Prenatal Care and Birthing Practice

Early Childhood Development - Week One

Prenatal Development

Reflecting on this weeks' course materials and the prompt for our blog posts this week, I am taking away two things.  One, I am fascinated over the amazing orchestration of creation that is prenatal development.  Two, my life lacks any form of significant birth story.  That being said, instead of sharing a personal birthing experience, I am going to instead share a number of small glimpses of experience that I do have and hope that the next two years or so bring me my own personal experience through the birth of my own first child.

Here are some personal tidbits:

• Very generally, I know that my sisters and I were born in a suburban hospital in Denver, Colorado.  As far as I know, my own birth was fairly standard for that type of situation.  My parents have never really talked about it.
• My sisters, born three years after me, however, are twins, so their story is slightly more interesting.  They were born by scheduled cesarean section when I was three and a half.  I only remember getting to stay overnight at a friend's house, but my dad did share a little bit with me about their birth that I found interesting a few months ago.  He explained to me that when they pulled the first baby out, he simply followed the nurse (or pediatrician) with that baby to watch the tests and keep an eye on his new daughter.  He said this completely matter of fact, then as an afterthought, mentioned that he paid no attention to the second baby's birth or tests.  This doesn't really reflect anything about his love for all three of his daughters, but does present an interesting picture of the conflict of a cesarean birth of multiples, I suppose.

 

Here is a photo an early photo of me and my dad.
While I don't remember it, I'm sure he was an important part of my birth.

• Not exactly a birth story, but very relevant to this week: my husband and I have a good friend whose family (pregnant wife, two-year-old son, and himself) moved to Ecuador recently as quasi-missionaries.  They were excited at the prospect of giving birth in a foreign country and expanding their family in that way.  In hindsight, I'd say they should have done more research.  They recently chose to move back to the United States for the birth of their child because they were told my doctors in Ecuador that they would have little control over the medical intervention options in giving birth in Ecuador.  As they explained, malpractice lawsuits have become so prevalent in Latin America that very few doctors are willing to take risks on vaginal deliveries.  Given any indication of prolonged labor, fetal distress, or maternal danger, the doctor will immediately prepare for a cesarean section, despite any previously communicated desires of the family.

• My husband is a medical student and recently spent eight weeks on his OB/GYN rotation.  He would have so many stories to share.  He shared very little medical knowledge with me, as I am not very much so a blood and guts kind of girl.  He did, however, share an interesting question with me one night after working on Labor and Delivery.  In a situation where there were complications in a birth, he asked me whether my preference, in a traumatic situation, would be that he goes with our baby to the NICU after he or she is born, or that he stays with me while they deal with the complications, stitches, etc., relating to me.  Instantly, when he asked, I answered that he should stay with me.  I don't handle doctors well, he would have the best understanding of what is going on, and I need a lot of mental support, always, but I'm sure especially in some kind of situation like this.  However, after some of the things we've learned this week, I'm not so sure that's the correct answer anymore.  While I justified my answer before by saying the baby will never remember if no one follows him or her, maybe the contact of having a father nearby would be more beneficial than I initially thought.  Just an interesting question a young married couple ponders as they fall asleep.

A photo I took from my dorm room window of Lake Geneva
and the French Alps while living in Lausanne, Switzerland.

The country I chose to research further regarding how births occur is Switzerland.  Switzerland is a small, independent minded European country situated in the middle of France, Germany, Italy, and Austria.  In college, I lived in a small French speaking Swiss town, Lausanne, for eight months while studying abroad.  While I certainly made very few inquiries into their birthing practices at that time, I thought it would be interesting to learn now.  As a well developed European nation with nationalized health care, the similarities with a United States birth like my own certainly outweighed the differences.  Here is what I learned:

• Rates of maternal and infant mortality in Switzerland are far lower than in the United States.  Switzerland ranks 25th lowest in the world in maternal mortality with a 8.00 deaths per 100,000 live births, while the US ranks 48th with 21.00 deaths per 100,00 live births.  For infant mortality, Switzerland has 3.73 deaths per 1,000 live births, ranking 21st in the world, while the US marks 6.17 deaths per 1,000 live births, coming in at 57th worldwide (Central Intelligence Agency[CIA], 2014).
• Women in Switzerland are given the choice among a traditional birth in a public or private maternity hospital, an ambulatory birth (if both mother and child are healthy after giving birth in a hospital without complications, they return home after a few hours, but are visited regularly by a midwife), a less-clinical, home like birthing house environment, or even a home birth with an attending midwife (Angloinfo, 2000-2014).  From my reading, it sounds as though alternative options to a hospital birth are more commonplace than in my traditional US experience.
• I found it very envious that women in Switzerland are lawfully guaranteed fourteen weeks of paid maternity leave, and even more, the law prohibits women from returning to work in the first eight weeks after birth (Angloinfo, 2000-2014).

This exercise in comparing birth practices between the US and Switzerland showed me that while a developed nation has greater access to healthcare and better health outcomes from pregnancy, the line between hospital births and maternal and infant mortality isn't necessarily linear.  While it is important for women to have access to medical care, there can be healthy, positive success for women and babies through alternative options when managed well.  The universal healthcare system of Switzerland is an appropriate example of how this can be done well.

Angloinfo. (2000-2014). Having a baby in Switzerland. Retrieved from http://geneva.angloinfo.com/information/healthcare/pregnancy-birth/

Central Intelligence Agency. (2014). The world factbook: Switzerland. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/sz.html