The Myth of Normal 120

Chapter 11 What Choice Do I Have? Childbirth in a Medicalized Culture At the beginning of the twenty-first century, we have to rehumanize birth, realizing there are limits to our domination of Nature. —Michel Odent[*] Over my decades as a family physician, I attended nearly a thousand deliveries. Standard operating procedure was to perform an episiotomy on every woman giving birth, just as I’d learned in medical school. “Time to make a little cut now,” I would announce as the infant’s head reached the perineum, ready to exit the birth canal. Having injected local anesthetic near the vaginal opening, I would make an incision a few inches long, “catch” the baby, and hand it to the nurse. I then set about repairing the wound I had inflicted. I knew no other way. Years later I happened to learn from some midwives—who, in the Dark Ages of the 1980s, were still working illicitly here in British Columbia—that episiotomies are completely unnecessary in most labors. There was an organic process trying to happen, they kindly explained, which allowed a child to be born without my surgical intervention: Who knew? More surprises followed. Women can, it turns out, deliver babies without their feet in stirrups and even without reclining on a narrow metal contraption. “Try taking a shit while lying down and your legs in the air,” a midwife suggested when I questioned her wisdom. Other startling news was that, barring complications, the newborn is best handed to the mother for skin-to-skin contact, rather than