Excerpted from Birth as an American Rite of Passage
Sterile Sheets, Disinfectant and Hand-Strapping
Description and Official Rationale
No one should be permitted in the delivery room without a scrub suit, a mask covering both nose and mouth, and a cap that completely covers the hair. Preparation for actual delivery entails thorough vulvar and perineal scrubbing and covering with sterile drapes in such a way that only the immediate area about the vulva is exposed. (Cunningham et al. 1989:315)
I could find no rationale for such sepsis in obstetrical texts, merely the flat statement that it was necessary. Attention to sterility is generally necessary in the hospital because of the enormous number of germs concentrated there. Historically speaking, of course, sterile techniques for birth were developed to prevent the spread of childbed fever, a major killer of postpartal women in hospitals until the germ theory of disease became widely accepted.10 According to one of the obstetricians I interviewed, sterility at delivery is necessary because the routine episiotomy makes birth a surgical procedure with a high chance of infection for the mother. Moreover, he continued, the manual extraction of the placenta common in hospital birth also carries with it a high chance of infection for the laboring woman. This particular obstetrician insisted that the need for sterility had nothing to do with the baby.
If he is correct, then I am hard-pressed to find an official rationale for the practice of strapping women's hands and forbidding them to touch their babies. (To some extent, it may have been a carry-over from the days of heavy scopolamine use, but it continued for many years after scopolamine was replaced by the epidural.) Although this practice, common fifteen years ago, has nowadays been phased out in most American hospitals, it seems to have reflected a basic tenet of the technocratic model--the deep belief that the mother is (conceptually) dirty whereas the baby is clean. Only the recognition of this underlying belief can make sense of the convoluted reasoning that allowed a baby to be placed on the mother's abdomen while she was forbidden to touch it with her hands, because if she were to do so she would contaminate the sterile field, whereas the baby itself would not. That this belief is still extant in modern, enlightened hospitals that no longer require the strapping of hands is indicated by the fact that those women in my study who delivered in alternative birthing centers in the hospital without such sterile techniques were not allowed to put their babies in the nursery, as these babies were considered to be "contaminated."
Women's Responses
Well, they poured this bucket of stuff over my crotch and splashed me with colored disinfectant--that was weird. And I had my hands--they said they wouldn't have to cuff my hands or anything if I'd just keep them under the sheets and at one point I said "Lenny, get my glasses," I sure wanted my glasses on so I could see because I couldn't wear my contacts in labor. And at one point I instinctively tried to adjust my glasses, and about three people yelled at me--get my hands back under the sheets, because I would kind of mess up their sterile conditions. [I knew] that was dumb, [but] I was so afraid that I was going to break one of the rules and that they weren't going to let me touch my baby or something.
-Constance O'Riley
They strapped my hands down with all three of my births. I thought it was awful. The second two they did loosely so--I mean the first one it was like I was in prison or something. And so I said, "You know, that really hurts, can...." "You might touch something sterile." Here it is your baby and they don't want you to even--but the second two they still tied them down after I'd had such good success. You would think--and here I was doing the same thing the second and third time. You'd think that they would show a little respect for you and treat you--if I wasn't the type personality I was, that sort of stayed on top of things, all those combinations could really tend to throw you into depression. You know, treating you like you're not very bright, like you don't really know what's going on with your own body.
-July Sanders
Ritual Purposes
The sterile sheets with which the birthing woman is draped from neck to foot reinforce the symbolic inversion that was completed with the lithotomy position, as the one part that is always covered in public is now the one part left uncovered. The sterility of the sheets itself carries a profound series of messages. Besides intensifying both society's purification of the initiate begun during the prep and the message of her fundamental irrelevance to the birth, the emphasis on sterilizing the area around the vagina graphically illustrates to the woman that she and her sexuality are intrinsically dirty, whereas her baby--society's product--is pure and clean. The profound invisible message behind this more obvious one is that our culture's categories are real and are to be believed in and practiced in behavior.
© Robbie Davis-Floyd PhD, Used with Permission
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