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The “problem” with our current maternity care system started in 1910 with the uncritical acceptance of an unscientific premise by medical professionals and the lay public in the US.
This unscientific premise was based on two unproven theories that a hundred years later have still not been scientifically evaluated and remain at odds with maternity care systems used worldwide:
(1) that the recently combined disciplines of obstetrics and gynecology as a single surgical specialty (1900) was the only appropriate providers for all childbirth services;
(2) that 20th century safety in childbirth demanded a new and medicalized standard of care for all childbearing women that routinely or ‘pre-emptive’ used a series of medical and surgical intervention
The reason these ideas were uncritical accepted and endorsed by professionals and public alike was lack of accurate information, as well as a misunderstanding of what the true dangers of childbearing were and what actions at a practical level would make childbirth predictably safer.
In all these things, the obstetrical profession was well-meaning. Nonetheless, policies and practices based on there assumption turned out to be wrong. They erroneously believed the new ‘scientific’ practice of medicine (circa 1910) rendered all previous childbirth practices obsolete and that its medical and surgical ‘replacements’ were superior in all aspects. Taken together, these theories meant midwifery as an independent profession was considered both unsafe and obsolete, and needed to abolished as quickly as possible.
The same uncritical acceptance of the same unscientific premises over the course of the last hundred years continues today, unabated and unchanged, and are the source of the contemporary problems with our maternity care system.
The most central problem is simply that the US doesn’t actually have a ‘maternity’ (mother-oriented) care system as is the norm worldwide. For the last century we have had a surgical speciality that is in charge of all childbirth care, for which it uses a highly (and increasingly) medicalized system. As judged by the biological and practical needs of childbearing women, this functions so poorly functioning that the US is 50th worldwide in neonatal mortality and 39th in maternal mortality
Te reason result of that the inappropriate, dysfunctional and unproductively expensive and nearly universal lack of access to appropriate form of care for this healthy populationTo help those who have graciously offered to help publicize the problem
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