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[narrator] This is a stretch test,
which engineers use
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00:00:10,260 --> 00:00:14,472
to measure the strength and stretchiness
of materials, like rubber.
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00:00:15,640 --> 00:00:18,101
But here,
it's testing something different:
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00:00:18,226 --> 00:00:20,854
tissue from a human cervix.
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00:00:21,980 --> 00:00:25,400
The cervix is the gate
between a woman's uterus and her vagina.
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It blocks anything,
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00:00:27,193 --> 00:00:29,946
-like a penis, from going any further up.
-[whistle blows]
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[narrator] And it stops important things
in the uterus,
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00:00:32,282 --> 00:00:35,368
like a growing fetus,
from coming down too early.
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Think of the uterus like a balloon.
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You blow up the balloon with air.
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You have to keep the air in the uterus
or the baby inside the uterus,
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00:00:42,709 --> 00:00:45,587
and that cervix is the knot
that keeps the uterus closed.
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As an engineer,
what's really struck me about the cervix
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00:00:49,924 --> 00:00:52,177
is that a pregnant specimen in the lab...
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00:00:52,260 --> 00:00:54,679
It just keeps stretching and stretching.
It never breaks.
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[narrator] Over nine months of pregnancy,
the cervix gets five times stretchier.
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When it's soft like the skin on your lips,
it opens up.
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And as you may know from experience
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or from a common TV trope,
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that's usually when...
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Mindy, your water just broke.
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Ah! My water just broke.
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Oh! I'm sitting here in a puddle of water.
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Uh... my water broke.
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Oh, that's cool.
We got another one here in the fridge.
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After the baby comes out,
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this very compliant material
has to remodel and repair itself.
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I don't know
of any other engineering material
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that can soften
or remodel itself that quickly.
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[narrator] Put simply,
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the cervix is an anatomical
and engineering miracle.
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But that doesn't make childbirth itself
any less daunting.
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I'm not really scared. I'm, like...
Yeah, I am nervous.
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[laughs] I'm completely nervous,
like, but it's only
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because this is my first kid,
so I don't really know what to expect.
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[narrator] Around the world,
250 babies are born every minute.
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In hospitals or at home
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00:01:58,034 --> 00:02:00,662
with midwives, doulas, and doctors.
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00:02:01,204 --> 00:02:03,039
Some women use drugs for the pain,
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00:02:03,123 --> 00:02:04,374
some have C-sections
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or use other medical technology.
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And others don't.
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[doctor] Sweetheart, show me what you got.
Ready? Nice deep breath in.
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Breath. And push from your bottom.
You got this.
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00:02:14,175 --> 00:02:15,802
Two, three, four...
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00:02:16,386 --> 00:02:19,722
[narrator] But childbirth still kills
more than 800 women every day
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00:02:19,806 --> 00:02:20,765
around the world.
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And one global survey found that up
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to 30% of women rate childbirth
as traumatic.
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I just remember, like, closing my eyes
and going inside
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into, like, the deepest part of myself
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00:02:32,986 --> 00:02:35,238
to just be like,
"I have to get through this."
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I was, like, really traumatized
for a really long time.
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[narrator]
So, what makes childbirth so hard?
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And what can women do
to have the easiest and safest experience?
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-[woman] You got this.
-[inhales]
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-[theme music playing]
-[moaning]
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[gasps, exhales]
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[narrator 2] The contractions
in true labor
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always have a definite rhythm.
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[narrator 3] You may suddenly wonder
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how the baby can possibly
get through that small opening.
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Don't worry, you'll stretch enough.
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[man]
It is not only pathological knowledge
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which makes the great obstetrician.
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It is vigilance.
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One that does not let you forget you have
in your hands the lives of two people.
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[narrator] Most large primates give birth
in relatively similar fashion.
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The female carries the fetus
in her womb for 30 to 40 weeks,
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00:03:29,500 --> 00:03:31,920
and then the baby emerges
from the birth canal,
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usually headfirst, within hours.
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But there's one key difference:
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humans suffer a lot more.
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It's not like a baby just falls out,
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like some Monty Python sketch,
for non-human primates.
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They do struggle, and still,
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they have a seemingly
much more easy childbirth
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than we have.
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[narrator] Humans labor around nine hours
the first time they give birth
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and often go much longer,
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while most chimps labor
for just two hours.
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And there's one part
of the struggle of childbirth
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that's harder to quantify-- the pain.
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[woman 1] It felt like the bottom half
of my body was gonna explode
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00:04:10,750 --> 00:04:15,046
and erupt goo
all over the four walls of the room.
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00:04:16,089 --> 00:04:18,549
[woman 2] Like you're
in some kind of pain blender,
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00:04:18,633 --> 00:04:20,051
where you're just being spun around,
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00:04:20,134 --> 00:04:23,137
and you don't know what's going on.
It feels like you're being ripped in two.
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00:04:23,638 --> 00:04:25,306
[woman 3] Everything painted red,
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and there's, like, this alarm
that's like... [imitates siren]
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[woman 4] It looked like
I was experiencing an exorcism.
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[narrator] The question of why humans
have painful births comes down
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to anatomy and evolution.
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The theory goes like this:
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Humans, unlike other primates,
evolved to walk on two legs,
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which meant pelvises
became more complicated and narrow.
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Our brains also evolved
to be bigger than other primates',
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which means bigger newborn heads.
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00:04:53,293 --> 00:04:56,421
So chimps get to push out a small head
from wide hips,
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while we're stuck squeezing out
a big baby through a narrow space.
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But why did it stop there?
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Why didn't we keep evolving our anatomy
to make childbirth less painful?
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00:05:06,180 --> 00:05:10,101
Well, why didn't we evolve
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away from painful bowel movements?
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And why didn't we evolve
out of painful breakups?
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[narrator] Natural selection doesn't care
about pain,
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just survival. And even though it hurts...
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[screams]
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...we keep making babies anyway.
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What works, works.
And what's good enough is good enough.
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It's a terribly tight fit.
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It's a painful labor.
It's a long, protracted labor,
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but it works. It's good enough.
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[narrator] So, to continue the survival
of our species,
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women have always been stuck
with difficult childbirths.
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-[doctor] Almost there.
-[Daysha Anthony] How much more?
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00:05:41,716 --> 00:05:44,093
[doctor] Not much more.
One push at a time.
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[narrator] The Old Testament says,
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"With painful labor,
you will give birth to children,"
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00:05:49,307 --> 00:05:51,726
after Eve ate from the Tree of Knowledge.
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And this scroll from 12th-century Japan
shows childbirth as so deadly
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that it attracted evil spirits
who were drawn to near-fatal events.
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That's why so many cultures
throughout history found ways
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00:06:04,322 --> 00:06:06,824
to protect and comfort women
during childbirth...
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00:06:07,408 --> 00:06:10,244
with rituals
and the support of friends and family.
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Women also tried to numb their pain
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with opium and hashish
in the Mediterranean,
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00:06:17,085 --> 00:06:21,130
or in ancient Greece, willow bark,
which is chemically similar to aspirin.
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And scientists invented new tools
and technologies
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to help if the baby got stuck.
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Thanks to medical progress,
childbirth got less deadly over time.
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And one of the biggest areas of progress
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was the Caesarean section.
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C-sections actually originated
thousands of years ago.
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They're referenced
in almost every ancient culture,
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and were performed to save the baby
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when the mother had little
or no hope of surviving labor.
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One of the first known C-sections
where the woman actually survived
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happened in South Africa in 1826,
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performed
by the British surgeon James Barry,
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00:06:58,292 --> 00:07:00,795
who was actually born a female,
Margaret Bulkley.
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00:07:00,878 --> 00:07:03,131
But that wasn't discovered
till after his death.
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00:07:04,382 --> 00:07:06,801
And around the same time,
a medical missionary
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00:07:06,884 --> 00:07:09,595
observed Ugandan doctors
performing C-sections.
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He wrote about one operation
where the mother and baby both survived.
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There was no anesthesia,
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but the woman was liberally supplied
with banana wine.
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In the 20th century,
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C-sections started
to consistently save women's lives.
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And then, birthing technology
really started to pick up.
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Scientists started using pelvic X-rays
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to chart the average length
and rate of labor.
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And for women
who didn't progress fast enough,
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they developed a new drug
to artificially speed it up,
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00:07:42,462 --> 00:07:45,590
called pitocin,
a synthetic form of oxytocin.
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It's a naturally occurring hormone,
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but it floods a woman's body
at three events in her life:
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orgasm, breastfeeding, and labor.
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Pitocin worked so well
that doctors and women
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started scheduling inductions
if a woman went a week over her due date,
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00:08:01,189 --> 00:08:04,442
bringing some certainty
to an otherwise unpredictable event.
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00:08:05,067 --> 00:08:07,904
The history of medical intervention,
when it comes to childbirth,
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has a lot to do with the emergence
of obstetrics as a medical profession.
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[narrator] For most of history,
doctors didn't deliver babies,
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midwives did.
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Women trained in the real world,
through experience and observation.
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00:08:20,583 --> 00:08:24,587
Then in the 1700s in Europe,
midwives opened up schools
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with more official training programs.
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And as waves of European immigrants
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came over to America
in the following century,
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they brought these skills with them
as they settled in the northern states.
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While in the American South,
enslaved black women were forced
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to attend to the deliveries
and care of white children
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and were torn from their own families.
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And they continued working
as skilled midwives
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long after slavery ended.
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They were often referred to
as "granny midwives."
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They tended to be senior,
older members of their community
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00:08:53,866 --> 00:08:56,369
who had themselves already given birth
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and were viewed with respect
among their community.
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[narrator] But in the 1900s,
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doctors started to edge midwives out
of the delivery room,
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00:09:05,253 --> 00:09:06,921
and they made a convincing argument.
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00:09:07,004 --> 00:09:10,591
Birth might look simple.
It may have been going on for centuries.
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00:09:10,675 --> 00:09:16,347
But in fact, it was a pathological event
that requires medical intervention.
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[narrator]
Like a procedure called the episiotomy.
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During birth, it's common
for a woman to tear her vaginal opening.
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Then in the 1920s,
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00:09:24,772 --> 00:09:27,858
doctors started proactively cutting
the opening instead.
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I think the idea was that that would...
that would be easier to sew up.
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00:09:32,697 --> 00:09:35,950
And it turned out that giving people
an episiotomy
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makes the tearing much worse.
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[narrator] And around that same time,
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00:09:39,787 --> 00:09:42,915
Western doctors also started offering
new pain drugs,
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00:09:43,207 --> 00:09:47,003
like one trend that emerged out of Germany
called twilight sleep.
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00:09:47,128 --> 00:09:49,171
It was a mixture of a heavy narcotics:
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00:09:49,255 --> 00:09:51,549
scopolamine and morphine.
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00:09:52,049 --> 00:09:54,844
Extremely controversial
'cause it was really dangerous.
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00:09:54,927 --> 00:09:57,722
Many of the women who were
behind twilight sleep
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00:09:57,805 --> 00:09:59,765
were involved in the suffrage movement.
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00:09:59,849 --> 00:10:01,350
And their argument was
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00:10:01,434 --> 00:10:04,770
that women should have the right to have
a painless childbirth.
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00:10:04,854 --> 00:10:08,107
[narrator] But the drugs didn't actually
get rid of the pain,
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00:10:08,190 --> 00:10:09,942
just the memory of the pain.
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00:10:10,026 --> 00:10:13,988
Women in delivery rooms thrashed violently
and screamed.
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00:10:14,488 --> 00:10:17,950
They were often hooded
or placed in cage-beds while they labored.
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00:10:18,492 --> 00:10:20,745
The birthing experience
differed enormously
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00:10:20,828 --> 00:10:22,371
based on where you lived,
210
00:10:22,455 --> 00:10:24,707
your class background
and the color of your skin.
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00:10:24,790 --> 00:10:29,754
There is a theory that the more civilized
a race or a culture is,
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00:10:29,837 --> 00:10:33,924
the more difficulty the women
have experiencing childbirth.
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00:10:34,008 --> 00:10:37,011
And so, anesthesia was also required
214
00:10:37,094 --> 00:10:39,055
to make sure they could get
through the process.
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00:10:39,138 --> 00:10:41,807
Working-class women, women of color,
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00:10:41,891 --> 00:10:43,684
immigrant women, no problem.
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00:10:43,768 --> 00:10:45,311
Babies could just pop out.
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00:10:45,394 --> 00:10:47,980
It was the over-civilized,
upper-middle-class women
219
00:10:48,064 --> 00:10:49,023
that needed help.
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00:10:49,607 --> 00:10:51,651
[narrator] That stereotype lives on today,
221
00:10:51,734 --> 00:10:53,819
and it's one reason black women
in the UK
222
00:10:53,903 --> 00:10:57,156
are five times more likely
to die in childbirth than white women.
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00:10:57,907 --> 00:11:00,201
And they're three times more likely
in the US,
224
00:11:00,284 --> 00:11:03,120
where disparities exist even
at the same income level.
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00:11:04,080 --> 00:11:06,415
Biggest issue, they're not being heard.
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00:11:06,499 --> 00:11:08,084
When women have said, "I'm in pain,"
227
00:11:08,167 --> 00:11:11,170
the understanding
or stereotype of women of color,
228
00:11:11,253 --> 00:11:13,214
that they're not really in pain
the way they are.
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00:11:13,756 --> 00:11:15,341
[narrator] So back in the 1950s,
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00:11:15,424 --> 00:11:18,010
while many black women
didn't get pain medication
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00:11:18,094 --> 00:11:19,178
even when they needed it,
232
00:11:20,054 --> 00:11:23,849
white women started to speak out
about being over-medicated.
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00:11:23,933 --> 00:11:28,062
In 1958, The Ladies Home Journal
published an investigation,
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00:11:28,312 --> 00:11:30,231
"Cruelty in Maternity Wards,"
235
00:11:30,314 --> 00:11:33,275
"They give you drugs
whether you want them or not
236
00:11:33,567 --> 00:11:34,735
One woman wrote in,
237
00:11:34,819 --> 00:11:37,029
"They give you drugs
whether you want them or not,
238
00:11:37,113 --> 00:11:38,906
and strap you down like an animal."
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00:11:38,989 --> 00:11:43,077
Women start reacting
to what they believe to be
240
00:11:43,160 --> 00:11:46,914
absolutely horrific birth experiences.
241
00:11:46,997 --> 00:11:49,458
They get angry and think
they have missed out
242
00:11:49,542 --> 00:11:53,546
on what should be
the most incredible moment of their lives.
243
00:11:53,629 --> 00:11:56,465
And that somehow
that gets completely lost
244
00:11:56,799 --> 00:11:59,635
in the process of medicalizing birth.
245
00:11:59,719 --> 00:12:01,595
[narrator]
One of the most influential voices
246
00:12:01,679 --> 00:12:02,847
in the grassroots movement
247
00:12:02,930 --> 00:12:06,142
was Ina May Gaskin,
a midwife-turned-activist.
248
00:12:06,642 --> 00:12:09,812
In her 1975 book, Spiritual Midwifery,
249
00:12:10,396 --> 00:12:11,522
she said that when women are
250
00:12:11,605 --> 00:12:14,358
"empowered to birth without drugs
or interventions,"
251
00:12:15,025 --> 00:12:18,362
"birth is a spiritual experience
that each woman deserves
252
00:12:18,446 --> 00:12:20,239
in a safe and comfortable setting."
253
00:12:21,073 --> 00:12:25,619
There were a lot of hippie women involved
in the natural childbirth movement,
254
00:12:25,703 --> 00:12:29,498
but there were
also middle-class suburban housewives.
255
00:12:29,582 --> 00:12:33,127
There were people on all sides
of the political spectrum
256
00:12:33,252 --> 00:12:36,547
that simply thought, "I don't need to be
knocked unconscious
257
00:12:36,630 --> 00:12:37,798
in order to give birth.
258
00:12:37,882 --> 00:12:39,133
I am capable of doing it."
259
00:12:39,216 --> 00:12:43,053
[narrator] And by that time,
there was a hot new drug in town:
260
00:12:43,387 --> 00:12:44,430
epidurals.
261
00:12:44,972 --> 00:12:47,641
Scientists discovered that
injecting anesthesia
262
00:12:47,725 --> 00:12:51,145
into a certain spot in the spine
called the "epidural space"
263
00:12:51,228 --> 00:12:54,482
stopped pain signals traveling
from the spine to the brain.
264
00:12:54,565 --> 00:12:57,485
The entire lower half of a woman's body
265
00:12:57,568 --> 00:13:01,530
would go numb within minutes,
while she remained fully alert.
266
00:13:01,614 --> 00:13:03,491
It was great. It was very nice.
267
00:13:03,574 --> 00:13:04,950
No regrets on the epidural.
268
00:13:05,034 --> 00:13:07,328
I couldn't feel my body
from the waist down.
269
00:13:07,411 --> 00:13:09,163
And I knew at that point,
270
00:13:09,246 --> 00:13:11,999
it was one of the best decisions
I'd ever made in my life.
271
00:13:12,124 --> 00:13:13,250
I-- I was like...
272
00:13:15,085 --> 00:13:19,089
[narrator] The World Health Organization
says epidurals are perfectly safe
273
00:13:19,173 --> 00:13:20,466
for healthy women in labor.
274
00:13:20,800 --> 00:13:24,220
But of course,
half your body is numb so...
275
00:13:24,303 --> 00:13:26,430
The pushing stage of labor tends
to be a bit longer,
276
00:13:26,514 --> 00:13:28,557
maybe, on average,
about-- about 20 minutes.
277
00:13:28,641 --> 00:13:32,436
You have less control over your bladder,
278
00:13:32,520 --> 00:13:35,731
and it may be less easy
to walk around afterwards.
279
00:13:35,815 --> 00:13:39,485
[narrator] Another medical intervention
that's been surging in popularity:
280
00:13:39,568 --> 00:13:40,694
C-sections.
281
00:13:40,778 --> 00:13:43,823
That's how one-fifth of babies
around the world are now delivered,
282
00:13:43,906 --> 00:13:45,908
twice as many as in 2000.
283
00:13:46,450 --> 00:13:49,745
In some countries, they account
for more than half of all births,
284
00:13:49,829 --> 00:13:52,081
like Egypt, the Dominican Republic
285
00:13:52,164 --> 00:13:55,334
and Brazil, where the overall rate is 55%.
286
00:13:55,584 --> 00:13:58,921
But in private hospitals,
where doctors are being paid per service,
287
00:13:59,004 --> 00:14:01,966
not per hours worked, it's 83%.
288
00:14:03,175 --> 00:14:04,218
One study noted,
289
00:14:04,885 --> 00:14:07,596
"Savings in time gained
by cutting labor short
290
00:14:07,680 --> 00:14:11,392
may motivate obstetricians
to choose a cesarean delivery."
291
00:14:12,351 --> 00:14:15,229
And while the maternal mortality rate
is lower
292
00:14:15,312 --> 00:14:17,523
in countries that perform more C-sections,
293
00:14:17,606 --> 00:14:20,860
that's only true up to a C-section rate
at 19%.
294
00:14:21,777 --> 00:14:23,821
Above that, it doesn't make a difference,
295
00:14:23,904 --> 00:14:27,283
suggesting a lot of C-sections
are medically unnecessary.
296
00:14:27,408 --> 00:14:29,952
Women who have had a C-section
on one pregnancy are
297
00:14:30,035 --> 00:14:32,997
at higher risk for complications
in later pregnancies,
298
00:14:33,080 --> 00:14:36,041
including higher risks of miscarriage
and even stillbirth.
299
00:14:36,625 --> 00:14:39,587
[narrator] Natural birth advocates
say unnecessary C-sections
300
00:14:39,670 --> 00:14:43,007
are a result of messing with a woman's
natural rhythm of labor,
301
00:14:43,132 --> 00:14:47,219
a concept now known
as the "cascade of interventions."
302
00:14:47,303 --> 00:14:51,557
I "consented" to this emergency C-section
303
00:14:51,640 --> 00:14:55,394
due to, in my records, fetal distress
because of the heart rate monitor.
304
00:14:55,477 --> 00:14:58,230
We'll see babies have
fetal heart rate changes,
305
00:14:58,314 --> 00:15:00,274
particularly after getting an epidural.
306
00:15:00,900 --> 00:15:04,236
[narrator] And epidurals tend
to follow pitocin because...
307
00:15:04,320 --> 00:15:07,072
As they started increasing my dosage,
308
00:15:07,156 --> 00:15:11,327
I started having really,
really painful contractions.
309
00:15:11,410 --> 00:15:13,162
[narrator]
Pitocin can help when a woman's cervix
310
00:15:13,245 --> 00:15:14,914
isn't opening up fast enough.
311
00:15:14,997 --> 00:15:16,916
And so they upped my pitocin,
312
00:15:16,999 --> 00:15:19,084
which I needed
because I hit my due date
313
00:15:19,168 --> 00:15:20,794
and I still hadn't gone into labor.
314
00:15:20,878 --> 00:15:24,673
You know, the minute I had to be induced,
it was up to technology.
315
00:15:24,757 --> 00:15:28,427
[narrator] But there's one problem
with the cascade of interventions theory.
316
00:15:29,094 --> 00:15:32,181
In a large, randomized trial,
researchers found...
317
00:15:32,264 --> 00:15:33,307
Women who are induced
318
00:15:33,390 --> 00:15:36,435
are actually not more likely
to have a C-section.
319
00:15:36,518 --> 00:15:39,396
We probably do induce more frequently
than we need to,
320
00:15:39,480 --> 00:15:42,691
but there aren't any
hugely obvious downsides.
321
00:15:42,775 --> 00:15:44,944
[narrator] But last-minute changes
at the hospital
322
00:15:45,027 --> 00:15:47,696
can impact a woman's mental health.
323
00:15:47,780 --> 00:15:50,783
One study found that women
who had unplanned C-sections
324
00:15:50,866 --> 00:15:54,578
were more likely to experience
post-traumatic distress and depression.
325
00:15:55,663 --> 00:15:58,999
In her 2004 bestselling book,
Ina May Gaskin wrote
326
00:15:59,083 --> 00:16:03,504
that more drawn-out labors could be
"because of a lack of privacy or fear."
327
00:16:04,171 --> 00:16:05,965
She called it the "sphincter law,"
328
00:16:06,048 --> 00:16:08,425
saying the cervix was
like a sphincter muscle
329
00:16:08,509 --> 00:16:11,387
and that "sphincters do not respond well
to commands."
330
00:16:11,887 --> 00:16:18,018
Let's say you're in a public bathroom,
and you're trying to take a crap,
331
00:16:18,435 --> 00:16:20,688
and someone opens the door...
332
00:16:21,689 --> 00:16:23,273
or a loud noise, something happens.
333
00:16:23,357 --> 00:16:25,359
Your sphincter will freeze.
334
00:16:25,442 --> 00:16:29,071
Think about trying to push a baby out
of your vagina.
335
00:16:29,154 --> 00:16:31,365
You're trying to be relaxed, breathe...
336
00:16:31,865 --> 00:16:35,285
Fear is going to have a major impact
337
00:16:35,369 --> 00:16:37,371
on your ability to do so.
338
00:16:37,454 --> 00:16:41,000
[narrator] The idea that fear made
childbirth harder was also preached
339
00:16:41,083 --> 00:16:44,878
by the French obstetrician Fernand Lamaze
in the 1950s.
340
00:16:45,295 --> 00:16:48,549
He popularized
the psycho-prophylactic method,
341
00:16:48,632 --> 00:16:50,676
now just known as the Lamaze method,
342
00:16:50,759 --> 00:16:55,222
a set of techniques for a pain-free,
fear-free, drug-free birth.
343
00:16:55,305 --> 00:16:59,560
It involved breathing techniques,
different laboring positions, and massage.
344
00:17:00,686 --> 00:17:01,895
In his book, Lamaze wrote
345
00:17:01,979 --> 00:17:04,982
that we should not try to
"cure the pain of childbirth
346
00:17:05,065 --> 00:17:06,358
by the use of drugs"
347
00:17:06,775 --> 00:17:09,570
and instead,
just stop fearing the pain itself.
348
00:17:11,780 --> 00:17:14,992
But women's reasons for choosing
or rejecting pain relief
349
00:17:15,075 --> 00:17:16,535
have always been complex.
350
00:17:17,578 --> 00:17:21,290
In Japan, just 6% of women get epidurals,
351
00:17:21,373 --> 00:17:25,419
because there's a cultural expectation
that suffering is a part of childbirth.
352
00:17:25,502 --> 00:17:29,506
And while more than 70%
of American women choose epidurals,
353
00:17:29,590 --> 00:17:32,593
that means almost 30% decide
to go without.
354
00:17:32,676 --> 00:17:35,679
My family, when I told them
that I wanted to do a natural childbirth,
355
00:17:35,763 --> 00:17:37,848
they were like, "You can't do it.
You won't make it."
356
00:17:37,931 --> 00:17:40,100
[laughs] And I was just like,
"Oh, no, now I have to do it,
357
00:17:40,184 --> 00:17:42,436
'cause you can't tell me
that I can't do it."
358
00:17:42,519 --> 00:17:45,689
I just had this weird fascination
with what it would feel like,
359
00:17:45,773 --> 00:17:47,900
and I just wanted to know
what it would feel like.
360
00:17:47,983 --> 00:17:51,653
Now that I look back, I'm like,
"Why didn't I, like, want an epidural?"
361
00:17:51,737 --> 00:17:54,823
I have no idea
why I didn't want an epidural.
362
00:17:55,949 --> 00:17:59,953
[narrator] Today, some scientific research
suggests that being relaxed
363
00:18:00,204 --> 00:18:02,581
could have real physical impacts on labor,
364
00:18:02,831 --> 00:18:06,168
just as natural childbirth advocates
have argued for decades.
365
00:18:06,251 --> 00:18:10,089
The top of the cervix actually
has a lot of muscle that does contract,
366
00:18:10,172 --> 00:18:13,550
so that's what made us start to think,
"Okay, well maybe this is a sphincter."
367
00:18:13,634 --> 00:18:16,929
And so, that actually completely changes
the map that we're working with
368
00:18:17,012 --> 00:18:19,515
to understand what goes on in pregnancy,
369
00:18:19,598 --> 00:18:21,642
because in women who deliver early,
370
00:18:21,725 --> 00:18:24,353
that cervix starts to open prematurely,
371
00:18:24,436 --> 00:18:27,022
and it might actually be a sphincter
that's relaxing too soon.
372
00:18:27,856 --> 00:18:30,651
[narrator] But why that happens
in one patient over another,
373
00:18:31,235 --> 00:18:32,653
we don't fully understand.
374
00:18:33,403 --> 00:18:36,698
Mechanics obviously play
a really important role in pregnancy.
375
00:18:36,782 --> 00:18:40,244
I do need an engineer to help me
understand how strong is the tissue.
376
00:18:40,786 --> 00:18:42,496
We can run "what if" scenarios.
377
00:18:42,579 --> 00:18:45,541
So,
what if the patient has a short cervix?
378
00:18:46,041 --> 00:18:50,337
Will her cervix open if the baby kicks
or if there's a small contraction?
379
00:18:50,420 --> 00:18:55,551
Can that cervix mechanically withstand,
you know, the loads of pregnancy?
380
00:18:55,634 --> 00:18:58,637
We should know those answers.
You know, we're curing cancer.
381
00:18:58,720 --> 00:19:01,306
We should be able
to understand pregnancy a lot better.
382
00:19:02,015 --> 00:19:05,144
[narrator] That's why there's still
so much conflicting information out there
383
00:19:05,227 --> 00:19:06,812
on the best way to give birth.
384
00:19:07,437 --> 00:19:09,439
And a lot of it is very insistent.
385
00:19:09,690 --> 00:19:12,860
These baby boards are probably
where the seed was planted for me.
386
00:19:12,943 --> 00:19:15,946
Things like an epidural were cheating,
387
00:19:16,029 --> 00:19:18,115
and that the best way forward
388
00:19:18,198 --> 00:19:20,534
would actually be give birth
389
00:19:20,617 --> 00:19:23,162
without any medical intervention
whatsoever.
390
00:19:23,245 --> 00:19:25,914
I think sometimes the voices there
in the movement
391
00:19:25,998 --> 00:19:29,001
can push themselves
into a particular set of choices.
392
00:19:29,084 --> 00:19:30,085
And rather than saying,
393
00:19:30,169 --> 00:19:32,462
"Let's empower people
to make whatever choices they want,"
394
00:19:32,546 --> 00:19:35,299
say, "Let's empower them
to make these particular set of choices."
395
00:19:35,382 --> 00:19:39,428
Well, when I found out that my daughter
396
00:19:39,511 --> 00:19:41,972
was going to need to be delivered
via C-section,
397
00:19:42,055 --> 00:19:43,473
I felt like a failure.
398
00:19:43,557 --> 00:19:48,437
[laughs] I felt like I had failed to do
what I set out to do.
399
00:19:49,104 --> 00:19:52,608
[narrator] Natural childbirth advocates
may be criticized by some
400
00:19:52,691 --> 00:19:55,944
for exaggerating the negative impact
of medical interventions,
401
00:19:56,028 --> 00:19:59,281
but their advocacy
has also dramatically improved
402
00:19:59,364 --> 00:20:01,408
the way many women give birth.
403
00:20:01,491 --> 00:20:05,829
In the 1970s, episiotomy rates
in the UK were over 50%,
404
00:20:06,163 --> 00:20:09,041
sometimes performed
without the permission of the patient.
405
00:20:09,541 --> 00:20:13,754
But then, there was a backlash
against so-called "birth cuts."
406
00:20:13,837 --> 00:20:17,883
A survey was organized by British midwife
and activist Sheila Kitzinger.
407
00:20:18,300 --> 00:20:21,595
And she found episiotomies
caused more lasting pain
408
00:20:21,762 --> 00:20:23,889
than any other procedure in childbirth
409
00:20:24,264 --> 00:20:26,975
and that a natural tear
generally caused much less pain
410
00:20:27,059 --> 00:20:27,976
than a cut.
411
00:20:28,602 --> 00:20:31,563
A study was launched,
and three years later, it concluded
412
00:20:31,647 --> 00:20:35,817
that there was "no evidence to support
the supposed benefits of episiotomy."
413
00:20:36,777 --> 00:20:39,029
More research confirmed these findings,
414
00:20:39,112 --> 00:20:43,408
and by 2012, episiotomies in the UK
were down to 15%.
415
00:20:44,701 --> 00:20:46,245
And the natural childbirth movement
416
00:20:46,328 --> 00:20:49,248
brought back one of the most ancient types
of labor support...
417
00:20:50,082 --> 00:20:51,833
having a doula present.
418
00:20:52,501 --> 00:20:54,711
Doulas aren't doctors or midwives.
419
00:20:54,795 --> 00:20:56,755
They're trained birth coaches,
420
00:20:56,838 --> 00:21:00,425
there to support the laboring woman
and help make sure her wishes
421
00:21:00,509 --> 00:21:02,678
are being respected
by the medical provider.
422
00:21:03,262 --> 00:21:05,722
-[loud moaning]
-You're so strong. Look at you.
423
00:21:07,933 --> 00:21:10,602
[narrator] A number of studies
have confirmed the presence of a doula
424
00:21:10,686 --> 00:21:12,729
"reduces the need for interventions,"
425
00:21:13,313 --> 00:21:15,941
finding a 51% decrease in C-sections.
426
00:21:16,525 --> 00:21:20,153
I think it's partly just that it's nice
to have somebody in the room
427
00:21:20,237 --> 00:21:24,032
to say, "Yeah, this is-- this is normal."
Like, "This is okay."
428
00:21:24,116 --> 00:21:26,410
Like, "Everything is going fine."
429
00:21:26,493 --> 00:21:29,830
I think that that part of labor is quite--
can be quite scary.
430
00:21:29,913 --> 00:21:32,291
[Anthony continues moaning]
431
00:21:32,374 --> 00:21:34,001
We almost there, sweetheart.
432
00:21:34,084 --> 00:21:35,127
[Anthony panting]
433
00:21:35,210 --> 00:21:36,378
We are almost there.
434
00:21:38,213 --> 00:21:40,173
[narrator]
And the natural childbirth movement's
435
00:21:40,257 --> 00:21:43,010
underlying message
continues to resonate around the world...
436
00:21:43,343 --> 00:21:46,013
that women should
make their own choices
437
00:21:46,596 --> 00:21:48,265
based on what's best for them.
438
00:21:48,640 --> 00:21:50,892
I decided to have a natural childbirth
439
00:21:50,976 --> 00:21:52,894
because you go to a hospital,
440
00:21:53,228 --> 00:21:56,315
black women
are kind of disproportionately, like,
441
00:21:57,065 --> 00:21:59,192
ignored, I guess, in hospitals.
442
00:21:59,276 --> 00:22:03,405
The only birth I ever had witnessed before
was a friend who gave birth
443
00:22:03,488 --> 00:22:07,326
without any medicine or interventions,
but it was in a hospital,
444
00:22:07,409 --> 00:22:09,328
and I thought that was the best
of both worlds.
445
00:22:09,411 --> 00:22:11,663
My birth plan was go to the hospital,
446
00:22:11,747 --> 00:22:14,666
listen to everything the doctors say,
and then come back with a healthy baby.
447
00:22:14,750 --> 00:22:16,251
That was 100% of my plan.
448
00:22:16,335 --> 00:22:20,380
[narrator] There's no way yet to predict
how any one birth will go
449
00:22:21,048 --> 00:22:23,508
or what interventions are necessary
for each person
450
00:22:23,592 --> 00:22:25,844
because every woman is different.
451
00:22:25,927 --> 00:22:29,014
And then also, like,
every baby is totally different.
452
00:22:29,097 --> 00:22:31,933
The baby was, um, sunny-side up,
453
00:22:32,017 --> 00:22:36,271
the kind of labor pain that's, like,
way worse than regular labor pain.
454
00:22:36,355 --> 00:22:39,358
I turned blue.
There was blood everywhere.
455
00:22:39,441 --> 00:22:43,111
They ended up giving me pitocin
without any epidural,
456
00:22:43,195 --> 00:22:45,197
and then I had an episiotomy,
457
00:22:45,822 --> 00:22:48,325
and all of it was like a total shock.
458
00:22:48,408 --> 00:22:53,372
I had no idea that any
of this would be so hard.
459
00:22:54,039 --> 00:22:57,501
I was really nervous.
I know how much the tissue stretches,
460
00:22:57,584 --> 00:23:00,337
but I trusted my physicians,
and I was in good care.
461
00:23:00,420 --> 00:23:04,132
With my first kid, the experience
was more overwhelming.
462
00:23:04,216 --> 00:23:05,592
The birth experience with my second kid
463
00:23:05,675 --> 00:23:08,970
was, like,
sort of a very idyllic experience.
464
00:23:09,054 --> 00:23:10,555
I mean, also, with a lot of blood.
465
00:23:10,639 --> 00:23:12,933
I'm not gonna lie.
I am angry and resentful,
466
00:23:13,016 --> 00:23:16,019
and I have a lot to process,
five years later.
467
00:23:16,103 --> 00:23:20,148
And yet, at the same time,
it was amazing and wonderful.
468
00:23:20,732 --> 00:23:23,860
I still consider my C-section
to be natural childbirth.
469
00:23:24,653 --> 00:23:28,740
I don't consider anything humans do
to be unnatural or supernatural.
470
00:23:28,824 --> 00:23:32,702
[laughs]
And so natural is the only other option.
471
00:23:32,786 --> 00:23:37,749
I was afraid of pain,
and I had a full epidural.
472
00:23:37,833 --> 00:23:40,836
I thought, "This is so silly.
473
00:23:40,919 --> 00:23:44,047
I'm missing out on something.
I could have done this."
474
00:23:44,631 --> 00:23:48,760
I was angry at myself
and kind of ashamed that I just caved.
475
00:23:48,844 --> 00:23:53,390
They have nothing to be ashamed of
because they're still doing a big work,
476
00:23:53,473 --> 00:23:55,225
-which is bringing life into the world.
-...two, three...
477
00:23:55,308 --> 00:23:57,936
[Nicola Pemberton] Growing a human
and bringing that human into the world
478
00:23:58,019 --> 00:24:00,105
regardless of the route of delivery...
479
00:24:00,188 --> 00:24:02,691
Nine and ten. Beautiful.
Deep breath, deep breath!
480
00:24:02,774 --> 00:24:04,276
...is still a big feat.
481
00:24:04,526 --> 00:24:07,654
Right back at it. Ready?
And push on your bottom!
482
00:24:07,737 --> 00:24:09,739
[screaming]
483
00:24:12,033 --> 00:24:15,787
[clinician] Come on, baby, you got it.
That's it. You got it.
484
00:24:15,871 --> 00:24:17,956
-[doctor] Come on, give me another one.
-[clinician] Ready? This is it.
485
00:24:18,039 --> 00:24:21,751
-[screaming]
-[doctor] Here we go. That's it.
486
00:24:23,753 --> 00:24:25,755
[chattering continuing]
487
00:24:25,839 --> 00:24:28,675
[moaning]
488
00:24:28,758 --> 00:24:30,051
-[doctor] Let's go.
-[clinician] Ready?
489
00:24:30,135 --> 00:24:33,889
[doctor] Most important push of your life.
Ready? One, two, three. Right back at it!
490
00:24:33,972 --> 00:24:36,516
-You got it. Yes, Daysha. Hold her down.
-[screaming]
491
00:24:36,600 --> 00:24:39,978
[doctor] Open your eyes! Open your eyes!
Open your eyes!
492
00:24:40,061 --> 00:24:42,105
-[clinician] Look at your baby.
-[doctor] Open your eyes.
493
00:24:42,189 --> 00:24:44,191
[Anthony gasping]
494
00:24:47,277 --> 00:24:49,112
-[woman] Oh, my God!
-[sneezes]
495
00:24:49,196 --> 00:24:51,406
-[woman] Oh, my God!
-[doctor] Okay.
496
00:24:52,032 --> 00:24:55,160
-[woman] Oh, my God!
-[doctor] Congratulations, Mommy!
497
00:24:57,204 --> 00:24:59,831
You never worked on anything so hard
in your life.
498
00:24:59,915 --> 00:25:02,167
-I know he's worth it, right?
-[woman] My grandbaby.
499
00:25:02,250 --> 00:25:04,294
-My grandson.
-[doctor] Mm-hmm.
500
00:25:04,920 --> 00:25:09,216
[woman] Oh, look at him! He's so little!
501
00:25:09,299 --> 00:25:11,718
-[doctor] All right. Come on, bud.
-[baby crying]
502
00:25:11,801 --> 00:25:14,387
There you go. There you go. There you go.
503
00:25:15,514 --> 00:25:18,558
-[woman] Welcome to the world, sweetie!
-[baby continues crying]
504
00:25:18,642 --> 00:25:22,687
-[woman] Daysha, Daysha, you did it!
-[theme music playing]