A little over a century ago families had limited choices when giving birth. With the current technology available families tend to choose the cultural norm which can influence the psychological affects on the family. European countries tend to prefer a midwife to assist with birth without the use of painkillers. The Far East also deters from pain killers, but prefers hospital births with the father less involved. Turkey has recently begun delivering more babies in hospitals due to more doctors are residents of the country. Brazil also prefers hospitals births with a large number of caesarian section births.
The United States seems to be a compellation of different birthing choices. The choices made in birthing, however, may affect the psychological well being of the entire family. Birth Customs Around the World Most expectant mothers in Holland do not see an obstetrician, but instead are referred to a midwife. Doctors only intervene in high-risk cases or if complications arise during delivery. Dutch women decide whether they want a home or hospital delivery. All expectant mothers in Holland are required to pick up a kit that includes all of the medical supplies necessary for a home birth.
If the mother chooses not to deliver at home, the midwife will make a house call to check on the progress of the labor and determine the ideal time for you to go to the hospital. It is unlikely for Dutch women to get an epidural. Epidurals are usually only given if it’s convenient for the anesthesiologist’s schedule or if an obstetrician determines it is necessary. Giving birth naturally remains the ideal for the vast majority of Dutch women. If a mother gives birth early in the day without complications, she and the baby may go home in as little as two hours.
Once the mother and child are home nursing care is provided for seven days. The nurses not only provide medical care, but also clean, cook, and instrucs the parents in basic parenting skills. German birthing traditions are much like that of the Dutch due to German women see midwives for their prenatal care. Midwives are so respected that by law a midwife must be present at every birth, and a doctor is optional. German women who hold full-time jobs can feel secure knowing their position will be waiting for them when and if they decide to return to work.
As soon as a woman tells an employer she’s pregnant, she cannot be fired. Thus, during economic downturns, being pregnant can essentially save your job. Women may stop working six weeks before their due date and are forbidden from working for eight weeks after giving birth, all with full pay. Mothers may even take up to three years of unpaid leave, the third being a floating year that can be taken at any time and by either parent. Like Dutch and German women, the majority of Japanese women strive to give birth without the use of painkillers.
“According to Ai Azuma, a Tokyo native, this preference relates to the Buddhist perception of suffering: There is a belief among Japanese that labor pains act as a kind of test that a woman must endure in preparation for the challenging role of motherhood”(WHO). This centuries-old belief endures despite the fact that a growing number of doctors in Japan are recommending epidurals for their patients, suggesting that they create a more peaceful birth experience. Although more women are beginning to exercise this option, centuries of tradition still keep many others from considering the procedure.
Japanese women deliver in hospitals, but the baby’s father is not expected to act as the labor coach or even be in the room. Fathers are permitted to be present at the birth only if they have taken prenatal classes with the mother; if a c-section is performed, they must go to the waiting room. In general, hospital stays in Japan tend to be longer; mothers can expect a minimum five day stay for a vaginal birth and ten days or more for a cesarean delivery. In Brazil, elective c-sections have become almost commonplace. The overall c-section rate in Brazil is 40 percent, according to the International Cesarean Awareness Network.
If you look at only private hospitals, the rate is even higher and some cesarean birth rates are 100 percent, according to the World Health Organization (WHO). Private hospitals are the choice for around one-quarter of expectant Brazilian women, and these women hail mostly from the middle and upper classes. In Brazil, the doctor-patient relationship is very strong — women receive nearly all of their information about childbirth from their doctor, rather than from prenatal classes. If a woman’s doctor is advocating a c-section, she may well be swayed by his opinion.
The tide, however, is beginning to turn, at least in public hospitals, where the Brazilian government has instituted procedures to reduce the number of c-sections. In 1998 the government set a goal to reduce the public hospital cesarean rate to 25 percent or lower by 2007 according to (WHO). Turkey has recently changed its approach to childbirth. According to WHO: As recently as 20 or 30 years ago, midwives supervised most of the births in Turkey, especially in rural areas. Doctors were in short supply and most tended to practice in metropolitan areas, such as Ankara and Istanbul.
But as more university medical schools were founded and the number of doctors increased, care shifted away from midwives in favor of ob-gyns. (WHO, 2007) The shift toward doctors has also brought about a growing preference for elective c-sections among Turkish women. “In a recent survey, overall c-section rates for private hospitals in Turkey were nearing a staggering 75 percent”(Kybele, 2007) One reason for this trend, according to Kybele, a U. S. nonprofit group that promotes safe childbirth practices in developing countries, is that only a few Turkish anesthesiologists have specialized training in obstetric anesthesia.
Many women know they will not have the option of an epidural, so they instead opt for a c-section with general anesthetic. Kybele reports that this use of general anesthesia may be a contributing factor in Turkey’s having one of the highest maternal mortality rates in Europe. Kybele coordinates programs to train doctors in administering epidurals; the doctors then teach their fellow physicians. Turkey has been very receptive to the program, so the hope is that epidurals will be more widely administered in the future. The last fifty years have been a time of change for pregnant mothers in the United States.
As more medical doctors became available, midwives became almost non-existent. This was partially due in fact to mothers and families believed the hospital were a better choice for mother and baby. In the 1960’s and ’70’s, women began to question and challenge the way obstetricians were treating them. Many women felt obstetricians treated them as if childbirth were a sickness; thus causing women to begin to reclaim their power, and the homebirth movement was born. The 1990’s became a time of maternity awareness, a time when people were concerned with making the entire pregnancy and birth experience a family experience.
This awareness lead to hospitals creating family style rooms for mother and baby to ensure comfort and bonding, as well as more American businesses allowing more time off for after birth care through the government instituted Family Medical Leave Act (FMLA). Along with changes in who a woman chooses to assist in birth is the birthing method “During the 1970’s, the cesarean birth rate in the United States increased about threefold, from 5. 5 percent in 1970 to 15. 2 percent in 1978, and appears to be continuing to increase”(NLM).
According to the American Academy of Family Physicians the number of birthing mothers who choose an epidural for pain management is 50 percent. Effects of Birthing Choices The choice of how to deliver a child and parental involvement can affect not only the child psychologically, but the mother and father as well. According to the National Library of Medicine (NLM), “The presence of fathers in the operating room and closer contact between mother and neonate appear to improve the post-cesarean behavioral responses of the families” (NLM, 2007).
For several years families have been aware of the possibility of post partum depression in mothers; however, recently there has been findings this can affect a father as well. “”Fathers play an extremely important role in helping with their babies, and we need to offer them more support in clinical settings. We need to create a comfortable atmosphere where fathers can talk about how they are doing psychologically and emotionally”(USA, 2007).
In reviewing how different countries and cultures manage their birthing process it can be found that some countries have changed with technology, such as Turkey, the United States, and Brazil, where other countries have stuck with their old customs. The choice of birth process and assisting medications are influenced by the family’s culture; however, essentially it is the family’s choice. The options provided by medical care givers, such as doctors, nurses, and midwives before, during, and after birth, determine the psychological effects on the family. References American Academy of Family Physicians. (2007). Epidural Analgesia During Labor.
Retrieved May 7, 2007, from http://www. aafp. org/afp/981115ap/vincent. html Birthing Intuition. (2007). The Tradition of Midwifery. Retrieved May 8, 2007, from http://www. birthingintuition. org/aboutl. html Davis-Floyd, Robbie. (2006). Global Midwives. World Pulse Magazine. Retrieved May 7, 2007 from, http://www. worldpulsemagazine. com/issues/2/global%5fmidwives Fathers Also Experience Postpartum Depression. (2007, Feb. ). USA Today. Pg. 3. Retrieved May 8, 2007, from the Proquest database. International Cesarean Awareness Network. (1998). VBAC Information. Retrieved May 9, 2007, from http://www. childbirth. org/section/ICAN. html. Kybele.
(2007). For Safe Child Birth Worldwide. Retrieved May 8, 2007 from http://www. kybeleworldwide. org/ National Library of Medicine (NLM). (2007). What Are the Medical and Psychological Effects of Cesarean Delivery on the Mother, Infant, and Family. Retrieved May 9, 2007, from http://www. ncbi. nlm. nih. gov/books/bv. fcgi? rid=hstat6. section. 4608. Vanderlean, Jennifer. (2006). Childbirth in Other Cultures. Birthing Naturally. Retrieved May 7, 2007 from, http://www. birthingnaturally. net/birth/articles/culture. html World Health Organization. (2007). Maternal Health and Midwifery. Retrieved May 8, 2007 From, http://www. who. int/en/.
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