Birth Scripting is a phenomenon in the United States. Birth Scripting is a segment of behavioral scripting, where women are conditioned to respond to a situation (labor and birth) in a certain way. The way we respond to situations may be influenced by the media, familial responses, cultural responses or research.

On December 7 & 8, 2002, Dr. Phool Chandra presented a study at the New York State Society of Anesthesiologists' 56th Postgraduate Assembly in Anesthesiology. Physicians at the El Paso Campus/Texas Tech Medical Center surveyed 200 pregnant women to find out what they knew about coping mechanisms with labor. Sixty-two percent of the women were not aware of all options, even though 75% of all those surveyed had given birth before. Of the women who had given birth previously, less than half had received an epidural anesthetic during labor.

"Chandra said he thinks the women's age and ethnic background might explain why so few had used pain relief during labor, and why they expressed a preference for natural birthing techniques. Nearly three quarters of the women identified themselves as Hispanic, and about one half were aged 21 to 30.

He said there may be a cultural bias in favor of natural birthing, "in the sense of what has been told to the young mother by their older relatives who had the experience."
Giving a woman anesthetic during labor carries some risk. For example, if she takes a narcotic, the baby may have trouble breathing when it is born. "Any medication that you give to the mother is going to affect the baby, depending on how much and how long," Chandra said.

But he said, "The pain has to be somehow managed." Among all the options available, Chandra added, "we think that the local anesthetic epidurally is probably the better one, with a minimum effect on the baby, and giving the mother the best chance of enjoying the process."

Considering the survey results, Chandra and his colleagues intend to create a pamphlet to inform women about anesthetics in the hospital's prenatal clinic. But he said education about pain management should go beyond the hospital walls. "It should be at an earlier stage," he said. "It becomes kind of late when the patient is already in agony."

At first glance, this information appears to state that these women do not know their complete obstetrical options. However, it really states that the complaint is that they do not know their anesthesia/analgesia options. In fact, Dr. Chandra goes further and identifies a "cultural bias in favor of natural birthing."

This is birth scripting with a dash of cultural bias. Childbirth is most certainly a culturally sensitive ritual. Cultures definitely do offer rituals around births that correspond with their respective values. However, current mainstream US. Medical culture is based on technology. Rituals of a technological culture run counter to the process of birth. A technocratic birth tends to weaken a woman's instinctive ability to give birth and perhaps even to completely parent. Technology sends a message that the technocracy is more able than the mother - an example of this is simply in the words "deliver the baby" or "birth the baby."

Robbie Davis-Floyd PhD, states in an article on her website titled, "Culture and Birth: The Technocratic Imperative," 'So we "improve" it with technology. First we take it apart--deconstruct it--into identifiable segments. Then we control each segment with the obstetrical equivalent of dams and floodgates (EFM, pitocin, drugs.). When the unfortunate byproduct of this technological reconstruction of birth is a baby in distress from a now-dysfunctional labor, we rescue that baby with more technology (episiotomy, forceps, Cesarean section). Then we congratulate ourselves on a job well done, just as the builders of the salmon hatchery Reynolds visited in California put a plaque on the wall to congratulate themselves for "saving the salmon."'

After a quarter of a century of study and research and evidence, it is my firm belief that women are physically, emotionally and spiritually gifted to give birth naturally and normally most of the time. Occasionally, not routinely, interventions are needed for the health of the baby and the mother. As a nurse, childbirth educator, doula and trainer, I see that my colleagues constantly feel the impact of birth scripting.