Safer Childbirth?

1. Front Matter

   Pages i-xiii

   PDF

2. The revolution in maternity care: the diverse strands of a complicated tapestry

   • Marjorie Tew

   Pages 1-37

3. Birth attendants and their places of practice

   • Marjorie Tew

   Pages 38-72

4. The practices of attendants before birth

   • Marjorie Tew

   Pages 73-107

5. The practices of attendants around the time of birth

   • Marjorie Tew

   Pages 108-146

6. Maternity care; a public concern

   • Marjorie Tew

   Pages 147-179

7. Evaluating the results of maternity care: statistical instruments

   • Marjorie Tew

   Pages 180-197

8. Mortality of the mother

   • Marjorie Tew

   Pages 198-230

9. Mortality of the child

   • Marjorie Tew

   Pages 231-288

10. Epilogue: drawing fair conclusions from factual evidence

    • Marjorie Tew

    Pages 289-298

11. Back Matter

    Pages 299-314

    PDF

In all industrialized countries, the last fifty years have seen both a momentaus improvement in the safety of childbirth and the completion of a momentaus revolution in maternity care, with the philosophy and methods of the obstetric profession triumphant. This book tells the story of how these changes came about. lt is a story urgently in need of telling, for the subject is one about which there is almost universal misunderstanding. Far from being a record of conquering idealism, the realization of an advance in human welfare through the application of scientific knowledge to improve the natural process of birth by an altruistic profession with good reason to believe in the rightness of its methods, it turns out to be a record of the successful denial and concealment of extensive and unanimous evidence that obstetric inter­ vention only rarely improves the natural process. The evidence is found in the impartial statistical analyses of the actual results of care, which show consistently that birth is the safer, the less its process is interfered with. The findings of statistics are in complete accord with the expectations of biology and are in turn impressively supported by the observations of critical obstetricians, evaluating parti­ cular practices. Who should teil the story and present the accumulated evidence? lt might be difficult for any obstetrician to cast aside his or her loyalty to the profession and provide a dispassionate account of the whole picture.

• biology
• birth
• care
• cast
• child
• evolution
• philosophy
• safety
• statistics

Policies and ethics