By Angela Bowman
Hansen was surprised by her client’s reaction, “because she had said she was satisfied with the hospital birth.”
Most of the country’s 125 freestanding birth centers operate on the east and west coasts, with an especially high concentration in the southwest and California. New York City has two. These state-licensed facilities–often set up in renovated houses, with about ten beds–follow guidelines developed by the 800-member National Association of Childbearing Centers. Insurance companies recognize them, as does Medicaid. All have collaborative agreements with nearby hospitals, where women and newborns are sent in the event of complications.
To be sure, Illinois tends to be conservative in most medical matters. Some people attribute this to generally conservative midwestern values, others pin it on Chicago’s status as home to the great bastion of the medical establishment, the American Medical Association. In any event, change comes slowly here.
In a standard hospital birth, a woman is kept in bed, or more often on a delivery table, with her feet in stirrups. She gets fluids and often medication through an IV, and the activity of the fetus is electronically monitored through an array of electrodes placed on the mother’s belly. Obstetricians use the monitor in addition to standard criteria such as dilation, timing of contractions, and vital signs to assess the progress of the labor. Women generally receive pain medication, including normal analgesics and epidurals–injections to the base of the spinal cord that numb the patient from the pelvis down. If the practitioner judges that the labor is progressing too slowly, he or she may also administer a labor-inducing drug called pitocin.
Best of Chicago voting is live now. Vote for your favorites »
In the early 1900s, the hospital began its evolution into the locus of medical expertise and learning–in other words, doctors stopped making house calls. Instead, they brought women into the hospitals, where they could follow a more efficient, industrial model of care, and where their tools lay at arm’s reach. In 1926 one doctor compared a laboring woman to a broken-down automobile, himself to a trained mechanic, and the hospital to a garage.
