Marianne McDonald examines how we’ve come full circle and now have more childbirth options than any other period in history.
Did you know 250 babies are born every minute across the world?
Childbirth is considered one of the most natural experiences a woman can have, yet throughout history, we have attempted to engineer the process. Many women who have given birth will have wondered why, over all the years of evolution, our bodies have not evolved to have less painful births. After all, Chimpanzees labour for only 2 hours with minimal struggle compared to the average human labour of 9 hours.
Anthropologist Sherwood Washburn has one explanation, that is, when humans evolved to walk upright, our hips got narrower. Molecular biologist Dr Jonathan Wells has another. He believes we have adapted to nourish the foetus for as long as possible before it becomes too large to feed internally. Plus, the human brain has become larger, so our babies have bigger heads. But Dr Wells maintains that the female pelvis is perfectly adapted to deliver babies with bigger heads. This is because evolution doesn’t care about pain, he says, it only cares about how effective the mechanism is. And human labour and birth work just fine.
Pain relief methods for childbirth
Pain remedies have been used during labour throughout history. Hashish was used in the Mediterranean, for example, and willowbark (which has effects similar to Asprin) has been used in Greece since ancient times. For for the most part, however, and despite the dangers to mother and baby, women laboured naturally with little intervention until the medical revolution of the 17th century.
Here’s a brief history that may help you make the best possible birth choice for you:
- 1500s: Birthing women were attended to by midwives, who were mothers themselves and respected members of the community.
- 1700s: Midwives began opening schools to offer specialist training. Forceps were invented to assist when the baby got stuck and birth became less dangerous for both mothers and babies.
- 1900: Doctors entered obstetrics and began edging midwives out of the delivery room.
- 1910: Twilight births became popular and involved dosing the mother with morphine. The woman would have no memory of the pain of childbirth, but the practise did make birth more dangerous for mother and child. It was reported that women would thrash around in pain and were routinely tied to the bed to prevent injury.
- 1920: Births were now most commonly attended by obstetricians who had the belief that birth was a “pathological process” and, therefore, as much human intervention should be used as possible. Episiotomies became standard practice. Doctors would forcibly dilate the cervix and forceps were used often.
- 1950: Pitocin is invented by biochemist Vincent du Vigneud. The compound is a synthetic form of oxytocin and is used to stimulate labour. For the first time, inductions were scheduled if a woman went past her due date. Obstetrician Fernand Lamaze advocates for psychoprophylaxis during labour. This involved educating women on what to expect during childbirth and enabling them to relax their bodies using breathing techniques.
- 1960: Twilight sleep loses popularity as women complain about the harsh conditions of labour and not being able to recall the births of their children. The natural birth movement gains momentum. This is also when the ICEA (International Childbirth Education Association) was founded in response to the lack of care options available to birthing women. Doulas were trained to assist during deliveries, bringing back an ancient practice.
- 1970s: Epidurals became popular and were often performed without the consent of the patient. Midwife Ina May Gasken began campaigning for fewer interventions. Water births and breath work were used more commonly and fathers are now welcome in the delivery room. Episiotomy rates were still over 50%.
- 1980s: Many women began to advocate for alternatives to hospital birth, including home births and birthing centres. A 1984 study published in the journal Sleep concluded that episiotomies in fact caused more pain than natural tears and episiotomy rates dropped to around 15%.
- 2016: Cochrane Library report finds women who are attended by midwives and doulas during labour are less likely to require interventions. In recent years, there has been a sharp increase in the number of women opting for unmedicated, unassisted birth whether it be in a hospital, a birth centre or at home. As Bonita Katz, president of the ICEA, explains, family-centred care and the use of doulas during birth leads to a 51% decrease in C-sections.
The role of C-sections
- C-sections have been used throughout history as a way to save the life of the baby when there was little to no hope of the mother surviving labour.
- The first known C-section where both mother and child survived was performed in South Africa in 1826 by Dr James Barry.
- By the 20th century, C-sections were routinely saving women’s lives.
- From 2000 – 2015 C-section experienced a surge in popularity and now account for a fifth of all births worldwide.
Sources: Sex Explained, Childbirth, ICEA Educator training manual by Bonita Katz, Birth: The Surprising History of how we are Born by Tina Cassidy
Marianne is a freelance content creator and copy editor. She has been part of the Living and Loving team in various capacities over the last six years, but since becoming a mom to a boisterous boy, she has found a special interest in parenting issues including discipline, education and early childhood development. When not running after, and negotiating with, her three-year-old, you’ll find her experimenting in the kitchen.