Academy of breastfeeding medicine founder's lecture 2009: Maternity care re-evaluated.

Abstract In the 1990s a rising tide of medical, surgical, and instrumental interventions served to make childbirth almost treated like a disease. This report supports a different approach to childbirth. A case and discussions of induction are presented. A national survey of 1,573 pregnant women throughout the United States was collected. Although most U.S. childbearing women are low risk, childbirth is "procedure intensive." Women reported significant interventions such as regional analgesia (76%), ruptured membranes (65%), forceful pushing (75%), and cesarean sections (32%). The U.S. rate of cesarean sections in 2005 was the fourth highest among 25 countries. The epidural has many negative features. When used in labor it extends the length of time from 5 to 7 h, causes a raised temperature greater than 100.4 degrees C in 15-30% of infants and mothers, and produces a very sleepy baby at birth, irritable and with increased crying for 3 weeks. The three hormones that relieve pain are turned off by the epidural or a cesarean section. Maternal and infant mortality was doubled as a result of cesarean section. After cesarean sections, subsequent pregnancies have types of abnormal attachments of the placenta to the uterus. British physicians recommend normal birth, defined as labor that starts on its own and uses no analgesia, no inductions, no interventions, no epidurals, and no cesarean sections. The doula's presence decreases labor length, significantly decreases cesarean sections, means less use of pain medicine, and gives greater breastfeeding rates.