Scientists advance research and practice on "healthy" childbirth

with the development of maternal and child health care, childbirth from "breaking the ghost door" slowly transition to "living door". Even so, with the end of the United Nations Millennium Development Goals, the number of related deaths is alarming: 307,000 maternal deaths, 2.6 million still births and 5.9 million deaths of children under 5 years of age (including 2.7 million newborns) each year.
, people are faced with how to move from "survival" to "development promotion" and avoid interventions that are "too little, too late" and "too much, too early". On July 29, seven "new" articles appeared in the open access journal Public Science Library-Comprehensive. These articles describe the current norms and practices of childbirth and explore how childbirth can become a positive and transformative event for women. The research papers are based on a four-year European Fertility Action Project that brings together more than 120 scientists and policymakers from 34 countries.Lucy Frith, editor of the series, said:
The purpose of collecting these studies is to summarize and synthest some of the results in this area and to help increase understanding of this critical but easily overlooked area of childbirth. Every , thousands of studies on pregnancy and childbirth are published, the vast majority of which focus on pathology and interventions aimed at preventing related diseases. Although medical progress ensures the safety of mothers and children, there are still adverse consequences of improper medical care during childbirth.
2017, three-quarters of babies who died or suffered brain damage during childbirth could have been saved by better medical conditions, according to a British survey. The Royal College of Obstetricians and Gynaecologists surveyed 1,136 babies born in the UK in 2015 and published a report called Every Baby Matters.
babies were either born with brain damage or died during or within a week of giving birth. This is partly because hospital staff are not aware of the dangers to the baby in a timely manner because of the failure to continuously monitor the baby's heart rate during childbirth.
In addition, the United Nations Global Strategy for Women's, Children's and Adolescents' Health (2016-2030), in addition to listing the above-mentioned death figures, argues that too many women, children and adolescents worldwide still have limited or limited access to quality basic health services and education, clean air and water, adequate sanitation and good nutrition.
, the EU funded the childbirth initiative, which aims to advance research into antenatal care. Antenatal care refers to care from the beginning of childbirth to the time of delivery of the placenta.
review, the researchers described the project's goal as looking at childbirth from the concept of healthy occurrence. In this case, childbirth is not only a way to take the baby out of the mother's body, but also a positive process of neurosterone, psychological, physical and emotional transformation of the mother and baby.
" theory of health occurrence was put forward by medical sociologist Aaron Antonovsky, who concluded that health is more than just not being sick. It focuses on welfare/health rather than pathology. Soo Downe, chairman of the project, told China Science Daily.
researchers point out that maternal care is uneven around the world, with interventions "too little, too late" for women and infants in many poor areas, and "too many, too early" for many wealthier urban women and infants. Some of the project's research has focused on balancing these interventions.
s series of papers is only a small part of the team's work," said Downe, a team member. We hope that others will also be inspired to contribute to the growing knowledge system in this field in the coming decades. AsWorld Health Organization mentioned in its 2018 "Birth Care for a Positive Delivery Experience", women's experience of childbirth care is a global public health issue. The report defines a positive birth experience as "... Meet or exceed women's previous personal and socioc cultural beliefs and expectations, including the birth of healthy babies in a clinically and psychologically safe environment, and provide them with ongoing care and emotional support".
, the psychological problems of childbirth have been paid little attention to in obstetric care programmes or clinical practice.
Ibane Olza and colleagues in the Department of Medicine at the University of Alcala in Spain believe that birth can be considered a neurological-psycho-social event, and they have developed a comprehensive model to analyze the mother's experience and its relationship to neurosteroid events during childbirth.
researchers examined the physiological role of neurosterone processes, especially oxytocin, in the production and delivery, and how these hormones shape the subjective psychological experience of childbirth. The study combined the results of two previous systematic reviews, one on oxytocin levels in maternal plasma during childbirth and the other on women's subjective experiences during childbirth.
results show that neurobiological processes caused by the release of endotopotic oxytocin during childbirth can affect maternal behaviour and feelings associated with childbirth to facilitate delivery. The psychological experience at this point may facilitate the best transition to motherhood. "Some women experience spontaneous changes in consciousness that may be a feature of human physiological childbirth." Olza told China Science Daily.
data also highlight the key role of one-on-one support during childbirth, such as its physiological importance in reducing stress and pain in childbirth, and many aspects of modern maternal care need to be reconsidered.
, the role of midwives in the second birth is crucial. The second birth process refers to the process of full opening of the cervix and birth of the fetus. Maria Healy and colleagues at Queen's University Belfast in Northern Ireland reviewed the current literature on how midwives promote the second birth.
, the midwife's contribution can be divided into delivery posture, non-drug pain relief, push-and-push techniques and yin optimization, the researchers said. However, they also found that there was a lack of research into midwife practice. , Patrick Moran of the University of Dublin in Ireland and colleagues studied the long-term effects of reducing caesarean section rates and increasing vaginal delivery (VBAC) rates. The researchers modeled the economic impact of this change in the proportion of women aged 18 to 44 in two European public health systems.
caesarean section rate has been growing worldwide for more than 20 years. In Western Europe, the average rate rose from 19.6 per cent in 2000 to 26.9 per cent in 2015, an average annual increase of 2.1 per cent. However, medical studies have shown that caesarean section is a life-saving intervention, and once the proportion exceeds 10 to 15 per cent, there is no evidence that it can reduce maternal or neonatal mortality accordingly. Moreover, women born by caesarean section are more likely to have health problems, such as uterine rupture, hetero-pregnancy, stillbirth and premature birth, than vaginal delivery.
, the cost of a caesarean section outweighs the benefits. Analysis by Moran et al. found that for every 5 percentage points change in caesarean section and VBAC rates, it could save Ireland 1.1 million euros a year and England and Wales 9.8 million euros.
, previous studies have suggested that women should pay attention to postparto health and risk factor screening, especially those who have given birth more often.
Erin D. Michos, an associate professor at Johns Hopkins University School of Medicine in the United States, and colleagues, using the medical records of more than 3,400 people and survey data collected from them, further demonstrated that women who gave birth five or more times may have more risk factors for heart disease, including obesity, high blood pressure, and physical insanity, than women who had fewer births. Therefore, the researchers stress that postnatal planning should include strategies to help mothers keep their hearts healthy.
September 2010, I launched the Global Strategy for Maternal and Child Health because I believe the world can and should do more to save the lives of women and children and improve their well-being. Former U.N. Secretary-General Ban Ki-moon says he hopes to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births by 2030, and the neonatal mortality rate in countries to 12 deaths per 1,000 live births. (Source: Tang Feng, China Science Journal)
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