Preparing for the arrival of a child is an exciting time for potential mothers, but there is a lot to consider. Aside from painting the nursery and learning how to change a diaper, pregnant women and their partners need to make decisions on how they want to bring their child into the world. Whether by natural, drug-assisted or surgical means, there are associated risks and benefits across the board, depending on the circumstances. In this feature, we examine different birthing methods and their outcomes.

Birthing practices and ideologies have gone through many changes throughout history. In AD 98, a Roman named Soranus wrote an obstetrics textbook that was widely used until the 16th century.

During the Middle Ages, the business of childbirth was in the hands of the midwife, which, in Old English, means “with woman.” Pregnant women were attended by their female friends, relatives and local women who were experienced in helping with childbirth.

Depictions of labor during this time usually show women giving birth in an upright sitting position, using a birthing stool that left space in the seat.

Other positions during this time typically included half-lying positions or even a crouching position, and of course, there were no anesthetics available. However, midwives typically used oils and unguents to help reduce perineal tearing.

There was a significant shift in the business of childbirth during the 1700s. Newer technologies played a role, as did male midwives or physicians, who began taking over for the female midwife. In fact, during this time, female midwives lost much of their status and were portrayed as unhygienic and unenlightened, and they were even associated with witchcraft.

This is the era that heralded the use of certain instruments, such as the forceps and other more destructive tools like the vectis – a lever-type tool for altering the baby’s position – and a crochet tool with a hook, used for extracting a dead fetus from the mother’s body.

The 20th century brought childbirth from the home to the hospital, where hi-tech devices and procedures – such as the fetal heart rate monitor, cesarean sections (C-sections) and epidurals – became commonplace. By the late 1970s in the US, home birth rates fell to around 1%.