Wednesday, October 28, 2009

The Birthing Process- Your choices and Infant Mortality? What can we do?

Discussion 4-1

The process of birth occurs in three stages. The first of these processes is the dilation of the cervix and transition of the contractions to reach their optimal level (Berk, 2008). This is followed by the birthing process which includes the pushing of the baby down the canal and the emergence of the body (Berk, 2008). Finally, the placenta is delivered, marking the end of the process (Berk, 2008). Although, in a normal delivery, all of these processes occur in the same sequence, cultures define the environment and methods used to assist in the process.
Prior to the 1800’s in the Western Cultures, most births took place in the home (Berk, 2008). However, as risks increased and the industrial revolution brought more medical and professional services to urban areas, hospitals with doctors became the choice setting for birth (Berk, 2008). It is important to remember, however, in the hospital settings; during those times sanitary conditions and standards were low, which possibly increased the potential for harm to the mother and newborn.
Between the 1950’s and 1960’s a Natural child birth Movement emerged in which mothers opted for a more relaxed setting within the hospital, so birth centers were created (Berk, 2008). These allowed for members of the family to participate in the process, the declined use of pain medications occurred, and the onset of practices which assisted the mother in the birthing processes such as relaxation techniques, position and Lamaze (Berk, 2008). This allowed for the mother to have a choice in how the birth of her child would be conducted. Proponents Natural Child birth claimed to reduce pain and reduce anxiety (Berk, 2008). The Natural birth Process included classes about the process to decrease fear, breathing and relaxation techniques, and a coach to assist with the labor by offering encouragement and assisting with the techniques learned throughout the training (Berk, 2008).
Free standing birthing centers also became an option for the mothers. Free standing birthing centers allowed for the mother to choose the position, the environment, and allow whom she chooses into the delivery process (Berk, 2008). Positions included sitting upright or using a special birthing stool which allegedly led to decreased labor and increased oxygen to the baby; Water births in which the water supports the weight of the mother and thus allowing her to move into comfortable positions during the process (Berk, 2008).
During the 1970’s and 1980’s, Home Deliveries became more common. Home Delivery has historically been the preference in countries like England, Netherlands, and Switzerland, but in the Western culture it began to emerge as a choice for women who were at decreased risk for complications (Berk, 2008).
It is important to note that in all cases, there is a risk of complication during the delivery. However, even in hospital setting with a physician standing by, some of these complications cannot be corrected. Once the birth is complete, the risks for the newborn do not end. In fact, depending upon culture, socioeconomic standards, and available support systems, the risk may increase.
Unfortunately the greatest risk for infant mortality occurs with poor ethnic minorities (Gross, 2008). African American and Native American infants are twice as likely to die in the first year, while Canada has the greatest survival rate (Gross, 2008). The infant mortality is linked to physical defects and low birth weight (Gross, 2008). The numbers are actually staggering for the first month of life, with 67% of infant deaths in the United States (Gross, 2008).
Many countries have significantly lower rates of infant mortality in comparison to the United States. Research indicates that this likely due to health care and support that is universal to all who need it in these countries (Gross, 2008). Furthermore, these countries take a proactive approach in offering nutrition, medical care, and social economic supports to the new mothers (Gross, 2008). Western European countries, for example, offer low cost or free prenatal care, home based health services, follow up to the new mother and infant after birth, counseling, and ongoing medical services to the infant (Gross, 2008).
Post Natal development is critical to the survival of the infant. Many countries with high mortality rates lack clean drinking water, immunizations, are in desperate poverty, and have inadequate medical supports (Gross, 2008). Besides these basic needs, the physical contact from the mother is critical. Research indicates that infants who are deprived of comforting physical touch experience higher rates of failure to thrive (Gross, 2008).
So, although history shows progress in the actual birthing process, the post natal care and treatment services available still pose a huge threat to the survival of the infant.

Valerie Poling

References:
Berk, L. E. (2008). Foundations of Development. In L. E. Berk, Infants, Children and Adolescents (pp. 129-145). Allyn and Bacon.
Gross, D. (2008). Physical Growth Health and Nutrition. In D. Gross, Infancy: Development from Birth to Age 3 (pp. 141-174). Pearson Education, Inc: Allyn and Bacon.



Now, after reading that... I am curious, what do you think we should do? 67% of infants die during their first month in the Western Culture? how Can that be? With all the advances in medical technology that we have? yet, those advances are not freely accessible to the poor, uneducated, and those in certain outlying areas...
Is universal health care the solution? Or is this simply going to decrease the available services?

I would love to get a real conversation going on this one... hear your thoughts, see it from a different perspective... So, share here!

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