What do obstetricians say: How far have we come to reduce unnecessary production and medical care?

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For gentle childbirth, perhaps readers still have questions, we can listen to what the doctor says. The second physician is Lu Xinfen, director of the Reproductive Medicine Center of Far Eastern Memorial Hospital. We also asked her if when we talk about "medicalization of production", has this situation improved from now in 2019? What else should be improved? (Additional screening: Gentle delivery room|Obstetrician and gynecologist: giving birth to a baby and having sex are actually very similar)

Photo provided by Far Eastern Memorial Hospital

Q1: Many people say that there are many medical practices in production that are unnecessary. For example, shaving, enema, cutting the perineum, pushing the stomach, etc. As far as you can see, have these medical behaviors improved?

"More than 20 years ago, when I delivered a baby in a hospital, the nurse in the delivery room would shave and enema the woman who was about to give birth. This is done because of the concern that bacteria on feces and hair can cause wounds and baby infections. Enemas can remove feces in the intestines during delivery, reduce involuntary defecation during labor, and avoid feces on the delivery table. Some people don't like the feeling of stomach cramps during enemas, and some people feel embarrassed about unconsciously relieving themselves on the delivery table without an enema. Now our hospital routinely does not prescribe enemas. As for shaving, we disinfect the production area before giving birth, so shaving without shaving will not cause the effects of infection. As medical studies have shown that maternal infection is not directly related to shaving and enemas, such medical treatment has been greatly reduced clinically."

"As for cutting the perineum, many people say that women in Europe and the United States often do not cut it, and we judge that there is still a difference between the pelvis of Westerners and the East. The reason why the perineum is cut is because during childbirth, the mother often has vaginal lacerations, so that the wound is at least flat. If it is not cut, it will crack into the urethra and anus, and the difficulty of suturing and stopping bleeding will also increase. So as for the ratio you mentioned, I saw the teacher perform surgery in the early days, and some old doctors would indeed cut the wound very much, which also made the mother uncomfortable. I have given birth to children myself, and I can cut them without cutting, and when I really want to go under the knife, I tend to cut them shallowly."

"Pressing the stomach is indeed a very dangerous behavior. If the fetal position is not correct, we will slightly help the baby correct the fetal position and try to let the head be below to give birth. If you encounter an emergency, such as shoulder dystocia or head jamming, you will still be medically assisted to 'press the stomach'. In addition, modern people exercise less, and lack knowledge, some mothers do not know how to exert force, at this time medical treatment does need to intervene, or let the mother lie on her side, the baby is easy to descend. In the end, if it really doesn't work, our doctor will evaluate whether it can be vaginal delivery, otherwise it will be a caesarean section."

Q2: We define gentle childbirth as "a mode of production centered on pregnant women" and minimize unnecessary behaviors. We are curious, how do you practice this concept yourself?

"From a mother's point of view, I can completely understand their concerns. Production should indeed not be overly medicalized, but we also see that the medical system is changing year by year. We will do what we can to be patient-centred."

"To be honest, I think a mother who is willing to practice gentle childbirth must be very strong." (Extended reading: "Wish Me a Good Pregnancy" is the most real production documentary: having a child is not a romantic thing)

"Regarding gentle births, many hospitals now have a kind of delivery room called LDR. It is a delivery room that promotes the possibility of staying in the same bed before, during and after childbirth. Otherwise, sometimes, the mother is in so much pain that she can't stand it, so she transfers her to the cold delivery table, which is very unfriendly. In fact, in general hospitals, family members can accompany birth, but photography is not necessarily possible. In the Lede Children's Room, we try to hide medical equipment in the furniture, such as oxygen and suction first aid, and place it behind the painting. If you have favorite paternity music, we can also play it. So, if you say that gentle production is a 'mother-centered' production concept, I think the closest production method we do is Lede Childcare."

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Q3: Have you ever encountered a manufacturer who came to you with a "production plan"? How do you communicate?

"A few years ago, there were also mothers who would bring birth plans from other families, but in recent years there have been fewer of them. We will roughly talk about what can be done and what cannot be done."

"In addition, every medical act I do will definitely explain what to do and what the reason is. This is the most basic communication. Of course, we hope that there will not be too many medical practices. For example, 24-hour fetal heart sound detection, admission to the hospital for intravenous drip, if the mother requests, we can let her not be tied up 24 hours a day, but the closer to delivery, for safety, we will still hope to be monitored. As for intravenous drips, it is to replenish the water lost during childbirth, as well as electrolyte imbalances caused by vomiting or weakness. The disadvantage is that it affects the convenience of activities. Therefore, if the mother can eat freely, replenish water, and do not vomit severely, she can not use an intravenous drip first. But intravenous indwelling needles are a must, and in case of emergencies, hemorrhagic shock, it is a life-saving channel for administering drugs."

"Foreign medical advice suggests that low-risk women can give birth gently at home. I think that if some women are healthy and low-risk mothers, it doesn't matter if they can give birth smoothly. But if you encounter a dangerous situation, you still need to have adequate medical support and it is safer." (Further reading: Breaking tradition! Princess Meghan of the United Kingdom chose to give birth to a baby at home)[1]