How should women facing labor approach their birth plan?

Preparing for the arrival of a child is an exciting time for potential mothers, but there is a lot to consider. Aside from painting the nursery and learning how to change a diaper, pregnant women and their partners need to make decisions on how they want to bring their child into the world.

According to koodakpress، Whether by natural, drug-assisted or surgical means, there are associated risks and benefits across the board, depending on the circumstances. In this feature, we examine different birthing methods and their outcomes.

Birthing practices and ideologies have gone through many changes throughout history. In AD 98, a Roman named Soranus wrote an obstetrics textbook that was widely used until the 16th century.

During the Middle Ages, the business of childbirth was in the hands of the midwife, which, in Old English, means “with woman.” Pregnant women were attended by their female friends, relatives and local women who were experienced in helping with childbirth.

Depictions of labor during this time usually show women giving birth in an upright sitting position, using a birthing stool that left space in the seat.

Other positions during this time typically included half-lying positions or even a crouching position, and of course, there were no anesthetics available. However, midwives typically used oils and unguents to help reduce perineal tearing.

There was a significant shift in the business of childbirth during the 1700s. Newer technologies played a role, as did male midwives or physicians, who began taking over for the female midwife. In fact, during this time, female midwives lost much of their status and were portrayed as unhygienic and unenlightened, and they were even associated with witchcraft.

This is the era that heralded the use of certain instruments, such as the forceps and other more destructive tools like the vectis – a lever-type tool for altering the baby’s position – and a crochet tool with a hook, used for extracting a dead fetus from the mother’s body.

The 20th century brought childbirth from the home to the hospital, where hi-tech devices and procedures – such as the fetal heart rate monitor, cesarean sections (C-sections) and epidurals – became commonplace. By the late 1970s in the US, home birth rates fell to around 1%.

The rise of the C-section

Fast forward to the present day, and the business of childbirth looks very different from its early origins. The Centers for Disease Control and Prevention (CDC) report that there were over 3.9 million births registered in the US in 2012. Of these, over 2.6 million were delivered vaginally, and nearly 1.3 million were delivered via C-section.

Additionally, the vast majority of these births took place in a hospital; only 1.4% of deliveries occurred elsewhere. Of these, over 65% took place at home and 29% occurred in a birthing center.

In 2009, the total C-section delivery rate reached an all-time high, at 32.9%, which represented a 60% increase from the most recent low in 1996, at 20.7% of all births.

Given this significant spike, the American College of Obstetricians and Gynecologists (ACOG) issued clinical guidelines in February of this year to reduce the occurrence of C-sections that were not medically indicated, as well as labor induction before 39 weeks. These guidelines included initiatives aimed at improving prenatal care, changing hospital policies and educating the public.

C-sections are deemed medically necessary when circumstances make a vaginal birth risky for the mother or baby. For example, physicians or midwives may recommend one when the fetus is in the breech position – when the baby’s buttocks or feet are facing the pelvis rather than the head – or when the placenta is covering the cervix – called placenta previa.

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