Grandparenting Class

Changes in Childbirth over the last few decades

Several factors have stimulated changes over the last few decades including differences in styles of birth, increased options in pain management, enhanced incidence of epidurals and the inclusion of the expectant father or support person in the birthing experience.

Prenatal Care

Nutrition – It is important that the mother-to-be maintains a healthy diet during pregnancy and postpartum, which means eating a balanced diet from all the essential food groups. It is more important for pregnant mothers to obtain adequate nutrients than to eat too many empty calorie foods. The old adage of “eating for two” should not be followed.

There has been a large focus on folic acid in the media over the last few years. Folic acid (when taken in the preconception period and during pregnancy) has proven to help prevent some birth defects affecting the brain and spinal cord. Folic Acid can be found in orange juice, green leafy vegetables and fortified breakfast cereal or in prenatal vitamins.

Of some concern currently, is the risk of obtaining Listeria from processed foods like deli or luncheon meats and hot dogs (unless they are thoroughly cooked). Pregnant women should avoid unpasteurized cheeses (ex. Brie cheese), which also pose a risk. In addition, foods with high amounts of mercury (like tuna) should be limited to no more than three servings per week.

Cats – Pregnant women should not handle or change the cat litter due to the risk of being infected with toxoplasmosis.

Exercise – To maintain a healthy pregnancy, a woman should maintain an exercise regimen. The best exercise is walking, dancing, swimming, stationary cycling or low impact aerobics. Women are encouraged to stay active as much as their comfort level will allow. This will increase their stamina in labor and delivery and decrease some of the natural discomforts of pregnancy.

Education – Women today are more informed than ever about prenatal care, labor, delivery and infant care through education obtained from the workforce, their physician, the Internet and various classes.

Labor and Delivery

Technological Advancements – Advancements in technology have changed the scope of practice during the prenatal period through delivery and beyond. Advanced fetal monitoring, amniocentesis and Level II ultrasounds have enhanced the screening process, while other technology has increased the ability to take care of ill and premature infants. Delivery methods have also changed, including (in some areas) more vaginal deliveries after cesarean sections and the need for a cesarean delivery for a breech baby.

Although the actual need of an infant requiring any specialized care is very small, the Family Birth Center here at Mercy is a designated Level II Center for Labor and Birth and is equipped with a Level II Special Care Nursery to help alleviate any anxieties and take care of the newborn with special medical needs. The Family Birth Center provides a comfortable surrounding with sophisticated resources and skilled nursing staff to ensure a safe environment for the birth and management of emergency situations. Click here for more information.

Options – For a safer and more meaningful experience, the options in labor and delivery have increased and changed over the last few decades. A long time ago, women had babies in the home environment and then eventually moved this practice to the hospital. The hospital at that time was very structured, cold and sterile appearing. Now that method has been replaced with a consumer-oriented hospital that is family-centered to make the birth an even more special event. The mother-to-be and their support person have an increased ability to make informed decisions about the labor and birth process. Now there are many more choices available to women regarding all aspects of the labor and birth experience. A safe, meaningful birth occurs by focusing on new technology, parental choice and physician input. The family-centered environment allows the family to bond without exclusion of family members.

Pain Management – A few of you may have experienced being "put to sleep" for your births. On the other end of the spectrum, few pain management options were available. Now there are a variety of pain relief methods available ranging from breathing and relaxation techniques to an epidural. Breathing and relaxation focus on deep breathing, slow breathing, patterned breathing, guided imagery, music, aromatherapy, visualization, focal point, massage, meditation, pressure points, hydrotherapy, position changes, walking during labor or sitting in a rocking chair. Pain medicine is also available through the vein (blood) or as a shot, to take the edge of the pain away. Many people are choosing to obtain epidurals. This occurs when a small plastic catheter is placed into the women's back (the spinal cord) to numb the laboring woman from the waist down. A large number of women choose this option because of their increased ability to enjoy the birth experience, although some risks are involved. A trained anesthesia personnel places the epidural, at the patient and doctor discretion. Even during a Caesarean delivery, the mother can remain awake with either epidural or spinal anesthesia. Only in an emergency cesarean delivery would the need arise for the use of general anesthesia or putting the mother to sleep.

Monitoring – Monitoring has changed over the years as well. All women are now placed on fetal monitors during some portion of their labor. The monitors are attached with a stretchy belt onto their belly that connect to the machine. The monitor traces the contractions she is having as well as how well the baby is reacting to these changes. We can place internal monitors by the baby after her water is broken if a more accurate reading is required.

Forceps, Vacuum Extractor and Cesarean Birth – There are several devices available to assist with the impending delivery if needed. Forceps are often referred to as "salad spoons" used by the physician to assist with the delivery as the mother continues to push. A vacuum works much the same way, but symbolizes a suction cup on the baby's head.

The current national rate for Cesarean delivery is 25.93%. The increase over the last few years has partially stemmed from the decrease in number of people who choose VBAC (vaginal birth after a cesarean) due to their doctor's recommendation. There are many things the mother-to-be can do to reduce her chance of a cesarean including learning other options, maintaining proper nutrition and exercise, adequate prenatal care and maintaining a positive attitude and support system.

Postpartum Care

Hospital Stay – The length of time a new mother stays in the hospital has changed over the years. Originally, new mothers stayed in the hospital a long time. Now insurance dictates how long they are allowed to recuperate. Currently, most women stay 48 hours with a normal vaginal delivery and 72 hours for a cesarean section. This gives the mother time to rest, develop some routines and to learn cues from the baby. Education from staff plays an important role at this time to assist with breastfeeding, care of the infant, bathing, sleeping patterns, etc.

If you would like to take a tour of the Family Birth Center to see where your grandchild will be born, please call 712-279-2116 to set up an appointment. The tour is free of charge, but an appointment is recommended.

Next section: Changes in infant care