Doctors, Parents Cooperate To Ease Birthing

Korea ranks number one in the world in its use of Caesarean sections, with a staggering 43 percent of babies being delivered under the knife. By comparison, the C-section rate in the United States stands at 20 percent, and in Japan at 15 percent.

Amid this alarming statistic, there is a growing dissent against conventional birthing practices that wrestle away the woman's right to control the process and place it in the hands of medical professionals, who often intervene aggressively in what critics say should be a natural process.

While the medical profession should be credited with saving countless lives in complicated births and high-risk pregnancies, procedures that should be reserved for difficult cases are being practiced even on women who should be able to deliver naturally without such aid, according to Park Moon-il, professor at Hanyang University Hospital and author of "Birth Revolution for Mothers and Babies," published last year.

"The medical profession and mothers have such blind faith in modern medicine that even healthy expectant mothers are losing the ability to deliver babies on their own," Dr. Park suggested.

However, quiet changes are taking place in some hospitals that are giving women more choices and allowing the family to become active participants in birth. Patients at Eunhe OB-GYN in Dejo-dong, Seoul, know that they will be encouraged to deliver naturally, in contrast to other hospitals which usually recommend C-sections.

The clinic has one of the lowest C-section rates in the country at 17.9 percent. The clinic also attempts to make the birth a festive occasion with the mother and the father in lead roles and the doctor playing a supporting and watchful role.

About a week before the delivery date, the expectant parents are asked to bring a "wish list" of what they would like the hospital to do during the birth. Mothers often ask for specific music and dim lights, and fathers may ask to cut the umbilical cord. The newborn baby is brought to the mother to be held the moment it is born. A key element in this "gentle birth" is allowing the women to do what comes naturally. Women are encouraged to get off their backs during delivery and assume varied positions, not only to alleviate their own labor pains but also to help the baby along as it makes its journey into the outside world.

One way of achieving this is by giving birth in a bath of warm water. Proponents of this method claim that the comfort of the warm tub relaxes tension and eases labor pains, while allowing the mother the freedom to move more freely to assist the descent of the baby. Buoyancy also promotes more efficient uterine contractions and better blood circulation, resulting in better oxygenation of the uterine muscles, less pain for the mother and more oxygen for the baby. When the baby does meet the world, he does not arrive in a strange, cold environment but into water heated to 37 degrees centigrade, similar to its environment in the womb.

Upright delivery is also fast regaining favor after centuries of neglect. Paintings and carvings by ancient civilizations show women either standing or squatting to give birth. Birthing chairs, used well into the mid-18th century and abandoned when it became the vogue to give birth lying down, are making a comeback, this time in the form of a swing or a wheel.

Looking like a space-age contraption, the Roma Birth Wheel allows the mother to take advantage of gravity, reinforcing the dynamics inherent in contractions. "The wheel facilitates natural vaginal delivery by increasing blood circulation to the uterus and the placenta and relaxing the muscles in the pelvic floor," explained Kang Joong-ku, head of Sanbon Cheil Hospital, Sanbon-dong, Kyonggi province. Nearly 1,000 births at the hospital have taken place using the Roma Birth Wheel in the past year.

The mother is only moved to the wheel when she is 3-4 centimeters dilated and about halfway through the birth, as sitting in an upright position for more than 2-3 hours can be uncomfortable for the mother. Once on the chair, the woman can swing back and fro with the contractions to ease the pain and use the heated pad to assuage the backache that most women feel. The chair can be tilted and moved up and down using a remote control, allowing the doctors to perform any medical procedure that is necessary.

Although research into the merits and demerits of the wheel is still incomplete, most of the mothers found the experience satisfactory, noting that the wheel allowed them to assume positions that facilitate effective pushing.

"Labor time is reduced by as much as half," said Dr. Kang, who plans to publish a medical journal paper on the use of birth wheels.

"Mothers are definitely happy on the wheel," he observed, although at the expense of doctors, who often find themselves rather uncomfortably on their knees to support the baby as it is delivered. "But the whole thing is about a mother-centered birth," said Dr. Kang.

by Kim Hoo-ran