I have previously discussed some of the issues which complicate the discourse around ‘normal’ birth’ and ‘safe’ birth and the concept of risk.
The term ‘normal’ is problematic as it has social meaning (i.e what is usual) and also that what is not ‘normal’ is ‘abnormal’ .
I prefer to use the term ‘physiological’ which means the usual fuctioning of a living organism.
There is current discussion on the push for ‘normasl’ birth and to reduce the CS rate and/or unneccessary interventions.
This is a complex issue, there is still much to learn about how and why risk status changes during the birth process and when it is necessary to intervene to prevent risk.
For my Masters in Public health dissertation I was interested in the differences in post birth condition of mothers and babies after vaginal births with and without common interventions.
For this I used the current definition of ‘Normal birth’ (from http://www.birthchoiceuk.com/Professionals/BirthChoiceUKFrame.htm?http://www.birthchoiceuk.com/Professionals/statistics.htm )
women have a “normal birth” if they do not have any of the following procedures:
- induction of labour (with prostaglandins, oxytocics or ARM)
- epidural or spinal
- general anaesthetic
- forceps or ventouse
- caesarean section
I looked at ‘The Incidence of Women giving birth in Liverpool in 2005-07 having a ‘Physiological Birth’ as compared to ‘Normal Births’ and ‘Cephalic Vertex Births’: Are there differences in health outcomes for mothers and babies by type of birth?’. This was a quantitative hospital-based cross-sectional study using delivery records’ data available at Liverpool Women’s Hospital (LWH). All birth records with a gestation of 37-42 weeks from 01.01.2005 to 31.12.2007 were obtained for mothers who gave birth to live singleton infants and whose delivery records had been entered on the hospital database (13, 963 Vaginal births)
I presented my results at the ‘Normal Birth confernce in 2009.
The incidence of physiological birth in Liverpool in 2005-07 was 24.5%
19.1% of women having their first baby had a physiological birth.
Physiological birth was associated with-
- Greater odds of breastfeeding after delivery and on discharge
- Lower odds of having a post partum hemorrhage
- Lower odds of having a perineal tear
- Lower odds of babies being born in a compromised condition
The powerpoint I prsented at the conference with the full results is attached below. This data is currebntly unpublished although I have been working on a journal article for some time.