childbirth

   Childbirth and its management have been subject to radically different arguments since the 1960s, with one argument coming from the medical community and a second coming from women. The principal source of controversy has been the issue of defining what is best for women during childbirth, with, on the one hand, a medical view of the paramount need to establish maximum safety, and on the other hand, a contention about the need to secure circumstances for women that reflect the totality of physical, psychological and social aspects of childbirth. The dominant voice in the care of pregnant women, represented by the Royal College of Obstetricians and Gynaecologists, consistently argued before official review committees, from the Cranbrook Committee in 1959 to the Short Committee in 1984, that birth in hospital, especially birth in consultant-led units, would ensure the greatest safety for women and babies. The counter-argument began with two womenled organizations, the Association for Improvements in Maternity Services (1960), a platform for exposing poor, unevaluated hospital care, and the National Childbirth Trust (1961), which focused on preparing women to enjoy childbearing, according to individual needs and expectations. Both promoted the value of a woman’s control of her own birth situation. Their work was strengthened by Sheila Kitzinger, doyenne of the British childbirth movement, who emphasized in many books that the highly individual nature of birth was disrupted by a medical policy of increasing technological intervention. The lack of a sound evaluative basis for the medical model of birth led to reconsiderations within the medical community. A 1987 report from the National Perinatal Epidemiological Unit challenged the notion that hospitalized birth was responsible for the drop in perinatal deaths. In 1992, the Winterton Parliamentary Committee concluded that the medical model of birth should no longer drive maternity services. The 1993 government publication, Changing Childbirth, accepted the need for unbiased information about maternity services and choice for women, in deciding their preferred maternity care and place of birth.

   See also: family planning

   Further reading

    Department of Health (1993) Changing Childbirth, London: HMSO (current government policy on maternity care).

    Kitzinger, Sheila (1987) The Experience of Childbirth, 5th edn, Harmondsworth: Penguin (remains the essential text for women).

   JO MURPHY-LAWLESS