Earlier this month, Childbirth Connection released the results of “New Mothers Speak Out,” their 6-month post-partum follow-up study to the Listening To Mothers II Survey. It made headlines in the Wall Street Journal with some alarming findings:  Nine percent of the women surveyed screened positive for all the criteria of Post Traumatic Stress Disorder,  and twice that many showed some signs of PTSD.  Mothers who had experienced high rates of medical interventions were more likely to report signs of PTSD. These mothers were also more likely to describe their experience of childbirth as “feeling powerless in a threatening environment.”

There are some excellent obstetricians, family doctors, hospital-based midwives, and nurses who are caring for laboring women and new mothers in a way that is gentle, respectful, and empowering. There are also practitioners who are not even aware of the way their customary manner and routine procedures traumatize their patients. Furthermore, the hospital system itself is frequently percieved as a “threatening evironment” in which mothers (and fathers) justifiably “feel powerless.” The result is that mothers and babies are subjected to unnecessary procedures and interventions, and face a significant risk of coming out of their birth experience both physically and emotionally scarred.

Of the 150,784 Ohio births recorded by the Health Department in 2007, 44,860 babies - 29.75% - entered the world through a surgical incision. Cesarean section, like any major surgery, carries physical risks for both the mother and baby. The psychological and sociological implications of having 1/3 of all children born by cesarean - frequently in an atmosphere of tension, fear, and stress - are barely beginning to be explored. But we now know that, contrary to the prevailing view only a few decades ago, newborn and preborn babies are conscious, aware individuals whose early experiences have a significant impact. Though babies have limited means of communicating with their parents and caregivers and may never be able to verbally express or consciously retain the memories of their pre-birth and birth experiences, they are laying down somatic memories during this period which they will carry for the rest of their lives.

An Israeli news report today announced dramatically higher incidence of adult schizoprenia for babies whose mothers were only two months pregnant during the 6-day war in 1967. If exposure to maternal stress hormones so early in gestation has a demonstrable effect, what is the long-term result for the infants of those 9%-18% of mothers whose labor and birth experience makes them feel so powerless and so threatened that they respond in the same way as war and disaster survivors? How do resuscitations and NICU stays (more common in cesarean-born babies), to say nothing of the routine hospital procedures for healthy babies, impact the newborn psyche?

Frederic Leboyer brought to light the question of the newborn’s experience of medicalized childbirth more than thirty years ago, but his work, and subsequent research on newborn consciousness, has done little to change institutionalized newborn care. In 2008, women who seek a gentle birth experience - for their infant as well as for themself - frequently find that the only way to get the birth they want is to avoid the hospital.

Home birth opponents, including the AMA and ACOG, denigrate mothers for placing an “experience” over the health and safety of their baby. (It is ACOG’s official opinion that “Choosing to deliver a baby at home… is to place the process of giving birth over the goal of having a healthy baby,” though all available evidence indicates that planned home birth with a qualified attendant is a safe and reasonable choice for healthy women.) By framing the issue in these terms, pitting the process against the end result, they deny the increasing weight of evidence that the experience matters. Of course the most important goal is a healthy baby - but it is also clear that the process of childbirth profoundly impacts the mental health and well-being of both mothers and their babies. Women and families, no matter where they choose to give birth, need and deserve maternity care that promotes both a safe birth, a healthy mother and baby, and a non-traumatic (or perhaps even positive and empowering?) experience of childbirth.