The Over-Medicalization of Childbirth and the Role of the Doula
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The process of childbirth has recently come to be seen almost exclusively as a process of pathology in this country. The medicalization of childbirth, while not inherently negative, has nevertheless now reached an unsustainable level, which has negative consequences for mothers and babies. This is best exemplified by the rising rates of surgical births in the US. Over the past 25 years, rates of cesarean section have increased by 136% (World Health Organization [WHO], 2014), to well above the optimal rate of cesarean section at the population level- 9-16% (Betran et al. 2015). In fact, current cesarean rates are more than double those suggestions, at 30.5-32.7% (Zhang et al. 2010; Declercq et al. 2013; Martin et al. 2015). The first strategy to mitigate this over-medicalization is the use of a doula at birth, a supportive companion who is not a friend or loved one, but who is professionally trained to provide labor support (DONA 1998). The benefits of a doula are astounding, especially on the representative measure of medicalization- the cesarean birth. According to a chronology of published literature from over twenty years, having a doula at a birth makes it much less likely to end in a cesarean section (Klaus et al. 1986; Kennell et al. 1991; Scott et al. 1999; Mottil-Santiago et al. 2007; Hodnett et al. 2012). The widespread use of doulas is the first step for the next generation of women to take back birth.