Placental birth : a history : thesis submitted to Massey University of Palmerston North in fulfilment of the requirements for the degree of Doctor of Philosophy in Midwifery
Open Access Location
This mixed method historical research uses both written material and topical oral history interviewswith medical and midwifery practitioners, to offer a signal contribution to midwifery knowledge. It fills a void in midwifery history concerning the management of the birth of the placenta. Because placental birth is not a discrete entity but is part of the birth continuum, the research has also contributed to the historical knowledge of birth in seventeenth and eighteenth century Britain and Europe and Maori birthing prior to European settlement. It also illuminates birthing practices and their contexts for both Maori and European from the early nineteenth century to the present day. In the early years of the twentieth century a ‘cause and effect’ cycle of three synergistic and catalytic factors, medicalisation, hospitalisation and nursification produced clinical and political changes that created a weave into which changes to the management of the birth of the placenta could be woven. It took time for modern midwives practising alternative birthing to unlearn their medicalised training and regain their trust in women’s ability to birth. The reintroduction of midwifery autonomy and the passing of legislation concerning consumer choice and consent in health care facilitated the introduction of alternative midwifery practices into hospitals, exposing more midwives and doctors to physiological placental birth. A theoretical model based on comparative obstetrics and reproductive physiology was used to analyse the management of placental birth over time, and in the varying contexts studied. This model is offered as a tool for clinical decision-‐making, and for educating women and maternity practitioners in facilitating the birth of the placenta. This New Zealand research supports the use of physiological placental birth, in well women having normal pregnancies and labours, as safe and beneficial to women and their babies.
Placenta, Natural childbirth, Birthing customs, Midwifery, Childbirth management