Lifetime Television, once known for its melodramatic movies of the week, has been bringing us reality shows for many years—from Dance Moms, to Preachers’ Daughters, to True Tori, the network has given us the opportunity to watch both regular people and the rich and famous in their natural habitats.
Now the cable channel is taking on childbirth, and it too will be done in a natural habitat.
The new show, Born in the Wild, will follow couples who eschew hospitals and doctors for babbling brooks and fields of wildflowers. As the press release announcing the show teased: “What happens when the craziest experience of a woman’s life becomes truly wild, and soon-to-be parents decide to take on an unassisted birth in the outdoors?”
Women should be free to choose their childbirth experience. If you want to give birth at home or in the backyard or in the woods, you should be free to do so. If you want a camera crew to watch as you give birth, go ahead. But this show strikes me as a step too far. It is capitalizing on the misperception that modern medicine ruined childbirth, and that childbirth was better in the “old days” when women trusted their bodies and did it the way nature intended. Moreover, the show’s premise is disingenuous at best; trading modern medical equipment for a camera crew and a satellite van does not take us back to nature.
Modern Medicine Did Not Ruin Childbirth
The complaint about childbirth having become too medicalized is a common refrain among a certain group of new parents today. The argument suggests that women have been having babies for most of human history without pain medication, fetal monitors, and emergency C-sections, and that we should go back to the day when childbirth was run by the woman herself and not an army of doctors and nurses and specialists.
Yes, women have been having babies without intervention for centuries, but a hell of a lot of them died while doing it.
As part of her 2013 series on longevity for Slate, Laura Helmuth took on death in childbirth. She notes that in the United States today, about 15 women die in pregnancy or childbirth for every 100,000 live births. That’s quite high—in fact, for a developed country, we should be ashamed of our maternal mortality rate—but nowhere near as high as it has been in the past. In the 1600s and 1700s, between 1 and 1.5 percent of births ended in maternal deaths, which meant that women (who had a lot more children at the time) had about a 4 percent lifetime chance of dying in childbirth. Even in the early 1900s, childbirth was a dangerous proposition, with nearly 600 women dying for every 100,000 live births in the United States.
Interestingly, Helmuth explains that 100 years ago the medicalization of childbirth may have in fact make it more dangerous in some ways. As physicians tried to lure patients away from homebirths and midwives, they often offered unnecessary medical procedures designed to prove that women needed to be in a hospital setting. Moreover, they failed to take some easy steps—such as washing their hands between patients—that could have saved many lives.
But a lot has changed in medicine in the past century. The advent of antibiotics has meant that the most common killer of new mothers—post-birth infections—is no longer a big threat. And prenatal care is now able to detect many potentially life-threatening complications before they occur. What Downton Abbey viewer can forget when Lady Sybil died while delivering her baby? Eclampsia—the condition that likely killed that character—is now screened for throughout a woman’s pregnancy,
through the use of frequent urine tests and blood pressure monitoring.
The primary complaint about births in hospitals today is that too many women undergo unnecessary cesarean sections, which are major surgeries and carry more risks than vaginal delivery. This is in many ways a legitimate concern, as C-section rates rose dramatically between 1996 and 2009. In the past few years, however, major medical organizations have put out guidelines aimed at reducing C-sections that are not medically necessary, and the rates have stabilized. Although I agree that many obstetricians may still be too quick to order a C-section for reasons that may not be medically necessary, I do think we have to remember that in many instances this surgery can save both mother and child, and that women today are lucky it’s available.
My fear with the new Lifetime show is that it will tout the mantra of the over-medicalization of childbirth without ever challenging its legitimacy. Furthermore, as I mentioned in an article I wrote for RH Reality Check a few years ago, there is a lot of judgment swirling around women’s childbirth choices. Many proponents of natural childbirth (often used to mean a birth without any pain medication) seem to suggest that it is the only “real” or “legitimate” birthing experience, and some in the home birth movement have suggested that getting out of a hospital setting is the best option for those who want a meaningful childbirth experience. Given that the women who will be featured on Born in the Wild have all had at least one hospital experience in the past (it’s one of the requirements to be on the show) and are choosing something radically different, I worry that the show will perpetuate the idea that “real” women give birth without modern medicine.
The Wild or “The Wild”?
Even worse about the message that “real” women have their babies in a field without any help is that when it comes to this reality show, that is not what is happening. The women featured on the show will be surrounded by a production team, there will be an emergency medical professional on set, and though the couple can choose the location, the producers will only agree to it so long as they are within a certain radius of a hospital in case complications arise. You can’t tell me that that’s really the wild, or that it’s these births are truly unassisted.
There are women around the world who have no choice but to give birth without any medical care because they have no access to care or they can’t afford it. Their risk of complications and death is certainly higher than for women who have access to care. Women in areas like South Sudan, which has been in conflict for years, have no access to medical institutions. The last available maternal death rate in that country (from 2006) showed that 2,045 women died per every 100,000 live births. In Chad, where two-thirds of the population lives in poverty, more than 1,000 women die for every 100,000 live births. The rates throughout many regions in Africa hover near 500.
Here in the United States, the maternal death rate is also closely linked to poverty, race, and access. A report by the Department of Health and Human Services looked at maternal death from 1935 through 2007. It notes:
Compared to women in the low poverty group, women in the middle poverty and high poverty groups had 90 percent and 220 percent higher maternal mortality risks in 1969-1971 and 58 percent and 102 percent higher maternal mortality risks in 2003-2007, respectively.
The report also notes that the risk of maternal death over the last six decades has been four times higher for Black women than for non-Hispanic white women. Within racial groups, too, poverty continues to play a role. The report found that Black women in the high-poverty group had a 35 percent higher maternal death rate than Black women in the low-poverty group. Similarly, non-Hispanic white women in the high-poverty group had a 50 percent higher maternal death rate than non-Hispanic white women in the low-poverty group. Much of the disparity here is based on access to high-quality health care.
Born in the Wild has not yet aired, and I cannot claim to know the socioeconomic background of the couples who will be featured. We do know, however, that they will need to have had one hospital-based birth in the past, so it seems likely that their decision to forego medical intervention during delivery is a philosophical one rather than a financial one. I must admit it’s hard for me to get behind such a choice when so many women in the world die because they don’t have access to what these women could have had.
The likelihood, however, is that all of the births on this show will go smoothly and end in healthy infants. The show is taking precautions to choose only mothers at low risk for complications, and there is back-up medical care if need be. In addition, though these women are choosing to go it alone during delivery, unlike low-income women in this country and around the world, these women will likely have had prenatal care, which can predict and prevent many complications. And research has shown that for low-risk mothers who have access to emergency medical care should problems arise, home births can be as safe as hospital births.
So, as my grandmother would say, “Gai gezunterhait.” Go in good health. Do what you will.
I can only hope that when the show airs, the choice these women have made is not presented as morally superior, healthier, or more “real” than those of women who—like me—felt far more comfortable surrounded by fetal monitors, obstetrics nurses, and specialists than we would have surrounded by trees.