Barbara Wilson-Clay points out, rightly, that 'natural' birth has not always
been the safest, and indeed, women are still dying in childbirth in
unacceptable numbers but not so many in the industrialized world.  In our part
of the world mothers are more at risk from inappropriate overuse of
interventions, and I say this based on the number of mothers needing blood
transfusions and long hospitalizations for the complications of CS and
anesthetics, which is rising in Norway.  We have for many years enjoyed a spot
at or near the top of all lists of safety for mothers and babies but as our CS
rate rises we are seeing more and more women suffering life-threatening
complications as a direct consequence of the management of their otherwise
uncomplicated pregnancies and births.

In Norway the fall in perinatal mortality would have happened more steeply had
it NOT been for the effects of institutialization of birth.  Birth outcomes
were better in the countryside where mothers gave birth at home with qualified
midwives, than in the first training lying-in hospitals, where they were
attended by qualified midwives and obstetricians.  Michel Odent would indeed
be a good model to follow for safe birth environments - an environment whose
safety resides only in ability to intervene quickly is much less favorable
than one in which normal birth can take place undisturbed.
Rachel Myr
midwife, public health student, and IBCLC
Kristiansand, Norway

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