One of the accomplishments to which modern civilization can most proudly point is the improvement in obstetrical and infant care and the resulting decline in the horrendous death rates of mothers and infants. However, there are still far too many avoidable deaths of both mothers and infants in the world today.
The Course of Pregnancy
Conception takes place and pregnancy begins when the male reproductive cell, called the “sperm”, finds and unites with the reproductive cell of the female, called the “ovum.” This union normally occurs in one of the ducts or canals, called “Fallopian tubes,” which conduct the ova from the ovaries to the uterus, or womb. As development progresses, there is initially just one new cell, followed by two, four, eight, and so on. Then, as growth continues at a tremendous rate, cells differentiate into various tissues and organs.
The relative rate of growth is never as rapid as it is in the first few months of life, but it takes about four months after conception for an ordinary examination to be able to positively identify pregnancy. However, a special hormone test can almost certainly detect pregnancy two to three months earlier than this, and there are the well-known suggestive symptoms of pregnancy like morning sickness, cessation of menstruation, breast changes, and abdomen enlargement. The average pregnancy lasts 280 days, which translates to nine calendar months or ten lunar months, but there is no accurate way to predict the precise day the baby will be born.
Prenatal Care
A woman should see a doctor as soon as she has even the slightest inkling that she might be pregnant, not only to confirm her condition but also to ensure that she is taking good care of both her unborn child and herself. Although having children is a natural process, it has the potential to very quickly turn seriously abnormal. Only with adequate medical care during pregnancy can the health of both mother and child be protected.
Every woman should have a comprehensive physical examination at the start of her pregnancy, followed by follow-up exams by her doctor at least once every month for the first six months of her pregnancy, and then every nine weeks or more frequently until delivery. It is the pregnant woman’s responsibility to put herself under the care of a doctor at the beginning of pregnancy and to cooperate by following his advice and instructions thereafter. Once she has done so, the doctor is obviously responsible for the pregnant woman’s supervision.
Every expecting mother and her husband should educate themselves on the physiological changes that take place throughout pregnancy, labor, and the postpartum period. Additionally, they need to be aware of the key warning signs and symptoms of pregnancy complications, including persistent headache, frequent vomiting, dizziness, vision changes, swelling of the hands, face, or ankles, excruciating abdominal pain, vaginal bleeding, acute illnesses, obstinate constipation, and noticeable shortness of breath. They should notify their doctor as soon as any of these symptoms appear.
The Hazards of Pregnancy
4,978 childbearing-related deaths were reported in the United States over the course of the previous ten years. We cannot be proud of this record in any way. Following a thorough three-year investigation into the factors that contribute to maternal deaths in New York City, it was discovered that 66% of the victims could have been saved with the right care and treatment.
Three categories—poverty, ignorance, and subpar or ineffective professional care during pregnancy and delivery—can be used to categorize the general causes of insufficient care. Although some mishaps and severe bleeding during childbirth are unavoidable, most of them can be avoided with competent professional care. Almost all infections associated with childbirth, also known as puerperal sepsis, can be avoided.
Oliver Wendell Holmes, physician and author, declared in a paper entitled “The Contagiousness of Puerperal Fever” that physicians, nurses, and midwives were responsible for most of the infections which occur during childbirth.
Pregnancy-related toxemias, or poisonings, can be identified in their early stages and are typically successfully treated by the prenatal care plan that has been outlined. These poisonings harm the liver and kidneys and can also cause high blood pressure, vomiting, convulsions, and even death.
The maternal mortality rate at the Chicago Maternity Center is less than one-fourth of the national average, and its patients are some of the city’s poorest mothers. Mothers receiving prenatal care in Cattaraugus County, New York, have a mortality rate of 12 per 10,000 live births, compared to 38 for the entire country.
Place of Delivery
Mothers are giving birth to their babies in hospitals at a higher rate. The better amenities of a hospital delivery room are undoubtedly advantageous, especially if any unforeseen abnormalities or accidents should occur. However, hospital care is more expensive, and sadly, there is a higher risk of infection during delivery in many hospitals than there is at home. You can get advice on how to properly prepare for a home delivery from private doctors, public health nurses, or state and local health departments.
Professional Care During Delivery
Following a study of maternal mortality in fifteen states, the US Children’s Bureau found that 83% of women had medical care during pregnancy, 11% had midwives assist them, 4% had other non-medical attendants, and 2% had no one present at all. Unquestionably, a doctor with adequate obstetrics training and experience can be expected to provide the most competent service at a delivery. General practitioners are trained to perform both routine deliveries and some less severe abnormal ones.
They quickly make the necessary calls to consult with whoever will be in the patient’s best interest after realizing their limitations in dealing with some of the more uncommon and serious complications. While the vast majority of midwives in practice are old, careless, and dirty and have little to no training, midwives in some foreign countries are reasonably well trained to provide obstetrical service in normal deliveries. Exceptions to this are the trained nurse midwives who are rendering splendid service in the mountains of Kentucky and in certain other sparsely settled regions where medical service is not available
Normal and Instrumental Delivery
The vast majority of deliveries will be spontaneous, and this should be allowed because instrumental delivery increases the risk of infection, hemorrhage, and accidents to both mother and child. Practically speaking, instrumental or operative interference is only required in about 5% of deliveries.
In the New York study, deaths from surgical and assisted deliveries were five times more common than deaths from spontaneous deliveries. Naturally, the seriously abnormal cases are also included in this group of surgical deliveries. Contrarily, this same study reports that only 48% of deaths that followed spontaneous delivery were deemed preventable, compared to 77% of deaths that occurred after operations.
The experts in this field all concur that although instrumental delivery is frequently a life-saving procedure for mother or child, it is still used far too frequently. Because although these doctors bear some of the blame, some of the blame must also fall on the patients who insisted on using instruments to speed up the work.
An abdominal wall incision and a uterine incision are used during a cesarean section to deliver the baby. There are many cases where this procedure has saved both the mother and the child’s lives, but it comes with a significantly increased risk, just like instrumentation. With the right medical attention during pregnancy, many Cesarean operations could be avoided.
Anesthesia for Labor
The development of anesthesia is among science’s greatest gifts to humankind. Dr. Crawford Long of Atlanta, Georgia, was the first to use ether as a surgical anesthetic; however, Dr. Before a surgical clinic at the Massachusetts General Hospital, W. G. T. Morton showed how effective it was. The same year, a Scottish doctor named Dr. Anesthesia was first used in the practice of obstetrics by James Simpson. The use of painkillers during childbirth was once viewed as sacrilegious, but this opposition quickly subsided after Queen Victoria approved their use on the occasion of the birth of Prince Leopold.
A woman today has the right to demand some relief from the pain of childbirth, but no mother should demand it at the expense of her own or the child’s lives. There is no one method or set of methods that is universally applicable, and all substances used to produce anesthesia are toxic. The duration and intensity of anesthesia must be decided by the doctor; they cannot base their decision on a magazine article.
Abortion
The term “abortion” refers to terminating a pregnancy before the unborn child has sufficiently matured to be able to live outside of the mother’s body. The most accomplished abortion researcher, Dr. Frederick J. Taussig, calculates that there are roughly 600,000 abortions performed in the US each year and that 8,000 to 10,000 women die as a result.
Numerous of these deaths are listed as being the result of other causes, so they are not included in the mortality statistics. He estimates that one third of these abortions are spontaneous and two thirds are induced. Following an abortion, there is a three-fold increase in mortality and a ten to fifteen-fold increase in invalidity rates compared to term delivery. Abortion poses particular risks for infection, subsequent sterility, and endocrine disruptions that could result in chronic invalidism.
A thorough medical analysis of spontaneous abortion is necessary. Some cases are brought on by diseases like Syphilis, toxemia, and diabetes; others are brought on by deficiencies in the endocrine secretions related to pregnancy; others are caused by vitamin E deficiency; still others are caused by physical abnormalities of the pelvic organs. Obviously, the majority of these can be avoided.
There is a serious risk to both life and health when an abortion is forced. The death rate from abortions rose 25% while the overall maternal mortality rate fell by 15%. Many of these are self-inflicted using techniques that would make any person who is familiar with physiology and asepsis cringe. Others are performed as illegal operations by “doctors.” Some of these abortionists practice medicine unethically, others are members of cults, and still others lack any type of practitioner license.
The main causes of abortions are illegitimacy, large families—of course, poverty plays a role in this—marital issues, and selfishness. Rarely will a doctor need to perform an abortion to save the mother’s life, and there are some circumstances where it is best to limit the number of children. The only risk-free way to do this, however, is not through abortion but rather through using contraception or sterilization.
Obstetric Superstition
A long-standing superstition holds that a mother’s emotions, such as anger, fear, grief, or horror, may cause her unborn child to be markedly hurt or malformed. However, after conception, the mother’s body merely serves to provide warmth and nourishment for the baby until it has developed to the point where it is able to lead an independent existence. Some hereditary traits are transmissible from parents to offspring through the germ cells that unite to give rise to the new child.
The umbilical cord serves as the sole point of contact between the mother and the child. Even the mother’s blood does not mix with the child’s blood in this cord, which only contains arteries and veins and no nerves. Instead, nutrients and excretory products are exchanged through a membrane that divides the two circulatory systems.