Page 122 - 86 human physiology part-2

Pregnancy and Birth

Delivery Options

Hospital Births
The chances of having natural, uncomplicated birth are optimized by carefully selecting your
obstetrician and hospital. Doctors who work with midwives have lower cesarean section rates
because midwives handle less complicated pregnancies. Delivering babies by abdominal surgery
has been steadily rising in America over the past two decades, so that now 22-30% of births in
American hospitals are cesarean section. The U.S., despite having the most advanced technology
and highly trained medical personnel, ranks 23rd in infant mortality and 18th in perinatal
mortality.

Medical interventions such as epidural anesthesia, pitocin augmentation of labor, vacuum
extraction of fetus, episiotomy and separation of newborn and mother are common in American
hospitals. There are circumstances where medical procedures such as these are necessary, but
many parents and professionals now question the routine use of such interventions. In some
cases, the routine use of these procedures have lead to further complications. For example, the
epidural anesthetic, while providing pain relief, has shown to increase the operative vaginal
delivery rate (i.e. forceps and vacuum extraction rates slightly) especially in first time mothers.
Epidurals have not been shown to increase the cesarean section rate in recent well documented
studies.

Freestanding Birth Centers & Water Birth
"Freestanding" Birth Centers are not inside of or affiliated with a hospital. They are run by
collaboration of midwives or physicians. This is an alternative choice for the woman who does
not wish to birth in a hospital environment yet is not comfortable giving birth at home. Birth
centers do not provide any additional measure of safety than most planned home births with
qualified midwives; they may provide the expectant couple with the physiological comfort
necessary to enable the mother to relax.

Out of hospital birth centers are designed for women having low-risk pregnancies who want
drug-free birth with minimal intervention in a home-like environment. Family members may
participate in the birth. C-sections rates are lower than most hospitals because the pregnancies are
low risk. Freestanding Birth Centers are an alternative choice for a woman who has had a
previous cesarean and wishes to maximize her chances of a vaginal delivery. However, vaginal
birth attempts after a prior cesarean section have a 1-2% risk of uterine rupture. Heath insurance
may cover costs. Many birth centers offer birthing tubs where one can give birth in water.

Homebirth
Birth at home provides parents with intimacy, privacy, comfort and family-centered experience.
Childbirth at home may be a safe option for healthy women having normal pregnancies. It is for
those who have a very strong desire for natural childbirth and who are willing to take high degree
of responsibility for their health care and baby's birth. At home, the parents and midwife are in
control of the birthing environment, and strict time perimeters for length of labor are not
imposed, or routine medical interventions such as IVs done. However, the World Health
Organization (WHO) states that "giving birth in a health facility (not necessarily a hospital) with
professional staff is safer by far than doing so at home." (The World Health Report 2005). Also,
the American College of Obstetricians and Gynecologists (ACOG) opposes out of hospital births.
In choosing the comfort of home parents are also choosing to be further away from lifesaving
measures should complications arise.

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