Battle for the right to do what comes naturally

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The Independent Online
Childbirth has never been easy since God told Eve in Genesis: "In sorrow shalt thou bring forth children." But things have improved dramatically since the 1890s, when five mothers died per 1,000 births compared with a rate of less than 0.2 today.

Some of the most dramatic changes in childbirth have occurred since the end of the war. Doctors came back from the front, wanting their jobs back and took control from the midwives who before then had reigned supreme. At the same time, the NHS was born, centralisation took place and hospital rather than home births became the norm.

There was still great ignorance about giving birth, which was not helped by lack of information for women. In the 1950s one of the most popular books, the Sunday Express Baby Book, devoted just one paragraph of its 240 pages to the delivery itself. The author, a Mrs Woodman, reassured young mothers-to-be that all would be well: "In the delivery room, white with bright lights, you will be taken from a hospital trolley to the delivery table. The nurses will be standing by with the doctor and with their gentle help and encouragement, aided by the science they have studied so long, your baby will be born," she wrote.

Interest in natural childbirth had been quietly growing, however, since 1943 with the publication of Childbirth Without Fear, by Dr Grantley Dick- Read, which advocated relaxation techniques. In 1957, the Natural Childbirth Association of Great Britain, later to become the National Childbirth Trust (NCT) held its inaugural meeting.

Ultrasound was introduced in the 1950s as was electronic foetal monitoring but it was in the1970s that high technology really took off. At one stage, half of all labours were induced and Caesarians doubled between 1960 and 1970, again between1970 and 1978 and yet again during the period from 1978 to1994. Fewer than 3 per cent of women had drug-free births and by the1980s less than 1 per cent of births were at home.

At the same time, natural birth advocates were fighting back. Michel Odent, a French obstetrician pioneered the use of warm pools in the 1970s and today nearly all hospitals have facilities for water during labour. The 1980s also saw the active management of labour, pioneered in Dublin, which ensures no labour lasts more than 12 hours by artificially stimulating the uterus.

The culmination of the natural birth lobby's efforts was Changing Childbirth, the 1993 report of the Government's Expert Maternity Committee, which aimed to place women back in control in the labour ward.