Email us for more information at info KindredCommunity. The diverse and vital ways in which we embrace it has changed since the advent of modern medicine. Although many aspire for the most natural pregnancy and birth possible, it often does not come to fruition. Maternal health is no longer just the domain of physicians, but of expectant parents.
RJ wrote the first draft of this article but died before it could be completed. AM helped substantially to revise the article. MN is responsible for its final form. Over the past few centuries childbirth has become increasingly influenced by medical technology, and now medical intervention is the norm in most Western countries.
Instrumental delivery with forceps became the hallmark of the obstetric era. In the 19th and 20th centuries, medical influence was extended further by the development of new forms of analgesia, anaesthesia, caesarean section, and safe blood transfusion.
The introduction first of antiseptic and aseptic techniques and later of sulphonamides, coupled with changes in the severity of puerperal sepsis, lowered the maternal mortality that had made hospitals dangerous places in which to give birth.
The World Health Organization and Unicef estimated the average maternal mortality ratios for as 27 per live births in the more developed countries compared with per live births in less developed countries, with ratios as high as per live births for eastern and western Africa.
In a North American religious community that declined all forms of professional assistance, maternal mortality remained as high as years ago. It also cannot be assumed without careful attention to the evidence that access to obstetric care has invariably had beneficial effects.
In many countries women who have straightforward pregnancies are subjected to routine intravenous infusions and oxytocin in labour. Women without obstetric complications are encouraged to have electronic fetal monitoring and epidural analgesia.
Frequently labour will be in the dorsal position and delivery in lithotomy. Perineal injury is standard. As labour intervention has become more widespread, so too have assisted delivery rates and major surgery.
The extent of medicalisation in Spain is reflected in some of the highest caesarean section rates in Europe Specific concerns relate to painful intercourse and urinary and anal incontinence. There is a tendency to believe that most if not all deaths could have been prevented.
Although confidential inquiries into stillbirths and deaths in infancy repeatedly show that suboptimal care is a serious problem contributing to preventable deaths, death is probably unavoidable in some babies. The courts are not always good at distinguishing between preventable and unavoidable deaths.
Contribution of midwives to medicalisation Few investigations have assessed the influence of midwives on medicalisation. Quantitative studies provide some insight into the direction of change and how midwives feel about it. Use of inappropriate electronic fetal monitoring perhaps illustrates the extent and pervasiveness of medicalised practice in Western maternity care.
In the United States, Canada, and recently England, major reviews of the evidence have concluded that electronic fetal monitoring should be reserved for high risk pregnancies. A study commissioned by the Canadian health minister suggests that maternal or newborn programmes in Ontario can maintain low caesarean section rates over time, regardless of their size, location, level of care they provide, and population they serve.
This hypothesis has enormous implications and should be tested in other settings, including UK maternity units. Philosophy of care The Scandinavian countries and the Netherlands, which did not follow the trend towards steep increases in caesarean sections during the s, 9 have a tradition of perceiving birth above all as a normal physiological process and of valuing low intervention rates.
The justification has been providing women centred care, but many women report that they have inadequate information about the risks and benefits of procedures 9 and therefore the extent to which they can exercise informed choice must be questioned.
In Scotland, where wide variations in surgical deliveries have been found between units, four evidence based recommendations have been prioritised: It believes that women do not so much make informed choices as find themselves constrained by the culture of the unit they attend.
The organisation has published a birth policy calling for the maternity services to be managed in a way that will increase the proportion of straightforward vaginal births. As epidural analgesia has been shown in randomised trials to reduce the likelihood of a normal vaginal delivery this could contribute to the variation in normal delivery rates seen.
In a randomised controlled trial comparing community based care with standard hospital care a significant difference in caesarean section rates was found The rate for normal births at the Edgware Birth Centre in London and at a birthing centre in Sweden were In practice, these factors often overlap.
Further research is needed to test whether high rates for straightforward births can be achieved in well designed hospital settings with committed managers. Childbirth without fear should become a reality for women, midwives, and obstetricians.
True team working is needed, with development of a shared philosophy of care and mutual respect. The maternity services liaison committee is, and will continue to be, a useful forum for clinicians from all relevant disciplines to work together with informed user representatives and input from pregnant women and new parents, on initiatives to continuously improve the quality of care.
Reviewing the available clinical evidence, and learning lessons form individual cases, is important.The pregnancy and childbirth experience is considered one of the most coveted experiences in a woman's life.
The diverse and vital ways in which we embrace it has changed since the advent of modern medicine. Although many aspire for the most natural pregnancy and birth possible, it often does not come to fruition. Medicalization is the taking of something that is a part of the normal life experience and making it a medical problem, specifically one that requires treatment.
This occurs quite often, especially in the Western world, but there is not example that is more apparent as that of the medicaliz.
Attitudes towards the medicalization of childbirth and women’s characteristics. The Attitudes towards the Medicalization of Childbirth items and descriptive data are presented in Table 1.
The full range of scores from 1 to 5 was used in each of the 15 items. Mean scores ranged from to Male appropriation and medicalization of childbirth: an historical analysis Aims of the paper. This paper aims to explore through historical analysis some of the means by which medicine successfully appropriated and medicalized pregnancy and childbirth and to consider the impact that this has had on women’s experiences within maternity care.
Rather, the medicalization of pregnancy during the twentieth century was the result of a reconceptualization of pregnancy as biomedical and ultimately . Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth Attitudes towards the Medicalization of Childbirth This is in line with previous analyses arguing that wide scale application of risk management in pregnancy and excessive use of technology can diminish women's.