Safer Childbirth? A Critical History of Maternity Care

In all industrialized countries, the last fifty years have seen both a momentaus improvement in the safety of childbirth and the completion of a momentaus revolution in maternity care, with the philosophy and methods of the obstetric profession triumphant. This book tells the story of how these changes came about. lt is a story urgently in need of telling, for the subject is one about which there is almost universal misunderstanding. Far from being a record of conquering idealism, the realization of an advance in human welfare through the application of scientific knowledge to improve the natural process of birth by an altruistic profession with good reason to believe in the rightness of its methods, it turns out to be a record of the successful denial and concealment of extensive and unanimous evidence that obstetric inter­ vention only rarely improves the natural process. The evidence is found in the impartial statistical analyses of the actual results of care, which show consistently that birth is the safer, the less its process is interfered with. The findings of statistics are in complete accord with the expectations of biology and are in turn impressively supported by the observations of critical obstetricians, evaluating parti­ cular practices. Who should teil the story and present the accumulated evidence? lt might be difficult for any obstetrician to cast aside his or her loyalty to the profession and provide a dispassionate account of the whole picture.