Wednesday, June 04, 2008
Separate and Unequal
In this excerpt from a book-in-progress, Faith Gibson describes working as a L&D nurse in a segregated maternity ward in the South. She contrasts the care that white and black mothers received. Ironically, black mothers and babies fared much better because the institutional "neglect" allowed them to have physiological births with very little disturbance or management. From the early 1900s and well into the 1970s, the standard of care for white mothers in this hospital included separation from family members, enema & shave, confinement to bed, heavy use of narcotics and Scopolamine during labor and general anesthesia during the birth, episiotomy and forceps delivery, and separation of mother and newborn.
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Likewise, here in Australia, Aboriginal women have C section rates something akin to WHO recommendations for those women birthing in hospitals and with prenatal care.
ReplyDeleteWow, that sounds really fascinating. The interesting thing would be whether the black women were happy with their "care" (grateful for the natural births) or whether they felt it was incredibly unfair.
ReplyDeleteI suspect the latter, but I'd love to be wrong. (in this case :)
That sounds like a very interesting book- I hadn't thought about racial disparities in birth. I'll have to be on the look out for that book.
ReplyDeleteHmmm, interesting. Personally I'd rather be segregated against in that situation, though I must admit that Jon and I were a little ticked off at how thoroughly the nurses ignored us after we came into the hospital practically at the moment of birth last time.
ReplyDeleteI thought that was a very interesting article. I'd never thought about the impact of segregation on birth care before.
ReplyDeleteI read this back when she posted it--I felt vaguely uncomfortable with her contrasting what was then considered standard vs. substandard care. Sure, the black mothers were more likely to achieve physiological birth by way of neglect. But did they get the births they wished for, if they had any preferences at all? Or were preferences a luxury they didn't even assume they could afford? I'm far more interested in their experience from this angle.
ReplyDeleteOn a "down" side, though, is an anecdote from Peggy Vincent's Baby-Catcher, which is that she often saw black women coerced into signing consent forms for tubal ligations while they were drugged up after labor. The "nice doctor" would come up to them and say something like, "Oh, that was such a hard experience, wasn't it? I bet you don't want to go through that again!" and then when they said, "No, never!" he'd hand them a consent form and say, "Sign right here." This was what she saw as a student nurse -- I'm not sure where she was at the time, but it was definitely a racist (or at least a "class-ist" thing to do).
ReplyDelete-Kathy
...that is when they obtained "consent" at all. Does Mississippi appendectomy ring a bell? More horrible stories abound than non-blacks can even imagine...
ReplyDeleteWe had a nurses training where a nurse asked the speaker (a nurse and specialist in law - cover your butt, document, etc... training) a question about what would you do if a patient comes in in labor and doesn't want any monitoring (intervention), etc? The speaker said, "I wouldn't touch her with a ten ft. pole! and I'd call legal".
ReplyDeleteafter that a bunch of us in the local birth community talked about it, and soem of us joked that perhaps it might not be so bad to 'be at the hospital (if that is what you felt comfortable with), but with the nurses 'ignoring' you, and leaving you to birth the way you want, without intervention... I'm sure though that in those times, they probably had just enough intervention to make it as unnatural as possible (hosp gown, hosp bed, etc. etc...)and then the mothers were left to deal with the rigors of labor alone, and probably scared. The fact that segregation was in effect iw why here in AL and other southern states they originally trianed local women to be nurses and midwives, so that they could take care of their own, and the women never had to come into their 'white' hospitals. Sadly now we can't get them to legalize midwives at all here.