The Dramatic Ways Childbirth Has Changed
By Andrya Feinberg, contributor
When Childbirth Struck Fear in Women
Women’s expectations of childbirth have changed throughout the years. Hundreds of years ago, childbirth was incredibly risky business. In the 18th century, mothers frequently died from a strange illness called “childbed fever” after giving birth. They endured severe pain, developed a fever and many eventually died.
According to the article, The Tragedy of Childbed Fever, in the New England Journal of Medicine:
“Puerperal fever or childbed fever affected, on average, 6 to 9 women in every 1000 deliveries, killing 2 to 3 of them with peritonitis or septicemia. During times of epidemics, many more suffered and died. It was the single most common cause of maternal mortality, accounting for about half of all deaths related to childbirth, and was second only to tuberculosis in killing women of childbearing age.”
These deaths struck fear in the hearts of many child-bearing women as physicians struggled to find a cure. In the 1790’s, the disease was believed to be spread from patient to patient and it was thought that the doctor could “bleed” the patient who showed signs of the impending fever.
It was only in the 1800’s that physician Ignaz Semmelweis discovered that the infection was actually spread by doctors who hadn’t cleaned their hands prior to delivery. The medical breakthrough that eventually rose from that discovery? Hand sanitizing before surgery.
RELATED: Inside the Mind of a Labor and Delivery Travel Nurse
Changes in Pain Management for Mother and Child
Another area of medicine that improved care for new mothers was pain management. Let’s take a look at a timeline of how pain management has changed over the years for new mothers:
• Over a hundred years ago, childbirth occurred at home. The new mother’s family (if present) or her midwife were responsible for coaching her through the birth.
• In the late 1800’s, ‘Twilight Sleep’, which is a labor analgesic, became available in the hospital environment. Twilight Sleep is a combination of morphine and scopolamine, which relieves pain and made women forget about the pain and discomfort during their labor and delivery. Twilight Sleep sometimes led to difficulties in childbirth. Women who were ‘deep asleep’ couldn’t communicate, could barely push, and had babies who were born ‘groggy’ and sleepy and needed resuscitation. The doctors had to use forceps or deliver the baby by a cesarean section for mothers induced in Twilight Sleep.
• In the mid 20th century, the ‘saddle block’ spinal anesthesia was developed. It also helped reduce the pain of labor and delivery, yet left women unable to push or communicate clearly. Once again, this resulted in doctors having to use forceps and deliver babies by way of cesarean section.
• Today, anesthesiologists are continually refining, redeveloping, and reevaluating spinal anesthesia techniques and practices. Although women still request an ‘epidural’ or ‘spinal anesthetic’, hospitals are experiencing more women requesting a pain-free, or ‘natural’ delivery.
Pain-Free or ‘Natural’ Childbirth Is On The Rise
There are many reasons why women have embraced natural childbirth. Some didn’t like the effects that the spinal anesthetics had on their bodies or their babies. New mothers were often ‘too groggy’ and felt that they couldn’t fully participate in the first few days of motherhood. More and more women were declining spinal anesthetics and requesting natural childbirth. With the women’s movement, women also felt that they should be ‘in charge’ and more responsible for the techniques and methods in their labor and delivery.
Most recently, there has been a world-wide ‘pain-free birthing’ movement that has mothers trying new techniques for labor and delivery. Travel nurses, family, and friends are right there helping them through the process with these modern and not-so-modern techniques:
• Warm water immersion and birth
• Relaxation techniques
• Breathing exercises
• Birthing ball
Changes in Technology for Mother and Child
There have been breakthrough technological advances in the medical field for childbirth, including how the baby’s health and well-being is monitored, birthing practices and techniques, and labor and delivery.
• Over a hundred years ago, the doctor had to use a fetal stethoscope to monitor the baby. That was the only instrument that they had at that time.
• The electric fetal monitor was introduced in the 1960s. This instrument provided the hospital staff with only a paper record of the heartbeat. Now, nurses and doctors can place an external device on the mother’s abdomen, which uses Doppler ultrasound to electronically monitor the baby’s heartbeat. There is also an internal device which is placed on the baby’s head when the doctor performs the internal exam. Doctors and nurses can also place a handheld Doppler device on the mother’s abdomen to monitor the baby’s heartbeat.
• Today, there are a variety of tests, explains Kathryn Leggitt, RNC., MS., CNM., that doctors and nurses use to determine the health of both mother and baby, including:
o Prenatal Quad Screen: Identifies if a woman has an increased risk for having a baby with Down Syndrome.
o Amniocentesis: Diagnoses the baby as having Down Syndrome and determines if the baby has mature lungs.
Changes in Birthing Methods
To say that birthing methods have changed dramatically over the past few centuries is an understatement. In the ‘old days’, forceps were used most of the time, and cesarean sections were not common.
According to Leggitt, “Today, the cesarean section rate is approaching 30% in the United States. Inductions of labor are becoming increasingly more common, and today, an estimated 40% of all women are induced, despite estimates that only 10% of women need to be induced for a medical reason. Other practices, such as the routine placement of an IV, permitting a laboring women to have only ice chips, and not allowing her to use a tub if her bag of water has broken, have continued to be a standard of care, even though not supported by research.”
In this century, there is an abundant amount of information which enables new mothers to be more informed, plan alternative methods of labor and delivery, and be ‘in charge’ of their own pregnancy plan.
Labor and Delivery (L&D) travel nurses play a vital role in ensuring the safety and well-being of expectant mothers. Onward Healthcare's Labor and Delivery travel nurses have the skills, experience, and background necessary to help new mothers with the latest changes in childbirth.
Are you ready to help new mothers in the labor and delivery unit? Do you want to inform and educate others about the latest advances in childbirth? Now is the time to join Onward Healthcare, and gain the skills to advance your career when you start your new travel nursing job in the L&D unit today!
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