Normal Childbirth , livre ebook

Table of Contents

Cover image
Front matter
Copyright
Dedication
Contributors
Foreword
Chapter 1. From being to becoming
Chapter 2. The role of pain in normal birth and the empowerment of women
Chapter 3. Birth and spirituality
Chapter 4. Normal birth
Chapter 5. Midwives’ practices in 3 European countries
Chapter 6. Midwives constructing ‘normal birth’
Chapter 7. Rethinking risk and safety in maternity care
Chapter 8. The early pushing urge
Chapter 9. Fetal to neonatal transition
Chapter 10. Promoting normal birth
Chapter 11. Aspects of a controversy
Index
Front matter
Normal Childbirth
Cover photograph reproduced with permission of Martin Brown, Fairsnape Ltd
For Elsevier:
Commissioning Editor: Mairi McCubbin
Development Editor: Sheila Black
Project Manager: Gail Wright
Design: Charlotte Murray
Illustration Manager: Merlyn Harvey
Illustrator: Cactus

Normal Childbirth

Evidence and Debate
Second edition
Edited by
Soo Downe BA(Hons) MSc PhD RM
Professor of Midwifery Studies, University of Central Lancashire, Preston, UK
Foreword by
Robbie E. Davis-Floyd PhD
Senior Research Fellow, Department of Anthropology, University of Texas, Austin,Texas, USA

Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2008
Copyright

An imprint of Elsevier Limited
© Elsevier Limited 2004
© 2008, Elsevier Limited. All rights reserved.
The right of Soo Downe to be identified as author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publishers. Permissions may be sought directly from Elsevier's Rights Department: phone: (+1) 215 239 3804 (USA) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .
First edition 2004
Second edition 2008
ISBN 978-0-443-06943-7
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress

Notice

Neither the Publisher nor the Editor assumes any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.
The Publisher


Printed in China
Dedication
In memory of Tricia Anderson: her transformative infl uence on the lives of childbearing women will live on through generations to come.
All names used with participants' quotes are pseudonyms.
Contributors
The late Tricia Anderson, BA(Hons)MSc PhD

Formerly Research Midwife, Bournemouth University, UK, and Independent Midwife
Beverley A. Lawrence Beech

Chair, Association for Improvements in the Maternity Services
Sue Crabtree, BM MA RM

Self-employed/Independent Midwife, Palmerston North, New Zealand
Soo Downe, BA(Hons) MSc PhD RM

Professor of Midwifery Studies, University of Central Lancashire, Preston, UK
Amina M.R. El-Nemer, BSc MSc PhD

Lecturer of Obstetric and Gynaecology Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
Debra Erickson-Owens, PhD(c) CNM

Certified Nurse-Midwife; Doctoral Student, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA
Jennifer Hall, MSc PGDip(HE) ADM RN RM

Senior Lecturer in Midwifery, Faculty of Health and Social Care, University of West England, Bristol, UK
Victoria Hall Moran, BSC MMedSci PhD

Senior Lecturer, Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, Preston, UK
Nicky Leap, MSc DMid RM

Professor of Midwifery Practice Development and Research, University of Technology, Sydney and SE Sydney and Illawarra Area Health Service, Sydney, Australia
Christine McCourt, BA PhD

Faculty of Health and Human Sciences, Centre for Research in Midwifery and Childbirth, London, UK
Marianne Mead, BA(OU) MTD PhD RGN RM ADM

Reader in Midwifery, School of Nursing and Midwifery, University of Hertfordshire, Hatfield, UK
Judith Mercer, PhD CNM FACNM

Certified Nurse-Midwife; Clinical Professor, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA; Adjunct Professor of Pediatrics, Brown University, Providence, Rhode Island, USA
Belinda Phipps, BSc(Hons) MBA

Chief Executive, National Childbirth Trust, London, UK
Rebecca Skovgaard, CNM MS

Certified Nurse-Midwife, Strong Health Midwifery Group; Assistant Professor of Clinical Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
Denis Walsh, MA DipEd DPSM RM

Reader in Normal Birth, Midwifery Research Department, University of Central Lancashire, Preston, UK
Carol Young, BMedSci(Hons) DPMS RGM RM

Formerly Community Midwife, Derby City General Hospital, Derby, UK
Foreword
Robbie E. Davis-Floyd

Austin, 2008

Instead of approaching labour from a perspective of a catastrophe waiting to happen, it is time that professionals regain their trust in the physiology which enables healthy women to labour and deliver, mostly without interference. Pregnancy and labour should be seen as normal until proven otherwise.
– Marianne Mead, Chapter 5 , ‘Midwives’ practices in 11 UK maternity units'
Let me be very clear. As the chapters in this book illustrate, the Western technocratic approach to birth, which has become the global technocratic approach to birth, is wrong. Simply and fundamentally wrong. It has nothing at all to do with the normal physiology of birth, and everything to do with the imposition of technocratic values and practices on birth.
For example, the rarity of normal birth in my country, the United States, is indicated in a profound scene in The Business of Being Born , a 2007 documentary film produced by actress Ricki Lake. In this scene, Ricki asks a group of white-coated obstetrical residents, ‘Do you ever see normal birth?’ Uneasily shaking their heads and glancing down and sideways at each other, they collectively respond, ‘Um no, not really – normal birth? Um, no, we don't.’ It is no wonder that, as Beech and Phipps point out in Chapter 4 , ‘much of the research that purports to be about normal birth is in fact about highly managed obstetric deliveries’ – of course, because this research is conducted in hospitals where birth could theoretically be called ‘normal’ only because it is normal to give birth in hospital.
This book is not an indictment of obstetricians, only of the technocratic, pathology-oriented approach towards birth in which they are trained, and which puts a great deal of pressure on midwives and nurses as well, often impeding the efforts they make to foster normal birth. In Chapter 5 , Marianne Mead notes that ‘The situation we are experiencing today is primarily the result of good intentions, mainly the desire to reduce maternal and perinatal mortality and morbidity. However, in the absence of sound programmes of research, these good intentions have resulted in increased maternal morbidity… without a corresponding improvement in neonatal outcome.’ And it's not just increased maternal morbidity that results from these good intentions. A recent study by a group of WHO researchers and affiliates found that while below 15% higher caesarean rates were unambiguously correlated with lower maternal and neonatal mortality, above this range, higher caesarean rates were predominantly correlated with higher maternal and neonatal mortality from complications of caesarean for mothers and increased prematurity and other factors for babies. 1
What is normal birth? We find the following definitions in Chapter 4 , ‘Normal birth: women's stories’ by Beverly Beech and Belinda Phipps:

The designation normal to describe labour and childbirth has been in use for centuries. The current UK Midwives Rules and Standards talk about a ‘deviation from the norm’ when referring to areas outside the midwives' competence. It is commonly taken to mean a physiological labour and a vaginal birth with little or no external intervention…
When parents talk about ‘normal birth’ or ‘normal delivery’ they mean a physiological birth where the baby is delivered vaginally following a labour which has not been altered by technological interventions…
There are indications that normal birth, in the widest sense of a spontaneous physiological, straightforward birth that occurs in the context of supportive, caring, respectful professional care, may enhance the woman's self-esteem, and her physical and mental health. It may also impact upon her relationship with her child and offer a good foundation for future family well-being.
Chapter 6 on midwifery in New Zealand illustrates the fragility of this concept of normal – a concept so easily co-optable that New Zealand midwives often find themselves saying that most of the births they attend are ‘normal’, then realizing upon reflection that these ‘normal births’ include huge percentages of labour induction and augmentation, epidurals and other interventions, leading the midwives to question to what extent they can in fact be the guides and guardians of normal birth. Author Sue Crabtree concludes, ‘If we, as midwives, now support the view that “normal” includes a wide range of medical intervention, then we have little hope of educating women and the community that normal does not include those things. As a profession, I believe we need to increase our vigilance