The hospital my wife first gave birth at were very accommodating with her request. I think education of the individuals is a bigger issue than the hospitals (who have probably send and done all different ways.)
Hospitals are starting to bring midwives and doulas back. Of course, educating women and families about their options and pushing back on inducing labor and c sections would help as well.
They already tried pushing back against c-sections, turns out giving overly opinionated options to women that discourages things that are medically beneficial in a large portion of cases is not helpful and caused a lot of unnecessary suffering and some deaths, now that policy is thankfully long gone, though the opinionated attitude it generated in some continues on sadly.
my wife had a particularly large first baby, natural birth might have worked, but would have been risky, rather than being given unbiased options, she was pressured towards induction over c-section since it was “more natural” (I suspect mostly because it would have looked better in the hospitals stats to keep the c-sections down). The early induction failed after days of suffering (as early inductions usually do, turns out), and then she had a c-section anyway (which having reviewed the options was her original preference, but was pressured out by the doctor), the c-section was vastly more successful, as you’d expect from the statistics (and a lot less suffering, which doesn’t show up in the stats but is obvious once you concider the process).
Im willing to agree neither should be recommended in most cases, natural births are safer in most births, but the best thing anyone can do is give the facts as they apply to the person giving birth (and keep their opinions well out of it).
I fully admit that personal experience has biased me strongly in favour of c-sections, but only when the stats support them, which they often do.
Dr. Atul Gawande† reported 20 years ago how obstetricians standardized on c-sections because the suppposedly-better alternative, forceps, (i) was very difficult to teach and supervise, and (ii) used incorrectly, could result in horrible injuries to both baby and mother:
<QUOTE>
The question facing obstetrics was this: Is medicine a craft or an industry?
If medicine is a craft, then you focus on teaching obstetricians to acquire a set of artisanal skills—the Woods corkscrew maneuver for the baby with a shoulder stuck, the Lovset maneuver for the breech baby, the feel of a forceps for a baby whose head is too big.
You do research to find new techniques.
You accept that things will not always work out in everyone’s hands.
But if medicine is an industry, responsible for the safest possible delivery of millions of babies each year, then the focus shifts.
You seek reliability.
You begin to wonder whether forty-two thousand obstetricians in the U.S. could really master all these techniques.
You notice the steady reports of terrible forceps injuries to babies and mothers, despite the training that clinicians have received.
After Apgar, obstetricians decided that they needed a simpler, more predictable way to intervene when a laboring mother ran into trouble.
They found it in the Cesarean section. [0]
</QUOTE>
(Formatting edited.)
† Surgeon, Rhodes scholar, MacArthur Foundation "genius grant" recipient, professor at Harvard Medical School, author of The Checklist Manifesto among many other things.
If the water actually broke, inducing labor can be important to reduce the risk of infection though, since bacteria can easily get into the amniotic fluid. If the water didn’t break yet, then at least where I live they don’t induce unless you go so much over the expected birth date that there is a high risk you’ll need C-section if you wait more (in Northern Europe they generally don’t offer C-sections unless medically required).
Midwives provide most of the care for most births in hospitals in the UK AFAIK and have done so for decades (certainly where my older daughter was born).
In the U.S. at least the incentives are perverse. Probably what would actually move the needle is a test trial with results showing it's more cost and resource effective
Maybe this is a UK problem? Or the author just doesn't have kids? (and has no experience?)
German hospital beds for giving birth are at a 45 degree angle, which to me looked like a good compromise between "the mother can safely take a nap when she is tired" and "gravity will help you". Also, they have these thingys to put your legs up, so the overall posture is pretty close to squatting. (But with a back rest to prevent you from falling over if you're sleepy.) And modern German hospitals also have a bathtub with handrails to hang from above. And they have chairs with a hole in them. There's like a lot of options to choose from. But the nurses said that, statistically, most women choose the 45-degree-bed anyway. My guess would be because it looks the most comfortable.
> It's usually more dangerous for women to give birth lying down, so why do they? It's all because of a Frenchman who decided it was more convenient – for men.
The first paragraph itself makes me not want to read further.
This article mixes the science with unnecessarily gendered language. It turns "a lying down position helps the doctor" to "men decided women should be on their backs" and "one pervert king liked watching women give birth, therefore somehow that's why".
Can't we just focus on the scientific advantages and not try to shoehorn sexism into everything?
The claim also just doesn't make a lot of sense. So, a king or doctor decided women in France should be made to give birth on their backs a couple hundred years ago. Even if we accept that this would've been enough for a complete shift in how women give birth within France, how does that spread across the world?
I'd be interested in if these claims fit with places where "traditional" births/care systems are more common, i.e. places where births are primarily supported by the elder women of the community rather than formally educated medical professionals. Though, such places are also less likely to be reached by researchers.
>Even if we accept that this would've been enough for a complete shift in how women give birth within France, how does that spread across the world?
France was renowned as being at the frontier of medicine. At least, according to the New Orleans Pharmacy Museum (which I'd recommend visiting for anyone in the area). People around the world looked to it for cutting edge techniques.
Yes, but isn't the "one pervert king liked watching women give birth, therefore somehow that's why" actually correct, so that we should say something like "one pervert king liked watching women give birth and that's why people have done it this very, very silly way"?
I don't really agree, because these kings really had a say and people basically worshiped them. People imitate all sorts of things from how the kings and the courts did things, things like not buttoning the lowest button on their jackets, etc., so I think it may well have had a substantial influence.
knowing and thinking / assuming are two different things. Saying that "that's why people have done it" is simply and categorically wrong.
It is no doubt something that could prove interesting if shared when presenting the research (e.g. I went down this route, find this weird thing here, that unusual story there) but this article does accompany you through that process, it just presents the findings which makes the inclusion of this fact quite questionable.
I think it's useful to drive the point home that there is no good reason to give birth lying down. Otherwise you make it sound like "scientists say you should try this", and not "this was a stupid idea in the first place".
My issue with the article in general is that it undermines its own persuasiveness. It doesn't seem to say "giving birth sitting is better", or even "doctors wanted to have better visibility", but tries to cast it as a story of deliberate male oppression.
It's just unnecessarily divisive to try to turn this into a case of sexism, and I feel it takes away from the scientific angle of the article. Someone might very well dismiss the valid scientific findings as more about gender politics than science. It just doesn't seem to me like there's a need for the gendered slant.
I agree with you. Whenever anyone says "oh this is actually the males doing XYZ" it reduces the persuasiveness.
It reminded me, I'm in an activist parents group and the other day a mom there was arguing that when the media uses the word "parenting" in the context of our focus subject, it's really a manifestation of the patriarchy keeping women oppressed (the implication that dads don't really parent, they just help the moms). There's loonies everywhere.
I don't think it's shoehorned in this case, it's scientific to also look at the historical context and causes.
The article tries to explain two things, what scientifically are the pros/cons of the position, but also tries to explain why it's the default position that is used in most hospitals and have been for a long time now, and if it's true that it's due to either convenience to the men (at the time) physicians, or weird pleasure of the King, than in both cases it would have been "for men".
That said, I'll grant you it doesn't seem to really know what caused the back position to become predominent, it seems more to only mention two possible cause of many more and leaves much to be desired in a thorough root cause, and so it's probably partially thrown in just for better engagement with the article :p
> This article mixes the science with unnecessarily gendered language. It turns "a lying down position helps the doctor" to "men decided women should be on their backs" and "one pervert king liked watching women give birth, therefore somehow that's why".
Looking more into the history of it, I find the "gendered language" to instead be important factual context. It was also not the author who wrote about the king or other "gendered language" things but instead quotes from a birth center founder and a uni professor.
Also, in the article it says "They can thank a French man named François Mauriceau". The King was a possible influence but not "one pervert king liked watching women give birth, therefore somehow that's why". The article says nothing about "a lying down position helps the doctor".
Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending". This is an important tidbit, as the article continues, "(there was already a movement emerging to dispense of midwives and instead have male surgeons present at births)."
The only problem with the "gendered language" is not explaining it further, and probably where the immediate jump to thinking it's "sexism" comes from.
At that time "man-midwives", or people with medical education and the same educational requirements as a surgeon, decided "midwifery" was a great side hustle and created a movement to push traditional midwives out of the birthing process by saying the job required a medical degree, that only men could get. Since men had no idea what the natural process for child birth was, unlike midwives who probably went through it themselves, they decided that having a woman lying down was less work for the people attending. This happened specifically because they were male. The females were pushed out of the birthing process at this time. It went against everything that women had for millennia been doing. It's absolutely important to point that out when trying to give background on why -- all of a sudden -- this natural process was perverted. I don't know how else they could put it other than, it was more convenient (and profitable) for men at the time. And propagated because one guy, who thought of it as an illness, decided he knew better and other doctors decided to listen to him.
> The article says nothing about "a lying down position helps the doctor".
> Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending".
You contradict yourself in the very next sentence.
>> "more convenient for the male physician attending".
> You contradict yourself in the very next sentence.
"helping" a doctor do their function is not the same as being "convenient" for a doctor. Especially in the context of "a lying down position", which makes "helps the doctor" imply a functionally needed assist in the child birth. Being "convenient" is further expanded on in my last paragraph, and it in no way has anything to do with functionally "helping" the child birth.
90% of the article is about the scientific advantages. You've chosen to fixate on the "sexism" part which is, as other commenters pointed out, mainly there to explain why things are done this way today at all. I don't think it's the article that's the problem.
No you're right, the subtitle that says "It's all because of a Frenchman who decided it was more convenient – for men" was definitely me reading between the lines, I can't believe I even attributed a gendered slant.
Pardon me for paying attention to the actual article instead of the subtitle likely written by someone else. And it's not as if you can credibly claim it's not relevant, since the first thing we want to know about any stupid practice is why it got started. So unless you have evidence that it's incorrect, you're just getting offended at... actual facts.
I think you are being a bit hysterical and trying to find an issue where there’s none.
The article is just trying to find an historical explanation on why something so inefficient became norm in modern civilization, there’s no sexism here…
So you think "doctors wanted to see better and didn't think it would hurt anything" and "It's all because of a Frenchman who decided it was more convenient – for men." are equally gender-agnostic?
> Can't we just focus on the scientific advantages and not try to shoehorn sexism into everything.
Why are you trying to destroy journalism ? The guy is trying to make a point and he needed some "metaphors". If he only presents scientific facts, the article will be short and boring. /s
As a woman it will be neat/cute to watch YC men discuss this one. If anyone is really curious how this happened in American (and spread) I highly recommend the book “Born in the USA” by Marsden Wagner.
TL;DR men saw money/opportunity in stealing women’s confidence in their natural and intuitive ability to give birth, built up tools and laws around it, and now we are stuck with a high caesarean AND fatality rate even despite this “progress.”
I went to school to be a hospital midwife until I discovered what a sad racket it is. No wonder we also have high rates of postpartum depression.
I have a first responder friend who helped a guy who wanted to have sex with his cousin, but she wouldn’t unless he got a circumcision, so he chopped his dick off. I personally think he was not using it the way it was meant to be used at two distinct levels:
- you shouldn’t have sex with relatives
- you shouldn’t chop your dick off
The emergency room doctors sewed it back on. Not sure what to think about that.
https://www.campop.geog.cam.ac.uk/blog/2024/09/19/childbirth...
Childbirth was extraordinaly dangerous. 6-8 births per woman and a 1-2% chance of dying per birth for the majority of history.
We have no idea what that was like. Rates today are ~0.013%.
I wonder what it would take to get hospitals to change how women give birth based on this scientific evidence.
The hospital my wife first gave birth at were very accommodating with her request. I think education of the individuals is a bigger issue than the hospitals (who have probably send and done all different ways.)
Hospitals are starting to bring midwives and doulas back. Of course, educating women and families about their options and pushing back on inducing labor and c sections would help as well.
They already tried pushing back against c-sections, turns out giving overly opinionated options to women that discourages things that are medically beneficial in a large portion of cases is not helpful and caused a lot of unnecessary suffering and some deaths, now that policy is thankfully long gone, though the opinionated attitude it generated in some continues on sadly. my wife had a particularly large first baby, natural birth might have worked, but would have been risky, rather than being given unbiased options, she was pressured towards induction over c-section since it was “more natural” (I suspect mostly because it would have looked better in the hospitals stats to keep the c-sections down). The early induction failed after days of suffering (as early inductions usually do, turns out), and then she had a c-section anyway (which having reviewed the options was her original preference, but was pressured out by the doctor), the c-section was vastly more successful, as you’d expect from the statistics (and a lot less suffering, which doesn’t show up in the stats but is obvious once you concider the process). Im willing to agree neither should be recommended in most cases, natural births are safer in most births, but the best thing anyone can do is give the facts as they apply to the person giving birth (and keep their opinions well out of it).
I fully admit that personal experience has biased me strongly in favour of c-sections, but only when the stats support them, which they often do.
Dr. Atul Gawande† reported 20 years ago how obstetricians standardized on c-sections because the suppposedly-better alternative, forceps, (i) was very difficult to teach and supervise, and (ii) used incorrectly, could result in horrible injuries to both baby and mother:
<QUOTE>
The question facing obstetrics was this: Is medicine a craft or an industry?
If medicine is a craft, then you focus on teaching obstetricians to acquire a set of artisanal skills—the Woods corkscrew maneuver for the baby with a shoulder stuck, the Lovset maneuver for the breech baby, the feel of a forceps for a baby whose head is too big.
You do research to find new techniques.
You accept that things will not always work out in everyone’s hands.
But if medicine is an industry, responsible for the safest possible delivery of millions of babies each year, then the focus shifts.
You seek reliability.
You begin to wonder whether forty-two thousand obstetricians in the U.S. could really master all these techniques.
You notice the steady reports of terrible forceps injuries to babies and mothers, despite the training that clinicians have received.
After Apgar, obstetricians decided that they needed a simpler, more predictable way to intervene when a laboring mother ran into trouble.
They found it in the Cesarean section. [0]
</QUOTE>
(Formatting edited.)
† Surgeon, Rhodes scholar, MacArthur Foundation "genius grant" recipient, professor at Harvard Medical School, author of The Checklist Manifesto among many other things.
[0] https://www.newyorker.com/magazine/2006/10/09/the-score
If the water actually broke, inducing labor can be important to reduce the risk of infection though, since bacteria can easily get into the amniotic fluid. If the water didn’t break yet, then at least where I live they don’t induce unless you go so much over the expected birth date that there is a high risk you’ll need C-section if you wait more (in Northern Europe they generally don’t offer C-sections unless medically required).
Yes. Parent comment lacks context for why induced labor and c-sections are supposedly bad.
Midwives provide most of the care for most births in hospitals in the UK AFAIK and have done so for decades (certainly where my older daughter was born).
In the U.S. at least the incentives are perverse. Probably what would actually move the needle is a test trial with results showing it's more cost and resource effective
Mmmm… when they see their profits from medical interventions go down when women start trusting their bodies, they’ll nix that trial STAT.
Maybe this is a UK problem? Or the author just doesn't have kids? (and has no experience?)
German hospital beds for giving birth are at a 45 degree angle, which to me looked like a good compromise between "the mother can safely take a nap when she is tired" and "gravity will help you". Also, they have these thingys to put your legs up, so the overall posture is pretty close to squatting. (But with a back rest to prevent you from falling over if you're sleepy.) And modern German hospitals also have a bathtub with handrails to hang from above. And they have chairs with a hole in them. There's like a lot of options to choose from. But the nurses said that, statistically, most women choose the 45-degree-bed anyway. My guess would be because it looks the most comfortable.
Keep guessing. There are other reasons most women end up in the beds. (I’ve worked L&D and am a woman.)
> It's usually more dangerous for women to give birth lying down, so why do they? It's all because of a Frenchman who decided it was more convenient – for men.
The first paragraph itself makes me not want to read further.
I was curious about the claim so I did a web search for "Roman depiction of birth" and this is the first result:
https://www.worldhistory.org/img/c/p/1200x627/18720.jpg
The mother appears to be sedentary, rather than supine. I doubt I would have noticed that detail had I not read the article.
Might one suggest the Blonsky device https://allthatsinteresting.com/blonsky-device (ianad)
https://www.youtube.com/watch?v=AFNmwFpyB3E&t=7s
This article mixes the science with unnecessarily gendered language. It turns "a lying down position helps the doctor" to "men decided women should be on their backs" and "one pervert king liked watching women give birth, therefore somehow that's why".
Can't we just focus on the scientific advantages and not try to shoehorn sexism into everything?
The claim also just doesn't make a lot of sense. So, a king or doctor decided women in France should be made to give birth on their backs a couple hundred years ago. Even if we accept that this would've been enough for a complete shift in how women give birth within France, how does that spread across the world?
I'd be interested in if these claims fit with places where "traditional" births/care systems are more common, i.e. places where births are primarily supported by the elder women of the community rather than formally educated medical professionals. Though, such places are also less likely to be reached by researchers.
>Even if we accept that this would've been enough for a complete shift in how women give birth within France, how does that spread across the world?
France was renowned as being at the frontier of medicine. At least, according to the New Orleans Pharmacy Museum (which I'd recommend visiting for anyone in the area). People around the world looked to it for cutting edge techniques.
Yes, but isn't the "one pervert king liked watching women give birth, therefore somehow that's why" actually correct, so that we should say something like "one pervert king liked watching women give birth and that's why people have done it this very, very silly way"?
The article explicitly says that we don't know how much he influenced anything, so the mention just seems to be thrown in for the controversy:
> "The influence of the king's policy is unknown, although the behaviour of royalty must have affected the populace to some degree,"
Given that we aren't sure that the king affected anything, mentioning this feels more like editorializing than evidence.
I don't really agree, because these kings really had a say and people basically worshiped them. People imitate all sorts of things from how the kings and the courts did things, things like not buttoning the lowest button on their jackets, etc., so I think it may well have had a substantial influence.
knowing and thinking / assuming are two different things. Saying that "that's why people have done it" is simply and categorically wrong.
It is no doubt something that could prove interesting if shared when presenting the research (e.g. I went down this route, find this weird thing here, that unusual story there) but this article does accompany you through that process, it just presents the findings which makes the inclusion of this fact quite questionable.
I think it's useful to drive the point home that there is no good reason to give birth lying down. Otherwise you make it sound like "scientists say you should try this", and not "this was a stupid idea in the first place".
My issue with the article in general is that it undermines its own persuasiveness. It doesn't seem to say "giving birth sitting is better", or even "doctors wanted to have better visibility", but tries to cast it as a story of deliberate male oppression.
It's just unnecessarily divisive to try to turn this into a case of sexism, and I feel it takes away from the scientific angle of the article. Someone might very well dismiss the valid scientific findings as more about gender politics than science. It just doesn't seem to me like there's a need for the gendered slant.
I agree with you. Whenever anyone says "oh this is actually the males doing XYZ" it reduces the persuasiveness.
It reminded me, I'm in an activist parents group and the other day a mom there was arguing that when the media uses the word "parenting" in the context of our focus subject, it's really a manifestation of the patriarchy keeping women oppressed (the implication that dads don't really parent, they just help the moms). There's loonies everywhere.
I can imagine these two inverse outrages being deployed almost simultaneously:
* "When you call that parenting, you give unearned credit to men who aren't contributing, call it mothering."
* "When you call that mothering, you're letting men escape their duty to contribute, call it parenting."
Some sort of... prescriptive versus descriptive paradox, I bet it can be found in other contexts too.
> and not try to shoehorn sexism into everything
I don't think it's shoehorned in this case, it's scientific to also look at the historical context and causes.
The article tries to explain two things, what scientifically are the pros/cons of the position, but also tries to explain why it's the default position that is used in most hospitals and have been for a long time now, and if it's true that it's due to either convenience to the men (at the time) physicians, or weird pleasure of the King, than in both cases it would have been "for men".
That said, I'll grant you it doesn't seem to really know what caused the back position to become predominent, it seems more to only mention two possible cause of many more and leaves much to be desired in a thorough root cause, and so it's probably partially thrown in just for better engagement with the article :p
> This article mixes the science with unnecessarily gendered language. It turns "a lying down position helps the doctor" to "men decided women should be on their backs" and "one pervert king liked watching women give birth, therefore somehow that's why".
Looking more into the history of it, I find the "gendered language" to instead be important factual context. It was also not the author who wrote about the king or other "gendered language" things but instead quotes from a birth center founder and a uni professor.
Also, in the article it says "They can thank a French man named François Mauriceau". The King was a possible influence but not "one pervert king liked watching women give birth, therefore somehow that's why". The article says nothing about "a lying down position helps the doctor".
Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending". This is an important tidbit, as the article continues, "(there was already a movement emerging to dispense of midwives and instead have male surgeons present at births)."
The only problem with the "gendered language" is not explaining it further, and probably where the immediate jump to thinking it's "sexism" comes from.
At that time "man-midwives", or people with medical education and the same educational requirements as a surgeon, decided "midwifery" was a great side hustle and created a movement to push traditional midwives out of the birthing process by saying the job required a medical degree, that only men could get. Since men had no idea what the natural process for child birth was, unlike midwives who probably went through it themselves, they decided that having a woman lying down was less work for the people attending. This happened specifically because they were male. The females were pushed out of the birthing process at this time. It went against everything that women had for millennia been doing. It's absolutely important to point that out when trying to give background on why -- all of a sudden -- this natural process was perverted. I don't know how else they could put it other than, it was more convenient (and profitable) for men at the time. And propagated because one guy, who thought of it as an illness, decided he knew better and other doctors decided to listen to him.
[0] https://en.wikipedia.org/wiki/François_Mauriceau
> The article says nothing about "a lying down position helps the doctor".
> Mauriceau, who wrote a book "that helped establish obstetrics as science"[0], thought of pregnancy as illness, and that it would be "more convenient for the male physician attending".
You contradict yourself in the very next sentence.
>> "a lying down position helps the doctor".
>> "more convenient for the male physician attending".
> You contradict yourself in the very next sentence.
"helping" a doctor do their function is not the same as being "convenient" for a doctor. Especially in the context of "a lying down position", which makes "helps the doctor" imply a functionally needed assist in the child birth. Being "convenient" is further expanded on in my last paragraph, and it in no way has anything to do with functionally "helping" the child birth.
90% of the article is about the scientific advantages. You've chosen to fixate on the "sexism" part which is, as other commenters pointed out, mainly there to explain why things are done this way today at all. I don't think it's the article that's the problem.
No you're right, the subtitle that says "It's all because of a Frenchman who decided it was more convenient – for men" was definitely me reading between the lines, I can't believe I even attributed a gendered slant.
Pardon me for paying attention to the actual article instead of the subtitle likely written by someone else. And it's not as if you can credibly claim it's not relevant, since the first thing we want to know about any stupid practice is why it got started. So unless you have evidence that it's incorrect, you're just getting offended at... actual facts.
I think you are being a bit hysterical and trying to find an issue where there’s none.
The article is just trying to find an historical explanation on why something so inefficient became norm in modern civilization, there’s no sexism here…
So you think "doctors wanted to see better and didn't think it would hurt anything" and "It's all because of a Frenchman who decided it was more convenient – for men." are equally gender-agnostic?
This is why legacy media keep losing audience and trust.
No, that is because they sanewash trump and republicans constantly.
Not everything is about US domestic politics (although these certainly influence other countries).
> Can't we just focus on the scientific advantages and not try to shoehorn sexism into everything.
Why are you trying to destroy journalism ? The guy is trying to make a point and he needed some "metaphors". If he only presents scientific facts, the article will be short and boring. /s
As a woman it will be neat/cute to watch YC men discuss this one. If anyone is really curious how this happened in American (and spread) I highly recommend the book “Born in the USA” by Marsden Wagner.
TL;DR men saw money/opportunity in stealing women’s confidence in their natural and intuitive ability to give birth, built up tools and laws around it, and now we are stuck with a high caesarean AND fatality rate even despite this “progress.”
I went to school to be a hospital midwife until I discovered what a sad racket it is. No wonder we also have high rates of postpartum depression.
> meant
We're not meant to do anything. It's not like we were consciously designed with a purpose in mind. Do whatever you want.
I have a first responder friend who helped a guy who wanted to have sex with his cousin, but she wouldn’t unless he got a circumcision, so he chopped his dick off. I personally think he was not using it the way it was meant to be used at two distinct levels:
- you shouldn’t have sex with relatives
- you shouldn’t chop your dick off
The emergency room doctors sewed it back on. Not sure what to think about that.
[dead]
[flagged]
[flagged]