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July 15th, 2008
Birth of a Surgeon
Video: American Midwives 'Catch Babies' in Hospitals

WIDE ANGLE explores the often misunderstood role of midwives in the U.S. We learn about who they are, what they do and where they practice. While midwives attend births in most of the world, physician-attended births are the norm in the U.S.

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  • allie

    I am dissapointed to see that the angle of this presentation (no pun intended) was to portray midwives in the US as being able to do a C section at a moments notice. As a labor and delivery RN, I am often frustrated with the dynamic of the OB/GYN’s calling all the shots and the Midwives having to check in with them constantly. In many of the countries where the neonatal and maternal mortality rates are the lowest, midwives handle most of the births and OB’s are there on ly if really needed. It is not the same dynamic in those countries as in the US where the physician has all the power and the midwives have to answer to them. Someday hopefully midwives will gain the autonomy in their practice that they deserve and maybe we will begin to see better mortality rates in this country.

  • Sista Vickie

    Give thanks to PBS for viewing this honest and sometimes hard to swallow story on Birth of a Surgeon, maternal mortality, midwifery in the African country of Mozambique. Women in the disapora have to continue to educate, strive for basic human rights, mentor, respect one another if we are to become leaders in our own fields as it is our right. The struggle continues, so we must continue to be strong to fight infant and mother mortality tragedy during childbirth! We need more stories to be told like this one…..Give Thanks!

  • Susanrachel Condon

    I am a homebirth midwife. The tone of the moments you have chosen for this clip seem to center around midwives’ need to be defensive about whether our care is “safe.” We have outstanding statistical outcomes in homebirth without being able to “open the door and say ‘section'” …. and why did you finish the clip with a crying baby in a plastic box and no mother in sight? This image is not indicative of good care; but sadly it represents standard hospital care in this country.

  • Norah McMeeking

    Thought provoking, inspiring, filled with hope and practicality. I wish we could see more like this on television.

  • Eve

    As a mother living in the U.S. and who has had midwifery care throughout all three of my pregnancies and children’s births, I was so happy to see midwives depicted in this positive light. Too many people do not know that midwifery care exists in the U.S. these days and is a great complement to the traditional OB/GYN model of care.

    Midwives are trained, competent and very caring professionals and I am so glad to have known these wise women. I appreciate very much my midwives’ confidence, compassion and skill. Thanks for showing this side of maternal care!

  • Barbara Massey

    I had my baby (Shanti), in a birthing center (an essentially a homey ambience), in Ellsworth Maine. I had a female gynecologist. Back in 1981, at least from the Maine prospective, this was a progressive attitude. Being a feminist (Yes, I know how that sounds.), I was more than happy to put my, and would be baby’s life, in her very capable hands. BIG MISTAKE! In truth, she was no different than a man. Preface this by saying, there was a mid-wife (notice no capitalization?). However, I made the mistake in judgement, assuming the “Doctor” would be the wisest choice. Even though, the mid-wife had no tearing, at birth. It makes me want to be a mid-wife because the pro’s out-weigh the con’s.
    Suffice to say, my doctor didn’t really deliver my child. She merely barked orders, about “push, push, push”, and didn’t ease the baby out, like the many books I had read. Suffice to say, he (Shanti) shot outtome like a rocket, (I never did understand my own strength.) and without the assistance of my lover to catch him, he would have splattered all over the floor! The long story short, I split wide open, from stem to stern. And as she, the “Doctor” was sewing me up, I heard her brag about her “good work”. NOTHING COULD BE FURTHER FROM THE TRUTH! The only advantage that she (or any doctor) can support, is the fact that they can perform a cesarian, and a mid-wife can not. The PBS showing tonight, of the African mid-wives learning the cesarian operation, puts them at a great advantage in the world at large. Bravo! We need more like them. I, for one, would love to be where they are and bring new life into the world, so that mother and child benefit. Not to underscore the importance of doctors. Certainly, they can learn from one of the oldest profession’s of all of humankind. Viva Mid-wifery!

  • Claire R

    I am very disappointed at the excessive and unneeded interventions many of us have experienced in USA OB/GYN practices. I recently miscarried a pregnancy. Prior to the determination of non-viability, more than 8 blood tests were ordered: HIV, Rubella antibody, syphilis, chlamydia, blood type, total blood count, etc. Most of these tests had just been done weeks ago by a reproductive endocrinologist I had been seeing. I had the signed paper in hand to have them faxed over from the specialist. The nurse wanted the tests to be repeated anyway, so the results would be “in the computer system”. This would have wasted hundreds of dollars.

    When it comes to hospital delivery, patients are not informed that a too-early epidural can lead to a cascade of interventions, ending in c-section. And that the deep suctioning after the c-section can interfere with breastfeeding. How many c-sections are done to protect the doctor from liability, not the mother or the baby from harm? A 40% c-section rate is just too high – yet common in many USA hospitals.

    The final waste of health care resources in USA is routine infant circumcision – often suggested to the parents by doctors. Why are doctors willing to preform a cosmetic surgical procedure on infant males, removing normal, healthy tissue and risking outcomes such as meatal stenosis, adhesions, MRSA infection, etc? By the way, the CDC’s own studies show circumcision status has no impact on HIV transmission in high risk USA populations. I know a significant number of adult males who regret their parents “surrogate consent” to infant circumcision.

  • Annette Lewis

    As a midwife working in a very rural America setting for 30 years now, I was glad to see midwifery getting some recognition as positive solution to some dr- shortage problems. But I am saddened to see the US clip of midwives working in hospitals feeling that that setting is the best and safest for mom and baby, for those “just in case we need an emergency c-section” moments. Over the past 30 yeasr I have seen the swing from natural birth to the now highly medicalized approach and American women thinking this is “the best, the gold standard” when really is is fear- driven, and results in many problems. Fear of malpractice, everything going wrong and law suits. While I practice in birth center and out-of hospitals settings, I am glad there are medical facilities for the rare case when intervention is needed. But overall, the basic fact that pregnancy and birth are normal natural events and with mother’s education, compliance and good support, she can usually deliver in a non-medicalized setting with a great outcome. I hope the US someday gets to the point where midwives and out- of- hospital births are the norm, hospitals are there for emergencies, and malpractice is a thing of the past.

  • Kate Paxton

    I am a midwifery student at Columbia University. I wholy agree with the statement from the homebirth midwife above, noting the final clip with the crying infant in a plastic box. This is not midwifery care! These videos concern me because the American College of OB-GYNs recently lobbied the American Medical Association to lobby Congress to introduce legislation to illegalize homebirth! This is a startling movement to limit women’s choices in childbirth. We need to practice intuitive AND evidence-based healthcare. The evidence shows that planned homebirth is a great choice for many women. The evidence also shows that we have a miserable infant mortality rate in this country – one of the highest of all industrialized countries. In a country dominated by over-medicalized childbirth, it is the OB-GYNs who need to prove their safe, effective practices, not the midwives.

  • Brooke

    Thank you, thank you, thank you for this video. This is very accurate to how most midwives operate in the US and the way the two midwives I saw during my pregnancy operate. Like shown in the video, the midwives that I saw during my pregnancy also provide family planning services for women who do not have insurance or are on medical assistance and they deal with issues like domestic violence or other personal issues a woman may be facing. My delivery was performed completely by my midwife. The argument lately that “untrained” “undereducated” midwives should not be performing home births has always bothered me when midwives are the ONLY care available for women who are uninsured in many communities unless complications arise. That was the situation at the clinic I went to, the only places in my community who would even give me an appointment without insurance. I saw a doctor once when I needed to reschedule an appointment. Like woman in the video commented, the doctor checked me, made a comment to the nurse about how the midwives were not doing their job and told me there was no way I would be giving birth by my due date (the reason why I resheduled my appointment). The doctor didn’t take the time to listen to me that my daughter’s head had dropped into my pelvis a full month before and I went into labor the following evening, not two weeks later. So much for doctors better trained and educated.

  • Scott Hickling

    Why have my comments been censured? Not only did I place them here but also at the other broadcast posts that are soliciting comments. If I hear nothing back from this submission directly, within 24 hours, I will cc: our non-profit SIDS org attorney (that I am a member of and do research for upon directors request). I have in no way tried to sell my comments for anything but being my personal opinions without any, ANY, desire for financial gain. Doctors can state their education and associations for validity so why am I not allowed to state my affiliation with a life preserving (post birth) non profit org???

    Please enlighten me or be a minor project of personal freedom outrage..believe this, I will not stop until someone explains this reasonably to me.

  • Donna

    A certified RN midwife told me that when she did a homebirth she wanted the mother within a 25 minute drive of the hospital. She said if there is an emergency during a hospital birth, it could take about 25 minutes for them to be ready to do surgery, so if there is an emergency at a homebirth she could call ahead to the hospital for surgery to be ready. Sounds reasonable to me.

    That heartbreaking scene of the baby crying alone is enough reason for me to prefer homebirth over hospital birth if possible. What a sad symbol.

  • cosima

    There is so much for me to say as both a motherof 3 and a CNM who has worked in europe doing home birth and here in the US doing hospital and brth center birth… but to keep it simple: first as much as this video is too brief to achieve anything really lets just be glad already we are hearing about midwifery. Our numbers are small – but in NM where I practice now, 1/3rd of babies born vaginally are born into the hands of midwives… so perhaps we need to know that midiwifery is more alive than many of you may think. Additionally there is a need to discuss the well woman care aspect of our job which many people have no idea about. And lastly just to say… why end the video with a little baby crying out to be held when we have just stated repeatedly that our philosophy is to be with woman… how about baby?

  • Tina

    After viewing the video it occurs to me that what is needed is balance. In America we have c/section available by trained physicians, if necessary. But many of them are NOT necessary. Home birth/ birth centers are wonderful options for women here with trained midwives who can transport to a medical facility if needed. Yet, in other parts of the world, when women need c/sections there is not enough help. Home birth is the norm. for them. I noticed they performed repeat sections for fear of uterine rupture. I’ve had 6 VBAC’s and know many American women who have also. I wonder if this is just a result of the training there. Do they think it is necessary or do the women really have need for repeated sections due to poor nutrition and/ or weaker scars?
    I am so thankful to live here in the land of opportunities where women can make their own choices.
    I hope more people will reach out to our sisters in crisis in Africa.

  • Ann Davenport

    First of all, “delivery” is for pizza or Chinese food. You don’t “deliver” a baby, the woman GIVES BIRTH. Second, these women are not “your” “patient”…you don’t own them. They are women who choose to have a baby. Third, obstetricians are trained to take a woman’s natural physiological process and turn it into a fear-filled horror story. Sadly, the midwives interviewed here just propagate the medical model, don’t they?

  • REgine Marton

    I think that although this video presents very good professonals and their views about Midwifery, it also reflects a very partial aspect of what a Midwife is and can do.. Completely agree on comments above about excessive concernsin the movie about showing that a midwife is as safe as a physician, that a hospital is the place to be, just in case… there are also tragedies happening in hospitals and nothing will prevent them.
    It is very hard to present an objective and balanced view of births and Midwives in the USA due to the constant dramatization of childbirth in the US media, and I am happy to see that PBS is doing a big effort. This is however not enough and I wish Wide Angle would make a TV segment about birth and Midwives in the US (homebirth, birth centers, hospitals, CNM and CPM) and maybe call Michael Moore, Susan Hodge, Dr Declerc, Ina Mae Gaskin,and others to go deep in the money making reality of hospitals today. The “Business of being Born” already helped due to the mediatic image of Ricky Lake, but we need more documentaries on TV describing and denouncing what a huge market birth has become in this country..

  • Betsy Arnold-Leahy, LM,CNM

    I am a practicing midwife in the United States.
    Sadly as noted by Margaret Chen, care of mothers and babies in the US and the world is not often a priority. In the US, midwives are part of solution to healthy families in a nation with many resources and technology which is often seen as the savior over less interventive methods. This small clip shows the faces of a few of the many midwives in the NY area providing care to women and their families in an environment that is hostile to women taking charge of their bodies and their lives.
    In Mozambique, the midwives are a larger part of the solution in a country with fewer resources.These young women, bravely face a system that does not support them to the point of not being able to provide water or electricity as they save lives.
    Regardless of the site of delivery or assistant, the focus needs to be on the health of mom and baby. While cost, efficiency, are all items to be considered; if we put mom and baby first all things fall into place.
    Fortunately, those of us in the US do not see the shrouded body of a young woman who has succumbed to the dangers inherent in childbirth often. We who stand vigilant at that door are all too aware of those conditions, situations etc we may or may not have control over but must guard against. This healthy awareness can become a paralyzing, proscribing fear in many practitioners and some women during the process. The midwives guidepost to trust the normal process but be vigilant for problems serves us well. When the mother, baby, family, midwife, physician team works together most births are joyous occasions even in the face of untoward events.
    Support of this unit by outside institutions such as governments, insurance agencies, health ministries etc will go a long way to support families and our sister midwives who are brave enough to face whatever obstacles present on a daily basis wherever they may be.

  • Allison May

    Someone PICK UP THAT BABY!!! (what a stressful image!) I am in school to become a CNM, and I actually do feel comfortable knowing that I can order a c-section at a moment’s notice. Sometimes it is necessary (though, I admit, it’s probably less than 5% of the time). I want to do whatever is necessary to ensure the health of the mother and baby. That is why I want to be a midwife – because I believe the midwifery model of care, combined with certain medical interventions when absolutely necessary, are the best way to ensure healthy, normal births for mothers and babies. I had a homebirth with an amazing CPM myself less than 3 years ago, and I love and trust homebirth so much… but it is also wonderful knowing that, in case of emergency, we have the ability to move on to surgical interventions to save lives. However, I completely oppose planned inductions and c-sections that are planed for anything but known risks such as uterine fibroids or cervical problems.

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