For thousands of years of human history, it was the same. The birthing process – though a universal experience that resulted in the continuation of the human race – was an event shrouded in mystery and danger. The need for sanitation was unknown; fathers were unwelcome at the births of their babies; and maternal death rates were high. As recently as 100 years ago, one in 100 women died in childbirth.

 

Today, in developed nations, the situation has drastically changed. There has never been a better time to have a baby. Prenatal care protects both mother and baby. Couples prepare together for the birth of a child, and fathers can choose to witness their babies’ first breath. Modern medicine and sanitation have made childbirth more comfortable and immeasurably safer. And here in Madison, expectant mothers have many options for that very important day.

 

Since the 1950s, most women have given birth in hospital settings, and today this is still true. Many women feel more secure knowing that physicians and medical technology is readily available if needed, especially if they are first-time mothers or moms with pregnancies that may be high-risk.

 

In south central Wisconsin, more babies are born at Meriter Hospital than any other. While our mothers and grandmothers may have given birth in stark white hospital rooms only to have the baby snatched away and put into the nursery, hospitals today are baby- and mom-friendly and Meriter is no exception. 

 

“At Meriter you can have the birth the way you want in a safe environment,” says Patty Abraham, RN, BSN, nurse manager at Meriter Hospital Birthing Center. “You can have high-tech with our maternal fetal medicine specialists or high-touch with our obstetricians, family medicine physicians or certified nurse midwives.”

 

Rated in the top 10 percent nationally, Meriter’s birthing center offers private birthing suites with homelike amenities; whirlpool tubs and shower massages; room for a father or other children to stay; specially trained nurses; and breastfeeding support. Should there be any complications, advanced care is available and the hospital’s Newborn Intensive Care Unit provides care to premature or sick babies.

 

While hospital birthing has been “traditional” for a half-century, more and more women are opting for older traditions. Natural childbirth – which minimizes medical intervention like caesarean sections, the use of forceps and monitors, and anesthetics – can be a safe option for most mothers, and can take place in the home or at a free-standing birthing facility like Madison Birth Center.

 

“Our care is provided by certified nurse midwives and is mother- and baby-centered, not centered on (hospital) routines,” says Aszani Kunkler, midwife and director of Madison Birth Center. “A mother has instincts, and we support what she needs.”

 

A woman who has chosen natural childbirth will get to know the staff at the Center, who will work with her on nutrition, exercise, and emotional support, all of which “improve perinatal outcomes,” says Kunkler. “And we have excellent outcomes, with high satisfaction for the mothers.”

 

Hospitals, says Kunkler, “are designed for the highest levels of risk, but 80 percent of deliveries are normal.” Kunkler warns against what she calls “the cascade of interventions,” which can occur with some medical treatments and ultimately complicate the birthing process.

 

With natural childbirth, the cesarean rate is extremely low – between 3 and 7 percent – compared to caesarian rates at hospitals, which now account for almost a third of all births. “Vaginal birth is much better for both mother and baby,” says Kunkler. “We support labor as it is. We don’t mess with what works.” Should there be a medical necessity during a natural childbirth, a mother can be transported to the hospital – but it’s a rare occurrence. “We take the health and safety of the mother and baby very seriously,” she says.

 

Another option mothers have is to hire a doula, who can be at any birth – whether at home, a birth center, or a hospital. A doula, explains Rose Marie Bertrand, “eases and speeds labor using non-pharmacological means.” Techniques include massage, acupuncture, hot packs, cold packs, showers, tubs, and position changes. 

 

Bertrand, a doula who has been attending births since 1978, says that such techniques make the use of pain medication less likely, and decrease the need for forceps, vacuum or caesarian deliveries. “A woman who has had a doula tends to view her baby as ‘better than average,’ and is happier with the birth experience,” she says. Another benefit: “It makes it easier for the partner to just be there.”

 

A woman who wants to hire a doula can interview several of them (wisc.doulas.net is one local resource) and choose one she feels most comfortable with. She will meet with the doula several times during the pregnancy, and then will call her once she has gone into labor. A doula will stay and assist during the birth – no matter how long it takes – and stay with the mother and baby for a time after the delivery.

 

“So far I’ve attended 237 births,” says Bertrand. “I keep track. And I honor and respect every one of them.”