Birth Models That Work: The Netherlands

There was some internet buzz about Birth Models That Work, edited by Robbie Davis-Floyd, and since I wanted to get a copy of Birth as an American Rite of Passage, I went ahead and got them both.

I started the latter book, and am thoroughly enjoying it, so much so that I've broken my cardinal rule about finishing one book before beginning another and dug into Birth Models.

The first birth model described is the one practiced in the Netherlands. Danish midwifery has been a model that American midwives have marveled since the 70's, when the first renaissance of physiologic birth happened in the U.S. One of the primary driving reasons of the why's of birth management in that country is explained by a unique cultural perspective on the role of the birth attendant. The authors of this chapter explain, "In marked contrast to the U.S. [OBs] - who are inclined to heroic interventions, rescuing a laboring woman from protracted pain and life-threatening complication with surgery...or medication - [OB/GYNS] in the Netherlands shun the role of hero... The cultural disinclination toward obstetric heroism is sustained by a system that minimizes competition among [OB/GYNS] and between [OB/GNYS] and midwives. In market systems, [OB/GYNS] have an incentive to sell their 'superiority' as the heros of birth."

A Danish OB was quoted as describing the cultural character of the Netherlands as "emancipated" and "self-assured." Individuals have a culturally-instilled view of themselves as capable, which promotes a healthy sense of "mistrust," a kind of suspicion that proves how much one values oneself and compels one to ask a lot of questions before taking action.

I spoke with a pregnant mom recently who is having her first baby; she explained how happy she was when she was diagnosed with PIH, because suddenly, the quality of care she received was different. "Everyone [at the doctor's office] seems to actually care about me all of the sudden. When I didn't have any problems, no one took any time to explain anything to me."

I asked her, why didn't she ask them to take the time to explain things to her? She replied, "Oh, I ask questions, but sometimes I have to wait until the following office visit to really get answers." When I pointed out that she was often saying how she planned on asking questions at office visits, but put them off till the next visit, and how she'd been hoping to ask a particular question for about six weeks but it had yet to happen, she said, "They're just so busy, you know? That's why I'm happy to have their attention, now!"

This particular mom has also voiced to me her love of medical technology. "It makes me feel safe. I would have an ultrasound every day if I could." When I asked her why, she explained, "When I can see the baby, see him breathe and move, I feel like everything is okay, my baby is doing fine, look at him being active." I asked her if she has any faith in how her body works to grow and protect her baby, and she said she did on some intellectual level, but when a qualified medical professional tells her she and her baby are doing well, it makes more of an impact on how she feels than any self-possessed assurance.

Her deep desire to confirm her health through outer, technological means makes me wonder about her inner faith in herself. From the Netherlands, we have an account in Birth Models which tells us the cultural demeanor of its people is one of self-reliance. Where is the American woman's positive sense of self?