Natural Birth in a Medical World: A Deep Dive into Modern Childbirth
By A Midwestern Doctor (AMD) – 40 Q&As – Unbekoming Summary
Our oligarchs have managed to turn pregnancy—a natural, physiological process—into a “condition,” a “disease.”
A problem only their cartels can solve.
This calculated “disease branding1” has had profound societal implications. Women, once guided by knowledge, intuition, and the hands of skilled midwives, are now conditioned to fear childbirth. That fear is then expertly leveraged by Cartel Medicine, feeding an industry built on intervention, control, and profit.
What was once an event defined by maternal strength and autonomy has been transformed into a rigidly managed, industrialized process—one that too often leads to unnecessary interventions, trauma, and long-term health consequences for both mother and child.
AMD has produced an excellent deep dive into this subject, breaking down how this shift happened, why it persists, and what can be done about it. I’m summarizing and amplifying that work here, as it’s an issue I’ve studied, written about, and continue to follow closely.
Understanding these dynamics isn’t just about questioning medical authority—it’s about reclaiming informed choice, bodily autonomy, and the right to birth without unnecessary and dangerous interference.
With thanks to AMD.
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Analogy
Think of natural childbirth as a mountain stream finding its path to the ocean. The water naturally follows the path of least resistance, adapting to obstacles, changing course when needed, and moving at its own rhythm. This represents how birth naturally progresses when allowed to follow its own course.
Now imagine engineers deciding to "improve" this stream by building a series of locks and channels, like those found in a canal system. They create standardized water levels, control flow rates, and establish strict timing for when water can move through each section. While this system might seem more efficient and controlled, it fundamentally changes the natural flow. The water still reaches its destination, but it requires constant mechanical intervention, uses more energy, and loses the beneficial effects of its natural movement – like oxygenation and the natural filtering that occurs when water flows over rocks and through bends.
Just as the engineered canal system might seem more "advanced" than the natural stream, modern hospital birth protocols often appear more sophisticated than natural birthing practices. However, both the canal and the medical system can create problems they then need to solve – like water stagnation requiring additional pumps in the canal, or medical interventions leading to complications requiring more interventions during birth.
The ideal approach, like the best water management systems, might be one that respects and works with natural processes while maintaining the ability to intervene when truly necessary – similar to how a birthing center provides a natural environment with hospital backup when needed. This balanced approach acknowledges both the wisdom of natural processes and the value of modern medical knowledge when appropriately applied.
12-point summary
Historical Transformation: The medicalization of childbirth in America transformed a natural life event supported by respected midwives into a heavily interventionist medical procedure, driven largely by early 20th-century doctors like Joseph DeLee who viewed natural birth as inherently dangerous. This shift fundamentally altered how society approaches childbirth.
Intervention Cascade: Hospital births often create a "cascade of interventions," where each medical procedure increases the likelihood of requiring additional interventions. For example, continuous fetal monitoring restricts movement, leading to slower labor, which prompts Pitocin use, increasing pain and often resulting in epidurals, potentially culminating in C-sections.
C-Section Impact: The long-term consequences of C-sections extend far beyond recovery time, significantly affecting both mother and child. Research shows increased rates of autoimmune conditions, asthma, diabetes, and obesity in children delivered by C-section, largely due to disruption of the infant microbiome and missing crucial developmental processes during natural birth.
Evidence-Based Practices: Many common hospital interventions, including routine fetal monitoring, immediate cord clamping, and standard birthing positions, persist despite evidence showing they either don't improve outcomes or actually increase complications. For instance, continuous fetal monitoring increases C-section rates by 66% without improving infant outcomes.
Natural Birth Mechanics: The standard hospital birthing position (lying on back) contradicts physiological evidence showing upright positions, particularly squatting, significantly increase pelvic outlet size and utilize gravity. MRI studies demonstrate how traditional positions facilitate easier, more effective labor.
Economic Factors: The cost disparity between birthing options is substantial: hospital births ($10,000-$15,000), C-sections ($15,000-$30,000), and home births ($1,500-$5,000). This pricing structure often influences care decisions more than medical necessity, particularly given insurance coverage limitations for alternative options.
Support Impact: Continuous support during labor, particularly from doulas, significantly improves outcomes. Research shows doula support reduces C-section rates by 25%, shortens labor by 41 minutes, and decreases negative birth experiences by 31%, demonstrating the importance of emotional and physical support during childbirth.
Critical Timing: The immediate post-birth period proves crucial for both mother and infant. Practices like delayed cord clamping and immediate skin-to-skin contact significantly impact long-term health outcomes. Delayed cord clamping increases blood volume by up to one-third and provides vital stem cells, while skin-to-skin contact improves infant development and maternal bonding.
Birth Setting Options: The optimal birth setting varies based on individual circumstances. Birthing centers often provide an ideal middle ground, offering a home-like environment with nearby hospital access. This model, when properly implemented, combines the benefits of natural birth with the security of medical backup.
Pregnancy Preparation: Comprehensive preparation before and during pregnancy significantly impacts outcomes. This includes nutritional supplementation, emotional preparation, and addressing physical health factors. Proper progesterone supplementation, in particular, can dramatically reduce miscarriage risks.
Recovery Methods: Post-birth recovery can be optimized through various approaches beyond standard medical care. Alternative treatments for C-section scars, manual therapy for birth trauma, and specialized support for breastfeeding can significantly improve long-term outcomes for both mother and child.
System Reform Needs: Current birthing practices often prioritize hospital efficiency and standardization over individual needs and evidence-based care. Systemic changes are needed to better integrate natural birthing practices with medical support, improve staffing ratios, and create more flexible care protocols that respect both safety and personal choice.
40 Questions & Answers
Question 1: How did the role of midwives in American childbirth change from colonial times to the early 1900s?
In colonial America, midwives held highly respected positions in their communities, receiving housing, food, land, and salary for their comprehensive services that extended beyond childbirth to include nursing, herbalism, and even veterinary care. During the westward expansion of the 1800s, midwives played a crucial role, particularly in the Mormon migration to Utah, demonstrating their importance to community health and development.
This status dramatically shifted by the early 1900s due to a combination of economic pressures and societal prejudices. Male doctors, who had initially avoided delivering babies, began actively displacing midwives after witnessing the practice's success in Europe. This transition accelerated after influential Harvard professors promoted obstetrics as a way to secure long-term patient relationships, leading to the gradual medicalization of childbirth and diminishment of midwifery's traditional role.
Question 2: What role did Dr. Joseph DeLee play in transforming childbirth into a medical procedure?
DeLee significantly influenced modern obstetrics by establishing Chicago's first obstetric clinic and hospital in 1895, where he developed various medical interventions that helped lower childbirth mortality rates. His observations of complications and deaths led him to view natural childbirth as inherently dangerous, prompting him to advocate for extensive medical intervention in all births, not just complicated ones.
By 1920, DeLee had successfully argued for the routine use of forceps, episiotomy, and toxic anesthetics in most deliveries, despite opposition from colleagues who considered these approaches too aggressive for normal births. His growing influence in the profession and success in incorporating childbirth into medical education resulted in his standardized invasive approaches becoming increasingly popular, particularly as society embraced technological advancement in healthcare.
Question 3: How did the standardization of invasive birthing practices develop in American hospitals?
The standardization of invasive birthing practices emerged primarily through DeLee's influential position in medical education and his success in training numerous doctors in his methods. His approach gained momentum as society became increasingly enamored with technological advancement, leading to widespread adoption of his techniques despite their aggressive nature.
The process accelerated during the 1920s and 1930s when medical schools began incorporating these standardized procedures into their curricula. This standardization was further reinforced by the medical establishment's growing view of childbirth as inherently pathological, requiring medical intervention rather than viewing it as a natural process. This perspective persisted even though maternal death rates were actually highest between 1900-1930, when these practices were becoming standard.
I’ve birthed 10 children vaginally:
First one at a military hospital where they “stripped my membranes” - absolutely the worst experience of the 10. It’s a miracle I was willing to try again, in my naïveté.
2,3 and 4 - traditional hospital birth with epidural. Had weird symptoms after pitocin and hard time dealing with an episiotomy. (or two?)
5, 6, 7, 8 - home births with a midwife. Wonderful, excellent experiences. Sometimes tearing, but no problem stitching up without anesthesia if done quickly - all the blood has been “pushed away” so there is little feeling in the perineum. Baby 8 had a undiagnosed heart defect (only one sono done at 8 weeks) and Down Syndrome, and had to be rushed to ER, but I believe the vaginal home birth saved her life. It is certain, if I had had her in a hospital, they would’ve required a c-section.
9, 10, - had at a birthing center, water births. Absolutely lovely option - most comfortable way I birthed. I was 47 years old with the last one, and was considered “high risk” solely because of age.
Experienced midwives are picky about their clients and I believe that is another reason why homebirths are so safe. If there is an issue with baby’s or mother’s health, they will recommend hospital birth.
Thank you for another fabulous, informative article AMD. You are doing an amazing job!
Question 4: What was the "Midwife Problem" and how did it impact maternal care?
The "Midwife Problem" represented a significant debate in early 20th century healthcare regarding the role of midwives in American maternal care. One faction, primarily doctors, advocated for the complete abolition of midwifery to protect their professional interests and eliminate competition. The opposing side supported proper training and licensing of midwives, recognizing their potential to prevent maternal and infant deaths when properly utilized.
This debate led to varied outcomes across states, with some passing laws to regulate midwifery and establish training schools, while others effectively eliminated the practice. By the 1930s, the increased use of hospitals for deliveries made it possible to close many midwifery schools. However, the debate ultimately contributed to the emergence of nurse midwifery as a profession, particularly through the success of programs like the Frontier Nursing Service, which demonstrated significantly lower maternal death rates than the national average.
Question 5: What factors led to the revival of midwifery in the 1960s and 1970s?
The revival of midwifery resulted from a convergence of social and practical factors. Key professional organizations began endorsing nurse-midwifery, while the rise of feminism and positive media coverage increased public interest. Additionally, the healthcare system faced pressure from the baby boom generation reaching childbearing age, creating demand that existing obstetric services couldn't meet.
This revival was further strengthened by federal funding support and growing public demand for home births supervised by midwives. The increased demand led to the emergence of non-nurse midwives (lay midwives) with varying levels of training, who held their first national meeting in 1977. By the 1980s, nurse-midwives had established themselves throughout the healthcare system, though they faced ongoing resistance from some obstetricians who viewed them as economic competition.
Question 6: What are the typical steps in a standard hospital birth?
In a standard hospital birth, mothers are immediately placed in an unfamiliar environment where they undergo repeated vaginal examinations and are typically positioned on their backs with legs spread. They are connected to fetal heart rate monitoring equipment, either through abdominal sensors or sometimes through intravaginal electrodes attached to the baby's head. If labor progresses slower than hospital protocols dictate, synthetic oxytocin (pitocin) is administered to accelerate contractions.
The process continues with various medical interventions: epidural anesthesia for pain management, possible use of forceps or vacuum extractors if pushing isn't deemed fast enough, and potential episiotomy to widen the vaginal opening. If complications arise during any of these steps, the mother may be moved to have a C-section. After delivery, the cord is typically cut immediately, the baby is separated from the mother for various procedures including vitamin K shots and hepatitis B vaccination, and mother and baby are typically discharged within a few days if no complications arise.
It makes me viscerally sad to see how many people are turning towards surrogate pregnancies, as if the child birthing journey is just a “nuisance” of no importance. I feel like this trend is eroding away at what it means to be human; as the human birthing process, and even more so the human parent-child relationship, is quite unique within the animal kingdom.
Question 7: How does the common hospital birthing position impact labor and delivery?
The standard hospital position of lying on one's back with knees up significantly compromises the natural birthing process. This position effectively closes the pelvis, making it more difficult for the baby to pass through the birth canal. Additionally, MRI studies have shown that squatting positions, in contrast, significantly increase the size of the pelvic outlet, while lying down compresses the sacrum and reduces the ability of the coccyx and pubic symphysis to accommodate the passing baby.
Evidence strongly supports alternative positions, as demonstrated by a study of 2,992 home births where only 8% of mothers chose to deliver lying down. A 2017 Cochrane review found that upright positions decreased abnormal fetal heart rates, accelerated labor, and reduced the need for assisted births or episiotomies. The primary reason for maintaining the supine position in hospitals is that it makes it easier for healthcare providers to manage deliveries and train new staff, suggesting the practice prioritizes provider convenience over optimal birthing conditions.
Question 8: What is the purpose of fetal heart rate monitoring and what does research show about its effectiveness?
Fetal heart rate monitoring aims to detect potential danger to the infant by tracking changes in heart rate that might indicate compromised blood supply. While abnormal heart rates can correlate with various issues, this monitoring has become a cornerstone of obstetric practices and is almost universally implemented in hospital births, particularly as it's easier to monitor when the mother is lying down.
Extensive research, including a 2006 Cochrane review, has consistently shown that continuous fetal heart rate monitoring, when compared to periodic stethoscope examinations, does not reduce infant death or disability. Instead, it increases the likelihood of C-sections by 66% and instrumental births by 16%, primarily due to healthcare providers intervening when they observe abnormal heart rates. This represents a prime example of how medical technology, despite good intentions, can lead to unnecessary interventions without improving outcomes.
Question 9: How does Pitocin affect the labor process and what are its potential complications?
Pitocin, a synthetic form of oxytocin, is frequently administered to either induce labor or accelerate what is deemed a delayed labor. However, when given at excessive doses, which often occurs when natural labor progression is considered too slow by hospital standards, it can create a cascade of complications. The synthetic hormone can trigger contractions before the cervix is ready to open, leading to prolonged labor that may ultimately require C-section intervention, while also causing significantly stronger and more frequent contractions that increase maternal pain and distress.
These artificially intensified contractions can create serious complications, including compression of fetal blood supply leading to abnormal heart rates, increased risk of uterine rupture, and heightened likelihood of perineal tearing due to insufficient time for natural stretching. Research has shown that pitocin-induced labors have a 6% higher risk of postpartum hemorrhage and 46% increase in total postpartum bleeding. Furthermore, higher doses of oxytocin have been linked to a 60% increase in C-section rates, demonstrating how this intervention often leads to additional medical procedures.
I've home-birthed my 7 children, with the assistance of midwives, no drugs and had no problem. That was before giving birth in water was popular. I would have liked to try it.
Question 10: What are the benefits and risks of epidural anesthesia?
Epidural anesthesia, used in 70-75% of hospital births, involves injecting local anesthetic and sometimes opioids into the spine to numb everything below the injection site. While effective for pain management, especially when hospital interventions have made labor more challenging, epidurals carry significant risks including a 75% increase in fetal respiratory depression and reduced maternal blood pressure, with one study finding 41.9% of women experienced significant systemic reactions, including 36.2% developing severe hypotension.
The impact of epidurals on C-section rates remains controversial, with studies showing varying results from no increase to a 2.5-fold increase in C-section likelihood. Additional complications include long-term back pain or headaches from spinal membrane puncture, which while officially reported as rare (around 1%), may be more common based on clinical observations. Perhaps most significantly, epidurals can disconnect mothers from the birth experience by eliminating sensation, potentially affecting their self-esteem and sense of accomplishment in managing labor naturally.
Question 11: Why were episiotomies traditionally performed and what has research revealed about their necessity?
Episiotomies were historically performed in the majority of deliveries based on the mistaken belief that a surgical incision would help mothers by reducing natural tears. The practice was extremely common, with rates reaching 60.9% in 1979, though they declined to 24.5% by 2004 as evidence mounted against routine use. The surgical incision involves cutting the back of the vaginal opening and part of the perineum, followed by suturing after delivery.
Research has revealed significant problems with this intervention. The surgical incision often heals more poorly than natural tears, leading to a range of complications including perineal pain, infections, excessive bleeding, scarring, urinary or fecal incontinence, and sexual dysfunction requiring extended abstinence. The World Health Organization now states that episiotomies are justified in less than 10% of births, making this a prime example of how medical interventions can become standard practice before their risks are fully understood.
Question 12: How do forceps and vacuum extractions affect both mother and infant?
When forceps or vacuum extractions are employed, mothers face significant risks of injury. Approximately 25% of mothers experiencing forceps delivery suffer injuries such as vaginal tears and sphincter damage, with severe complications (3rd or 4th-degree tears) occurring in 8-12% of cases. Vacuum extraction shows similar risks, with 20.9% of mothers experiencing vaginal tears and 2.4% developing postpartum hemorrhages.
For infants, these interventions can cause both immediate and long-term complications. Severe traumas, including nerve injuries, skull fractures, and brain injuries occur in nearly 1% of assisted deliveries. The malleable nature of newborn skulls makes them particularly vulnerable to lasting effects - many adults still show detectable dents from forceps decades later, often accompanied by chronic headaches. While vacuum pumps are generally considered less traumatic than forceps, holistic medical practitioners often find them more problematic for skull development.
Question 13: What is the significance of immediate versus delayed cord clamping?
Immediate cord clamping deprives newborns of vital blood volume and stem cells contained in the placental blood, which are crucial for recovery from birth trauma and ongoing development. Research shows delayed clamping can increase blood volume by up to one-third and significantly boost iron stores essential for early brain development. This practice also reduces the need for transfusions, improves cardiovascular stability, enhances respiratory function, and decreases the risk of brain bleeds and serious intestinal conditions in premature infants.
Despite these benefits, approximately 50% of US hospital births still practice immediate clamping, primarily due to time pressures in busy delivery units. Historical records show cord clamping wasn't practiced until the 1600s, and by 1801, medical authors were warning about its negative impacts on infant health. While modern guidelines now recommend delayed clamping, the optimal delay (waiting until cord pulsation stops completely) often exceeds the brief pause currently allowed in most hospital protocols.
Question 14: What are the short-term surgical risks associated with C-sections?
C-sections, as major surgical procedures, require a significantly longer recovery period (4-6 weeks) compared to vaginal births and carry a global infection rate of 5.63%. During this critical bonding period with the newborn, mothers must manage post-surgical pain while caring for their infant. The procedure also carries risks associated with general anesthesia and potential organ injuries, particularly in emergency situations where speed is prioritized over surgical precision.
Immediate complications specific to C-sections include facial lacerations in 1.5-1.9% of infants during the extraction process. The surgery can also result in damage to the uterine lining, creating adhesions and scars that may complicate future pregnancies. Additionally, the general anesthetics used during the procedure can increase an infant's risk of neonatal complications, while mothers often experience challenges with breastfeeding, disrupted sleep patterns, and emotional difficulties including PTSD or anxiety in the immediate post-surgical period.
Question 15: How do C-sections impact future pregnancies?
C-sections create significant complications for subsequent pregnancies due to the formation of uterine scars. These scars can lead to abnormal placental attachment in future pregnancies, with two prior C-sections increasing the risk of placenta accreta by 13.8 times. This condition occurs when the placenta grows too deeply into the uterine wall, potentially causing severe hemorrhaging during delivery.
The weakened uterine scar from a previous C-section can rupture during subsequent deliveries, particularly if oxytocin is used to induce labor. This risk often results in doctors recommending repeat C-sections for all future births, creating a cycle of surgical deliveries. The situation becomes even more complex if the placental attachment becomes abnormal, further limiting birthing options and increasing risks for both mother and baby in subsequent pregnancies.
Question 16: What long-term health effects have been linked to C-section deliveries?
C-sections have been strongly associated with various chronic immunological conditions. A comprehensive Kaiser study of 8,953 children found C-section delivery increased hay fever by 37% and asthma by 24%, with particularly strong effects in girls. A Danish study of 750,000 children revealed approximately 20% higher rates of several autoimmune conditions, including laryngitis, gastroenteritis, ulcerative colitis, celiac disease, and juvenile arthritis among those delivered by C-section.
Additional research has uncovered metabolic impacts extending into adulthood. A study of 33,226 adult women found those born by C-section were 11% more likely to be obese and 46% more likely to develop type 2 diabetes. These long-term effects appear to be largely connected to disruption of the infant microbiome, as babies delivered by C-section miss exposure to beneficial vaginal flora during birth. This altered bacterial colonization can persist into adulthood, affecting immune system development and metabolic regulation throughout life.
Question 17: How do hospital interventions create a cascade effect requiring additional procedures?
Hospital interventions often initiate a domino effect of medical procedures, each addressing complications created by previous interventions. For example, the use of continuous fetal monitoring restricts mother's movement, often requiring them to labor in suboptimal positions. This can slow labor progress, leading to Pitocin administration. The intensified contractions from Pitocin increase pain, necessitating epidural anesthesia, which can further slow labor and may ultimately result in a C-section.
This cascade exemplifies a broader criticism of medical industry practices, where initial interventions often necessitate additional procedures to manage their side effects. While this pattern typically develops gradually in other medical contexts, the compressed timeframe of childbirth makes these cascading effects particularly visible. This situation is exacerbated by hospital understaffing and liability concerns, which create pressure to accelerate deliveries and follow standardized protocols regardless of individual circumstances.
Question 18: What impact do C-sections have on infant microbiome development?
C-section delivery fundamentally alters an infant's microbiome development by bypassing exposure to maternal vaginal flora during birth. This disruption can persist into adulthood, as the initial colonization of the gastrointestinal tract by beneficial bacteria occurs during vaginal delivery. The timing is crucial because shortly after birth, the stomach begins producing acid, making it more difficult for beneficial bacteria to establish themselves in the digestive system.
Research has demonstrated that this microbiome disruption directly correlates with increased risks of various health conditions. A prospective trial showed that the degree of microbiome alteration in infants delivered by C-section directly predicted their likelihood of developing asthma and allergic sensitivities. While some hospitals have begun exploring vaginal seeding (deliberately exposing C-section babies to maternal vaginal secretions) as a potential solution, this practice isn't yet widely endorsed by the medical community despite promising evidence from recent studies.
Question 19: What are the key differences between hospital births, birthing centers, and home births?
Birthing centers represent a middle ground between hospital and home births, offering a home-like environment with medical support nearby. The optimal model involves a birthing center located close to a partner hospital, with an open-minded obstetrician who reviews all cases and establishes clear criteria for hospital transfers. This arrangement allows most mothers to have peaceful, supported deliveries while ensuring rapid access to emergency care when needed.
Home births provide the most natural and comfortable environment but require careful preparation and qualified support. They typically involve less medical intervention and lower costs ($1,500-$5,000 compared to $10,000-$15,000 for hospital vaginal births). Hospital births offer immediate access to emergency interventions but come with higher rates of medical procedures and a more clinical environment. The key is matching the birth setting to individual risk factors and preferences while ensuring appropriate support and emergency plans are in place.
Question 20: How does continuous support from a doula affect birth outcomes?
Doula support during childbirth has been shown to significantly improve outcomes across multiple measures. A Cochrane review found that continuous support increased spontaneous vaginal birth rates by 8%, reduced C-section rates by 25%, and decreased instrumental vaginal births by 10%. Women with doula support experienced shorter labors (by 41 minutes on average), were 31% less likely to report negative childbirth experiences, and were 7% less likely to require epidurals.
The benefits extend to infant outcomes as well, with babies having a 38% lower chance of low five-minute Apgar scores when doulas are present. Notably, even brief training can make a difference - one study found that giving just two hours of doula training to a woman's friend provided many of the same benefits as professional doula support. This highlights both the crucial importance of continuous support during labor and the potential for improving birth outcomes through relatively simple interventions.
Question 21: What benefits does skin-to-skin contact provide for both mother and infant?
Skin-to-skin contact immediately after birth provides profound healing benefits through both hormonal and energetic mechanisms. For infants, this practice helps regulate vital signs, reduces NICU admissions for low blood sugar by 50%, and improves gut microbiome development. The contact enhances cognitive development, reduces crying, improves sleep duration, and helps develop the emotional capacities of the brain, particularly empathy. Most remarkably, in less affluent countries, skin-to-skin contact has been shown to reduce mortality in low birth weight infants by 25%.
Mothers experience equally significant benefits from this practice. Skin-to-skin contact reduces postpartum PTSD and negative emotions, particularly important for mothers who underwent C-sections. It improves breastfeeding success rates by 24% and extends breastfeeding duration. The practice releases oxytocin, the bonding hormone that creates contentment, trust, and security while reducing anxiety. These benefits extend to fathers who practice skin-to-skin contact, showing reduced anxiety and depression while improving infant vital signs and feeding patterns.
Question 22: How do alternative birthing positions affect the labor process?
Alternative birthing positions, particularly squatting and standing, work with gravity and natural body mechanics to facilitate delivery. MRI studies have demonstrated that squatting significantly increases the size of the pelvic outlet, providing more space for the baby to pass through. Additionally, these positions allow the coccyx and pubic symphysis to move freely, accommodating the baby's passage without the compression that occurs in typical hospital positions.
A 2017 Cochrane review confirmed these benefits, showing that upright positions reduced abnormal fetal heart rates, shortened labor duration, and decreased the need for assisted deliveries or episiotomies. When given the choice, as demonstrated in a study of 2,992 home births, only 8% of mothers chose to deliver lying down, suggesting that women naturally gravitate toward more physiologically advantageous positions when not restricted by hospital protocols. The benefits were further confirmed in a 2020 review that showed considerable reductions in perineal trauma with upright birthing positions.
Question 23: What role do midwives play in modern maternal care?
Modern midwives provide comprehensive care throughout pregnancy, labor, and delivery, operating in various settings from homes to birthing centers and hospitals. They typically offer more personalized attention and fewer interventions than standard hospital care, while maintaining the ability to recognize when medical intervention becomes necessary. Nurse-midwives, in particular, combine medical training with a more natural approach to childbirth, creating a bridge between traditional midwifery and modern medicine.
In the current healthcare landscape, midwives serve as advocates for natural birthing processes while maintaining safety through evidence-based practices. They often work in collaboration with doctors, particularly in birthing centers, where they follow specific protocols for identifying high-risk situations that require hospital transfer. This integrated approach has shown success in achieving lower intervention rates while maintaining safety, though accessibility to midwifery care varies significantly by region and is influenced by state regulations and insurance coverage.
Question 24: What nutritional considerations are most important during pregnancy?
Pregnancy nutrition requires careful attention to both supplement and food choices, with individual needs varying significantly among mothers. The cornerstone supplement for most pregnancies is Standard Process's Biodent, typically needed in doses of 1-10 capsules daily. Additional crucial supplements often include B6 (in the form of P5P), Folate B-12, and in some cases, zinc. These supplements should be carefully monitored and adjusted based on individual responses and needs.
Food sources of nutrients prove particularly important for fat-soluble vitamins. Mothers are advised to consume liver 1-4 times weekly based on their cravings, along with substantial amounts of raw butter (2 tablespoons 1-2 times daily). A well-balanced, preferably organic diet with adequate protein is essential, but it's important to avoid rigid dietary restrictions during pregnancy. Instead, mothers should focus on listening to their body's needs while ensuring adequate nutrition for their developing child.
Question 25: How can mothers prepare their bodies before conception?
Pre-conception preparation involves a comprehensive approach to physical and emotional health. Physical preparation includes regular exercise (particularly swimming when available), adequate sun exposure, and nutritional fortification. Key supplements during this phase typically include Biodent, P5P, Wheat Germ Oil, Folate B-12, and specific nutrients like manganese and zinc. Additionally, fathers often benefit from similar nutritional support, particularly with Biodent, Wheat Germ Oil, and Zinc Liver Chelate.
Emotional preparation proves equally important, with many practitioners recommending work with Emotional Code practitioners to address retained traumatic emotions that could affect pregnancy. The pre-conception period also provides an opportunity to optimize thyroid and progesterone levels, which can significantly impact pregnancy outcomes. Some practitioners recommend carefully timed heavy metal detoxification using low-dose EDTA protocols, though this must be completed well before conception attempts begin to allow for proper mineral repletion.
Question 26: What role does progesterone play in preventing miscarriages?
Progesterone serves as the primary hormone responsible for maintaining pregnancy, and its supplementation through vaginal suppositories has proven highly effective in preventing miscarriages. When properly administered throughout pregnancy, miscarriages become extremely rare unless the fetus is non-viable due to serious defects. The decline in progesterone levels with age directly correlates to increased miscarriage risk in older women, making supplementation particularly crucial for this population.
The recommended protocol typically involves using 1-3 100mg progesterone suppositories twice daily during the first two trimesters, with the exact amount determined by factors including prenatal history, age, adrenal function, and stress levels. This dosage is gradually decreased during the third trimester through a careful weaning process. Critically, abrupt discontinuation must be avoided as progesterone withdrawal can trigger miscarriage, highlighting the importance of proper management throughout pregnancy.
Question 27: What methods exist for turning breech babies?
Several approaches exist for correcting breech presentations, each with its own success rate and methodology. The standard medical procedure, external cephalic version, involves gentle abdominal pressure applied by an obstetrician while monitoring the baby's heart rate. This technique achieves success in approximately half of cases. Alternative methods include acupuncture using specific points in the feet, bodywork focusing on abdominal fascia, and the simple but effective technique of positioning the mother with feet above head while applying ice to the abdomen near the baby's head.
Among these options, the ice pack method offers particular advantages as it relies less on practitioner skill and works with the baby's natural tendency to move away from cold stimuli. However, it's important to note that sometimes babies cannot be turned due to abnormal positioning of their blood supply, which becomes evident through heart rate monitoring during turning attempts. This underscores the importance of careful assessment before attempting any turning procedure.
Question 28: How can common pregnancy complications be addressed naturally?
Pregnancy complications often respond well to natural interventions, particularly those addressing structural changes and fluid retention. For the common issue of ligamentous laxity, regular gentle manipulative treatments can provide significant relief. Edema often responds to supplements like Zeta Aid or AC Carbamide, while back pain frequently stems from psoas muscle compression and can be relieved through specific stretching exercises like lunges.
Pre-eclampsia, a more serious complication, may be related to insufficient uterine blood flow and can often be helped with treatments that improve blood flow, such as Zeta Aid. Magnesium supplementation starting in the second trimester, combined with epsom salt baths, has also shown benefit. However, care must be taken with blood flow enhancement during pregnancy, as pregnancy naturally involves some degree of blood stagnation, and excessive blood thinning could potentially cause complications.
Question 29: How do costs compare between different birthing options?
The financial differences between birthing options prove substantial, with hospital births representing the most expensive choice. A typical hospital vaginal birth costs between $10,000-$15,000 ($2,000-$5,000 with insurance), while C-sections range from $15,000-$30,000 ($3,000-$7,500 with insurance), potentially exceeding $70,000 with complications. In contrast, home births, including complete midwifery care throughout pregnancy, typically cost $1,500-$5,000, with some insurance coverage possible.
This significant cost disparity raises questions about the business model of hospital births and its influence on care decisions. The pricing structure, particularly the fact that cost-effective support from doulas is rarely covered by insurance, suggests a system that prioritizes medical intervention over natural birthing processes. These financial considerations often influence birthing choices, potentially pushing families toward more expensive hospital-based care even when alternatives might be more appropriate for their situation.
Question 30: What role do insurance policies play in birthing choices?
Insurance policies significantly influence birthing choices through coverage limitations and financial incentives. While hospital births typically receive the most comprehensive coverage, alternative options like home births and doula services often face limited or no insurance coverage, despite their demonstrated benefits and cost-effectiveness. This coverage disparity can force families to choose between financial security and their preferred birthing environment.
The structure of insurance coverage also affects the availability and quality of care options. For example, hospitals face pressure to maintain certain intervention rates to satisfy insurance requirements, potentially leading to unnecessary procedures. Additionally, the lack of insurance coverage for preventive services like doula support represents a missed opportunity to improve birth outcomes while reducing costs, highlighting how insurance policies can create barriers to optimal care choices.
Question 31: How does hospital staffing affect birthing interventions?
Hospital staffing levels create direct pressure for increased medical interventions in the birthing process. When obstetricians must simultaneously attend to multiple laboring mothers (often 6-10 patients), they face pressure to artificially sequence and accelerate deliveries to prevent simultaneous births. This staffing constraint leads to increased use of interventions like pitocin to speed up labor and scheduled C-sections to control timing.
The impact of staffing extends beyond direct interventions, affecting the entire birth experience. Limited staff availability reduces the time healthcare providers can spend supporting natural labor progression, leading to standardized protocols that prioritize efficiency over individual needs. This systemic pressure manifests notably in C-section rates, which studies show consistently spike during times when doctors typically want to end their shifts, highlighting how staffing patterns can override medical necessity in determining birth interventions.
Question 32: What are effective methods for treating C-section scars?
C-section scars can create significant chronic issues for women, often persisting for years or decades until properly addressed. Two primary therapeutic approaches have shown particular effectiveness: neural therapy and prolotherapy. Neural therapy involves injecting preservative-free local anesthetic (like lidocaine or bupivacaine) horizontally through the entire scar to reset nerve function, while prolotherapy uses irritating substances to provoke an immune response that remodels the scar tissue.
Treatment typically occurs every 4-6 weeks, with the choice between neural therapy (for minor scars) and prolotherapy (for thicker scars) depending on the specific characteristics of the scar tissue. Some practitioners also successfully incorporate DMSO treatments, though this approach generally proves most effective when combined with professional treatment of the uterine scar. The resolution of scar-related issues often brings relief from numerous chronic symptoms that women may not have realized were connected to their C-section.
Question 33: How can mothers optimize recovery after vaginal birth?
Vaginal birth recovery benefits significantly from alternative approaches to standard ice therapy. DMSO has proven particularly effective when applied to both the abdomen and vaginal area, with practitioners typically recommending 70% concentration for external use around the vagina and on the abdomen. For intravaginal application, a more cautious approach starting with lower concentrations and gradually increasing based on sensitivity (usually finding 50% optimal) helps ensure comfort and effectiveness.
Recovery optimization extends beyond physical treatments to include careful attention to the traditional six-week abstinence period from sexual activity. This healing window allows for proper tissue recovery and can be enhanced with complementary treatments like homeopathic arnica. The key lies in understanding that recovery involves both external and internal healing processes, requiring a comprehensive approach that addresses both immediate comfort and long-term tissue restoration.
Question 34: What approaches help establish successful breastfeeding?
Successful breastfeeding often depends heavily on addressing physical complications from the birth process itself, particularly compression effects on crucial nerves during delivery. Manual therapy, especially cranial sacral therapy or osteopathic manipulation, can effectively resolve these issues by addressing birth-related compressions that affect the infant's ability to nurse. This treatment proves particularly valuable in the early days when the infant's skull remains most moldable.
The establishment of early skin-to-skin contact plays an equally crucial role in breastfeeding success, showing a 24% improvement in breastfeeding initiation and duration. This practice works through multiple mechanisms, including hormone regulation, temperature stabilization, and the development of natural feeding reflexes. The combination of manual therapy when needed and consistent skin-to-skin contact creates optimal conditions for successful breastfeeding initiation and maintenance.
Question 35: How can birth trauma be addressed in infants?
Birth trauma in infants requires careful attention to both immediate and long-term effects, particularly regarding cranial compression during delivery. Manual therapy, especially when provided while the infant's skull remains malleable, can effectively address these compressions and their associated complications. Practitioners of cranial sacral therapy and osteopathy have documented significant improvements in various symptoms through gentle manipulation techniques designed specifically for newborns.
The timing of intervention proves crucial, as early treatment can prevent the development of chronic issues. Practitioners have observed that adults presenting with apparent birth trauma-related issues typically report never having received manual therapy as infants. This observation supports the value of early intervention, even in cases where trauma appears minimal, as the treatment carries minimal risk while offering potential significant long-term benefits in preventing chronic conditions.
Question 36: What criteria should be used to determine if a pregnancy is truly high-risk?
The designation of a "high-risk" pregnancy requires careful evaluation beyond standard medical protocols, as this label often leads to unnecessary interventions. True high-risk factors include placental positioning issues, though early diagnosis through ultrasound can create unnecessary stress as the placenta may naturally correct its position. Multiple pregnancies, previous C-sections, and certain maternal health conditions also warrant increased monitoring, but these factors should be evaluated individually rather than triggering automatic intervention protocols.
The assessment should consider that many standard "high-risk" designations arise from overly cautious interpretations of normal variations in pregnancy. For example, while advanced maternal age or mild variations in fetal measurements might trigger a high-risk designation in many practices, these factors alone don't necessarily predict poor outcomes. The key lies in developing a nuanced understanding of actual risk factors while avoiding the cascade of interventions that often follows a high-risk designation.
Question 37: How can mothers create an effective birth plan?
An effective birth plan requires comprehensive understanding of available options and potential decision points throughout the birthing process. This includes detailed preferences regarding interventions like continuous monitoring, pitocin use, and pain management, as well as specific requests for immediate postpartum care such as delayed cord clamping and skin-to-skin contact. The plan should reflect both ideal scenarios and acceptable alternatives if complications arise.
The preparation process should include identifying and communicating with all potential care providers, ensuring they understand and support the mother's preferences. This includes selecting appropriate advocates who can help maintain the plan's integrity during labor when the mother may be focused on the birthing process. The plan should remain flexible enough to accommodate genuine medical necessities while providing clear guidelines for avoiding unnecessary interventions that could trigger a cascade of additional procedures.
Question 38: What factors should be considered when choosing between home and hospital birth?
The decision between home and hospital birth requires careful evaluation of both medical and personal factors. Medical considerations include the mother's overall health, pregnancy complications, and distance to emergency care facilities. Personal factors encompass comfort level with natural birthing processes, availability of qualified support (midwives and doulas), and home environment suitability. Evidence suggests that for low-risk pregnancies, home births can be as safe as hospital births when properly supported.
Financial considerations also play a role, with home births typically costing significantly less than hospital deliveries. However, the decision should prioritize safety and comfort over cost. A middle-ground option often exists in birthing centers, which provide a home-like environment with proximity to hospital care if needed. The key lies in matching the birth setting to individual circumstances while ensuring appropriate support systems and emergency plans are in place.
Question 39: What emergency preparations should be made for out-of-hospital births?
Emergency preparation for out-of-hospital births requires establishing clear protocols and relationships with nearby medical facilities. This includes identifying the closest hospital with obstetric services, establishing a relationship with an open-minded obstetrician who can serve as a backup, and creating a detailed transfer plan that includes transportation arrangements and necessary documentation. The midwife should have established criteria for identifying situations requiring transfer and maintaining communication with hospital partners.
Practical preparations should include having essential emergency supplies on hand, ensuring all support persons know their roles in an emergency, and maintaining clear communication channels. About 5-10% of planned home births require hospital transfer, making it crucial to have these plans in place while maintaining a calm, supportive environment that doesn't create unnecessary anxiety about potential complications.
Question 40: How can mothers advocate for their preferred birthing choices in a hospital setting?
Effective advocacy in a hospital setting begins with thorough preparation and documentation of birthing preferences. This includes researching hospital policies beforehand, identifying supportive care providers when possible, and creating a clear, concise birth plan that focuses on key priorities. Having a doula or other trained advocate present significantly improves the likelihood of successfully maintaining preferred birthing choices, as they can communicate with medical staff while the mother focuses on labor.
Building a support team proves crucial, including partners, doulas, or midwives who understand the mother's preferences and can maintain diplomatic relationships with hospital staff while advocating for the mother's choices. This team should be familiar with both the mother's priorities and medical terminology to effectively communicate with healthcare providers. Success often depends on finding the balance between maintaining preferred choices and remaining open to necessary medical interventions when truly required.
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Disease Branding: The Strategic Framing of Medical Conditions in Pharmaceutical Marketing
Disease branding, a sophisticated marketing strategy employed by pharmaceutical companies, involves the deliberate redefinition or creation of medical conditions to align with therapeutic solutions. By assigning recognizable names and narratives to previously obscure or poorly understood health issues, this practice aims to shape public and professional perceptions, ultimately driving demand for specific treatments. While proponents argue it enhances disease awareness and reduces stigma, critics condemn it as "disease mongering"—a profit-driven expansion of diagnostic boundaries that pathologizes normal human experiences. This report examines the mechanisms, historical evolution, ethical implications, and real-world applications of disease branding, synthesizing evidence from medical literature, industry case studies, and critical analyses.
Historical Context and Evolution of Disease Branding
Early Foundations in Medicalization
The roots of disease branding extend to the 19th century, when medical professionals began categorizing behaviors and symptoms into diagnosable conditions. For instance, "drapetomania," a pseudo-scientific diagnosis ascribed to enslaved Africans fleeing captivity, exemplifies how medical labels have historically served socio-economic agendas8. Similarly, gout was framed as a "disease of the affluent," reinforcing class hierarchies while justifying therapeutic interventions8. These early instances laid groundwork for modern disease branding by linking medical terminology to cultural narratives.
The 20th century saw pharmaceutical companies adopt systematic approaches to condition framing. Lynn Payer's 1992 critique of "disease mongering" highlighted campaigns like Listerine's rebranding of halitosis (bad breath) from a social nuisance to a medical concern requiring specialized treatment2. This marked a shift toward corporate-driven medicalization, where commercial interests increasingly influenced disease definitions.
The Rise of Direct-to-Consumer Advertising
The 1997 FDA relaxation of direct-to-consumer (DTC) advertising rules in the United States catalyzed disease branding's proliferation. Campaigns for conditions like gastroesophageal reflux disease (GERD) and overactive bladder (OAB) exemplified this trend. By reframing chronic heartburn as GERD, GlaxoSmithKline positioned its H2 blocker Zantac as a superior solution to antacids, emphasizing acid blockade over mere symptom relief1. Similarly, Pfizer's rebranding of urinary incontinence as OAB replaced stigmatizing language with a neutral physiological descriptor, increasing patient willingness to seek treatment15.
Mechanisms of Disease Branding
Strategic Terminology and Acronyms
Effective disease branding relies on memorable terminology that legitimizes conditions while facilitating discreet discussion. For example, premenstrual dysphoric disorder (PMDD) replaced colloquial descriptions like "mood swings" with a clinical acronym, reducing stigma and aligning the condition with serotonin-based therapies like Lilly's Sarafem (a rebranded Prozac)17. Acronyms such as RLS (Restless Legs Syndrome) and ED (erectile dysfunction) similarly create medical shorthand that permeates public and professional discourse15.
Collaborative Framing with Key Opinion Leaders
Pharmaceutical companies often collaborate with physicians and researchers to codify new diagnostic criteria. Workshops and consensus panels, funded by industry, generate "scientifically validated" definitions that later appear in clinical guidelines. For instance, the 1994 World Health Organization panel on osteoporosis—funded partly by drug manufacturers—redefined the condition using bone density thresholds that classified millions of healthy postmenopausal women as "diseased," creating a vast market for bisphosphonates7.
Digital and Social Media Amplification
Modern disease branding leverages digital tools to target specific demographics. SEO-optimized websites, symptom checkers, and social media campaigns disseminate condition-specific content while avoiding direct drug promotion. EmagineHealth's guidelines for disease awareness websites emphasize keyword targeting, patient stories, and partnerships with advocacy groups to enhance credibility6. These campaigns often blur lines between education and indirect marketing, as seen in AstraZeneca's "Transforming Cancer Care" webinars, which highlight unmet needs alignable with the company's oncology portfolio1.
Case Studies in Disease Branding
Gastroesophageal Reflux Disease (GERD)
GlaxoSmithKline's rebranding of chronic heartburn as GERD in the 1980s illustrates how pathophysiological narratives drive therapeutic demand. By emphasizing esophageal sphincter dysfunction over dietary factors, the campaign positioned acid-blocking drugs like Zantac as first-line treatments. Subsequent proton pump inhibitors (PPIs) capitalized on this framing, despite growing evidence of overuse and long-term risks15.
Female Sexual Dysfunction (FSD)
The construction of FSD as a widespread medical condition in the 1990s involved industry-funded surveys claiming 43% prevalence among women. By framing common sexual dissatisfaction as a hormonal imbalance, companies like Pfizer and Boehringer Ingelheim sought to expand markets for testosterone patches and flibanserin. Critical analyses later revealed methodological biases in prevalence studies and undue industry influence on diagnostic criteria78.
Adult Attention Deficit Disorder (Adult ADD)
Initially considered a childhood condition, ADHD's rebranding to include adults in the 2000s opened new markets for stimulants like Shire's Adderall XR. Disease awareness campaigns highlighted underdiagnosis in adults, while pharmaceutical presentations to investors explicitly targeted the "adult market"7. This expansion coincided with a 300% increase in ADHD medication prescriptions between 2000 and 2010, raising concerns about overdiagnosis5.
Ethical and Societal Implications
Medicalization of Normalcy
Critics argue disease branding pathologizes ordinary experiences, transforming life stages like menopause or situational sadness into treatable disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM) expansions—influenced by pharmaceutical funding—exemplify this trend. PMDD, for instance, medicalizes severe premenstrual symptoms despite limited evidence of distinct pathophysiology from PMS17.
Stigma Reduction vs. Disease Creation
While campaigns like OAB successfully reduced shame around urinary incontinence, others exploit stigma to create demand. Requip's promotion of Restless Legs Syndrome (RLS) framed the condition as a legitimate neurological disorder, validating sufferers' experiences but also medicalizing a symptom cluster with unclear diagnostic boundaries15.
Economic Incentives and Resource Allocation
Pharmaceutical companies spend nearly twice as much on marketing as research, prioritizing blockbuster drugs over public health needs5. Disease branding diverts resources toward marginally beneficial treatments for branded conditions, while neglecting rare or unprofitable diseases. Osteoporosis campaigns, for example, prioritized bisphosphonate sales over fracture prevention through nutrition and exercise7.
Regulatory Challenges and Industry Accountability
Loopholes in Direct-to-Consumer Regulations
Many countries prohibit DTC drug ads but allow disease awareness campaigns that indirectly promote products. In the U.S., the FDA's "help-seeking" exemption permits ads describing symptoms without mentioning drugs, enabling campaigns like Pfizer's "Depression Hurts" (which coincided with Zoloft promotions)46.
Conflicts of Interest in Guideline Development
Industry funding of medical associations and guideline panels remains pervasive. A 2009 study found 75% of DSM-IV task force members had financial ties to pharmaceutical companies, raising questions about diagnostic inflation7. Recent reforms, including disclosure requirements, have done little to mitigate these influences.
Grassroots Resistance and Critical Movements
Organizations like Healthy Skepticism and the Cochrane Collaboration advocate for independent disease definitions and treatment evaluations. Public awareness initiatives, such as Ray Moynihan's investigative journalism, highlight industry manipulation of medical science37. However, these efforts struggle against well-funded corporate campaigns.
Conclusion: Balancing Education and Exploitation
Disease branding occupies a contested space between public health education and corporate profiteering. While legitimate campaigns have destigmatized conditions like HIV and depression, the systematic expansion of treatable diagnoses risks harming patients through overmedicalization. Moving forward, transparent collaboration between regulators, clinicians, and patient advocates is essential to distinguish disease awareness from disease mongering. Key steps include:
Stricter Oversight of Disease Awareness Campaigns: Requiring independent review of industry-funded initiatives to ensure balanced messaging.
Decoupling Guideline Development from Industry Influence: Establishing publicly funded panels to define diagnostic criteria.
Promoting Non-Commercial Health Education: Expanding government and NGO-led initiatives on prevention and holistic care.
As biotechnology advances and digital marketing grows more sophisticated, the line between empowering patients and exploiting them will continue to blur. Ensuring ethical disease branding requires vigilance, transparency, and a renewed commitment to prioritizing health outcomes over corporate profits.
Citations:
https://interfaces.com/blog/2010/10/how-to-brand-a-disease-and-sell-a-cure/
https://www.emaginehealth.com/blog/disease-awareness-website-digital-marketing/
https://www.linkedin.com/pulse/what-disease-branding-majgen-dr-bikash-mohanti
All three of my children were born naturally without hospitals or doctors. I had midwives who were ready to call a doctor. If there was an emergency except for my first child we were living in the jungles of Costa Rica took our little boat to town stayed in a little hotel in Golfito got a last-minute midwife and took our little boat back to our farm dirt floor shack, bamboo/bed washing diapers in the stream. It was really quite an idyllic having a baby is the most natural thing in the world. No way I was letting them inject my baby the first day they were born.
I have two kids. the first born in hospital, forced induction because water broke early. involuntary "vitamin k" shot. required a full 24 hour stay in hospital because doctor caused a vaginal tear by forcing pushing too early.
no other inoculations or medical interventions, with the exception of some stitches after a branch fell on her head while we were all swimming in a creek. she was always temperamental from infancy and uncooperative with authority. smart but unwilling to work. didn't get sick any more often than her brother. didn't handle assignments well when home schooled but would eventually do the work correctly after being forced to sit with it for around an hour. juvenile delinquent always getting kicked out of public school. diagnosed as Oppositional Defiant Disorder by the state shrink the school forced us to take her to thinking she was autistic. ran away at 17, quit school to live with a woman who helps local kids get out of the school system without graduating or getting equivalency certificate.
cost thousands and thousands of dollars to the hospital she was born at.
second born at home with midwife. he unfortunately inherited being a bit of a crybaby from me (emotional regulation is hard until you get used to it,) but is otherwise even tempered. hates getting in trouble and goes out of his way to avoid it. cooperates with instructions. super easy to home school. graduated a year early by finishing two required credits at summer school.
he's never once been to a doctor or hospital except when he was accompanying other family going in for diagnostics or treatment. gets the occasional cold. 18 now and working to save money for a fancy college he got partial scholarships to this fall.
cost: assisting the midwife's baby daddy changing a head gasket in his truck so he could learn how to do it. approximate retail value in 2007 of that labor was around $800.
no comparison. the hospital was horrible and cost enough to put a down payment on property. the home birth was cheap barter with no money involved, smooth as butter, and nobody was traumatized.