I am a midwife, childbirth educator, lecturer, doula, and natural mother of eight children. This is not a medical reference; I do not proclaim to give medical advice. Anything stated here is from personal experience, research, study, and opinion. Each woman has the responsibility to do her own research, consult with her own medical team, and make her own decisions about pregnancy and birth.

Monday, November 29, 2010

Who's to blame?

Bismillah al-Rahman al-Rahim
Me, Aisha (Natural Mom) with
one of my "Doula Babies"
shortly after birth

I write a lot about the benefits of having a natural, non-medicated birth.  I tell you that I respect doctors while also seeming to "blame" them for the many "unnecessary" medical interventions that often take over the birth process.  Well it's time to put things into perspective and look at the bigger picture.  

Please note that this article is totally based on my opinion, which there is no doubt weighs heavy on the side of natural birth. 

I hope you enjoy reading this commentary.  Please let me know if you have a story idea or would like to share your birth story. Now on to the article...Who's to blame?...
First I want to acknowledge that there is a word in the English language to describe an illness or adverse condition in a patient that is caused by the medical treatment they receive.  The fact that we even have such a word saddens me.  Iatrogenic is this word that describes adverse conditions brought at the hands of the doctor.  The one we rely on for our care, our health, our bodies, usually with complete trust and without much question. 

Although I contend that there are many problems that occur during labor and birth that are iatrogenic, I do not believe that our trusted doctors intentionally harm us.  In fact, in most instances, I'd venture to say that they truly believe that what they are doing is in our best interest.

One simple, seemingly harmless example is the routine use of glucose IV.  It is often used to prevent dehydration and gives doctors "peace of mind" that a line is running to the vein, "just in case a need arises for a higher medicinal administration."  

I agree that it is imperative to prevent dehydration during labor and birth.  Dehydration can cause very serious complications and it is reasonable for the doctor to want to safeguard his patient from these complications.  However we must consider that the unnecessary "routine" of administering glucose intravenously alters the blood sugar levels of mother and baby.  The IV line itself also limits the mother's mobility during labor and birth (a time when movement is paramount). 

To top it off, it was also noted in the July, 1984 edition of The American Journal of Medicine (Volume 77), "...rapid increases in circulating glucose levels produce a decrease in the ability of normal persons to tolerate pain."  Regardless of the other issues involved with unnecessary IVs, the simple possibility that it could reduce my ability to tolerate pain is reason enough for me to refuse it.  Personally, I think childbirth is painful enough!  

So what's wrong with drinking water?  This is the natural way to stay hydrated.  Even in the English translation of the Qur'an (Y. Ali 19:26) it says, "So eat and drink and cool (thine) eye," referring to providing relief to Mary whilst in labor with Jesus (PBUH).  Clearly Allah was offering water to drink, not a glucose IV to Mary during her labor.  If it's good enough for Mary, I'd say it's good enough for me!

As for the "open line to the vein, just in case," a capped off IV catheter can be inserted and accessed quickly enough in the event of an emergency.  But frankly, I'd prefer there not be an "open line" that gives such ready access to drugs entering my veins while I'm not looking or have not been properly informed of what's being given and why. 

I could ramble on and on about unnecessary medical protocols and elective medications.  I could site several examples about medical procedures interfering with the natural process of birth.  I could explain how interfering with one medical intervention increases the likelihood for the next higher intervention until finally you're having an "emergency" cesarean.  But instead I want to discuss the reasons why I believe our trusted doctors introduce these things to us in the first place.
  • It is what they have been trained to do.  No, not to harm us or to cause us iatrogenic injury, but to medically manage our labors, rather than patiently watching them happen.  Let's face it, they paid a lot of money and put a lot of time into their medical education.  That education has taught them how to manage abnormality, although the vast majority of women would experience complete normality in their labor and birth, if we just left them alone and let nature take its course.

  • Sadly, most women are not trained or prepared to handle natural childbirth.  Women often come in requesting that first intervention (pain medication) which sets off an entire chain of events that, simply put, is not natural and raises risks for both her and the baby.

  • Along the same lines, women do not take the time to educate themselves about the physiology of pregnancy, labor, and birth.  Therefore they do not know the intrinsic beharviors needed to work with their bodies at this important time.  Honestly, a woman uneducated in the way her body works during labor and birth is her own worst enemy.

  • Because the majority of women are not prepared, doctors seldom see a calm, confident woman who knows how to cope with her labor and birth without the aid of drugs or other medical interventions.  Most doctors and other obstetric professionals have rarely, if ever, witnessed a completely natural, non-medicated birth.  From their perspective, normality is actually the abnormality and abnormality is the norm.

  • Lastly, doctors have a job to do.  That job requires them to come to work at all hours of the day and night.  It is much more convenient for the doctor to take over the birth process, even to the point of performing elective cesarean surgeries to make it all fit their own personal schedules.  So what's wrong with this if it's what the mother wants?  Ahh, the answers to that one, I'll save for another post.
From my perspective it's the mother who's to blame for the iatrogenic problems in childbirth.  That's right, I said it, the mother herself is to blame for adverse conditions brought on at the hands of her trusted doctor.  It all boils down to her lack of education and preparation for her own birth. 

Every woman has nine months warning that she will be laboring and birthing at some estimated future date.  I find it completely irresponsible of her to just hand her body over to her obstetrician like a car to the mechanic.  After all, this is her body we're talking about, not to mention her baby!

Bottom line, if you're pregnant, or ever plan to be, get educated, get prepared, and become a responsible birth consumer.  Don't just be complacent to the protocols that are designed to manage abnormality.  Assume normality until there's some reason not to.  Explore your options and make informed decisions about what you want for your labor and birth.  Stay flexible and know that things may not go as planned, but I'm here to tell you, nothing goes as planned when there is no plan!  


  1. interesting post!! i am a doctor and also a mother. i smiled reading each line you wrote here as most of it are true. most doctor tend to caesaer their patient, but when it come to theirselves, they will fight not to open their abdomen to experience this normal natural birth.i personally do not agree of some protocol that easily push patient to OT for caesear as i belief time is the best healer. if both baby and mum cooperate well, the natural birth can always occur spontaneuously.but all this intervention interfere a lot in this normal natural birth whose many mother do not trust on their potential body given by THE BEST CREATOR, but trust the hand of the doctor who is just part of the CREATION

  2. Asalam alaikum,

    Thank you for taking the time to read and comment. I really respect the time and effort that goes into the medical education and degree.

    I just wish that more doctors would encourage their patients to get educated about birth and to prepare so that they don’t look to the doctor to take over birth, which is something no human can control.

    Women often push the doctor into intervening simply by not being able to cope with their own natural labor pain...which isn’t that bad if they would just relax and let their body work.

    We have become far to trusting of technology and drugs for birth. We should be grateful for these inventions when complications arise, but not to the point of dependence on them!

    Thank you for being humble enough to point out that doctors are part of the CREATION and they should not be looked upon as gods. May Allah reward you for your honesty as well as the care you provide to your patients.

    Best regards,

    -Aisha, Natural Mom