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Birth Myths and Facts

by Suzanne Arms

Myth:

Birth is too risky and dangerous to be allowed to occur naturally.

Fact:

Childbirth is a highly refined process that normally requires only the physical good health of the mother, adequate emotional support and privacy in labor, and the watchful attention of a skilled birth attendant to result in a healthy mother and baby. Just as a baby knows how to grow its body in all its amazing detail, a baby also knows how to birth itself. Given these truths, it is essential that we change the prevailing attitudes and practices around birth so that it can work as it is meant to work, and so that the overwhelming majority of babies and mothers will be able to complete this important development process without hindrance. Hospitals, physicians and medical procedures are there to help out in the unusual complication.

Myth:

No birth can be viewed as normal except in retrospect, because pregnancy and birth are medical conditions.

Fact:

The majority of complications that arise in pregnancy are related to socio-economic and psychological factors such as inadequate diet, drugs, environmental toxins, high levels of stress, and the ambivalence, anxiety or unhappiness of the mother, even racism. Many of these factors are related to how others treat the pregnant woman.

Research from around the world has proven again and again that the majority of complications in labor can be anticipated prior to the onset of labor; most of them can be avoided or successfully resolved without medical intervention if a woman has the knowledge and support she needs and comes to pregnancy and birth in good health – physically, mentally and emotionally. A skilled, caring practitioner who believes in the woman and baby’s ability to birth naturally and who has great faith in the physiological process is an additional asset. Given these things, birth can safely occur in any setting, home, birth center or hospital.

Myth:

The modern hospital is the safest place for all women to give birth. All other sites for birth are too dangerous. Furthermore, the bigger the hospital, the more sophisticated the technology, and the bigger the size of the baby intensive care unit, the safer the birth.

Fact:

Despite 75 years of routine hospitalization for birth there are still no reputable studies or scientific evidence showing that hospitals are the safest option. In fact, there are numerous reputable studies from the past few decades proving that hospital birth inevitably carries risks and hazards. The mere presence of a laboring woman in a hospital has been proven to increase the likelihood that she and her baby will be subjected to routine tests and procedures, each of which carries risk and increases the likelihood of problems in birth.

Routine hospitalization for birth is extremely costly to society, as it leads to the inappropriate use, and overuse, of specialist physicians, medicine, surgery and technology. The problems associated with hospital birth increase with the size of the hospital, especially those problems that arise due to impersonalized routine care because the mother and baby are treated as a product not as unique feeling human beings.

Myth:

Modern medical management and intervention in birth improve outcomes and should therefore be applied to all birthing women and their babies. The more modern technology is used in birth, the safer the birth and the better the outcomes.

Fact:

Medical management of birth entails numerous routine interventions in the natural process. All routine interferences in the natural physiological process are based upon a belief that birth can be safely controlled and managed, usually for the convenience of the staff, in order to speed up the process, and increase profits.

There is now a large body of scientific evidence showing that the entire medical management approach to birth carries significant risk of harm to the natural process and to the mother and/or baby. In addition, the use of any intervention tends to lead to other interventions, in a cascading effect.

Hospital routines start with having a woman exchange her own clothes for a hospital gown and being confined her to bed, putting in an intravenous drip of glucose rather than allowing her food and drink. From there it goes to hooking the mother to an electronic fetal monitor or rupturing her membranes and screwing an electrode from the monitor into the baby’s scalp. A growing number of mothers have labor artificially “induced”, all too often before the estimated due date, by drugs or by rupturing the membranes that hold the amniotic fluid that bathes the baby and protects it during labor. Many mothers also have artificial stimulation of contractions. Most ask for, and are given, sedatives, narcotics and/or anesthesia (epidural being the most common) to dull or eliminate the sensations of contractions, most of them then require additional drugs (artificial oxytocin, in the U.S. under the name Pitocin) to speed the labor up, because the prior drugs have slowed labor down.

Many babies, once they get the drugs their mother was given, either cannot find their way out of the uterus and down the birth canal – which is work the baby is designed to do – or go into “fetal distress” and are given a mechanical delivery (forceps or vacuum to pull them out), an episiotomy cut in the woman’s perineum, or cesarean (major abdominal surgery). The umbilical cord is usually clamped and cut immediately, depriving the baby of the backup supply of oxygenated blood from its mother, which is a vital failsafe or backup for the baby as he or she learns to breathe on its own.

Once the baby is born, the baby may be briefly shown to – or even given to the mother to hold. Then it is taken across the room and placed in a mechanical baby warmer or taken immediately to a nursery. In the nursery most babies are given their first shots within minutes or hours of birth, and approximately 60 percent of U.S. baby boys are circumcised (have their foreskin surgically removed), as most parents give consent without understanding the risks or lifelong consequences of removing the most sensitive part of the penis.

Once any intervention is used, the natural course of the labor is usually altered. For all of these reasons – as well as the impact that each intervention can have on the mother and baby's psychological well-being and bonding – intervention should be used only in instances of true complications and after safe, non-interventive measures have been tried.

Myth:

Electronic fetal monitoring is necessary for all babies, to prevent problems that might occur during labor and to ensure their safety.

Fact:

Just as with routine hospitalization for birth, electronic fetal monitoring (EFM) has never been scientifically proven either safe or effective. Yet it was heavily and aggressively marketed, right from the start, under the premise that it is necessary for determining the wellbeing of a baby during labor. This marketing was undertaken despite the fact that there was, at the time, no research on the safety or effectiveness of this machine. This costly device was introduced in the early 1970s, using hired nurses in uniform to tout its supposed “safety”, an unethical practice, to say the least. Within a few years electronic fetal monitors were purchased by every hospital in the country, and many bought one for each labor room.

In the first decade after EFM was introduced, there was a doubling of the cesarean rate, without any improvement in neonatal outcomes. Then, as early as 1985, extensive research was finally published, notably a Harvard study of 10,000 consecutive women, which showed that no more than 1 baby's life in every 10,000 women electronically monitored might be saved. In addition, this research proved that monitoring laboring women routinely would create more problems and would hurt more babies in the process.

Routine EFM use continues across the country – although some hospitals only require that form of monitoring upon admission and for a few minutes every hour of labor. Routine EFM use has now been proven to increase the cesarean rate, which always increases risks to both mother and baby. Note: The now out-of-control cesarean rate has not been associated with any improvement in birth outcomes!

EFM has been a major contributing factor to the increasing medicalization of birth and the turning of the natural physiological process into pathology. It inhibits a woman’s movement during labor, sending the message to her subconscious brain that birth is a medical event and labor is dangerous. Furthermore, internal electronic fetal monitoring (which many hospitals prefer because it gives a more accurate reading of the baby’s heart rate) requires rupturing the amniotic sac and screwing a scalp electrode into the baby's head.

In most hospitals EFM is still used routinely today, more than 25 years after it was proven to have no value. Doctors will admit it has no real benefit. Hospital administrators see the monitor as a way to cut down on the nursing staff and hospital attorneys view EFM as a way to ensure against losing malpractice suits.

Myth:

Homebirth is always unsafe. Birth centers are a little safer but still not as safe as a hospital.

Fact:

Research done in the Europe and North America show that a healthy woman who starts labor in good health, with a positive attitude and showing no sign of complications, is actually safest giving birth in the familiarity of her own home, assuming a skilled midwife is in attendance and there is hospital backup no more than 20-30 minutes away. Freestanding birth centers are as safe as, but no safer than, well-attended home birth for healthy women.

Part of what makes a woman’s home or a birth center safer than a hospital in most instances is the fact that these environments encourage a mother’s instincts and control of their own experience. Equally important is that these 2 settings do not offer risky drugs, procedures and surgery. Birth attendants in these settings generally avoid intervening in the natural process – for example, by leaving the membranes intact, by welcoming the mother being upright, active and changing positions during labor, and by providing her with ongoing emotional and physical support and appropriate food and drink.

Both birth center birth and home birth have been scientifically proven to be safer than hospitals for this healthy population. These women are at the lowest risk for developing complications during labor. Fully 80% of all birthing women in America fall into this category.

Myth:

Babies need the safety that a modern hospital provides.

Fact:

Hospitals are not safe places for healthy newborns, whose liver, brain and immune systems are too immature to be able to ward off the harmful effects of drugs give to the mother. All babies receive many developmental benefits from natural (physiologically normal) birth “The gold standard” for birth ought to be whatever meets the full needs of babies. It has been scientifically proven that the mother’s body is the best environment for the baby both before and after birth. However small or compromised a baby is at birth, its mother’s body and her breastmilk provide the best protection and nourishment that her baby needs to build a healthy mind and gut and strong immune system. Hospital newborn intensive care units must therefore be redesigned to prevent any separation of mother and baby, and to have “kangarooing” (the baby on the mother’s body), as that is proven to be the best way to stabilize any newborn’s temperature, respiration and heart rate. All newborns and mothers must be cared for as one unit, because they are biologically one symbiotic system.

Whenever a baby is unable to be born naturally – without intervention of any kind – every effort needs to be made to make up for what that baby has missed (e.g. being born through vaginally or being born prematurely or low birth weight. Because intervention in birth, even when it is needed, stresses the baby, these babies need to get whatever help they need to heal birth-related shock and emotional trauma.

Newborns are especially vulnerable to hospital-born drug-resistant infections. Today there are 25 known strains of pathogens that are completely resistant to all current antibiotics. Most of these are found in hospitals. Babies who are physically separated from their mothers and who do not receive their mother’s breastmilk exclusively – starting right after birth – are at increased risk for contracting all kinds of infection. Most hospitals routinely separate newborns from their mothers for some period of time, and their practices make breastfeeding more difficult.

Myth:

Babies need to be “observed” in a hospital nursery for at least some time after birth, in order to assure that they are healthy.

Fact:

As many as 20% of our nation's full-term healthy newborns currently spend time in intensive care for no medical reason. Most of them are there for "observation" or "just-in-case" treatment, because of drugs given to, or procedures done on, their mothers. The additional cost of each day a baby spends in intensive care runs an estimated $2,500-$7,500. Intensive care baby units usually run at a 90% or higher occupancy rate. As soon as an intensive care unit is built or expanded, the number of babies sent to it increases, because there is little incentive to keep babies out of neonatal intensive care units – especially in big teaching hospitals.

While in intensive care – even just for "observation" – babies endure numerous painful, risky procedures in addition to being separated from their mothers. The more aggressive the management of newborns is in such nurseries, the greater the potential for emotional shock and long-term trauma – if that shock is not relieved. Doctors and nurses are not trained to look for the signs of shock and trauma in either babies or mother and are not skilled in helping heal birth-related trauma.

Myth:

The length of a woman's labor and whether her birth is medically complicated or becomes a medical emergency is the result of factors beyond her control.

Fact:

Numerous recent studies have shown that the circumstances of labor and birth can be dramatically affected by the nature of the birthing environment (e.g. the dominant presence of metal and machines, and the lack of privacy and support). The attitudes of the mother and her caretakers are even more important. Every person who comes in contact with a woman in labor either increases or diminishes her fear and her self-confidence.

Studies of both midwifery care and doulas (one-to-one labor support by a skilled person) have shown that the rate of medical intervention and the length of labor are dramatically reduced with competent doula and/or midwifery care. Note: A physician can provide midwifery care, just as a midwife can be highly interventionist. The difference has to do with training, attitude, and the type of system in which they work – whether it promotes or hinders natural birth.

Myth:

Cesarean surgery is today very safe, poses minimal risk to mother and baby, and is only done when medically necessary.

Fact:

Cesarean surgery has become much safer than it was prior to 1970, because of the method of anesthesia used (epidural being the norm today, rather than general anesthesia) and other technical advancements. However, cesarean is always major abdominal surgery and therefore always carries the same immediate risks that any major surgery entails: 1) unstoppable bleeding (hemorrhage), 2) unexpected and catastrophic drug reactions, and 3) infection, for the mother, and 4) surgical accidents and complications.

There are different risks for the baby. Cesarean born babies are much more likely to have immediate problems with breathing, for example, and often end up in intensive care separated from their mothers during the critical first hours after birth. When cesarean is performed by schedule, without labor, the risks are even greater, including the additional complication of the baby being pre-term. Cesarean-born babies are more likely to require intensive care after birth and to have increased difficulty establishing breastfeeding. Cesarean also prevents the baby from having its gut colonized with the mother’s gut bacteria, which happens when a baby come out of the vagina. This colonizing of the baby’s gut is very important for creating a healthy digestive system. There is increasing research of the connection between a healthy functioning gut and a healthy brain.

Cesarean surgery automatically denies the mother and baby the experience of completing the birth as they are biologically designed to do. That alone makes cesarean risky, for vaginal birth gives numerous physiological and psychological benefits to the woman and the baby for their immediate and lifelong health and development. For all of these reasons, and because cesarean requires the greatest expenditure of resources, cesarean should only be done when medically necessary and other measures of resolving complications are either not possible or have not worked. Research shows that there is little significant improvement in outcomes when the cesarean rate is higher than 7%. Today in the U.S., Canada and many European countries the cesarean rates is 1 in every 3 births. This trend has also hit developing countries, which do not have the resources to make cesarean birth reasonably safe. Cesarean birth is also much more costly, thus wasting their limited resources that are needed elsewhere.

When a country has a cesarean rate of over 30%, the vast majority of those operations are medically unnecessary and are performed on healthy middle and upper class women, not poor women or pregnant teens, the women who are at higher risk for problems in birth.

Current obstetric texts state that the "expected maternal death rate" from vaginal birth is 6 per 100,000.The risk for maternal death from a cesarean is four times higher than for vaginal birth.

One additional fact is that, after several decades of an increase in vaginal births after cesarean (called VBAC), today hospitals are refusing to provide VBAC. With no scientific evidence to justify it, "Once a cesarean, always a cesarean" is again becoming the norm. This is despite the fact that between 75 and 90% of women who have had one or more cesarean births can go on to have a normal vaginal birth. This trend is expected to result in virtually no VBACs in a few years, denying women their right to a normal vaginal birth and causing harm to both mothers and babies by forcing them to have unnecessary cesarean surgery for birth.

Fact:

The cost of birth changes from year to year and also depends upon what the hospital and physicians are paid by the government for providing maternity care to poor women. In 2006 – the most recent year for which figures are available – the average vaginal birth in the U.S. (including prenatal care) cost $8-12,000. The typical cesarean costs $15-20,000. That figure can double when the cesarean is complicated or when the baby when a baby spends any amount of time in a neonatal intensive care unit (NICU). Even when families have insurance that is supposed to cover the cost of birth, they usually leave the hospital with a large bill to pay out-of-pocket.

Myth:

Modern women should not have to endure pain in labor. Anyway, labor pain has no value and the drugs used in labor are safe and have no negative side effects on labor or on the well-being of babies.

Fact:

The normal pain of labor serves an important physiological function. It alerts the woman that labor has begun and that she needs to find a private, undisturbed place to give birth. Natural, normal labor and delivery (physiological birth) foster fiercely protective behavior on the part of the mother, both during labor and when with her baby in the months, especially if she and her baby are not separated after birth. Interfering with this crucial process tends to hinder the mother-infant bond and create worried, anxious, insecure and/or depressed mothers who are less confident in their ability as mothers. When a mother doubts her own ability and judgment she is more likely to look to outside so-called “experts”, rather than paying close attention to what her own signals and her baby's signals are telling her to do. Women whose birth experiences are interfered with through technology and drugs do not produce the proper physiologic balance of hormones that promote love and bonding and relaxation with their babies. Thus modern intervention in birth undermines women’s mothering instincts and pleasure in parenting. While it is possible for women to regain their confidence and trust in themselves and their babies, trust regained is not the same as never having lost it in the first place.

The intensity and pain of contractions, which is experienced by many women, comes from the normal stretching of muscles and tissue. Anxiety and tension resulting from excessive fear simply intensify the pain, make contractions less effective and lengthen labor.

Studies that compared the use of a “doula” (a one-to-one skilled labor companion, usually female) in labor to the use of an epidural anesthesia found that women report as much pain relief with a doula as with the drug!

Any drug and any other toxic substance – including man-made chemicals found in foods and plastics – and the artificial hormones used to stop, induce or speed up labor – that a mother gets in pregnancy, during labor, or while she is breastfeeding will get into her baby's blood stream. Because the newborn baby’s body is physically immature and not capable of eliminating artificial toxic substances, such as drugs, these substances tend to settle in the baby's liver and other cells. Drugs in birth get to the baby in higher proportion than to the mother because of the baby's small size. A recent study of a random series of newborns that took samples of their cord blood found an average of 187 man-made chemicals!

It has also been proven that the drugs used to relieve pain in labor interfere with the female body’s natural ability to release a hormonal “cocktail” that takes the edge off of contractions and provides a sense of euphoria – even ecstasy – during birth. Physiologically it is impossible to artificially diminish or numb the sensation of pain without also diminishing or eliminating the sensation of pleasure. The experience of euphoria, ecstasy or orgasm can only contribute to a woman’s healthy bonding with her baby, even when the birth itself has been long and very challenging for both of them.

One final note: Virtually all women can cope with labor if they have adequate privacy and support and preparation that gives them knowledge, tools, and a positive attitude. Many women who prepare for birth using hypnosis (e.g. Hypnobirthing® ) report that labor did not feel especially painful. There are some women who, even without any special preparation, do not find labor to be painful. There are also some who find the contractions of dilating the cervix and the baby coming down the birth canal to be pleasurable, and some find themselves experiencing orgasm in birth.

Myth:

Epidurals shorten labor, enhance birth, and have no negative effects on mother or baby.

Fact:

Epidural anesthesia usually lengthens labor and carries many common, and some uncommon, but extremely serious, side effects. Epidural frequently causes a rapid drop in the laboring mother's blood pressure, resulting in fetal distress and an emergency cesarean. An epidural frequently makes it difficult for the baby to negotiate its way, leading to it getting “stuck” in the mother's pelvis, and requiring the use of forceps, vacuum extractor or cesarean. Babies whose mothers have had epidurals frequently have a difficult time getting breastfeeding started, which all too often results in the woman quitting breastfeeding and using artificial formula, which is never as beneficial as breastmilk and breastfeeding.

Epidurals can cause a laboring woman to run a fever. Studies show that more than 95% of women who get a fever in labor have had an epidural. The longer the epidural is in place the more likely it is that her temperature will rise. Since a fever in the mother can be a sign of a dangerous infection in the baby, babies born to women who have fevers during labor are routinely sent to the intensive care nursery, where they are usually aggressively treated for possible infection. They get a “septic workup”, which means they must endure frequent, painful blood drawings, often one or more spinal taps, and typically are given full-spectrum antibiotics while their blood is being cultured to determine whether or not they even have an infection. All this is done while the baby is separated from the mother routinely, because the modern neonatal intensive care nursery has yet to be redesigned to care for each mother-baby as one unit.

About 85% of all babies given antibiotics in the neonatal intensive care unit have been born to mothers who had an epidural in labor.

Myth:

Obstetricians are trained to handle complications and therefore should be in charge of all births. No other health worker is sufficiently skilled.

Fact:

Obstetricians are not trained to approach birth as a normal process and have little or no training in providing the education, support and counseling during pregnancy, and the support during labor, that keeps birth safe. The average obstetric training still includes only a day or two on nutrition and no training at all on labor support. Numerous studies show that physicians – especially neonatologists and perinatologists – are best used as back-up technical support for primary care community-based health workers, notably midwives and family physicians.

Most obstetricians do not show up at a birth until the woman is fully dilated and pushing. They usually give their orders over the phone. Because they are not present with a woman during labor, they are more likely to rush to judgment and treat any normal variation that a nurse reports in labor as a crisis that requires immediate intervention, notably cesarean. Because obstetricians are trained to administer drugs and do surgery, they naturally prefer that to normal physiologic birth.

Most insurance companies and HMOs pay more money to the obstetrician for each intervention he or she performs and pay more when a cesarean is done. Juries tend to believe that doing a cesarean proves that a physician has done everything possible for the mother and baby. There is little incentive for using non-interventive labor aids (such as changing a woman’s position in labor or using herbs, acupuncture, homeopathic remedies, aromatherapy and body work) and every incentive to use drugs and surgery for convenience, malpractice protection and personal profit. We must keep in mind the training for physicians focuses almost exclusively on giving drugs and performing surgery.

Myth:

Midwives are not as competent as doctors and need direct supervision by a physician to provide safe care to a birthing woman and baby.

Fact:

Studies repeatedly show that, when midwives attend women throughout pregnancy (providing continuity of care), the rate of premature and low birth weight babies, and the rates of re-admission of babies to hospitals in the year after birth, and infant mortality, is as much as 75% lower than when the same population of women is cared for by physicians. This has been found to be true no matter what the woman's age, education, background or risk level.

Midwives (and, where they exist, physician assistants trained in maternity care) can better provide primary care to mothers and babies and do so at greatly reduced cost, with increased safety and better outcomes. Midwives spend more time with their patients, which translates into more patient education, and a greatly reduced need for hospitalization and expensive (and risky) hi-tech care. The midwifery model of care focuses on prevention of problems and has proven optimal for both positive immediate outcomes and positive long-term outcomes. This is because the midwifery model of care expects, protects and promotes normalcy. The midwifery model, which can be taught to nurses and physicians too, includes training in preventing and treating complications in all sites. It focuses on using the least amount of medical intervention, under the premise: Above all, do no harm. Midwives are trained to be competent in giving emergency first aid care in any setting.

Because the midwife model expects that the birth attendant will be with women throughout labor, birth attendants trained in this model identify problems as soon as they arise. Midwives are trained to observe the laboring woman, to see whether any problem that arises resolves itself and, if not, to do simple interventions, get a medical opinion, transfer the woman to the care of a physician, or transport the woman and baby to a hospital.

The rates of cesarean, epidural and other interventions among patients of midwives practicing in hospital settings, while higher than for midwives attending home births and in birthing centers, is still a fraction of the rate for obstetricians. Midwives attending births at home and in birth centers have the lowest rates of intervention. Most home birth midwives have cesarean rate between 3 and 10%.

There are several different forms of training for midwives. Not all midwives are nurses. “Direct-entry” and other professional midwives are trained in the use of various natural, safe aids (i.e. herbs, homeopathic remedies, aromatherapy and body work) to help keep labor progressing and help women cope with pain. Midwives seldom do episiotomies, preferring to protect a woman's tissues from scissors or serious tears by skillful hands-on care and birthing positions that aid smooth delivery.

Myth:

It does not matter what kind of birth the mother and baby have, so long as the baby and mother appear to be healthy afterward.

Fact:

The long-term health and development of a baby, as well as the health of the mother and family, is directly dependent upon the quality and strength of the mother-baby relationship. Anything that makes their relationship more problematic is a serious personal, family and public health matter. In addition to their physical well-being, a mother and baby need to have the experience of success in birth. Anything that interrupts the natural process, increases stress or results in the baby being separated from the mother after birth (which is more likely when there is intervention in the natural process) can result in birth trauma. A traumatized baby can lose trust in the mother and other care providers and carry a lifelong imprint of anxiety. Trust is crucial to healthy bonding, a healthy self-image, and a healthy curiosity for life.

Myth:

Babies do not have sufficient brain development at birth to remember their birth and are thus not affected by whatever their birth was like, even if it was very difficult. The mother's experience is quickly forgotten by her in the months and years following birth. For these reasons, the kind of birth they have is of little importance in their lives.

Fact:

The experiences that happen to us from in the womb through the first hours after birth set physiological traces in the brain and nervous system that remain with us as definite patterns. For example, leading edge brain research shows: 1) there are likely two different ways memory is stored: things learned under extreme stress and things learned in an ordinary state; 2) the brains of babies and young children who have had too much stress may not know how to turn off the production of survival-based stress hormones for years to come.

A large and growing body of scientific and clinical evidence, from 1990 on, shows that babies do remember their experiences, including the time from conception through birth and until they learn to talk. This memory, which may not be explicitly recalled, is called “implicit” memory. It is stored in the cells of their nervous system and brain. Many adults and some children – especially toddlers – have had spontaneous birth memories, including specific details of things that were said to their mothers during labor and the clothes that the staff wore!

Shocking and traumatic experiences can lead to lasting trauma in babies and also to a pervasive sense of “learned helpless”, which may require special attention and care to heal from. Some trauma in some babies spontaneously resolves itself, especially when there is prolonged breastfeeding and intimate, affectionate and playful connection and stimulation between the mother (or mother-surrogate) and the baby.

A woman's experience of birth relates directly to her sense of competence and confidence as a mother. A mother whose baby has been separated from her at birth is more likely to view her baby as delicate and feel more dependent upon outside experts than her own intuition.

Even at the end of their lives, even when most other memories fade, most women will recall the experiences of their births (except for the parts where they were drugged) with greater vividness and detail than any other life experience. Our birth shapes us.

Myth:

Any caring person can provide a baby with all that he or she most needs.

Fact:

Newborn babies recognize and prefer their own mother's scent and face to anyone else’s. They also prefer their own mother's voice above any other, even in the womb, because hers is what their own heart and ears are calibrated to. Within just days after birth, a baby will choose her own mother’s breastmilk over any other woman’s milk.

A baby’s sense of whether the world is a safe place that can be trusted is largely related to baby’s experiences with his or her own mother. A mother both mirrors the world to her baby – by the expressions on her face, the tone of her voice, the feel of her touch – and is the window to the world outside – by how she treats her baby, how quickly and how tenderly and playfully she interacts with her baby.

The amount of time a mother spends in intimate physical contact with her baby in the days following birth is directly correlated to how confident and compassionate she is as a mother. In various studies, mothers of babies who are closely bonded because of early and prolonged intimate contact respond more quickly and more compassionately to their baby's cries. This difference in mothers has been found to continue for 18 months and longer.

A difficult and "high needs" baby's very survival is dependent upon the strength of its mother bond. The weaker the bond the more likely the mother is to be un-protective, neglectful or abusive when under extreme stress or to permit someone else to harm her child.

References for the above factual data:

Chard, Tim & Richards, Martin, Editors. Benefits & Hazards of the New Obstetrics. William Heinemann Medical Books/JB Lippincott, 1977

Duran, AM. "The safety of home birth: the farm study". Am J Public Health. 1992 Mar; 82(3):450-3

Enkin, M et al. A Guide to Effective Care in Pregnancy and Childbirth, second edition. Oxford University Press, 1995

Goer, H. The Thinking Woman's Guide to a Better Birth. Perigee Press, 1999

Greulich, B et al. "Twelve years and more than 30,000 nurse-midwife-attended births: the Los Angeles County + University of Southern California Women's Hospital Birth Center Experience". J Nurse Midwifery 1994;39(4):185-96

Haire, DB and Elsberry, CC . "Maternity Care and Outcomes in a High-Risk Service: the North Central Bronx Hospital Experience". Birth 1991;18(1):33-37

Harvey, S et al. "A randomized, controlled trial of nurse-midwifery care". Birth 1996;23(3):128-35

Jabaaij, L, et al. "Home births in The Netherlands: midwifery-related factors of influence". J Nurse Midwifery 1996 Sep;12(3):129-35

Klaus, Marshall, MD, Kennell, John, MD & Klaus, Phyllis, CSW, MFCC. Bonding. Addison-Wesley, 1995

MacDorman, MF, Singh, GK, 1998. "Midwifery care, social and medical risk factors, and birth outcomes in the USA". J Epidemiology and Community Health 1998 May;52(5):310-7

Mehl-Madrona, L et al. "Physician and midwife-attended home births. Effects of breech, twin and post-dates outcome data on mortality rates". J Nurse Midwifery 1997, Mar-Apr;42(2):91-8

Rooks, J, CNM Midwifery and Childbirth in America. Temple University Press, 1997

Scott, DB & Tunstall, ME. "Serious Complications Associated with Epidural/Spinal Blockade in Obstetrics: a 2 Year Prospective Study". Int J Obstet Anesth 1995;4:133-9

Spitzer, MC. "Birth Centers. Economy, safety, and empowerment". J Nurse Midwifery 1995 Jul-Aug;40(4):371-5

Wagner, MD. Pursuing the Birth Machine: The Search for Appropriate Technology. Ace Graphics, 1994

World Health Organization. "Appropriate Technology for Birth". Lancet 1985;2(8452):436-7

Suzanne Arms

Suzanne Arms is recognized around the world as an advocate for parents and babies, children and families. Suzanne is the author of seven books, and the director of two films, and is involved in an amazing number of projects surrounding pregnancy, birth and parenthood. She researched, wrote and taught the first course on the Evolution of Childbirth Practices. She is finishing up a one-hour made-for-tv documentary called Birth that will air on PBS soon. She also co-founded one of the first free-standing birth centers in the US, The Birth Place (1978-1998). Suzanne’s complete bio can be found here.