Returning to US birth challenges, a well-known midwifery/homebirth supporter, Dr. Stuart Fischbein, is being threatened with sanctions and removal of privileges for supporting women in having VBACS and breech births. You can keep up with his situation on his blog.
Tying the two together thematically, is an excellent article from Dr. Marsden Wagner from 2000, that is a very accurate assessment: Fish can't see water. My favorite quotes from this article are as follows:
I think these observations are key. We have a majority of people in industrialized countries who do not know what normal birth looks like. Fear-based recommendations are then made for maternity care based on a "lens" of birth that only includes intervention and and interference.
But we do not have humanized birth in many places today, including Australia. 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, medicalised birth cannot see the profound effect their 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 medicalising 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-medicalised' birth is. The entire modern obstetric and neonatological literature is essentially based on observations of 'medicalised' birth." - World Health OrganizationWhy is medicalised birth necessarily dehumanizing? In medicalised birth the doctor is always in control while the key element in humanized birth is the woman in control of her own birthing and whatever happens to her.