The medicalisation of childbirth
Caroline Squire in The Social Context of Birth, 2017
Childbirth is in itself a natural physiological process. Prior to the advent of scientific medicine, birth was a social event, and the only ‘intervention’ was the presence of a midwife, who provided social support and had the experience of having attended other births, so possessed knowledge of childbirth and its processes. The social setting in which birth now occurs is one where the dominant culture is that of science and the dominant discourse is that of risk. It is this risk discourse which has intensified the fear of childbearing and consolidated institutional control by continuing to associate childbirth with danger and hospitals, as institutions of medicine, with safety. Obstetrics, the dominant form of knowledge, is regarded as mainstream, male-stream knowledge, whereas natural childbirth is labelled as ‘alternative’ and associated with greater risk. Midwives are part of this scientific movement and are not exempt from protocols, standards and policies based on risk assessment. The guidelines which now define and constrain almost every aspect of their role are ratified by obstetricians, thus giving obstetricians the authority to set criteria for women’s choices (such as those ‘allowed’ to have a home birth).
The medicalisation of childbirth
Chang Amy, Caroline Squire in The Social Context of Birth, 2017
Childbirth is in itself a natural physiological process. Prior to the advent of scientific medicine, birth was a social event, and the only ‘intervention’ was the presence of a midwife, who provided social support and had the experience of having attended other births, so possessed knowledge of childbirth and its processes. The social setting in which birth now occurs is one where the dominant culture is that of science, and the dominant discourse is that of risk. Midwives are part of this. Obstetrics, the dominant form of knowledge, is regarded as mainstream, male-stream, knowledge, whereas natural childbirth is labelled as ‘alternative’ and associated with greater risk. Midwives are part of this scientific movement, and are not exempt from protocols, standards and policies based upon risk assessment.
A Functional Approach to Gynecologic Pain
Sahar Swidan, Matthew Bennett in Advanced Therapeutics in Pain Medicine, 2020
The anatomic role of the uterus is to provide a hospitable environment for implantation, growth, and ultimately delivery of the pregnancy. At the onset of menses, sloughing of the endometrium causes a release of prostaglandins that induce uterine contractions. Unlike the contractions associated with childbirth, the uterine contractions of menses have dysfunctional and uncoordinated rhythms, and result in high intrauterine pressures. These pressures may be greater than 150–180 mmHg, and sometimes exceed 400 mmHg; they often begin from an elevated basal tone (>10 mmHg), and occur at a high frequency of more than 4–5 per 10 minutes.13 By comparison, labor contractions are associated with pain when the amplitude is >10 mmHg over baseline, and such contractions are deemed sufficient to cause cervical effacement. Dysmenorrhea can therefore be seen as “mini-labor.”
Reflections on a Qualitative Interview Series on Childbirth
Published in Issues in Mental Health Nursing, 2020
Childbirth is a life-changing and transformative experience for women and families. The birth experience has the ability to deeply impact women psychologically, physically, and emotionally in positive and negative ways. Qualitative research is a complementary method for researching childbirth because it does not practice reductionism by reducing human beings or experiences into separate parts (Munhall, 2012). Due to the complex and integrated nature of the birth experience, a holistic approach is needed in order to gain a comprehensive and realistic understanding of what the experience entails for women. The qualitative methods most applicable to the birth experience are phenomenology, ethnography, and narrative inquiry. By using different qualitative research methodologies, different facets of the birth experience can be viewed.
Can maternal hormones play a significant role in delivery mode?
Published in Journal of Obstetrics and Gynaecology, 2022
Christina Pappa, Fani Gkrozou, Evangelos Dimitriou, Orestis Tsonis, Aikaterini Kitsouli, Dimitrios Varvarousis, Vasileios Xydis, Minas Paschopoulos, Panagiotis Kitsoulis
Childbirth is a complex process that demands the orchestration of multiple factors such as the structure and alterations of the maternal pelvis, the resistance and the stiffness of maternal pelvic and perineal tissues, the maternal position during labour, the intensity of uterine contractility, labour analgesia as well as the foetal position and presentation (Barbera et al. 2009; Reitter et al. 2014; Brik et al. 2017). For that reason, the implementation of a functional, well informed biomechanical model of childbirth seems to be imperative in the near future. Such models could initially offer a better educational basis to clinicians through enhanced hands-on training and could be further used for tailored birth planning. Challenges for future research will be to develop a computerised system which will be supportive to clinical decision. Demographic variables of maternal and foetal characteristics, data deriving from studies on hormonal changes and data supporting predictive factors of successful vaginal delivery can be used to form the basis of such a system (Bademkiran et al. 2021; Katsura et al. 2021). Well established data on transabdominal and transperineal imaging traits of crucial pelvic structures such as the pubic symphysis, the pubic arch and the pelvic floor muscles during pregnancy and parturition can also be included (Yan et al. 2016; Jean Dit Gautier et al. 2018; Lapeer et al. 2019).
Comparative evaluation of normal saline, 1/3-2/3, and ringer's lactate infusion on labour outcome, PH, bilirubin, and glucose level of the umbilical cord blood in nulliparous women with labour induction: a randomised clinical trial
Published in Journal of Obstetrics and Gynaecology, 2022
Ladan Haghighi, Fatemeh Jahanshahi, Mojgan Mokhtari, Zahra Rampisheh, Mina Momeni
Childbirth is one of the prominent health indicators in any country, with profound psychological, social and emotional consequences for the mother and her family (Marshall and Raynor 2014). Childbirth consists of four stages. The first stage of labour can also be divided into two phases of latent and active. The first stage begins with the onset of uterine contractions, which are sufficient in number, intensity, and duration and ends with the completion of cervical dilatation (10 cm). Upon completion of the cervical dilatation, the foetus is delivered as the next stage. The third stage begins immediately after foetal delivery and ends with placental expulsion. Finally, the fourth stage of labour refers to the first two hours after placental expulsion. In the process of childbirth, the four factors of uterine contractile force, pelvic position, foetal situation, and mental condition of the mother are actively participating. Several factors, including maternal anxiety, fatigue, therapeutic interventions, obesity, abnormal foetal presentation, and epidural analgesia, cause prolongation of labour (Hutchison et al. 2020). Prolonged labour is the most common reason for a planned shift to caesarean section and the cause of 8% of maternal mortality in developing countries (Kubli et al. 2002). Therefore, detecting abnormal labour progress and controlling the potential complications can effectively prevent neonatal and maternal mortality and morbidity. To this end, proper methods and approaches with the least side effects are required to avoid prolonged labour (Tranmer et al. 2005).
Related Knowledge Centers
- Birth
- Cervical Dilation
- Pregnancy
- Infant
- Mother
- Vaginal Delivery
- Caesarean Section
- Hospital
- Home Birth
- Cervical Effacement