widely accepted in hospitals and by most care providers. Women give birth lying on their backs, and in many cases push when their doctors or nurses tell them to, rather than when they feel a natural urge to. 

An article I found about healthy birth practices explores where current research stands on birth positioning and directed pushing and emphasizes the gaps in the research and what is currently practiced in the majority of hospitals. The authors first focus on birth positioning. There have been over 30 years of research which confirms that giving birth in a supine position has no advantages for mothers or infants, and in fact is clearly inferior to traditional positions of standing, sitting, or squatting. Despite this knowledge and no research that refutes it, the number of women who give birth in a supine position has continued to increase. The article then discusses directed pushing. For about as long as people have been questioning the supine position, there has been research into the practice of directing women to push as soon as the cervix reaches full dilation. Patient-directed pushing has been shown by multiple studies to be a superior practice, which promotes the health of mothers and infants, and is more in line with the body’s natural physiological processes, ensuring a smoother birth. 

I find it a little bit unbelievable how this research has been consistently refuting accepted practices for three decades, and still almost nothing has changed. When medical practices that are widely accepted conflict with the natural physiological processes of the human body, there is something obviously wrong. Is it ethical to continue to promote practices that are continually proven to be less effective and even harmful? I would say that it is most certainly not. This is an excellent example of the way in which health care systems often exhibit bias against female patients. It is a discrepancy we do not talk about enough, so I think it is important to teach ourselves about examples such as this one. 

Source: 

DiFranco JT, Curl M. Healthy Birth Practice #5: Avoid Giving Birth on Your Back and Follow Your Body's Urge to Push. J Perinat Educ. 2014 Fall;23(4):207-10. doi: 10.1891/1058-1243.23.4.207. PMID: 25411541; PMCID: PMC4235063.