Claudia Breglia is a certified nurse midwife, owner of Born at Home and also president of the California Association of Midwives. Her history and experience in the business of delivering babies is extensive, so she knows the politics that come with home birth in today’s world—and also what every woman should know about the rite of passage called giving birth.
You’ve delivered hundreds of babies. What would you like to tell expecting mothers?
Childbirth should not cause post-traumatic stress disorder. It should provide you with this tremendous sense of what a strong and capable woman you are. And there’s this new addition to your family that you feel totally capable of being a parent to. When we give our birth away, that’s what we give away.
Why does the rest of the developed world, in terms of delivering babies, use technology as a last option but have lower infant and maternal mortality rates?
The rest of the world uses midwives, who are trained to deliver babies vaginally, whereas the United States uses obstetricians largely, who are trained to be surgeons. Surgeons do surgery. So if you don’t want surgery, you shouldn’t go to a surgeon.
Are epidurals bad?
Epidurals can seriously stress and endanger the baby and diminish the natural bonding between mother and child at birth, because the naturally occurring, pain-relieving hormonal cocktail is not passed between them in the presence of the drug.
Did The Business of Being Born, a movie that championed natural birthing methods for safety’s sake, have a negative impact?
It was Ricki Lake’s movie. … I think what that did was it made a lot of people go, “Hey! We don’t have to go to the hospital; there are other options—we’ll try it out!” So we got a lot of clients who thought it looked cool; they wanted the birth tub.
You do home deliveries. How often do you have to take a woman to the hospital?
It happens more now than it used to, but part of that is because, for the first half of my career, I was working with Amish women who have, like, a million babies.
But the other thing that makes Amish birth so effective and work so well, even for first-time mothers, is that there’s no culturally or socially induced fear. There’s just this deep understanding of the fact that that’s what God made them to do: to get married and have babies—and everybody that they know has had about 12 babies at home.
Large farm equipment causes more injury and death in those communities than having babies. Birth is just a part of life. You grow up, you get married, you plant a garden, you sew some clothes, you can a hundred quarts of applesauce, you have a baby, you sew baby clothes. You know? So there’s no fear and no sense of, “I don’t think I can do it. It’s going to be too painful. Everyone I know had a cesarean.”
Why do you think mothers are afraid of giving birth?
Unfortunately, most people in our culture are learning the bulk of what they know about birth from shows like A Baby Story. That show has a 54 percent planned cesarean rate, because it’s much easier to film a planned cesarean than it is to film a spontaneous labor that could happen at any time, but also because it’s a rapidly growing trend. They call it “designer birth.” Most people on there get epidurals.
The statistics are very skewed and don’t reflect what’s going on in the general population or what birth is really like, but this is how people are learning about what birth is like. We’re seeing a lot more transports, because we’re seeing a lot more fear and a lot less acceptance that birth is not a scary, dangerous event, but a natural and empowering event.
Is Western medicine noticing the successful use of midwives in other wealthy countries and the successful nonuse of surgical procedures or drugging the mother?
So, one of the things widely thought was that cesareans should be done in place of vaginal delivery because vaginal birth causes incontinence and lifelong this and that, so the American College of Obstetricians and Gynecologists came out with this practice guideline that didn’t get nearly the publicity that some of their other stuff did, and it said in effect, that, “Oops, we seem to have misunderstood the research,” and actually, it’s the episiotomy that causes incontinence, which has always been done to “protect the pelvic floor,” because they cut the vaginal opening with scissors to make it larger, which they rationalized speeds the delivery and leads to less tearing—but cutting the vagina with scissors wasn’t damage?
Um, get those scissors away from me. So what did they find out?
Women don’t tear as frequently as women were being cut, and episiotomies caused prolonged pain, sexual dysfunction, pelvic-floor dysfunction including urinary, fecal and flatulent incontinence, and so it wasn’t in fact vaginal birth, but vaginal birth with episiotomy that was causing all these long-term consequences. Tears were found to heal faster with less pain and dysfunction associated. Do your Kegels, and don’t let anyone cut you.