In February 1962 the prestigious magazine American Journal of Obstetrics and Gynecology He presented, among his scientific articles, this "revolutionary" obstetric table manufactured by American Sterilizer that promised significantly improve the way women care both in gynecological visits and when giving birth.
That is to say, that's how it was born 50 years ago and the truth, seeing the photo, one feels a little chills, and that one is a man, and not a woman. But on second thought, and now? Because this image looks terrible, but now it is practically the same. Don't you have to think?
So don't stop, that's how they stop you
Professional delivery care has promoted a decrease in maternal, fetal mortality and morbidity associated with the process. The problem is that in an attempt to control it all such attention went a lot of thread until it reached a point that a woman did not give birth, but gave birth to her.
The deliveries were instrumentalized in such a way that it seemed that a woman would no longer be able to give birth if she was not controlled until satiety from minute 1. And it was seen that this was not so and that what a woman needed, actually it was have trained and experienced professionals with still hands. She giving birth, and they are available in case something is distorted (well, since they are, they do not need to be watching, they can give encouragement, support, love and confidence in the process).
But to get to that, to make that setback again (or that advance), there is still some time. The professionals they have to be recycled, some, who will not do it because they are anchored in the past, have to retire and give way to the new batches, more aware, the protocols have to be fulfilled and the women, many accustomed to getting to the hospital to have the child taken from you, have to take action on the matter and be leading actresses along with their babies, asking for information at all times and making decisions when necessary.
The AMSCO 800 table
At that time this was presented as a true revolution to improve births. But who is better for the mother who is tied by the ankles, by the wrists and held by the shoulders, or for the gynecologist, who is sitting as comfortable?
And I repeat, it is a photo of 53 years ago and now the thing has not improved so much in many cases. They are no longer so scary, they are blue, which seems more friendly, they have fewer irons and can be moved so that they seem less "torture colt", but the woman's final position, in many current births, is exactly that .
And what's wrong?
Well, that is not a logical way to give birth. Imagine a woman in the middle of the jungle thousands of years ago. Do you really think I was looking for a place to put myself in that position?
On planet earth we have a force called "force of gravity" (you know, the force that attracts things on the surface towards the center of the earth), which is "Dramatically better" to give birth. Even the children understand it: a moment ago I had my three-year-old son trying to get a piece of plasticine out of a boat and put the open part of the boat down while he was beating it. The absurd thing would have been to hit him with the open part up.
For that, the logical thing is to put the "open part" down, so that the child comes out taking advantage of the force of gravity, and not horizontally or, as the woman is seen in the fantastic AMSCO 800, slightly inverted.
53 years to realize that the woman is badly placed?
Nerd. What I say today is nothing more than a reminder of something known decades ago. In 1985, what we know as the Declaration of Strength was signed, organized by World Health Organization Y the Pan American Health Organization, where midwives, obstetricians, pediatricians, epidemiologists, sociologists, psychologists, economists, health administrators and mothers congregated.
They were all and, together, they drafted a document containing the guidelines for birth assistance. Among many recommendations, it was decided that women should be accompanied by a trusted person throughout the process, it should receive all the information so that he could make the relevant decisions, that the baby should remain with the mother at all times, that at the time of giving birth the woman's perineum was protected (avoiding routine episiotomy), that caesarean section should only be performed in case of absolute necessity and that the woman should have total freedom of movement during dilation and delivery, avoiding the position of lithotomy, which is the position in which the woman is at the obstetric table of the photo and the position in which many women are still put today to give birth.
Since 1985 and those recommendations are only followed by a minority (here would come an expression with a bad word ... I leave you free to choose which one defines it best).
Why it is recommended not to lie in such a mass of irons
Ok, it looks ugly, your legs go up, you get there all open in front of the professionals who help you give birth and we criticize it because 30 years ago it was said in Brazil that you had to do it differently, along with other recommendations That few people follow. If this is done, it will be for something, right?
Well, yes, it is for something, but it is not because it is better for the baby or the mother, because if we thought about what is better for the mother, she would not be advised to go anywhere, but she would be told to "get as you are more comfortable , wherever you want, "offering different methods that could help you control pain.
You will tell me, but lying down, it is not so bad, right? Well, I do not know. Perhaps a woman is the position she prefers, but the logic seems to be against that position:
- When the woman lies down, the birth canal is transformed into a upward curve which forces the woman to push the fetus down an inclined plane.
- The baby, by gravity, is lying on the mother's large blood vessels, interfering with the circulation, lowering her blood pressure and decreasing, therefore, fetal oxygenation. Come on, lowering the pressure of the woman lowers the pressure in the exchange of nutrients placenta-fetus, including oxygen.
- By avoiding continuous pressure of the head of the fetus on the perineum, distension of the fetus is not allowed to be paused and effective causing a more abrupt distension at the time of the expulsion that leads to unnecessary episiotomies or that increases the risk of tears.
- The coccyx has the ability, in a vertical delivery, to move back up to 2 cm to increase the space. While lying down, not only cannot he do so, but he compresses himself against the birthing bed and moves forward, narrowing the pelvic outlet.
So yes, if you think that woman at the delivery table is not well, you are absolutely right, but then you have to keep in mind that all the women who give birth in the same position today are also in a little position recommendable.
