Fluid modernities: the birthing pool in late twentieth-century Britain.

Birthing pools are a common feature of maternity units across Europe and North America, and in home birth practice. Despite their prevalence and popularity, these blue or white, often bulky plastic objects have received minimal empirical or theoretical analysis. This article attends to the emergence, design and meaning of such birthing pools, with a focus on the UK in the 1980s and 1990s. Across spheres of media, political and everyday debate, the pools characterise the paradoxes of 'modern maternity': they are 'fluidly' timeless and new, natural and medical, homely and unusual, safe and risky. Beyond exploring the contradictions of 'modern maternity', we also make two key interventions. First, we contend that modern maternity has substantially expanded in recent decades to hold and include additional ideas about comfort and experience. Second, we flag the culturally specific notions of 'modernity' at play in modern births: the popularity of the birthing pool was typically among white, middle-class women. We argue that birthing pools have had an impact at a critical moment in birthing people's care, and we map out the uneven and unjust terrains through which they have assumed cultural and medical prominence.

Portals to the past and bridges to the future: exploring the impact of doulas on the birthing experiences of black and Latinx women.

INTRODUCTION: In the USA, maternal morbidity and mortality is markedly higher for women of colour than for white women. The presence of a doula has been associated with positive birthing outcomes for white individuals, but the experiences of women of colour remain underexplored. The purpose of this qualitative paper is to understand the attitudes of black and Latinx communities towards doula-supported birthing practices. METHODS: The perspectives of people of colour, both birthing women and doulas, were investigated through popular media sources, including blogs, magazine articles, podcasts and video interviews. Of 108 popular media sources identified in the initial search, 27 included direct accounts from birthing women or doulas and were therefore included in this paper. Thematic analysis was conducted by the grounded theory method. RESULTS: Emerging themes reveal that doula presence allows for the experience of ancestral power, connection to the granny midwives, cultural translation in medical settings and physical protection of the birthing woman. When labouring with the support of a doula, women report the emotional and physical presence of their ancestors. Similarly, doulas recognise an ancestral presence within the birthing woman, and doulas experience their occupation as carrying on ancestral tradition and feel a strong vocational tie to the granny midwives of the American South. Lastly, doulas mediate communication between birthing women, their families and medical providers by emphasising the need for consent and patient autonomy. CONCLUSION: By connecting women of colour to historic and ancient spaces as well as providing comfort and familiarity in the birthing space, doulas grant their clients the self-advocacy and empowerment needed to survive the present. Doulas serve as protectors of women of colour and have become an important piece to bridging society from the current maternal health crisis to a more equitable future.

Historical Dynamism of Childbirth in Japan: Medicalization and its Normative Politics, 1868-2017.

This article explores the changing institutional and technological frameworks of childbirth practices in Japan, highlighting the historical dynamism and the normative dimensions of women's experiences. This article shows how childbirth in Japan was subject to a very powerful and far-reaching process of medicalization going back to the mid-nineteenth century. In present-day Japan, the drive towards high-tech medicalization remains strong, but there is also an emphasis on the need to be "natural" and "healthy" and to avoid unnecessary medical interventions in the body. These two seemingly contradictory sets of demands are an important feature of contemporary Japanese society. Their coexistence is only possible due to the continuing hold of a system of moral responsibility that emphasizes the duty of mothers to do whatever is necessary in terms of medical care to protect the safety and the well-being of their babies.

Socio-historical evolution of the episiotomy practice: A literature review.

Episiotomy is an enlargement of the vaginal orifice made by a surgical incision of the perineum. This review aimed to provide a socio-historical retrospective on the practice or episiotomy. Using the criteria from the PRISMA guidelines, the authors conducted a literature review, browsing twenty databases and several papers available in the gray literature. Sixty-four articles, seven reports, and fifteen books were selected. Through this study, four eras with different approaches to episiotomy practice could be identified: 1792-1920, 1920-1980, 1980-1996, and 1996-2018. This review shows that institutionalization and medicalization of birth lead to a systematic practice of episiotomy in many westernized countries until 1996. Lay questioning and evidence-based medicine may have reversed this trend into a restrictive practice. After making an inventory of the factors associated with the evolution of change in the rate of episiotomies, the review finally revealed that evolution of the practice of episiotomy has also been influenced by ideological, political, and social factors.

Mrs Stone and Dr Smellie: British eighteenth-century birth attendance and long-run levels and trends in maternal mortality discussed in a north European context.

This is a book review turned research paper. The aim is to estimate the differences in the maternal mortality rate (MMR) between untrained midwives, expert midwives, and the famous obstetrician Dr Smellie in eighteenth-century Britain. The paper shows that the birth attendance practices of the expert midwife Mrs Stone and of Dr Smellie were very similar, though Stone used her hands whereas Smellie used forceps. Both applied the same invasive techniques to successfully deliver women with similar fatal complications, techniques that untrained midwives and most surgeons of the time could not perform. However, the same procedures, if used for normal births, would have increased the MMR. So, the key to the low MMR of both was that they kept interventions away from the majority of births that were normal. The paper quantifies the likely MMR for a 'Stone and Smellie style' birth attendance and concludes that the wider dissemination of their techniques can explain the decline in the British MMR.

Childbirth and Trauma, 1940s-1980s.

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history.

The Island of Alternatives: Power, Medical Science, and "Gentle Birthing" in Socialist Czechoslovakia.

Beginning in the early 1980s, medical experts and birthing women increasingly voiced criticism of what had long been the technocratic, depersonalized nature of obstetric treatment in Czechoslovakia, despite the limited opportunities for them to do so publicly. A few maternity hospitals responded to the complaints by introducing radically different regimens of care. This article examines the history of one reformist project that took place in the small town of Ostrov nad Ohrí. Ostrov means "island" in Czech and, during the last decade of Communist rule in Czechoslovakia, the Ostrov hospital became an island of alternative obstetric care, embracing Leboyer's method of "gentle birthing," acupuncture, fathers in delivery rooms, and assorted technological innovations that aimed to spark fundamental change in familial and social relationships, and humanize childbirth. While many medical professionals decried these reforms as nonsensical and dangerous, a number of parents-to-be flocked to Ostrov to give birth, circumventing the official rules mandating that they receive healthcare in their area of residence. This proactive consumerist behavior among expectant parents, in tandem with the call of some physicians for more attention to individual and family needs, despite the opposing official political discourse, is evidence of a grassroots movement for market-oriented principles in healthcare that reflected broader societal change during the last decade of the Communist regime.

Back to Bed: From Hospital to Home Obstetrics in the City of Chicago.

This article analyzes the role of doctors and activists in Chicago who successfully redefined the practice and politics of childbirth both locally and ultimately nationwide. It begins with the story of Joseph DeLee's Chicago Maternity Center, responsible for supervising over 100,000 home births between 1932 and 1972. Most of the mothers cared for by the Center were nonwhite, poor, and had little or no access to prenatal care, yet their babies had a far higher survival rate than the nationwide average. Thousands of medical students from all over the Midwest experienced their first deliveries not in hospitals, but in these homes. The article then addresses a very different demographic: a rising number of middle-class white families in the suburbs of Chicago who, beginning in the 1950s, opted for out-of-hospital births. Many of them learned about home birth through their involvement in La Leche League, the breastfeeding organization formed in a Chicago suburb in 1956. Seemingly separated by class, race, and locale, the link between these two groups of home birthers was the philosophy and training in place at the Chicago Maternity Center.

[Obstetric medical book and women's childbirth in Qing dynasty: the case of the treatise on easy childbirth].

Ye Feng composed what was to become one of the most famous and widely-circulating medical works of the late imperial period, the Treatise on Easy Childbirth. Ye Feng proposed the idea of natural childbirth, When the correct moment for birth had arrived, the child would leave its mother's body as easily as "a ripe melon drops from the stem". He argued attempts to facilitate birth were therefore not only unnecessary, and female midwives artificial intervention was not required. However, this view is to overlook the pangs of childbirth, and women bear responsibility for the failure of delivery. So his views reflect the gender order in male-dominated. Also he constructed the negative image of the midwife and belittle her childbirth techniques. As a result, midwife are excluded from the childbirth field, male doctors grasp guardianship rights of the female body. Ye Feng declared that the key to safe and successful delivery could be summed up in just a few words: "sleep, endure the pain, delay approaching the birthing tub". This view must be consistent with the Confucian norms, women to export to equip the 'patience' and 'self-control'. These norms were exposed desire men want to monitor and control the female body, effect on consolidation of patriarchal family order. In sum, the discourse of "a ripe melon drops from the stem"and "sleep, endure the pain, delay approaching the birthing tub" comprised an important intellectual resource that male doctors drew on to legitimate themselves as superior overseers of women's gestational bodies.

[The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes with Experienced Tests)].

Through the cases of approximately 80 females in the case records of traditional physician Yi Sugwi (1664-1740?), the present study divided and reclassified the lives and diseases of females during the latter half of the Joseon Dynasty into childhood, obstetrics- and gynecology-related problems in adulthood, other diseases in adulthood, and old age and analyzed them. According to the results, female children were treated less preciously than were male children so that treatments by traditional physicians were sought out less when they were ill than in the case of male children, and acute infectious diseases were the most serious health problems. In the process of receiving treatment from traditional physicians as adults, females came in contact with traditional physicians, who were male, when necessary including face-to-face sessions and the reception of pulse examination but the yangban (literati-official) class practiced sex segregation as much as possible while the lower classes were considerably free from such restrictions. For female adults, the most serious health issues were pregnancy and childbirth so that they received help from traditional physicians and midwives when there were problems. Traditional physicians determined females' pregnancy and the health of fetuses and pregnant women through pulse examinations and medication and actively responded to diverse problems that surfaced in the process with medication and other treatments. Acute infectious diseases, too, were serious diseases suffered by females, and problems involving cold damage and the digestive system were among diseases frequently suffered by females in adulthood and old age. In old age, females often became ill in the arduous process of dealing with the deaths of adult descendants, siblings, and spouses, and tumors were among the major causes of their deaths. The deaths of those aged 70 or above were accepted as quite natural. Aged females endeavored to maintain their health and played the role of elders giving care to their descendants.

Revisiting the daily human birth pattern: time of delivery at Casa de Maternidad in Madrid (1887-1892).

OBJECTIVES: Among the ancestral characteristics of the primate group to which Homo sapiens belongs we find a pattern of daytime physical activity, but one notable exception is birthing which usually begins with night-time labor. In populations with a moderate or high level of medicalized labor, there is evidence that the medical preferences interfere with the underlying biological mechanism for the circadian pattern of human birth. METHODS: This study analyses the hourly patterns of 4,599 single live births in the House of Maternity in Madrid between 1887 and 1892, a period of very limited obstetric intervention and without the influence of artificial lighting. In order to determine the influence of natural light on labor, two periods of maximum and minimum light have been established around the summer and winter solstices of the years in question. RESULTS: A clear circadian pattern of births emerges, with very early morning and early morning births dominating, and a sharp drop from midday until nightfall. The hourly distribution on both solstices follows this pattern, but with a clear peak shift: in winter, there is a greater concentration of deliveries in the early morning, whereas in the summer, the highest concentration is between 8 and 12 in the morning. CONCLUSIONS: The results confirm that non-intervened human birth has a clear diurnal cycle, with a higher incidence of deliveries in the early morning or morning. The shift in distribution during the winter and summer solstices seems to confirm the effect of light on the labor process.

[Cesarean section through history].

According to historic documents, delivery by abdominal and uterine incision was already known to mankind at the beginning of the second millennium BC. This delivery method was eventually referred to as "Cesarean Section" because it was wrongfully attributed to the way by which Julius Caesar was born. The indications for cesarean sections performed in ancient cultures and to the end of the medieval period were mainly kings law, that mandated burial of the fetus separately from his mother, legal rights regarding inheritance of the father or religious motives mandating baptism of the newborn in order to ensure him eternal life in heaven. As from the second half of the 19th century AD, and with improvement in surgical techniques, as well as in the perioperative environment (asepsis, antibiotics, anaesthesia, blood transfusion, etc.), the obstetric outcome of cesarean sections was dramaticay improved, both in terms of maternal, as well as fetal, outcome. Hence, it became very prevalent throughout the world. The emergence of medico-legal medicine and medical ethics issues, have further contributed to the use of cesarean sections as the ultimate solution of every unusual delivery.

[The early years of anatomy and obstetrics at the Göttingen University, 1734-1760]. / Az anatómia és a szülészet kezdeti évei a göttingeni egyetemen, 1734-1760.

In the Age of Enlightenment medical education was based on new fundamentals. According to experts at that time, a medical faculty had to have five branches: anatomy, botany, chemistry, practical and theoretical medicine. Perhaps Göttingen was the most successful university foundation at that time, because a generous financial support was provided, outstanding professors were invited and an education without censorship was warranted. The spirit of Enlightenment affected both the structure and the standards of education of the facultas medicinae. The word-wide reputation of this faculty was earned by Albrecht von Haller. Haller conceived both the still highly regarded botanical garden and the anatomical theatre, which was the first of its kind in the German speaking area. Furthermore, he founded one of the first clinical obstetrics departments in the world. Students gained theoretical knowledge, were trained practically and had the opportunity to make scientific observations and medical experiments. This paper describes the founding era of the medical faculty of University of Göttingen from a historical-cultural view of point, based on contemporary documents from Germany and Hungary.

She will givebirth easily: therapeutic approaches to childbirth in 1st millennium BCE cuneiform sources.

This article offers, in the first place, an overview on women's healthcare in relation to childbirth in ancient Mesopotamia, as an introduction that helps to evaluate the meaning of the 7th century Assur text BAM 248 within therapeutic cuneiform texts on childbirth. We proceed to analyse the variety of therapeutic approaches to childbirth present in BAM 248, which brings together various healing devices to help a woman give birth quickly and safely. We analyse the text in its entirety as an example of intersection between different medical approaches to childbirth, given the number of differences in the complexity of remedies, in the materia medica employed, in the methods of preparation and application, even in the technical knowledge required and also, most probably, in the social origin and/or use of the remedies in question.

She will give birth easily: therapeutic approaches to childbirth in 1st millennium BCE cuneiform sources.

This article offers, in the first place, an overview on women's healthcare in relation to childbirth in ancient Mesopotamia, as an introduction that helps to evaluate the meaning of the 7th century Assur text BAM 248 within therapeutic cuneiform texts on childbirth. We proceed to analyse the variety of therapeutic approaches to childbirth present in BAM 248, which brings together various healing devices to help a woman give birth quickly and safely. We analyse the text in its entirety as an example of intersection between different medical approaches to childbirth, given the number of differences in the complexity of remedies, in the materia medica employed, in the methods of preparation and application, even in the technical knowledge required and also, most probably, in the social origin and/or use of the remedies in question.

The physical activity of parturition in ancient Egypt: textual and epigraphical sources.

Many medical and magical texts concerning childbirth and delivery are known from ancient Egypt. Most of them are spells, incantations, remedies and prescriptions for the woman in labour in order to accelerate the delivery or protect the unborn child and parturient. The medical and magical texts do not contain any descriptions of parturition itself, but there are some literary, astronomical and mythological texts, as well as a few incantations, which describe the biological act of childbirth and also miscarriage in more detail. Besides the textual sources, the decoration of temple walls and mammisis (birth houses), as well as illustrations on a birth brick provide an insight into the moment of delivery. In this paper, I focus on the "scientific"depiction of the biological act of childbirth, on how it is described in non-medical sources. Although the main sources are mythological-theological texts with numerous analogies, it is remarkable how many details they provide. They contain descriptions that would be expected in the context of medical sources.

She will give birth immediately. Pregnancy and childbirth in medieval Hebrew medical texts produced in the Mediterranean West.

This essay approaches the medieval Hebrew literature on women's healthcare, with the aim of analysing notions and ideas regarding fertility, pregnancy and childbirth, as conveyed in the texts that form the corpus. Firstly, the work discusses the approach of written texts to pregnancy and childbirth as key elements in the explanation of women's health and the functioning of the female body. In this regard it also explores the role of this approach in the creation of meanings for both the female body and sexual difference. Secondly, it examines female management of pregnancy and childbirth as recorded in Hebrew medical literature. It pays attention to both the attitudes expressed by the authors, translators and copyists regarding female practice, as well as to instances and remedies derived from "local" traditions--that is, from women's experience--in the management of pregnancy and childbirth, also recorded in the texts. Finally, the paper explores how medical theories alien to, or in opposition to, Judaism were adopted or not and, at times, adapted to Jewish notions with the aim of eliminating tensions from the text, on the one hand, and providing Jewish practitioners with adequate training to retain their Christian clientele, on the other.