the baby with the greatest possible tenderness. Imme-
diately after delivery the baby is placed on the moth-
er’s abdomen, where the baby can start breathing
before the umbilical cord is cut. After a few minutes
the obstetrician places the baby in a lukewarm bath,
an environment very much like the amniotic fluid. In
this way the difference between the fetal environment
and the world is minimized.
Is Leboyer’s method better? Safe? Of the few
studies that have been done, the results seem to indi-
cate that babies delivered this way are similar to oth-
ers delivered in a more conventional fashion.
Whether or not there are any long-lasting effects will
have to be judged after sufficient information is avail-
able about these ‘‘gentle birth’’ babies as they grow.
Alternate Birth Centers
Hospitals operate as bustling, crisis-oriented
places. Such institutions are for sick people, and preg-
nancy is not considered an illness by supporters of a
new kind of environment for giving birth—the alter-
nate birth center. Alternate birth centers were devel-
oped because many parents objected to what they felt
to be the impersonal, needlessly technological, and
increasingly expensive childbirth procedures avail-
able in the conventional hospital setting. As a growing
number of women chose to give birth at home, the
risks involved became a concern. Alternate birth cen-
ters, then, are a response to both the dissatisfaction
with hospitals and the hazards of home births.
These centers were all but unheard of in 1969.
Within a few decades, at least 1,000 had been estab-
lished, and the trend continued into the early twenty-
first century. In 1978 the medical establishment offi-
cially endorsed many elements of this alternate care,
recommending that it be included in conventional
maternity services. Out-of-hospital facilities for the
management of low-risk deliveries were also estab-
lished.
Alternate birth centers provide a relaxed, home-
like atmosphere for the pregnant woman, her family,
and the newborn. The most dramatic aspect of an al-
ternate birth center compared with a conventional
hospital is the room where the deliveries take place.
Unlike the operating-room atmosphere to which la-
boring women are generally sent at the most uncom-
fortable, critical moment, the birthing room—the
location of the woman’s predelivery hours—is a
cheerfully decorated suite resembling a bedroom.
Women in labor move about freely. They rest as they
choose and may be accompanied by their husbands,
families, and friends. An attending nurse, midwife, or
doctor delivers the baby into this low-key, family-
oriented environment. It is dimly lit, quiet, and
peaceful.
The new mothers, and those with them, report a
sense of control and contentment in contrast to the
anxiety and isolation experienced by many in the tra-
ditional delivery room. Many of these centers also en-
courage the participation of other siblings in various
stages of the pregnancy and birth.
Following the birth, the new family remains in the
birthing room, in close physical contact. The newborn
is placed on the mother’s bare skin (which can act al-
most like a ‘‘natural incubator’’) and has the first op-
portunity to suckle and enjoy eye contact. A soothing
warm bath may be administered. In these first hours,
bonding between the parents and child has a unique
quality. In some birthing rooms, siblings may also
share these special experiences. The entire family
leaves the alternate birth center together, usually ear-
lier than from the traditional setting.
For safety, birthing-room facilities keep a signifi-
cant amount of emergency equipment hidden within
the suite itself and deliver only low-risk births. None-
theless, of these births, approximately 10 percent de-
velop problems best handled in a more conventional
setting. When located in a hospital, birthing rooms
are usually adjacent to traditional delivery and oper-
ating rooms.Midwives
At one time the use of a midwife conjured up vi-
sions of birth-attending barbarians in a dimly lit, un-
sanitary room. Today, nothing could be further from
the truth. Midwifery as a profession has the status it
deserves as an integral and indispensable component
of prenatal care and childbirth. Popular in Europe for
many years, it is becoming more so in the United
States.
Midwives are increasingly associated with physi-
cians, where they can handle the majority of the pre-
natal care that needs to be done and up to 90 percent
of the actual births. The remaining births that are of
high risk are usually under the physician’s care.
A woman might choose to have a child delivered
by a midwife for several reasons. One of the most im-
portant is that the traditional medical community
continues to treat pregnancy as an illness and the
pregnant woman as a sick person. This kind of think-
ing is slowly being rejected, in part as the result of a
U.S. Supreme Court action ruling that pregnancy is
a disability and not a disease. There are several other
reasons why midwives are becoming more popular:- New changes in the law allow the licensing of
midwives. - There is, as a result of the women’s movement,
a sharp increase in the demand for women prac-
titioners to assist in deliveries.
54 BIRTH