BORN SUPREMACY Choice is yours

A quar­ter of a cen­tury of change has put new mums in the driver’s seat on birth

The Advertiser - SA Weekend - - FAMILY -

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fa­ther of wil­liam, 22, and daniel, 20 GIV­ING BIRTH has swung back from be­ing seen as a med­i­cal emer­gency to a nat­u­ral event, one of South Australia’s se­nior midwives says.

Cae­sar­ian rates have soared, along with the age of new mums, while other changes in the past quar­ter cen­tury in­clude dads be­ing joined by sis­ters and grand­moth­ers in the de­liv­ery suite.

Even steril­ity has changed. In­stead of in­stantly cleans­ing new­borns, mod­ern midwives en­cour­age a cud­dle rather than a rinse.

Pro­to­col now is to put bubs warm from the womb straight onto mum’s tummy for bond­ing, breast­feed­ing and even a bit of bac­te­rial ex­change.

The bot­tom line for mums is more choice – in­clud­ing pain med­i­ca­tion – as tech­niques, tech­nol­ogy, med­i­ca­tion, at­ti­tudes and much more have changed in a pe­riod where IVF also has changed lives.

As Kate Mid­dle­ton pre­pares to give birth, the grad­ual changes in birthing since she was born has given women more op­tions, less pain and more com­pany.

Clin­i­cal Ser­vices Co­or­di­na­tor of the Women’s and Chil­dren’s Hos­pi­tal Mid­wifery Group Prac­tice pro­gram Al­li­son Wal­dron has lost count of the num­ber of ba­bies she has de­liv­ered over the past 25 years as a mid­wife.

One of the big­gest changes in this time has been whisk­ing new mums home soon af­ter birth in­stead of fuss­ing about them in hos­pi­tal.

“We used to keep new moth­ers in hos­pi­tal for five days or there­abouts but now, if ev­ery­thing is nor­mal, we dis­charge them within 24 hours,” she says.

“There is also a lot more home-based sup­port to go with that.

“We are see­ing a lot more Cae­sar­ian births, some of the is­sues con­tribut­ing to this re­main un­known but we have a lot more mums over 35 birthing in SA and with older women you have more med­i­cal is­sues con­tribut­ing which can lead to Cae­sar­i­ans.”

In 1981 the Cae­sar­ian rate in South Australia was 16.9 per cent, while in 2011 it was 33.2 per cent.

Ms Wal­dron says the age­ing of moth­ers is also see­ing an in­crease in in­ter­ven­tions in­clud­ing in­duc­tions and epidu­rals.

“We are see­ing less teenage births than 25 years ago and as the per­cent­age of women over 35 giv­ing birth rises it brings the risk of com­pli­ca­tions,” she says. “Epidu­rals have im­proved a lot over the past 25 years. Once women could not feel their legs and could not feel the urge to push be­cause of the heavy block, they now give good pain re­lief but are a lot lighter.”

Ms Wal­dron says a ma­jor change in the past quar­ter cen­tury has been the at­ti­tude to­wards steril­ity in the de­liv­ery suite.

“We would shave and scrub the women, ev­ery­one would be in ster­ile gowns and gloves and we would wash the new­born baby with med­i­cated sponges,” she says.

“Now it is clean but not ster­ile – we have re­alised the benefits of nat­u­ral flora on the skin, so we just wipe the baby clean and then it is skin-to-skin on the mum’s tummy for a cud­dle and a breast feed, rather than sep­a­rat­ing them.”

Ms Wal­dron notes the march of men into the de­liv­ery room to sup­port their part­ners and share the ex­pe­ri­ence largely started in the 1970s – but now there are of­ten more fam­ily mem­bers on hand.

“We of­ten now get the woman’s mother and sis­ter or a friend also in there giv­ing sup­port as well as the part­ner,” she says. “Many women are also seek­ing out al­ter­na­tive ther­a­pies to help them through labour, such as hyp­nother­apy.”

Other ma­jor ad­vances in re­cent decades in­clude im­prove­ments in tech­nol­ogy from hu­midi­cribs to ul­tra­sounds, as well as screen­ing pro­grams testing for ge­netic ab­nor­mal­i­ties.

And one other big change Ms Wal­dron has noted since 1990 – a lot more women are ea­ger to find out the sex of their baby be­fore birth.

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