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Copy of Home Birth; an old trend, new again
Transcript of Copy of Home Birth; an old trend, new again
Prepping for a home birth
Why did home birth regain popularity?
The earliest birth attendants were women . In ancient mythology , goddesses were present at deliveries.
Prehistoric figures and ancient Egyptian drawings show women giving birth in sitting or squatting position. Birthing midwives are also mentioned in the Old Testament.
The history of obstetrics
is linked to the history of
Obstetrix was the laten word for "midwife": it's thought to derive from obstare (to stand before), because the attendant stood in front of the woman to receive the baby.
The writings of Hippocrates in the fifth century BC described: normal birth
Instrumental delivery that was restricted to stillborn babies
In the latter part of 15th century
first obstetric pamphlets were printed in Latin or in German, but made little
In 1513, an obstetric textbook appeared and became a bestseller and translated to several languages
In the 17th century, male midwives became fashionable in France. The best known of them was "Francois Mauriceau" whose name is familiar to today's obstetricians due to (Mauriceau-Smellie-Veit manoeuvre) for dealing with aftercoming head in a breech delivery.
By the later part of the 18th century, man midwives began to be fashionable in England
Although they knew about forceps,the usage of it was very limited and Conservative management was the main base.
The use of birthing tubs can ease labor pains and decrease the need for pain medication. It also can decrease vaginal trauma.
There is a risk, albeit small, that the baby breathes underwater. But babies are born with a 'dive reflex', which allows them to block their throats when underwater.
During the third trimester, self-hypnosis and other relaxation techniques can reduce birthing agita. However, enough evidence is still lacking.
Home birth advocates argue that healthcare policies, driven by monetary and legal interests, turn a blind eye to what really benefits the mother and the baby.
A desire to give birth in a familiar, relaxing environment where she can dress and wander freely
A desire for an intervention-free drug-free birth
A desire to control labor position
Previous negative hospital experiences
Cultural or religious norms
Choose a healthcare provider; a certified nurse-midwife, a midwife or a doctor
Prepare for a hospital transfer
Choose a pediatrician
These conditions necessitate a hospital transfer
Labor isn't progressing
Signs of fetal distress e.g., traces of meconium or fetal bradycadia
Umbilical cord prolapse
Three pieces of evidence...
The evidence suggests that home birth is safer than an interventive hospital birth...
A 2013 nation-wide cohort dutch study concludes that "There was no evidence that planned home birth among low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system."
BMJ. 2013 Jun 13;346:f3263
Another study was published in Brazil in 2012 analyzing the data of 100 pregnant women between 2005 and 2009 also suggests that planned home birth is safe
Rev Saude Publica. 2012 Aug;46(4):747-50
'Birthplace in England' is study that compares low-risk pregnancies in terms of their planned place of birth: home, midwifery units or obstetric units. The study also supports providing choices to women
Birth. 2012 Jun;39(2):165-7
The US health policies always stand against home birth. In a recent article published in 2013, the authors urged obstetricians and midwifes to refuse to participate in planned home birth. Moreover, they also called on obstetricians not to participate in or refer to randomized clinical trials of planned home vs planned hospital birth
Am J Obstet Gynecol. 2013 Jan;208(1):31-8
Home birth is not right for everyone...
Home birth is not recommended for women who..
Have diabetes, chronic hypertension, a seizure disorder or any chronic medical condition
Previously had a C-section
Use tobacco or illegal drugs
Develop a pregnancy complication, such as pre-eclampsia, preterm labor or significant anemia
Are pregnant with multiples or whose babies don't settle into a cephalic position
Are less than 37 weeks or more than 41 weeks pregnant
Home birth; an old trend,
In the end...
Rhythmic motions while sitting on a sturdy chair or a birthing ball can be soothing
Eases back pain and is a good position for a back rub
Helps the baby descend and rotate. This can be done also with leaning forward
At the start of 19th century, childbirth was still dangerous to women and it remained so until well into the 20th century despite several advances. Among the poor, rickets caused pelvic deformities and maternal mortality rate still high.
Meanwhile in Britain,
midwifery became a compulsive subject for medical students.
Midwives were no longer illiterate.
The development of antisepsis and anaesthesia paved the way for the introduction of "Caesarean section"
Sitting with one foot up
Helps the baby descend and rotate. Supporting under the knees is helpful
Helps open the pelvis and allows bearing down to be more efficient
Leaning forward and pulling the knees toward the body are helpful
Soothes the pain and maximizes blood flow to the uterus and the baby
The 20th century witnessed the development of (Antenatal care), which was very vital in decreasing the maternal mortality rate. Many antenatal clinics were established.
There was also developments in the techniques of instrumental delivery that allowed using the forceps safely.
The modern vacuum extractor was invented which causes less maternal trauma.
Introduction of many antibiotics to guard against infection.
Introduction of oxytocin and ergometrine prevented the incidence of postpartum Hemorrhage.
Mayo clinic-health information
In spite of the ongoing controversy about home birth, it still remains an option for women as long as well-planning is ensured
By the 2nd half of 20th century, attention shifted from the mother to the fetus.
Fetal monitoring in labor (ECG and blood sampling from the scalp)
The other important development was obstetric US.
The content of this presentation was collected from...
Can ease back pain and help open the pelvis
On hands and knees
Takes the pressure off the spine an increases blood flow to the baby
This presentation outlines..
I. A glimpse of the history of obstetric practice
II. The reasons why home birth regained popularity
III. The safe home birth plan
IV. The evidence supporting home birth
V. Those who are not a perfect fit for a home birth
Other reasons include...
A woman who desires a home birth should...
Create a birth plan
a woman experienced in childbirth who provides advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth..
Stereotypically, midwives have been portrayed as a poor, dirty and ignorant alternates to obstetricians. But in fact they can make a safe alternative for low-risk pregnant women, as long as a specialist consultation is always available.
Note that a doula does NOT provide medical advice and cannot replace a licensed healthcare provider such as a midwife or a doctor.
Planning should cover...
where labor will take place
labor method e.g., water birth
It's worth saying that home birth gives a woman a wide array of labor positions to choose from e.g.,
Women who plan to give birth at home might consider...
Is there any evidence that supports home birth?
Take a look at theses
The Business of being born
Pregnant in America
One born every minute