A 1988 study comparing labor pain experienced by women in teaching hospitals in the Netherlands and the United States found that the Dutch women did not expect to experience as much pain and used far fewer drugs for pain relief than American women. "There is in Dutch birth participants a deep-seated conviction that the woman's body knows best and that, given enough time, nature will take its course, whereas birth in America was characterized as much more of a 'medical event," noted one of the study's authors. In the Netherlands most women are cared for by midwives, which suggests that women are helped and encouraged in a variety of nondrug pain relief methods; 35 percent of Dutch births still occur at home. As old-fashioned and unscientific as that sounds to many of you, nearly twice as many Dutch babies survive per capita (even after allowing for racial differences) than in the United States.
But we don't live in the Netherlands; we live in medically oriented North America, where birth conjures up much fear and anxiety. And too many laboring women have been told we are going to give you Pitocin (or a cesarean)," which can increase their discomfort and pain, sometimes leading to panic and a body's total shutdown of labor.
Due no doubt in part to stories like this, we found that many of the original 2,000 survey mothers weren't satisfied with their birth experiences. According to the questionnaire responses we've received from readers, most women giving birth in traditional hospitals with obstetricians today still aren't satisfied. (See Chapter 3 for an entirely different reaction from those women who gave birth elsewhere with midwives.)
Although most of you used a variety of tests and procedures during your pregnancy and birth, many also worry about the effects some of these interventions can have on your infant. And the older your child gets, the more critical some of you become. For those of you who had been looking forward to an unmedicated birth, some now feel guilty or defensive about erroneously believing that you "flunked" childbirth because you used drugs for pain relief.
Several dozen of you wrote early on to say that you were interested in organizing surveys or consumer groups. More often than not, those plans changed, and some of you decided to train as childbirth educators or midwives instead.
Perhaps the biggest trend we've seen in reader replies, particularly over the last few years, is the interest in and use of the doula, a woman who offers comfort and support during labor. And if you didn't have one of these compassionate women at your last birth, you plan to the next time.
Your stories have told us that for most of your births hospital routines are remarkably similar in the United States, from California to Maine. We noticed, however, that questionnaire responses show a big jump in the use of midwives in the last few years, and the births they attend are often more individualized. Your letters have also made it clear that your birth preferences can vary from pregnancy to pregnancy.
I had two very different experiences with childbirth. My son (number-one child) was a twenty-seven-week preemie. I am still grateful that the interventions used were available. I feel all were necessary, and I have nothing but praise for the hospital, nurses, doctors, and technologists who contributed to saving our son. Three years later I gave birth to a healthy, full-term baby girl. Same doctors, hospital, nurses, etc. Also some interventions. It was a nightmare. I felt so helpless. I checked myself and my daughter out of the hospital against medical advice thirty-six hours after her birth because of all the interferences.
Just as one woman's Dr. Right is another woman's Dr. Wrong, one woman's good birth experience is another woman's misery.