Birth Interventions

These articles explore some of the issues surrounding the use of medical interventions and technologies during pregnancy and birth.  Given that pregnancy is a healthy condition for almost all women, the benefit of routinely applying lmedical care must be questioned. Whilst these procedures, tests and medications can in some cases, be life saving, their impact on healthy women and their babies needs to be considered carefully, with all decisions based on clear medical evidence stemming from a sound research base.

 

Nitrous oxide - no laughing matter

by Andrea Robertson

Nitrous oxide (often called 'laughing gas'), in combination with oxygen (50% of each gas), has been in use for two centuries
as a simple anaesthetic agent, and in obstetric care since the 1930s. It is the most popular form of anaesthesia in UK labour
wards, where it is available in 99% of consultant units (Chamberlain et al, 1993), as well as in birth centres and for home births.

Read more: Nitrous oxide - no laughing matter

   

Pain in labour - your hormones are your helpers

by Dr Sarah Buckley

Imagine this. Your cat is pregnant, due to give birth around the same time as you are. You have your bags packed for hospital, and are awaiting the first signs of labour with excitement and a little nervousness.

Meanwhile your cat has been hunting for an out-of-the way place - your socks drawer or laundry basket - where she in unlikely to be disturbed. When you notice, you open the wardrobe door, but she moves again. Intrigued, you notice that your observation - even your presence - seems to disturb the whole process. And, wish as you might to get a glimpse into the mysteries of birth before it is your turn, you wake up the next morning to find her washing her four newborn kittens in the linen cupboard.

Why does birth seem so easy to our animal friends when it is so difficult for us?

Read more: Pain in labour - your hormones are your helpers

   

Epidurals - real risks for mothers and babies

by Dr Sarah Buckley

Epidural pain relief is an increasingly popular choice for Australian women in the labour ward. Up to one-third of all birthing women have an epidural1, and it is especially common amongst women having their first babies2. For women giving birth by caesarean section, epidurals are certainly a great alternative to general anaesthetic, allowing women to see their baby being born, and to hold and breastfeed at an early stage: however their use as a part of a normal vaginal birth is more questionable.

Read more: Epidurals - real risks for mothers and babies

   

Fish can't see water

The need to humanize birth in Australia

This paper was presented at the Homebirth Australia Conference, Noosa, Australia, November 2000

By Marsden Wagner (MD, MSPH)

Humanizing birth means understanding that the woman giving birth is a human being, not a machine and not just a container for making babies. Showing women - half of all people - that they are inferior and inadequate by taking away their power to give birth is a tragedy for all society. On the other hand, respecting the woman as an important and valuable human being and making certain that the woman's experience while giving birth is fulfilling and empowering is not just a nice extra, it is absolutely essential as it makes the woman strong and therefore makes society strong.

Read more: Fish can't see water

   

Getting what you want from your birth experience

by Doris Haire

A good childbirth experience should be happy and gratifying, as well as safe. You are much more likely to have a good experience if you establish early a good communication with your doctor or midwife. Sometimes it is the expectant parents who must take the lead in establishing a rapport, but don't let that hold you back. It's your childbirth experience. It's up to you to let the doctor or midwife know what you want. If he or she is not in agreement with your wishes, it is far better to find that out while you still have time to shop around for a doctor or midwife who does agree with you.

Read more: Getting what you want from your birth experience

   

Ultrasound More Harm Than Good?

by Dr Marsden Wagner

The ultrasound story begins in July 1955 when an obstetrician in Scotland, Ian Donald, borrowed an industrial ultrasound machine used to detect flaws in metal and tried it out on some tumours, which he had removed previously, using a beefsteak as the control. He discovered that different tumours produced different echoes. Soon Donald was using ultrasound not only for abdominal tumours in women but also on pregnant women. Articles surfaced in the medical journals, and its use quickly spread throughout the world.

Read more: Ultrasound More Harm Than Good?

   

Normal Birth - What are the Chances?

by Sally Tracy

Based on the findings of a study by Christine Roberts, Sally Tracy & Brian Peat:

Rates for obstetric intervention among private and public patients in Australia: a population based descriptive study. BMJ 2000; 321: 137-141

Australian maternity care has features of the British and American systems; all women are covered by national health insurance which provides free maternity care for public women in public hospitals but about one-third take out private medical insurance or pay for private obstetric care (private patients). Private women receive antenatal care from their chosen obstetrician in private rooms and give birth either at a private or public hospital. Public women attend antenatal clinics at public hospitals where care is provided by rostered midwives, residents, registrars and staff obstetricians.

Read more: Normal Birth - What are the Chances?

   

The Active Management of Labour

by Dr Marsden Wagner

What is Normal?

Active management illustrates the confusion in the medical approach as to what is normal and what is pathological in birth.

Read more: The Active Management of Labour

   

TENS - a marketing triumph

by Andrea Robertson

I am fascinated by the popularity of using transcutaneous electrical nerve stimulation (TENS) devices during labour. This handy little piece of technology arrived on the maternity scene many years ago, and is now particularly entrenched in Britain (it may have been introduced into other countries but has not taken hold there with the same enthusiasm).

How has is become so popular, when there is no evidence of its efficacy, it promotes a reliance on technology and costs money? Clever marketing, for a start!

Read more: TENS - a marketing triumph

   

Pregnancy tests - a vital topic for prenatal education

by Andrea Robertson

One of the important aspects of running an accredited training course is the responsibility inherent in making sure that our students are current with the latest research information regarding all aspects of pregnancy, birth and breastfeeding. These students will ultimately we working with expectant parents and those of us who lead this training course know that we are in effect presenting our own prenatal programs: our students are leading these groups espousing information and ideas they have gleaned from this Course as well as other sources.

Read more: Pregnancy tests - a vital topic for prenatal education