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2018 Feb

21st-Century Birth Trends

Birth has often been an uncertain process for women. Just a few decades ago, the common practice was multiple women laboring in a large room without their partners and being sedated into “twilight sleep” to deliver. Women might sleep for hours after birth, not seeing the baby they’d just delivered. The husband saw the baby through the nursery window. Birth was not very personalized. Thankfully, we have learned and changed since then.

In the 21st century, women have more options, support, and comfort measures than ever. Pregnancy and birth are more evidence-based, but also have flexibility to adapt to different situations. We’ve shifted to recognizing that birth is an important life event while keeping the process as safe, comfortable, and customized as possible. It’s taken a lot of conversations to remind everyone this is a natural, normal life event for the majority of women. As a certified nurse midwife with a doctorate in nursing, I believe blending the science with compassionate care is where modern birth is headed.

Besides expert medical care throughout pregnancy, women have more ways to find out what’s going on, through monitoring, ultrasound, prenatal testing, and other advanced technologies. Today’s mom can use a birth plan app and/or an online personal preferences form and regularly talk to her obstetrician or midwife about her options in person or through an online medical record tool like MyChart

Before Sentara CarePlex Hospital in Hampton began delivering babies in January, we asked women what they wanted in a modern birthing center. Simply put, they asked for a more personalized experience and home-like amenities. Of course, excellent and safe care is at the center of everything we do, but we know details matter.

Social media has changed our birth expectations. This formerly private event is now much more public, and we even see a more liberal use of cameras in the delivery room. There’s often a birth watch. Is the baby here yet? Is a photo posted? You used to hear the news 2-3 days later. Now it’s hours, or even minutes. We know this is part of the modern experience, and amenities can make this smoother, like in-room charging stations for smart phones.

Medical technology has helped improve outcomes, but that technology changes the experience, too. For our military families with a deployed family member, it’s not uncommon to have someone join a birth via Skype! It can be an important bonding experience to see the birth at that moment.

Some things about birth will never change, though. Women want to feel safe. They want to know that their medical providers truly care about them. They need reassurances as they transition to parenthood. I like to think of this as “knitting a sweater around them.” We want them to feel comfortable, warm, and safe as they make this step into parenthood.

Our practice of family-centered care includes keeping mother and baby close, encouraging support from family members, and promoting rest. Part of the intangible support of your care after birth is that we help you get to know your baby, who is yours from that first moment, and to teach you to take care of him or her.

Another major shift in maternity care is the emphasis on being accommodating to all types of choices and preferences. Birth is a life-changing event. Pain in labor is not like anything else. If what works for you to get your baby here is the beat of heavy metal music, that works for us. If you want to move around, howl, dance, or stay on your hands and knees, and you can safely do that, great. If you want more family present and we can have them in the room safely, you’ve got it. And if you don’t have any particular preference (maybe because you’re a first time mom), it’s our job to be flexible as you make those decisions in the moment.

We also try to anticipate needs as much as possible, so that we can care for women as individuals. Prior to birth, we ask you to complete a personalized profile questionnaire, taking into account physical comfort preferences, cultural beliefs, privacy and language needs, food allergies and sensitivities, previous birth experiences, and how you like to communicate with their health care team.

Our role in the 21st-century birthing experience is to provide moms with support, expert medical advice, and be open to the conversation. We see all kinds of families and all kinds of situations, but our end goal is always the same: healthy mom and healthy baby.

Donna Patno, DNP, CNM, is the Director of Women’s Services and Patient Care Services for Sentara Healthcare on the Peninsula. She’s a Certified Nurse Midwife and has a Doctorate of Nursing Practice (DNP) from Case Western Reserve University.