Monday, October 29, 2012

Call the Midwife: A historical guide to outdated birth practices

Call the Midwife on PBS is not only a well-written show based on a real-life British midwife’s work in the years shortly after WWII in London’s East End. It is also an excellent way to understand the true nature of midwifery, how childbirth has changed, and how it has not. I’ll be posting several pieces about the series as it unfolds.

One thing that is fascinating to me is seeing birth anachronisms – methods and instruments that are no longer used (for good or bad). And Episode One contains a wealth of examples. First, the midwives give mothers enemas. This practice thankfully fell out of favor decades ago. The rationale behind them was that by cleaning out the mom, the baby would have more room to maneuver and help the labor progress more quickly (as well as prevent soiling during labor). The technique was called “high, hot and a hell of lot,” referring to where to hold the container of hot water and how much to use. But enemas can be painful during labor and they were found to be of no benefit.

Episode One also contains a scene with pubic hair shaving, which midwives and doctors used to do in an effort to make the area more antiseptic. However, many studies later revealed that small nicks from shaving actually introduced germs into the mom’s bloodstream and could cause infection, so it is no longer recommended, except sometimes in c-sections. Phew.

Finally, perhaps the most awful of all of the outdated interventions seen in Episode One is the episiotomy – a scene that will make anyone cringe! -- where a cut is made to make the birth opening larger. These were once routine, but again, many scientific studies have debunked the method, showing that introducing a cut could make a mother tear more deeply and have more pain later when she might not tear at all if left alone.


sbee said...

I've been enjoying the show greatly. My thought after watching the first episode was that these NHS nurses actually served an important but unintentional role in helping transition birth to the hospital. They brought more of the tools and procedures - that we've since seen are not helpful - that people came to expect with "modern" care. That first episode especially was an interesting combination of the 'heart' of homebirth midwifery as it's practiced in the US today, and the more invasive techniques that are more routine in the hospital nowadays.

Catherine said...

Thanks so much for this! I love the show and wondered how accurate it is. Even the midwives scoffed at the glass enema tubes! And I can't wait to read your take on the breech birth in a later episode.