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A Swiss childbirth center reports of a dramatic shift in the type childbirth
practices performed there in recent years. A new birthing concept was
initiated in 1991 due to popular demand by women and couples for a more
"natural childbirth" experience.
The new practices consisted of restrictive use of invasive methods,
and freedom of choice of different birth methods including waterbirths
and other alternative birth methods, but with careful monitoring and birth
management remaining in place.
A total of 9,418 births took place at the clinic between 1991, when the
new program was introduced, and 1997.
The data relating to various medical interventions were compared to
a total of 5,602 births from 1986 to 1990 in the same clinic and to data
from a contemporary group from Swiss clinics, a total of 344,328 births
from 1986 to 1997.
The authors state that " ... alternative birth methods are very
popular" and they note the following trends and statistics:
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The waterbirth rates rose
steadily during this period and stabilized at around 40-50% of the
total spontaneous births.
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The bedbirth rates account
for approximately 40% of the spontaneous births.
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Other birth methods such as standing, supported by a rope, on
the mat or on all fours are utilized, but are much less popular and
account for the remainder.
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The episiotomy rate dropped
from a previous rate greater than 80% to lower than 15%.
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The cesarean section rate
in our clinic (around 10%) has remained substantially below the Swiss
average (around 15%).
- The rate of the spinal and epidural analgesia was maintained at
a constant level, around 13%, while the Swiss average rates doubled
and reached 23% in 1997.
The authors conclude that "...natural birth management can be well
integrated into the security-oriented way of thinking of classical medicine."
It should be noted that nearly all women giving birth in the region give
birth in the clinic without preselection or bias, since it was the only
birth clinic in the entire region. The only women referred elsewhere are
approximately 2%, which are sent to a larger university-based birth clinic,
mostly because of preterm births (before end of the 33rd week).
In a separate article in the same journal, the authors explore more
in-depth, their experience with waterbirths. Please see the article
addressing this issue in this week's newsletter.
Fetal Diagn Ther 2000;15:283-290.
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