Oboji se zavedajo, da je porod naravni dogodek in medikalizacija ni vedno potrebna, a je pogosto rezultat zahtev porodnic in vpliva farmacevtske industrije.
RJ wrote the first draft of this article but died before it could be completed. AM helped substantially to revise the article.
MN is responsible for its final form.
Over the past few centuries childbirth has become increasingly influenced by medical technology, and now medical intervention is the norm in most Western countries.
Instrumental delivery with forceps became the hallmark of the obstetric era. In the 19th and 20th centuries, medical influence was extended further by the development of new forms of analgesia, anaesthesia, caesarean section, and safe blood transfusion.
The introduction first of antiseptic and aseptic techniques and later of sulphonamides, coupled with changes in the severity of puerperal sepsis, lowered the maternal mortality that had made hospitals dangerous places in which to give birth.
The World Health Organization and Unicef estimated the average maternal mortality ratios for as 27 per live births in the more developed countries compared with per live births in less developed countries, with ratios as high as per live births for eastern and western Africa.
In a North American religious community that declined all forms of professional assistance, maternal mortality remained as high as years ago.
It also cannot be assumed without careful attention to the evidence that access to obstetric care has invariably had beneficial effects.
In many countries women who have straightforward pregnancies are subjected to routine intravenous infusions and oxytocin in labour. Women without obstetric complications are encouraged to have electronic fetal monitoring and epidural analgesia.
Frequently labour will be in the dorsal position and delivery in lithotomy. Perineal injury is standard. As labour intervention has become more widespread, so too have assisted delivery rates and major surgery.
The extent of medicalisation in Spain is reflected in some of the highest caesarean section rates in Europe Specific concerns relate to painful intercourse and urinary and anal incontinence. There is a tendency to believe that most if not all deaths could have been prevented.
Although confidential inquiries into stillbirths and deaths in infancy repeatedly show that suboptimal care is a serious problem contributing to preventable deaths, death is probably unavoidable in some babies. The courts are not always good at distinguishing between preventable and unavoidable deaths.
Contribution of midwives to medicalisation Few investigations have assessed the influence of midwives on medicalisation. Quantitative studies provide some insight into the direction of change and how midwives feel about it.
Use of inappropriate electronic fetal monitoring perhaps illustrates the extent and pervasiveness of medicalised practice in Western maternity care. In the United States, Canada, and recently England, major reviews of the evidence have concluded that electronic fetal monitoring should be reserved for high risk pregnancies.
A study commissioned by the Canadian health minister suggests that maternal or newborn programmes in Ontario can maintain low caesarean section rates over time, regardless of their size, location, level of care they provide, and population they serve.
This hypothesis has enormous implications and should be tested in other settings, including UK maternity units. Philosophy of care The Scandinavian countries and the Netherlands, which did not follow the trend towards steep increases in caesarean sections during the s, 9 have a tradition of perceiving birth above all as a normal physiological process and of valuing low intervention rates.
The justification has been providing women centred care, but many women report that they have inadequate information about the risks and benefits of procedures 9 and therefore the extent to which they can exercise informed choice must be questioned.
In Scotland, where wide variations in surgical deliveries have been found between units, four evidence based recommendations have been prioritised: It believes that women do not so much make informed choices as find themselves constrained by the culture of the unit they attend.
The organisation has published a birth policy calling for the maternity services to be managed in a way that will increase the proportion of straightforward vaginal births.
As epidural analgesia has been shown in randomised trials to reduce the likelihood of a normal vaginal delivery this could contribute to the variation in normal delivery rates seen. In a randomised controlled trial comparing community based care with standard hospital care a significant difference in caesarean section rates was found The rate for normal births at the Edgware Birth Centre in London and at a birthing centre in Sweden were In practice, these factors often overlap.Medicalization.
and making it an illness in need for medical attention and procedures. which can potentially put more of everyday life under medical scrutiny.
such as pregnancy and childbirth. The medicalization of childbirth is in most cases extremely necessary. Since the medicalization of pregnancy in the early 's, the infant mortality rate has decreased 90%, and maternal mortality has decreased 99%.
Bottom line, childbirth is not a medical procedure unless you let it become one. A well written birth plan will take all the questions and worries out of the medical decisions facing the newborn's parents during this blessed event.
The Medicalization of Pregnancy - A Chapter Excerpt from Natural Pregnancy Book by Lauren Feder, MD. Press Room. Kindred’s Top 15 Articles From ! The pregnancy and childbirth experience is considered one of the most coveted experiences in a woman’s life. The diverse and vital ways in which we embrace it has changed since .
A ship upon a stormy sea: The medicalization of pregnancy.
Author links open A common mechanism through which Prenatal Care advances a disease-like conceptualization of pregnancy is through the application of host Using the Bureau Central File Catalog I traced all women's letters cataloged under pregnancy, childbirth.
We performed an intervention consisting of an educational program and modified guidelines to achieve a more appropriate use of oxytocin. This prospective intervention study included first-time mothers at term with spontaneous onset of labor before (October to May ), and after the intervention (April to April ).