The study of the WHO recommendations on birth practices based on long-term studies has made me think. Why do obstetricians fail to comply with these recommendations? Why are they playing Gods in white coats?

Every woman has the right to care in accordance with current knowledge of medical science. I intentionally highlight the current word, as Czech obstetricians still apply methods that have long been declared undesirable, ineffective or even harmful and health threatening. Obstetricians, unfortunately, record the fact that most women are not aware of what is and is not harmful to normal childbirth, and if a woman is brought to the maternity hospital to be born, she is often misled.

Let's look at the facts that every pregnant woman should know (but also the general public to "straighten" the distorted concept of childbirth), but the obstetrician usually silent about them.

The position on the back of the back is comfortable for the obstetrician, but it is risky for a foster woman
In the back lying position, which is a routine standard for Czech nursing homes, the woman is making an effort against Earth's attraction, while gravity helps in the upright position of birth. The skeleton and the crosstalk, ingeniously depressed during pregnancy due to leaked substances to allow them to recede on Day D, can not fulfill this function while lying down on the back, and the porosity of the delivery routes is as much as 30% less. Excessive pressure on the coccyx often causes the pain of this part to be long after delivery. Also, the shape of the birth paths is pointing lying upwards, so the woman is "uphill". Logically, then, delivery is very demanding and painful, and the risk of using pliers or vacuum extractors increases, and the risk of episiotomy. Not to mention that some obstetricians are able to reach even the forbidden and health and life-threatening methods, Kristeller's expression.

When the lying down on the back, the child's head descends directly on the dam, so the dam can not be extended well. There are plenty of reasons for a woman to be born in a place other than this routine. Also, WHO, based on these findings, recommends that the parent intuitively choose the birth position itself. The position on the back on the back is also considered to be clearly harmful. If for some reason the lying position is necessary, you can at least put the woman on the side to be a free coccyx.

How many obstetricians or midwives invite a woman to try to find any position that comes to her in the ejection phase of childbirth? Why is it that usually a woman who does not know about the disadvantages of this position, most of the obstetricians automatically "put on the blades"? Obstetricians often argue that in the case of lying down, the health care professional has a good access to a woman in case of complications. Unfortunately, the public is convinced that the very position of lying on the back is often the cause of these complications. For the convenience of both sides there are so-called birth chairs.

Episiotomy (healing of the dam) heals worse than natural tearing and is often unnecessary
This is the most common obstetric surgery performed in the Czech Republic to a much greater extent than is appropriate. WHO does not recommend so-called episiotomy in more than 10% of vaginal births, yet more than half of women are born in 38 in Czech nursing homes. There is even a maternity hospital, where in 2013 80% of the dam was made (source: www.jaksekderodi.cz). That the shroud protects a woman from tissue damage, as the future obstetricians at the medical faculties are teaching, is a mythless foundation.

Perhaps the only benefit of the splinter is that it is better than natural tear (which is an advantage for the obstetrician, not for the woman itself), however, it is painful, it usually heals worse, and there is a risk of further complications (long-term pain, , painful intimate contact (ad). In case of tearing, the body walks through the least resistance, while during the treatment the midwife does not try to avoid large vessels and muscles.

As I have written above, when lying down on her back, the birth paths are narrower and the descending head pushes directly onto the dam, which can not retreat - prevention of the cut is therefore a change in the postpartum position. Sometimes, however, it is enough to give the parent more time.

Synthetic oxytocin causes painful contractions and interferes with bonding
Synthetic oxytocin (pitocin) is used primarily to support the opening of labor, but the tax on accelerating is a much more painful contraction than natural contractions. Natural oxytocin is washed into the body in waves so that the woman can relax between these waves, whereas pitocin is constantly in the vein to the body and also prevents the release of endorphins that help to treat the pain. Childbirth so often becomes so unbearable that a woman is forced to ask for a softener, another chemistry. Pitocin caused by strong and painful contractions without rest can also be prepared by a child of oxygen. Unfortunately, it also negatively interferes with the early bond - the so-called bonding. Oxytocin, released into the mother's body immediately after delivery, causes immediate love for the baby. Mother after natal delivery, excited with oxytocin, she suddenly has enough energy, she wants to dance, she is able to take care of her child without problems, as with so many discussed the ambulatory delivery of Duchess Kate. Mothers "dressed up" with artificial oxytocin are often disappointed that, despite the way they enjoyed their child for nine months, they feel after childbirth as if their child was alien, it is harder for them to "mate" and trust in maternal competence is less.

I have no doubt that there are occasions when an accelerated delivery of artificial oxytocin may be desirable. The problem, however, occurs when it is used to speed up a normal delivery, instead of giving priority to other methods of natural acceleration - such as a change in position, free movement of a woman, psychological support. It should also be borne in mind that a normal childbirth simply has its own time.

Controlled pushing is harmful for mother and child
Once, for the ejection part of parturition, a short quick breathing, so-called canine breathing, has been learned, but it can cause hyperventilation. Today, in some maternity wards, women are commanded to push with restrained breath, which the WHO has identified as clearly harmful to the process. A woman who is urged to push when she does not feel pushing and does not push when she or her body is pushing herself, she may feel confused and feel that she is doing something wrong. A woman should push on contractions and feelings. Controlled pushing can cause damage to the urinary tract, pelvic and perineal structures, depletion of the mother and can contribute to the detoxification of the fetus.

You have the right to unrestricted contact with the child
After childbirth in Czech maternity hospitals, children and mothers are often separated because of "necessity" of various examinations, measurements and weighing, if the child is alright, the child can be examined on the body of the mother, and the measurement and weighing can be left for later. Taking (healthy) children is also happening under the pretext of warming the baby in an incubator or heated bed, or for a mother to relax. All these procedures, however, differ with the WHO's knowledge that the close contact between the child and the mother is the best way to maintain the child's body temperature and promote early bonding and supplementation of energy through endorphins washed out by joyful mother-child communication. For the child's health, it is advisable to encounter bacteria on the skin of their mother, not the bacteria of care providers. In addition, the WHO encourages healthcare professionals to allow mothers unrestricted access to a child day and night. By law, as a legal representative, you have the right to have unlimited contact with the child.

What the WHO does not recommend anymore and, on the contrary, welcome
Other routine WHO practices include routine enema and shaving, routine preventive introduction of a cannula, routine use of a midwife's position during the first labor period, feeding water, glucose or artificial feeding to children who are breastfeeding and any time or breastfeeding frequency. On the contrary, for the benefit of the WHO, the development of a birth plan, the provision of fluids during childbirth, empathic support during childbirth, non-pharmacological methods of pain relief, fetal monitoring by listening (not an electronic monitor requiring a lying position every two hours for about 20 minutes, so very unpleasant), freedom in choosing the position and movement during the entire delivery, umbilical cord abortions until reaching, breastfeeding support unlimited.

The WHO supports self-help parents and encourages health professionals to not interfere with normal labor. As stated in the WHO Manual Caring during normal labor: "... normal childbearing with low risk requires only careful monitoring by a trained and competent midwife to detect early onset complications. It does not need any interventions, but encouragement, support and a little loving care. "

Note: Facts about recommended and non-recommended, harmful birth defects can be verified by the WHO manuals, which are also available on the site Asociace českých dul. A summary of the WHO's most important findings is also produced on the site Movement for Active Motherhood.

Time to return to the question at the beginning. Why do obstetricians (or midwives, however, take into account that they are subordinate to obstetricians and have to comply with a standard for a given maternity hospital) do not respect the WHO recommendations on clearly harmful practices? Not wanting to change a routine? Fear to let a woman simply give birth to herself because of the perception of childbirth as a disease, a package of potential problems? Mistrust in the ability of a woman to give birth to a child? That they probably did not see a single birth during their studies?

There is a theory (only theory, nothing to do, please do not take the following words personally) that the part of the brain did not develop due to the trauma due to the trauma that individuals separated shortly after delivery from the mother (as my parents' generations were becoming routinely). Yes, it is a bold theory, but it is worthwhile to think about what really can cause a fresh newborn to be taken from mother to child itself. If the child's first experience with the world is left alone (and in earlier times it was common for several long hours, if not days), she may subconsciously feel rejected, unwanted. This trauma has been developed in the past by the non-contact way of education - frequent postponing of babies in strollers or cradles, non-response to the baby's needs (ignorance of crying), early breastfeeding. And so I think that what the obstetricians lack is maybe more love. Primary love that was not filled at the very beginning of their lives. And that we are again women, who can heal our men with what they have never experienced - an unconditional love that knows that they are human, forgiving divine, and acknowledging their mistakes and not continuing them MoUDRé.