| Chapter 2: | Expected Childbirth Pathways |
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Chapter 2
Expected Childbirth Pathways
About a century ago, when my great-grandmother was a young woman pregnant with her first child, she expected her journey from conception to delivery to involve waiting for labor to begin and enduring the experience (probably at home) for as long it took to reach its conclusion—optimally, vaginal delivery of a live newborn. Mothers of her time expected childbirth to proceed along this one and invariant conception-to-delivery pathway because none other existed, at least for the vast majority of mothers (R. W. Wertz & D. C. Wertz, 1989). In this context of limited options, mothers were the primary decision makers and agents in the birth process; nature was the primary agent in childbirth outcomes.
It is safe to say that 21st-century U.S. mothers would quickly trade childbirth of a century past for that of today, believing that contemporary birthing women and their offspring enjoy greater safety and a range of desirable options in childbirth. Greater safety is indisputable: Since 1900, infant mortality has decreased 90%, and maternal mortality has decreased 99% (United States Center for Disease Control and Prevention, 1999a). In real numbers, 6–9 women died per 1,000 live