Brittany Ashinhurst

Lara Fields
PHY 1100
The Miracle of Childbirth
Childbirth is when a woman has hopefully made it to the end of her pregnancy and her body is
ready to push or deliver the baby. The childbirth process is normally divided into 3 stages: labor,
delivery of the baby and the delivery of the placenta and umbilical cord. (Human Development a
Cultural Approach Pg 85) Labor is when the cervix dilates and the muscles of the uterus contract to push
the fetus into the vagina. It is also the longest and most taxing physically and emotionally of the 3
stages. The first birth for a woman labor can last up to 12 or more hours. But each labor after that is
usually 6. Delivering of the baby is the second stage. This is when the mother has the urges to start
pushing. This can last anywhere from a few pushes to a few hours. When the babys head is at the outer
opening of the vagina that is what is called crowning and the delivery is almost complete. Sometimes
women need help if the baby is stuck or having hard time getting past the vagina opening so then a Dr.
will perform an episiotomy in which the Dr. makes an incision to make the vagina opening larger to help
make it easier for the mother and baby. Once the baby has been delivered it usually takes up to 30
minutes to carefully deliver the placenta and umbilical cord.
Personally I think childbirth is one of the most magical events that can happen to a mother and
her partner. I have been able to experience childbirth 3 wonderful times. All 3 of my labors took about
hours from when I got to the hospital to when I delivered the babies and afterbirth (placenta and
umbilical cord). My first birth I opted to have an epidural for the sake of my husband. I wanted him to
enjoy the birth of our first baby so he would eventually want more. My second baby I decided I was
going to natural with no pain medications but a few hours in the baby was in distress and I was then
prepped for a C-section. Thankfully by the time my doctor got there my baby was crowning and so I
didnt end up with a C-section. My third baby I had with no pain meds and ended up having a pain free
unintentional water birth at the hospital and delivered the baby myself because my doctor hadnt
arrived yet and the nurses were running around trying to get the room set up. After having my 3
rd
child
it made me think differently about childbirth here in America. In our culture it is normal to schedule C-
sections for convenience, the majority of the births happen in hospitals and pain meds are heavily used.
Where as in other countries homebirths and midwives are used in place of hospitals and doctors and
pain meds are rare. Overall its really just a fascinating, magical process that in some ways are identical
around the world yet completely different.
For years, Sweden has been in the top 5 countries in the world to have a baby. In 2013
they were ranked #5 with 2.73 deaths per 1,000 births compared the United States which was
ranked 50
th
at 5.98 (http://www.indexmundi.com/g/r.aspx?v=29). Some of those reasons
include many policies and services which create a safe, secure, and supportive environment for
women and children. One critical factor is the availability and quality of prenatal care services.
Sweden for decades has had socialized health care that seems to work for their country.
Therefore all pregnant mothers and their babies have access to free healthcare.
When a woman finds out shes pregnant she goes to her local clinic and sees a midwife
who will be the primary caregiver throughout her pregnancy. The only time she will see an
obstetrician is if there is an emergency or if they know of a problem beforehand that requires a
cesarean section. A Female Obstetrician (OBGYN) said In Sweden midwives have their own
place. Women have always delivered other women. We have good statistics here because the
moms get good education through the midwives and the classes they hold. OBs do what they
are trained inpathology. I almost never attend a normal birth. I am so busy already I dont
want more to do (Journal of the Association for Research on Mothering. 62 Volume 11, Number
1 Jan E. Thomas). With uncomplicated pregnancies a woman will have 7-9 prenatal visits. The
first visit will last roughly two hours with the remaining visits being thirty minutes each. There is
minimal testing done and the pregnant mom never has to worry about stepping on the scale
and they never receive any vaginal exams. When a woman finally goes into labor or her water
breaks she will call her midwife. A woman can stay at home for up to 3 days after her water has
broken before they recommend her going into a birth center or the hospital. Once she is at the
birthing unit, hospital or if she chose to have a homebirth the midwife will then let her labor as
she pleases and ask her how she would like to deliver the baby whether its a water-birth,
standing/squatting, etc. Also less than 50% of woman will have an epidural and if its their
second baby an epidural is rare. The assumption is birth will be normal. Since midwives provide
virtually all prenatal care in Sweden, there is a strong emphasis on birth as a natural process
that should not be interfered with unless necessary. The following brief statements, all from
different midwives, emphasized the way they approach pregnancy and birth: Midwives are
protectors of natural birth, We generally trust in everything going right, If its not necessary,
we dont do it. (Journal of the Association for Research on Mothering. 62 Volume 11, Number 1
Jan E. Thomas)
Researching birth practices in Sweden really opened my eyes. It made me think that
maybe there are practices in the United Sates that are unnecessary that are causing more harm
than good? And since Sweden is ranked one of the best they are obviously doing something
right.
According to the World Health Organization (WHO) Caesarean sections, when adequately
indicated, can prevent poor obstetric outcomes and be life-saving procedures for both the mother and
the fetus. However, at a time when the caesarean delivery rate as a percentage of live births has
been rising globally, there is growing concern about unnecessary caesarean sections. Unnecessary
caesarean sections can increase the risk of maternal morbidity, neonatal death and neonatal admission
to an intensive care unit. (http://www.who.int/bulletin/volumes/91/12/13-117598/en/) In 2012
America had 1,296,070 cesarean sections which comes to 32.8% and more than 60% had an epidural
compared to Sweden which stands at 17% for cesarean sections and less than 25% for epidurals. Both
America and Sweden are developed countries yet what they believe to be culturally normal is
completely different when it comes to pain medications and cesarean sections. Nowadays,
educated, middle-class American women feel they have a right to effective pain management
during labor and that an extremely painful birth is culturally unacceptable. It highlights how far
American women's expectations regarding pain during childbirth have changed over the past
200 years, (Susanne Klausen, Birth in Transition, Journal of Womens History, Volume 2,
Number 3, Fall 2013). Yet in Sweden even though pain medications are easily available less than
50% of women will request for the use of pain relief medications. In Sweden natural birth with
no pain medication is considered culturally acceptable. When they do ask for pain relief they
primarily use Entonox also known as Laughing Gas. Epidurals are rarely used for normal birth.
The main use for epidurals in Sweden is in case of a cesarean section.
The outcome for both cultures whether the women had drug free natural birth, used
pain medications, chose to schedule a cesarean section or ended with an emergency cesarean
section they all end in love and accomplishment. How a mother choses to birth her baby and
what she believes her choice is the best decision for her and her baby doesnt change the
amount of love she has for her child or how hard her body worked to create and deliver her
baby.
In the ideal world each mother would have a safe birth just as she planned and of
course each baby would be born healthy and strong. One thing that would change would be
that every mother both in developed and developing countries would have access to materials
that would educate her about her pregnancy and her options about giving birth. The education
would include her options for pain relief, where and how she would like to birth whether thats
at home or a scheduled cesarean section. And everything else that is important about giving
birth. That way the mother completely understands and is educated about the risks/benefits of
her birthing preferences. Another thing that would change is that developing countries would
have more medical resources easily available and that both developing and developed
countries would use those medical resources accordingly and when necessary.
This ideal world situation would advance the welfare of mothers and their babies.
Immediately it would help mothers and babies in developing countries help with birth
complications that can be deadly. Two of the most common birth complications are failure to
progress and breech presentation of the fetus. Failure to progress means that the woman has
begun the birth process but is taking longer than normal. (Arnett, pg 87) This can be a
dangerous because if labor lasts too long the womans body can physically get to a point where
she and her body are too tired to continue through the birthing process which can lead to
health problems and even death to both the mother and baby. Breech presentation is when
the fetus is turned around so that the feet of buttocks are positions to come first out of the
birth canal. Breech births are dangerous to the baby because it can cause the umbilical cord to
be constricted during deliver, potentially leading to insufficient oxygen and brain damage
within minutes. (Arnett, pg 87) Having the medical resources easily available can help prevent
major life threatening problems and help keep mother and baby healthy. Education would be
the greatest impact. Many women wont do any research on their options and just blindly take
their doctors advice. Just because they are a doctor doesnt mean they are a good one or will
do whats best for their patients. The Centers for Disease Control and Prevention collected data
throughout the United States and reported that Out of 3,946,814 births in America in 2012
1,296,070 or 32.8% were cesarean sections. (www.cdc.gov/nchs/fastats/delivery.htm) Having
the education woman will know all their options and go for second or third opinions if they are
having doubts with their care. Having the medical technology available is very important
especially in emergencies but that doesnt mean we should use it because we have it and its
convenient.
Overall my research on the topic of childbirth has been very interesting. I do believe that
cesarean sections are over used here in America. There are times when they are necessary and
life saving which is a huge blessing and advantage we have here in American compared to
developing countries around the world who do not have the medical advances we have here in
America. I think America should take a step back and evaluate how we've come so far yet gone
way off track. We should consistently be in the top 5 with Sweden and with mortality rates
related to childbirth. I believe if we all educated ourselves and did as much research about our
pregnancies and our options like we do with our school then we would have mothers and fathers
more involved with their pregnancy and not blindly following their doctor. She should be
informed and understand what her options are and get a 2nd or 3rd opinion if she feels her doctor
isn't giving her the best advice. Now I'm not saying all doctors are bad and we should to a point
listen to them but a lot of times they are busy and or tired and things get missed and fall through
the cracks. So if we can educate ourselves we act as our backup and can stay on top of our health
and the health of our babies.

References
Susanne Klausen, Birth in Transition, Journal of Womens History, Volume 2, Number 3, Fall
2013(http://muse.jhu.edu.dbprox.slcc.edu/journals/journal_of_womens_history/v025/25.3.klausen.ht
ml)
http://www.who.int/bulletin/volumes/91/12/13-117598/en/
http://www.who.int/gho/publications/world_health_statistics/EN_WHS2013_Full.pdf
http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_01.pdf
Jeffrey Arnett, Human Development, a Cultural Approach, pg. 87
http://www.indexmundi.com/g/r.aspx?v=29
Journal of the Association for Research on Mothering. 62 Volume 11, Number 1 Jan E. Thomas