As human technology advances so too do our medical care capabilities. Just in recent decades the options for a women giving birth have become more numerous as well as safer and healthier for women and their children. These medical and technological advances such as high-grade epidurals and advanced cesarean sections are amazing for those mothers and children who, maybe even 50 years ago, would not have had a chance; but what most people don't realize is that these procedures are not so beneficial for those women who have low risk pregnancies (Wagner). The reason these procedures are so commonplace among even the healthiest of pregnancies is because women see the decrease in mortality rate of women and children in recent decades and automatically associate it with these procedures. This downward trend in mortality actually "is due not to what doctors do, but rather to what women do, particularly in terms of nutrition" (Wagner, "An Epidemic"). In fact, in his article, Wagner continues by blaming modern medical professionals for an "excessive and escalating use of unproven and sometimes dangerous technology". The fact is that there has been an exponential rise in everything from painkiller use to elective cesarean sections, yet most women who choose these methods are very unaware of what they are subjecting themselves to. Women of today need to be more educated on the options they have when it comes to giving birth, for a large majority or pregnancies the best option for both the women and the child's health and safety is the most natural and least invasive method.

What Choices Do You Have To Make?

When it comes to preparing to give birth, there are more choices than most women even imagine. A woman should be fully aware of what she is choosing and the risks and rewards associated with each. As I continue in the paper, I will elaborate on the specific choices a women must make, whether she knows it or not, while explaining that the typically traditional choices tend to lead to lower satisfaction ratings and more danger than one may expect. Many people do not realize the number of things they have to choose ahead of time to make their birth the best experience possible. It tends to be a lot of work but, in the end, these choices are necessary and vital to the health and happiness of the woman, child, and anyone else involved in the birth. 

Where Is The Ideal Place To Give Birth?

In regards to the location to where a woman chooses to give birth the main options are hospitals, birthing centers, and their homes. The majority of women nowadays scoff at the idea of at-home or birthing center births and instead choose hospitals. Contrary to popular belief, at-home births tend to have the highest satisfaction rates and often the highest rates of safety precautions being taken, because the medical providers that run at-home births tend to have extensive experience in avoiding possible problems (Falcao). Hospitals are the most commonly chosen places, but also the ones with the lowest rate of satisfaction due to the fact that most women feel they don't get the attention or respect they deserve as a patient (Remer).  Often this disdain stems from beliefs that alternative birthing methods are more dangerous, more painful, or more costly. This may surprise many women, but these beliefs are all common misconceptions. In this section, I will explain how at-home births have abnormally low rates of health and wellness risks, as well as low rates of emergency cesarean sections and interventions of labor compared to all births nationally (Simkins). This trend of lower risks and rates is not limited to emergency intervention; it also includes a lower use of unnecessary pain-killing drugs which, contrary to popular belief, can lead to a healthier and more satisfying birthing process. Finally, I will briefly touch on how at-home or even birthing centers can still be a more cost effective option for expectant mothers.

What most women don't realize is that at home births are specifically designed to have ultimate safety in mind for even the worst-case scenario. "During the hours leading up to a birth, if a cesarean becomes necessary, there is a safety margin of 30 to 75 minutes in which to assemble a surgical team" (Falcao). What this means is that even if a pregnancy suddenly take a turn for the worst in a home birth (which is a rare occurrence as it is,) a women has the option to use necessary surgical methods. Along with this assertion, which proves the safety ratings are the same as they would be in a hospital setting for emergency care intervention, Falcao adds facts that increase the safety rating for other aspects beside emergency situations. She reveals at home births also have lower infection rates, higher personalized care rates, and lower drug use rates (Falcao). The fact is that hospitals tend to provide more generalized care, and focus less on the needs of the individual because they are trying to deal with so many patients at once (Remer). This causes a drop in safety precautions and personalized attention to the mother and the child. Incidentally, this impersonal care is correlated with a higher use of drugs. This actually has a distinct possibility of adding more pain to the process as well as lowering the satisfaction women feel about bringing their child into the world naturally. In regards to cost, a majority of women are able to get at-home or even birthing center care at a much lower cost due to the fact that they don't have exorbitant hospital bills to pay for. Many insurance plans cover birthing centers and even home births as well, so the prices can be much more reasonable and affordable for even families with relatively low-incomes (Stowers).

Overall, safety, comfort, and cost-effectiveness can be greatly increased by the personalized care at home or in a small setting like a birthing center. They are able to care for only you, concern themselves with a high standard of safety and cleanliness, and they are trained specifically to make this process easy and enjoyable so the women feels like she has the most control in the process of giving birth (Remer). Most people assume that what is widely done is the right choice for them but, in most cases, the safer and happier choice is the more underrated and lesser-known one. 

Should You Undergo A Cesarean Section?

Another choice a woman has to be informed about is whether or not to undergo a cesarean section. Cesarean rates have increased exponentially in recent years, but the problem with this drastic increase is that it has nothing to do with more women needing the cesarean sections. Generally, in recent statistics, elective cesareans account for more than half of these types of surgeries (Wagner). Like any major unnecessary surgery, there are very many negative effects that can result. Some of the most common negative outcomes that result are psychological outcomes. "Psychological outcomes such as negative feelings, fear, guilt, anger and postpartum depression are common consequences of both emergent and elective cesarean sections." (Pathways). These feelings are results of a disconnect between a woman and her child during childbirth. For many women who undergo cesarean sections they are unable to hold their baby for a while; and they have their own recovery process, which diminishes their ability to care for their child for a while. Some of the more serious consequences are the physical and health related consequences. According to Pathways magazine, "One half of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births." This is due to the surgical nature of the procedure. Any surgery poses great risks of complications, reactions, and mistakes. In this case, the doctors are working inside your body to extract the baby so complications can arise from problems completely unrelated to the childbirth itself.

Knowing all this, it may seem surprising that the rates are rising so much. The reason the rates are increasing so much, despite the risks associated with them, is that many modern OBGYNs recommend these surgeries where they are unnecessary. In their perspective it saves time, is more profitable, requires less stress of working with the woman and her family as she is in labor, and can be easier to defend in court if anything goes wrong (Wagner). None of these are inherently beneficial to the woman, but many women don't know this so they continue to take their advice without researching alternatives. What this means is that it is often the responsibility of the women to question whether a cesarean section is really the best option for them, and to question their OBGYN about if the rewards will outweigh the risks.

Should You Use Drugs To Assist You?

A woman also has to choose whether or not to utilize pain medications, such as an epidural, while giving birth. There are positives and negatives to medications, but generally many people experience downsides with the medicines. Some risks they pose that many women are not warned about is that they inhibit endorphins, increase pain from fear and tension, and cause women to feel disconnected with the process (Beier). This can actually lead to more pain rather than less depending on the circumstances.

When it comes to the administration of drugs during childbirth, many women believe it will be necessary due to the alarming amount of pain people tell them they will experience. Giving birth is rumored to be one of the worst pains someone can experience, yet women have done it for thousands of years and have endured this pain, in many cases more than once. One reason this is possible is because "a laboring woman's body produces oxytocin to increase the effectiveness of her contractions, she also produces an equivalent level of endorphins for pain relief" (Falcao). These hormones are the best way of coping. They are completely natural, and unlike many epidurals and medications they do not transfer to the baby (Beier). It may seem daunting to give birth without medicine, but many women find that they are more than up to the task. In fact, "many women who have had babies both at home and in the hospital assert that birthing is much less painful at home, in familiar surroundings, with birth attendants who could cater to every need." (Falcao). This feeling of being more comfortable, relaxed, and cared-for can cause a woman to release even more endorphins to the point where many women actually find a sense of relief and power in the process. There is pain but it, in some respects, is better than being completely numb because they still have a control over giving birth to their child.

Who Should Care For You During This Process?

The best way to give women the chance to have their personal optimal birth experience is to educate them on their other options. No one choice is necessarily better than the others for everyone, but women tend to blindly follow what they are told by their primary care doctor such as their OBGYN. It has been found, not that OBGYNs are poor medical providers, but that they tend to have such a general position as a woman's health provider that they spend less time overall helping women give birth than other providers such as a midwife. "Compared with physician-attended low-risk births, midwife-attended low-risk births have 33 percent (one-third) fewer deaths among newborn infants. Furthermore, midwife-attended births have 31 percent (nearly one-third) fewer babies born too small, which means fewer retarded and brain-damaged infants" (Wagner, Technology). This is often the case with hospital physicians and even nurses who tend to be spread thin trying to care for a large multitude of patients at once. 

In a rather tongue-in-cheek article, Molly Remer describes her negative experience of a hospital birth in detail. She writes that women should be prepared to "have staff talk over you, rather than to you, and to have many different people walk into your room whenever they want without your permission and without introducing themselves." She continues throughout the article to share how she felt about the staff she experienced in general. She felt as if she were just another patient they were working on rather than actually working with. Often health care providers do not do this on purpose they just tend to be bogged down in all the cases they are seeing at once. With a health care provider like a midwife, women tend to get more specialized and individualized attention (Morris). Midwives have a specific specialization so all their time and practice goes into helping women give birth. Even though they can be associated with hospitals, they tend to be much more invested in the individuals they work on because they have less people to worry about. 

Another option to consider is hiring a doula in addition to a primary care provider. Doulas cannot function as primary care providers on their own as they are not medically trained, nor are they able to write prescriptions or perform any tests. Rather, their function is one of support to women as they go through the process of childbirth (Morris). Many women look to doulas to help them have a healthier pregnancy with less drug intervention, though doulas are available regardless of which methods the woman chooses (Morris). 

CONCLUSION

Overall, while each choice brings its own differences, when you analyze them all together you see a pattern. Women should be turning away from all of the unneeded technological advances in modern childbirth. While many are beneficial, and in the case of a high-risk situation they are life saving, for a majority of women all these procedures do is add to the risk. Every woman and every pregnancy is different, but also every woman is looking for the optimal experience. As Marsden Wagner, a renowned perinatologist and perinatal epidemiologist recommends: "Use scientific evidence as the basis for your decisions, not what doctors and hospitals call "community standards," ...  Say "show me the data" again and again. Read up, using a critical eye. Protect yourself and your baby by rejecting out of hand any suggestion that you should put blind faith in what you are told or read."

All women prefer and deserve to be cared for and educated about what is best for them as an individual, and not treated like just another patient. By learning their options and choosing the more 'non-traditional' or 'natural' options, women can increase both the safety of childbirth but also their satisfaction with it by using the experience to empower themselves and grow closer to their child.

