What a HUGE difference in childbirth experiences I had! Being yelled at and ridiculed by Beth Israel labor & delivery staff sent me into panic mode, causing Isadora's delivery to be a wildly scary and thus painful experience. Whereas our son was born in a tub by being breathed down while you played guitar. No fear. No panic. No intense pain. It seems like a simple formula.
I never believed the study that said if you had pitosin it did NOT increase the rate of a C-section. It seems like common sense to me that if you had drugs that increased your contractions and the way the baby was being unnaturally squeezed, that there would be a bigger threat to the baby's health and thus an emergency C-Section would be far more common. Thank you for doing the research and bringing some sanity back into childbirth.
No infant or child should ever be subjected to the utter barbarity of adults taking cutting instruments to his (or her) private parts. "Circumcision" is torture, utter disrespect for nature and the integrity and autonomy of the victim, and, to put it most clearly, "circumcision" is a euphemism for genital mutilation.
I had an amazing (even if long) home delivery of my first child in Brazil with midwives. No pain, just effort. My water never broke and i delivered her in her intact sac. It was so beautiful. Im sure the story would have been so different in a hospital.
Sixty years ago, confident mature intelligent erudite Medical Professionals - such as Dr. Setty - were the Norm in the American Medical System. If, today, confident mature intelligent erudite Medical Professionals were the Norm in the American Medical System, this discussion would be quite different.
Medicalized birthing is usually at the expense of the mothers comfort-- I recently watched an interview about this with Dr. Stu Fischbein-- it sounds more and more like we need to OVERHAUL the entire medical industrialized complex-- get back to natural and compassionate care instead of following "hospital rules & protocols' made for expediency and profit most of the time.
Wow, Madhava! What a wealth of knowledge, reflections, and personal lived experiences on the matter. A friend, who is naturopathic doctor and just experienced a natural birth in her own home, told me recently that the birthing process is fundamentally a parasympathetic experience. In other words, birth tends to unfold most naturally in states of safety, trust, relaxation, surrender, and embodied presence ... not fear, hypervigilance, stress, bright lights, constant monitoring, nervous system activation, and all the concerns you eloquently speak to in this Substack piece.
Yes! We are setting up these poor Moms to "fail". As I noted, there are no doubt situations where our technology is life saving but the overall fear around this event is responsible, in part, leading to bad outcomes.
What a clear-eyed and compassionate witness from inside the system. As a board-certified anesthesiologist, Madhava Setty, MD, is describing how the over-medicalization of childbirth — skyrocketing C-section rates (now nearly 23% overall, quadruple what they were in 1970), routine inductions, and epidurals for 75% of first-time mothers — has quietly robbed so many women of the deep, intuitive, almost magical experience of birth. He contrasts the body’s innate intelligence (the same emergent intelligence that has sustained life for billions of years) with rigid hospital protocols, while still honoring that urgent interventions truly save lives when needed. His personal stories of his wife’s two births — one stressful and intervention-heavy, the other a peaceful, unmedicated Hypnobirthing experience in a tub — make the loss feel immediate and human. This lands right in the heart of the bigger story so many of us are waking up to: ancient evolutionary strategies that once protected us have hardened into anti-evolutionary hierarchies that now work against our well-being. Birth is one of the most visible places where the luminous weight of the chain of being still tries to shine through — a mother and baby co-creating in real time, guided by the same wisdom that has carried trillions of beings forward. I’m linking this post over to a perinatal discussion forum I help steward. It belongs exactly in that conversation. Thank you for naming the “insult to intuition” so gently and clearly. Curious: in your experience as an anesthesiologist, what small shift in the room or in a mother’s own sovereignty has helped restore even a spark of that magic when the system starts to take over?
My relative just birthed her fourth by herself in the back seat of her car (hubby had covered with mattress cover) in the hospital parking lot. She had to calm the panicked staff when they arrived.
This was her best birth w no one intervening.
That started as soon as she got inside though as they panicked their way through her recovery.
It is significantly difficult to have a natural or somewhat natural birth near or inside a hospital (to mitigate emergencies).
Great article! Personally, I’ve been at a loss to reconcile my own experiences with those of my daughters. I had four children, all except the second were born at home. Painful,very, but natural deliveries, no epidurals or pain relief of any kind. (The hormonal ‘high’ after the births was amazing.)
My three daughters, similar build to me, have had five babies between them. One had forceps for the first then ventouse for the second. The second had shoulder dystochia for the first, with forceps etc, and a planned Caesarean for her second. My third daughter had forceps for her delivery. With the exception of the Caesarean, all the births were protracted and highly stressful.
I’ve wondered recently, would the fact that they all had epidurals have affected the babies, and reduced their ability to wiggle themselves into the best position for birth? Hence the need for forceps, ventouse, etc?
I have never regretted insisting on having my babies at home!
Some areas of the world have not lost their traditional midwifery practices. In this tradition, several women often participate in supporting a laboring woman, which can include assisting with physically demanding positions under the guidance of the midwife.
Think about the social cohesion that would arise if every birthing mother was attended by many other women in the community.
As somebody who has given birth, I am not impressed with arguments that the experience is magical, but I would say that moving birth into the operating room has dismantled a fundamental social structure. Sometimes I think this was the real reason the medical profession objected to midwives.
I feel that mothers delivering while laying horizontal doesn’t facilitate the birthing process. I understand (and I’m not an expert but happy to be correct when in error) that gravity has a lot to do with birthing. That the baby’s head needs to press down on the mother’s pelvis and this activates the pelvis doing a remarkable thing - it softens to let the baby out more smoothly. Without that pressure on the pelvis, the bones stay hard so the baby has a harder time and so does mother. It sounds actually like another sadistic thing they put women through that’s probably deliberate like vaccine damage. I had a stillbirth and they gave me drugs (which I normally NEVER take) to expel the 7month old fetus. I don’t know how much time I lost, something like ten hours. Eventually I asked if I could stand up and almost immediately, the fetus slid out. The nurses were so relieved but this needs to be looked at as it causes distress for the baby to come into this world so violently when it could be a simple glide in most cases. Birthing will probably still be painful as the body has to do so much, but I bet it would decrease the hours of labor by a longshot.
Thank you for raising awareness about avoiding over-medicalization of this uniquely significant experience in women's lives. I'm very happy to have birthed my 2 daughters in the early '80's at the Ignaz Semmelweis Klinik, a public maternity hospital in Vienna, Austria, where natural childbirth was emphasized with all the high-tech stuff available in case of emergencies. ;-)
You and Jill are rock stars! Love that Jill trusted herself in the face of questionable medical orthodoxy. So nice to hear about T.’s calm, non-medicalized magical birth. You’re a rock star with amazing expertise and intellectual wattage yet open to nurses, Mickey Mongan and your intuition. Like true Rock Stars, you tap into source that runs counter to orthodoxy. Thanks for thinking, writing and both you guys for being in this world!
I delivered both of mine vaginally. It required rescue cerclage got the first and elective for the second. My first was full blown pre-eclampsia and delivered just shy of 33 weeks. That one is now 14yo, 6'0" and in 8th grade. My my second one was a surprise and got prophylactic tx and delivered with induction at 38 weeks.
What a HUGE difference in childbirth experiences I had! Being yelled at and ridiculed by Beth Israel labor & delivery staff sent me into panic mode, causing Isadora's delivery to be a wildly scary and thus painful experience. Whereas our son was born in a tub by being breathed down while you played guitar. No fear. No panic. No intense pain. It seems like a simple formula.
I never believed the study that said if you had pitosin it did NOT increase the rate of a C-section. It seems like common sense to me that if you had drugs that increased your contractions and the way the baby was being unnaturally squeezed, that there would be a bigger threat to the baby's health and thus an emergency C-Section would be far more common. Thank you for doing the research and bringing some sanity back into childbirth.
Now maybe look into circumcision. 🤯
"Now maybe look into circumcision." THANK YOU!
No infant or child should ever be subjected to the utter barbarity of adults taking cutting instruments to his (or her) private parts. "Circumcision" is torture, utter disrespect for nature and the integrity and autonomy of the victim, and, to put it most clearly, "circumcision" is a euphemism for genital mutilation.
I had an amazing (even if long) home delivery of my first child in Brazil with midwives. No pain, just effort. My water never broke and i delivered her in her intact sac. It was so beautiful. Im sure the story would have been so different in a hospital.
Sixty years ago, confident mature intelligent erudite Medical Professionals - such as Dr. Setty - were the Norm in the American Medical System. If, today, confident mature intelligent erudite Medical Professionals were the Norm in the American Medical System, this discussion would be quite different.
Medicalized birthing is usually at the expense of the mothers comfort-- I recently watched an interview about this with Dr. Stu Fischbein-- it sounds more and more like we need to OVERHAUL the entire medical industrialized complex-- get back to natural and compassionate care instead of following "hospital rules & protocols' made for expediency and profit most of the time.
Wow, Madhava! What a wealth of knowledge, reflections, and personal lived experiences on the matter. A friend, who is naturopathic doctor and just experienced a natural birth in her own home, told me recently that the birthing process is fundamentally a parasympathetic experience. In other words, birth tends to unfold most naturally in states of safety, trust, relaxation, surrender, and embodied presence ... not fear, hypervigilance, stress, bright lights, constant monitoring, nervous system activation, and all the concerns you eloquently speak to in this Substack piece.
Yes! We are setting up these poor Moms to "fail". As I noted, there are no doubt situations where our technology is life saving but the overall fear around this event is responsible, in part, leading to bad outcomes.
What a clear-eyed and compassionate witness from inside the system. As a board-certified anesthesiologist, Madhava Setty, MD, is describing how the over-medicalization of childbirth — skyrocketing C-section rates (now nearly 23% overall, quadruple what they were in 1970), routine inductions, and epidurals for 75% of first-time mothers — has quietly robbed so many women of the deep, intuitive, almost magical experience of birth. He contrasts the body’s innate intelligence (the same emergent intelligence that has sustained life for billions of years) with rigid hospital protocols, while still honoring that urgent interventions truly save lives when needed. His personal stories of his wife’s two births — one stressful and intervention-heavy, the other a peaceful, unmedicated Hypnobirthing experience in a tub — make the loss feel immediate and human. This lands right in the heart of the bigger story so many of us are waking up to: ancient evolutionary strategies that once protected us have hardened into anti-evolutionary hierarchies that now work against our well-being. Birth is one of the most visible places where the luminous weight of the chain of being still tries to shine through — a mother and baby co-creating in real time, guided by the same wisdom that has carried trillions of beings forward. I’m linking this post over to a perinatal discussion forum I help steward. It belongs exactly in that conversation. Thank you for naming the “insult to intuition” so gently and clearly. Curious: in your experience as an anesthesiologist, what small shift in the room or in a mother’s own sovereignty has helped restore even a spark of that magic when the system starts to take over?
How we choose as a culture to give birth has many implications as to how we select to live.
My relative just birthed her fourth by herself in the back seat of her car (hubby had covered with mattress cover) in the hospital parking lot. She had to calm the panicked staff when they arrived.
This was her best birth w no one intervening.
That started as soon as she got inside though as they panicked their way through her recovery.
It is significantly difficult to have a natural or somewhat natural birth near or inside a hospital (to mitigate emergencies).
Great article! Personally, I’ve been at a loss to reconcile my own experiences with those of my daughters. I had four children, all except the second were born at home. Painful,very, but natural deliveries, no epidurals or pain relief of any kind. (The hormonal ‘high’ after the births was amazing.)
My three daughters, similar build to me, have had five babies between them. One had forceps for the first then ventouse for the second. The second had shoulder dystochia for the first, with forceps etc, and a planned Caesarean for her second. My third daughter had forceps for her delivery. With the exception of the Caesarean, all the births were protracted and highly stressful.
I’ve wondered recently, would the fact that they all had epidurals have affected the babies, and reduced their ability to wiggle themselves into the best position for birth? Hence the need for forceps, ventouse, etc?
I have never regretted insisting on having my babies at home!
Some areas of the world have not lost their traditional midwifery practices. In this tradition, several women often participate in supporting a laboring woman, which can include assisting with physically demanding positions under the guidance of the midwife.
Think about the social cohesion that would arise if every birthing mother was attended by many other women in the community.
As somebody who has given birth, I am not impressed with arguments that the experience is magical, but I would say that moving birth into the operating room has dismantled a fundamental social structure. Sometimes I think this was the real reason the medical profession objected to midwives.
I feel that mothers delivering while laying horizontal doesn’t facilitate the birthing process. I understand (and I’m not an expert but happy to be correct when in error) that gravity has a lot to do with birthing. That the baby’s head needs to press down on the mother’s pelvis and this activates the pelvis doing a remarkable thing - it softens to let the baby out more smoothly. Without that pressure on the pelvis, the bones stay hard so the baby has a harder time and so does mother. It sounds actually like another sadistic thing they put women through that’s probably deliberate like vaccine damage. I had a stillbirth and they gave me drugs (which I normally NEVER take) to expel the 7month old fetus. I don’t know how much time I lost, something like ten hours. Eventually I asked if I could stand up and almost immediately, the fetus slid out. The nurses were so relieved but this needs to be looked at as it causes distress for the baby to come into this world so violently when it could be a simple glide in most cases. Birthing will probably still be painful as the body has to do so much, but I bet it would decrease the hours of labor by a longshot.
Thank you for raising awareness about avoiding over-medicalization of this uniquely significant experience in women's lives. I'm very happy to have birthed my 2 daughters in the early '80's at the Ignaz Semmelweis Klinik, a public maternity hospital in Vienna, Austria, where natural childbirth was emphasized with all the high-tech stuff available in case of emergencies. ;-)
Wonderful post! We had our second child at home with midwives, and were very glad that we did it that way.
You and Jill are rock stars! Love that Jill trusted herself in the face of questionable medical orthodoxy. So nice to hear about T.’s calm, non-medicalized magical birth. You’re a rock star with amazing expertise and intellectual wattage yet open to nurses, Mickey Mongan and your intuition. Like true Rock Stars, you tap into source that runs counter to orthodoxy. Thanks for thinking, writing and both you guys for being in this world!
I delivered both of mine vaginally. It required rescue cerclage got the first and elective for the second. My first was full blown pre-eclampsia and delivered just shy of 33 weeks. That one is now 14yo, 6'0" and in 8th grade. My my second one was a surprise and got prophylactic tx and delivered with induction at 38 weeks.