Technology and Society Impact of Technology on Childbirth Image: http://www.geh.org/ne/mismi2/m198904260001_ful.html This does not include discriminatory practices against women of various races or low income women or treatment of insured vs non-insured or those who use medicaid

Conception Fertility Drugs Artificial Insemination Test-tube baby Cloning image: http://www.lifesitenews.com/news/australian-judge-rules-conception-occurs-at-implantation-rather-than-fertil/

Pregnancy Monitoring Fetal Surgery Blood Tests Urine Tests Ultrasound DNA Tests Fetal Surgery Image: http://www.ehow.com/how_3391689_ensure-pregnancy-healthy.html

Scheduled Delivery Inducing labor early Planned C-section. Based on Ultrasound determined weight “Late Birth” based on Due Date estimate Planned C-section. For convenience of mother, doctor (when not medically necessary) Image: http://www.laptopstolullabies.com/2012/05/c-section-smackdown-emergency-versus.html

Managed Labor/ Cascade of Intervention Hospital Setting Monitors, IVs Loss of privacy/control of environment Psychological effects, stress Timing/Duration Inducing drugs, breaking the membranes Length of labor/artificial deadlines Birth Process Pain killing drugs – Epidural ( US rate 90%+) Position, lack of ability to move freely Episiotomy Forceps, Suction C-section – ( US rate >25%) Image: http://blueridgeobgyn.wordpress.com/tag/stadol/ Cascade of Intervention: http://www.childbirthconnection.org/article.asp?ck=10182

Side Effects? Postoperative Complications Effects on Nursing the baby Infections of baby or mother Continued pain Effects on Nursing the baby Effects of epidural, C-section, drugs Social customs that play a role Nursing only for poor, negative body image Working moms: Pumping/Freezing 60% try, 20% after 2-4 months, Less than 5% at a year. Postpartum Depression Infant/Mother Mortality Image: http://www.pediatricsonhudson.com/breastfeeding-groups.html

Questioning the Model Is childbirth a disease/illness that needs medical intervention? How much intervention is needed? Is technology serving us or interfering with a natural process? Image: http://capturedbycarrie.com/blog/page/35/ Evidence Based Maternity Care? http://www.childbirthconnection.org/article.asp?ClickedLink=1083&ck=10575&area=27

Cesareans Gone Wild? http://1.bp.blogspot.com/_TLN3D8ugIMI/S9olvzm9sxI/AAAAAAAAARQ/sfy0ZiVlKSI/s1600/Map_US_Cesarean_Rates_2007.jpg

The Rise in Cesarean Rates http://2.bp.blogspot.com/_TLN3D8ugIMI/S9p25v6_xdI/AAAAAAAAARY/H_49XNQlAeU/s1600/US+CS+by+years.bmp

Caesareans around the World Lowest: Netherlands holding steady between 13 – 14% from 2001 to 2010 Low: Sweden, Norway, Finland, Iceland, Israel all holding steady around 16% from 2001 to 2010 High: Australia, Germany, Korea, Switzerland, USA all above 30% by 2010 Highest:Mexico and Turkey above 40% by 2010 http://www.cesareanrates.com/blog/2012/12/8/world-cesarean-rates-oecd-countries.html http://www.cesareanrates.com/blog/2012/12/8/world-cesarean-rates-oecd-countries.html

More $$$ = Better Outcomes??? “The United States spends $98 billion annually on hospitalization for pregnancy and childbirth, but the US maternal mortality rate has doubled in the past 25 years. The U.S. ranks 50th in the world for maternal mortality, meaning 49 countries were better at keeping new mothers alive.” Huffington Post Web site: http://www.huffingtonpost.com/2012/08/24/maternal-mortality-rate-infographic_n_1827427.html Image: http://www.slocounty.ca.gov/health/prevention/mathealth.htm

Alternatives/Adjuncts Hospital/Birthing Center/Home Privacy/Calm Environment Mother-centered practices Midwife/Doula/Doctor Guided Breathing/Relaxation Alternate Positions/Birthing Chair Hypnobirthing Water birth Images: http://pregnancy.about.com/u/sty/birthstories/readerbirthstories/VBAC-Home-Water-Birth.htm Deadly Delivery by Amnesty International http://www.amnestyusa.org/sites/default/files/pdfs/deadlydelivery.pdf