If maternity care is getting riskier, it seems safer to concentrate it..

Despite the upset in rural areas, and the rurality lobby, there is a falling birth rate in indigenous peoples, and immigrants, whose birth rates are rising, tend to live in the cities. Sian Griffiths and Sanya Burgess report “Natural Births get harder for women” in The Sunday Times 24th may 2015.

With good prevention, planning, back up, and transport systems the results for Maternal Mortality and Neonatal health can be as good for the rural location of the world as for city dwellers. So this is a commissioners issue, of safety against convenience, and the ignorant will vote for convenience, until they are the victims. If maternity care is getting riskier, it seems safer to concentrate it.. For you’re first child/delivery, on the whole you will be prepared for a little inconvenience to reduce risk maximally.. When it comes to the second, if things have gone well first time, then by all means take a risk, but do not blame anyone but yourself if things go wrong.

2004-09-25B

WHEN the television presenter Kirstie Allsopp gave birth to her first child at the age of 34, she planned a natural birth. She had even booked a birthing pool.

 

In the end, however, on medical advice Allsopp had a caesarean section, and another when her second child was born two years later.

“Natural childbirth is brilliant when you can manage it, but no one wants to gamble with the health of their baby,” she told The Sunday Times.

Allsopp is one of a growing number of women who are giving birth with the aid of drugs, chemicals and surgery.

But a new book by a leading obstetrician warns that the medicalisation of labour leaves women at serious risk of being unable to give birth naturally or to breastfeed their babies in the future.

In Do We Need Midwives?, to be published this summer, the French doctor Michel Odent, who pioneered the use of birthing pools in hospitals, argues that so many pregnant women are given drugs, chemicals or surgery in labour, that future generations are at risk of losing their natural ability to push babies out unaided. Already, he says, there is evidence that women are taking longer to give birth than in the past.

“Women are losing the capacity to give birth and they are losing the capacity to breastfeed,” he says. “That is the primary phenomenon . . . the number of women who give birth to babies naturally is becoming insignificant.”

Odent, 85, is critical of the rise in caesarean sections and the growing use of synthetic oxytocin.

In England in 2013-14 more than one in four of all births (26.2%) were by caesarean section, a 0.7-point rise on the previous year, while the rate of births induced using chemicals such as synthetic oxytocin rose 1.7 points to 25%.As a result of this trend, Odent believes women’s natural ability to produce oxytocin, which initiates labour and plays a crucial role in breastfeeding, is declining. Evolution will eventually erase physiological functions that are underused, he says.

“I believe that the human oxytocin system — oxytocin being the hormone of love, fundamental to birth and bonding, even in adulthood — is growing weaker. The future of the human capacity to give birth is at risk,” he says in a contribution to another new book, Mama: Love, Motherhood and Revolution, by Antonella Gambotto-Burke.

Odent, who was head of the surgical and maternity units at the Pithiviers hospital in France, has cited two research studies in support of his theory. One shows that on average women took 2½ hours longer in the first stage of labour between 2002 and 2008 than between 1959 and 1966. “To me it demonstrates the obvious — that women are losing the capacity to give birth.”

In the book by Gambotto-Burke, Odent draws on an American study of 14,000 college students which revealed a declining capacity for empathy. The 30-year study, from 1979 to 2009, showed that six years ago college students were 40% less empathetic than their counterparts in the 1980s and 1990s. This, he says, supports his argument that oxytocin levels are weakening.

He argues midwives need to become “protectors of the evolutionary process”, shielding women from doctors who try to intervene in births; women should be given space and peace to give birth naturally.

In the foreword to the book by Gambotto-Burke, he suggests that midwives should sit quietly in the corner of a darkened labour room knitting, which would calm the mother-to-be, enabling her body to produce the natural cascade of hormones needed to give birth.

Emma Bailey, a mother of two, thinks Odent has a point. She had surgery during the birth of her first child, Alice, 3, and after her second, Thomas, now nine months, she again had to stay in hospital.

By contrast, Bailey’s mother had no complications when she gave birth and needed no medical intervention. “I definitely believe that women’s bodies are changing,” said Bailey.

Soo Downe, professor in midwifery studies at the University of Central Lancashire, said: “Odent has in the past said things that seem preposterous but a few years later are borne out by the evidence. Giving women synthetic oxytocin interferes with the balance of hormones. Evidence is growing that there are long-term consequences.”

 

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This entry was posted in A Personal View, Commissioning, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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