I fully admit that personal experience has biased me strongly in favour of c-sections, but only when the stats support them, which they often do.
<QUOTE>
The question facing obstetrics was this: Is medicine a craft or an industry?
If medicine is a craft, then you focus on teaching obstetricians to acquire a set of artisanal skills—the Woods corkscrew maneuver for the baby with a shoulder stuck, the Lovset maneuver for the breech baby, the feel of a forceps for a baby whose head is too big.
You do research to find new techniques.
You accept that things will not always work out in everyone’s hands.
But if medicine is an industry, responsible for the safest possible delivery of millions of babies each year, then the focus shifts.
You seek reliability.
You begin to wonder whether forty-two thousand obstetricians in the U.S. could really master all these techniques.
You notice the steady reports of terrible forceps injuries to babies and mothers, despite the training that clinicians have received.
After Apgar, obstetricians decided that they needed a simpler, more predictable way to intervene when a laboring mother ran into trouble.
They found it in the Cesarean section. [0]
</QUOTE>
(Formatting edited.)
† Surgeon, Rhodes scholar, MacArthur Foundation "genius grant" recipient, professor at Harvard Medical School, author of The Checklist Manifesto among many other things.
Childbirth was extraordinaly dangerous. 6-8 births per woman and a 1-2% chance of dying per birth for the majority of history.
We have no idea what that was like. Rates today are ~0.013%.
The first paragraph itself makes me not want to read further.
German hospital beds for giving birth are at a 45 degree angle, which to me looked like a good compromise between "the mother can safely take a nap when she is tired" and "gravity will help you". Also, they have these thingys to put your legs up, so the overall posture is pretty close to squatting. (But with a back rest to prevent you from falling over if you're sleepy.) And modern German hospitals also have a bathtub with handrails to hang from above. And they have chairs with a hole in them. There's like a lot of options to choose from. But the nurses said that, statistically, most women choose the 45-degree-bed anyway. My guess would be because it looks the most comfortable.
https://www.worldhistory.org/img/c/p/1200x627/18720.jpg
The mother appears to be sedentary, rather than supine. I doubt I would have noticed that detail had I not read the article.
Can't we just focus on the scientific advantages and not try to shoehorn sexism into everything?
I'd be interested in if these claims fit with places where "traditional" births/care systems are more common, i.e. places where births are primarily supported by the elder women of the community rather than formally educated medical professionals. Though, such places are also less likely to be reached by researchers.
France was renowned as being at the frontier of medicine. At least, according to the New Orleans Pharmacy Museum (which I'd recommend visiting for anyone in the area). People around the world looked to it for cutting edge techniques.
> "The influence of the king's policy is unknown, although the behaviour of royalty must have affected the populace to some degree,"
Given that we aren't sure that the king affected anything, mentioning this feels more like editorializing than evidence.
It's just unnecessarily divisive to try to turn this into a case of sexism, and I feel it takes away from the scientific angle of the article. Someone might very well dismiss the valid scientific findings as more about gender politics than science. It just doesn't seem to me like there's a need for the gendered slant.
It reminded me, I'm in an activist parents group and the other day a mom there was arguing that when the media uses the word "parenting" in the context of our focus subject, it's really a manifestation of the patriarchy keeping women oppressed (the implication that dads don't really parent, they just help the moms). There's loonies everywhere.
I don't think it's shoehorned in this case, it's scientific to also look at the historical context and causes.
The article tries to explain two things, what scientifically are the pros/cons of the position, but also tries to explain why it's the default position that is used in most hospitals and have been for a long time now, and if it's true that it's due to either convenience to the men (at the time) physicians, or weird pleasure of the King, than in both cases it would have been "for men".
That said, I'll grant you it doesn't seem to really know what caused the back position to become predominent, it seems more to only mention two possible cause of many more and leaves much to be desired in a thorough root cause, and so it's probably partially thrown in just for better engagement with the article :p
Looking more into the history of it, I find the "gendered language" to instead be important factual context. It was also not the author who wrote about the king or other "gendered language" things but instead quotes from a birth center founder and a uni professor.
Also, in the article it says "They can thank a French man named François Mauriceau". The King was a possible influence but not "one pervert king liked watching women give birth, therefore somehow that's why". The article says nothing about "a lying down position helps the doctor".
Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending". This is an important tidbit, as the article continues, "(there was already a movement emerging to dispense of midwives and instead have male surgeons present at births)."
The only problem with the "gendered language" is not explaining it further, and probably where the immediate jump to thinking it's "sexism" comes from.
At that time "man-midwives", or people with medical education and the same educational requirements as a surgeon, decided "midwifery" was a great side hustle and created a movement to push traditional midwives out of the birthing process by saying the job required a medical degree, that only men could get. Since men had no idea what the natural process for child birth was, unlike midwives who probably went through it themselves, they decided that having a woman lying down was less work for the people attending. This happened specifically because they were male. The females were pushed out of the birthing process at this time. It went against everything that women had for millennia been doing. It's absolutely important to point that out when trying to give background on why -- all of a sudden -- this natural process was perverted. I don't know how else they could put it other than, it was more convenient (and profitable) for men at the time. And propagated because one guy, who thought of it as an illness, decided he knew better and other doctors decided to listen to him.
> Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending".
You contradict yourself in the very next sentence.
>> "more convenient for the male physician attending".
> You contradict yourself in the very next sentence.
"helping" a doctor do their function is not the same as being "convenient" for a doctor. Especially in the context of "a lying down position", which makes "helps the doctor" imply a functionally needed assist in the child birth. Being "convenient" is further expanded on in my last paragraph, and it in no way has anything to do with functionally "helping" the child birth.
The article is just trying to find an historical explanation on why something so inefficient became norm in modern civilization, there’s no sexism here…
Why are you trying to destroy journalism ? The guy is trying to make a point and he needed some "metaphors". If he only presents scientific facts, the article will be short and boring. /s
TL;DR men saw money/opportunity in stealing women’s confidence in their natural and intuitive ability to give birth, built up tools and laws around it, and now we are stuck with a high caesarean AND fatality rate even despite this “progress.”
I went to school to be a hospital midwife until I discovered what a sad racket it is. No wonder we also have high rates of postpartum depression.
We're not meant to do anything. It's not like we were consciously designed with a purpose in mind. Do whatever you want.
- you shouldn’t have sex with relatives
- you shouldn’t chop your dick off
The emergency room doctors sewed it back on. Not sure what to think about that.
