Obstetricians and midwives have become so successful at routinely delivering healthy babies to healthy mothers, that most people don't realize that this is a development of the twentieth century. In 1900, the death of women in childbirth was common, and virtually every woman expected to lose at least one child during labor and delivery. The practices and equipment of modern obstetrics have made all the difference in dramatically increasing the chances of a safe delivery.
There are proponents of natural childbirth without medical intervention of any sort. They contend that pregnancy and childbirth are and should be entirely natural processes. However, there is no reason to believe that just because something is a natural process, it is inherently safe. Think about it this way. While it is very likely that your baby will have a safe and healthy childhood, you are probably not planning to leave that to chance. You will take your baby to the pediatrician for routine checkups and immunize him or her to prevent dangerous childhood diseases. If your baby gets sick, you will not hesitate to use antibiotics, or whatever else is necessary to restore good health. The entire process of pregnancy through labor merits the same degree of close supervision and treatment, if it is indicated.
Modern obstetrics is based on the principle that most women will have uneventful labors and deliver healthy babies easily. Nonetheless, careful monitoring is done to detect those few babies that show subtle signs of difficulty and to treat them before a problem develops. Moreover, obstetricians are regularly called upon to rescue those babies that find it difficult or impossible to negotiate the birth canal.
Do obstetricians and midwives sometimes overtreat? Undoubtedly! That's because their standards are so high. To be sure that not even one baby will be harmed during delivery, it is almost impossible not to treat some babies that probably would withstand the stress of birth without help. To do otherwise is high stakes gambling. Most babies, even those showing signs of significant distress, would probably be okay without intervention. Some definitely will not. The average obstetrician or midwife is not a betting person; most won't take chances with your baby's health, even if the chances of a bad outcome are relatively small.
The chapters in this section are devoted to describing and explaining the most common practices and procedures of modern obstetrics. Each practice will be considered in detail, including possible reasons for its use, as well as how it works, and how it feels. Many of these procedures are optional in a lot of circumstances. That's why it's important to know as much as possible about them beforehand, because your practitioner will likely want to know your preferences.
In order to make a reasonable decision about what methods are best for you, it is important to be realistic about just how much pain is involved. The good news is that there are lots of options available for pain control-psychological options as well as medical ones.
Here, some particular comments are in order about childbirth and pain relief. Contractions are not called "labor pains" for nothing. They are not "sensations" and I've certainly never heard a patient characterize them as "orgasmic," though some books describe them as such. Although the pain of childbirth has been recognized in ancient writings dating back thousands of years, the following new myth about childbirth has become popular in recent years: Childbirth is not inherently painful, so "real women" don't need pain medication because they are actually "empowered" by experiencing the pain. But when you stop and think about it, this doesn't make much sense. A seven-pound baby is about to be pushed out of your body through a narrow (although elastic) tube. How could this be pain-free? There are a few lucky souls who may experience painless childbirth, but the vast majority of women describe it as the most physically painful experience of their lives. Whatever you do, do not plan too far ahead. You do not know how much pain you will have and you do not know how you will respond to it. Keep your options open.
In our relentlessly competitive society, it is often difficult not to set goals for ourselves, even in the most intimate of circumstances. It is important to remember that childbirth is not an athletic event. No team of judges will award the perfect score to the woman who refused an episiotomy, or deduct points from the woman who requested an epidural. Childbirth is a deeply personal experience. You should feel comfortable making the choices that are right for you; do not judge yourself by someone else's standards.
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