Final (in addition to M1 & M2 material)

Question 1

Compared to vaginal delivery, C-sections pose greater risk of what?

Answer 1

cardiac arrest
hysterectomy
infection
fever
pneumonia
blood-vessel clotting/hemorrhaging
higher risks for the baby

Question 2

How much would Canada’s healthcare system save if the rate of first-time C-sections could be reduced to the recommended rate from the WHO?

Answer 2

The Canadian healthcare system could save close to $25 million

A c-section rate of 15% is what is recommended by the world health organization.

Question 3

In Canada, is it generally common for women to request a c-section?

Answer 3

No, the number is probably very low. Very few mothers request a c section without a medical reason

Most of the mothers who had a C-section indicated that it was their healthcare provider who made the decision

Question 4

Why is it likely that a women has strictly C-sections after having one prior?

Answer 4

Doctors perform repeat C-sections to avoid tearing the scar left on the uterus from a previous C-section (which is very uncommon, but dangerous if it does tear)

However, there is strong evidence that recommends women to have a vaginal delivery even after having a previous c-section (**example of how evidence does not typically change medical practices)

Question 5

What is one of the main contributors to an increased c-section rate that is not consistent amongst all provinces in Canada?

Answer 5

Dystocia (term used for an extremely difficult birth)

It isn’t likely that the rates of dystocia would be so
different across the province, it is more probable that some doctors turn too quickly to the surgical solution despite evidence that longer births are common amongst multiparous ppl.

Question 6

The newest generation of obstetricians in particular holds negative views of ________________ and a
preference for _____________/______________.

Answer 6

NATURAL childbirth

C-SECTIONS/OTHER MEDICAL INTERVENTIONS

Question 7

How the gestation length of human pregnancy limited? (according to evidence)

Answer 7

New research suggests that the length of human pregnancy is limited primarily by a mother’s METABOLISM, not the size of the birth canal.

^^this challenges the long held notion of an evolutionary trade off between childbirth and a pelvis adapted for walking upright

This means the 2 traits that set humans apart from other primates (big brains and the ability to walk upright) could be at odds when it comes to childbirth.

Question 8

What is the “obstetric dilemma?”

Answer 8

that the human female pelvis represents a compromise between designs most suitable for childbirth and bipedal locomotion, respectively

(supposedly) explains why humans often require assistance from other humans during childbirth to avoid complications, whereas most non-human primates give birth unassisted with relatively little difficulty

Question 9

What is a problem with the “obstetric dilemma”?

Answer 9

THAT THERE’S EVIDENCE THAT ITS NOT TRUE

There is no evidence that hips wide enough to deliver a more developed baby would be a detriment to walking, in fact there is evidence that there is no correlation between wider hips and a diminished locomotor economy

Question 10

What has been the view been for decades towards explaining the timing of human gestation and birth? Does new research align with this?

Answer 10

It’s been explained as a balance between 2 constraints:
1. the size of the women’s hips
2. the size of the infants brain
^^this is the “obstetric dilemma”

New research says this is not the case! Instead, the
timing of childbirth occurs when women’s bodies can no longer keep up with the energy demands of
pregnancy (that happens at around nine months)

Question 11

Studies of mammals show that during pregnancy females reach their species’ “metabolic ceiling,” which refers to ________________.

Answer 11

Max limit of the amount of energy they can expend.

Question 12

Evidence shows that gestation is determined by _______

Answer 12

ENERGY

Question 13

Do humans and chimpanzees give birth similarly or differently?

Answer 13

Very similarly!

A key feature of human childbirth (thought to be only unique to humans) the arrival of the baby facing backwards relative to its mother, can also be observed in chimpanzees

Question 14

“It’s clear from our observations that chimp babies are
born __________ ____________, but they give birth _________”

Answer 14

FACING BACKWARDS

ALONE

Question 15

Noncommunicable diseases account for ______% of deaths globally and is increasing

Answer 15

60%

*WHO predicts a 17% increase over the next 10 years

Question 16

What are the 4 lifestyle factors identified by the WHO that are driving the noncommunicable disease epidemic?

Answer 16

1. smoking
2. misuse of alcohol
3. poor diet
4. lack of excersise

Question 17

When is the critical time for seeding our microbiome?

Answer 17

DURING CHILDBIRTH

**foundations for founding the baby’s bacterial ecosystem starts inside the mother during pregnancy
(bacteria is transferred from mother to baby as the baby is birthed, first intro to the world of bacteria)

Question 18

What does the term “completed self” mean?

Answer 18

the idea that we are meant to be 90% microbial since birth

Question 19

After birth, what is the next stage of microscopic transfer of microbes?

Answer 19

happens during skin-to-skin contact of the baby and mother (transfer of skin bacteria)

Question 20

Is breastmilk part of microbe transfering?

Answer 20

Yes, breastfeeding gives many important things to the baby, one thing being microbes.

Question 21

When a person cannot naturally breastfeed their child, what happens?

Answer 21

Not breastfeeding disrupts the immune system function.

Question 22

According to the Microbirth film, what happens to babies born via c-section?

Answer 22

they have a higher risk of short-term health problems, commonly respiratory problems, and more issues with being able to be fed and are more tired.

Not being born vaginally, the baby did not get the microbes needed naturally, and instead the infants immune system has been primed with the wrong bacteria.

Question 23

What is a strategy for babies who are born via c-section to still get the microbes they need?

Answer 23

Vaginal swabs with gauze during the last hour before the c-section and as soon as the baby is born, the gauze is rubbed all over the baby to attempt and restore important microbes

Question 24

From the Microbirth movie overall, what are the most important things we can do during birth for a healthy baby?

Answer 24

• insure microbial seeding occurs completely at birth (preferably vaginally)
• skin-to-skin contact
• breastfeeding of long duration

^^all of these things will influence the health across a lifespan

Question 25

Is the stress of labour good or bad for the baby?

Answer 25

It's good. For birth studies where antibiotics are used during labour and c-sections, there can be negative impacts on the child long-term

Question 26

There is a 20% increased risk of _________ and ___________ if born through c-section as well as ___________.

Answer 26

asthma and type 1 diabetes BMI increase (obesity epidemic?) **however, association does not mean causation!!

Question 27

Is the occiput anterior position and head rotation unique human birth?

Answer 27

NO There is evidence that it happens the exact same way in chimpanzee births

Question 28

Do all chimpanzee births occur by the mother picking up the baby right away.

Answer 28

No, not in all cases. It is likely that there are at least some cases in which wild chimpanzee mothers deliver their baby by DROPPING IT, without immediate lifting. (not dangerous to drop the chimpanzee, as they often give births in their nests which is padded)

Question 29

It has been observed that chimpanzees give birth in the _____________, the same way as humans.

Answer 29

Fetus emerged in an occiput anterior position

Question 30

It has been suggested that the occiput anterior emergence pattern accounts for the uniquely human aspect of birth, which is thought to reveal that human birth is __________________________.

Answer 30

Attended by other individuals, such as midwives, and mothers actively seek assistance in childbirth. *This is questioned as primates give birth in solitude and there is evidence that chimpanzee births occur in the occiput anterior position.

Question 31

What did male P. Cambelli hamsters do during the birth proccess of their female partner?

Answer 31

- licked amniotic fluid before birth - mechanically assisted with the delivery - opened an airway by clearing the nostrils - licked and sniffed the pups immediately after birth - ate the placenta **all evidence that paternal hamsters mechanically assist with delivery and provide parental care during birth.

Question 32

Describe what Amber was told by medical professionals in the Pennsylvania case

Answer 32

After an ultrasound, the doctors decided that the baby was too big to deliver vaginally (about 13lbs) and that a c-section was needed. (she already had given birth to 6 babies babies vaginally, each close to 12 pounds, and had faith in her body)

Question 33

What was the outcome of the Pennsylvania case? Why is it controversial?

Answer 33

Amber did not follow the doctors advice to have a c-section and went to another hospital. Meanwhile, the hospital’s lawyers obtained legal guardianship of her unborn child ---> a court allowed the hospital to force Amber into surgery if she returned to that hospital At the other hospital, Amber had an easy natural birth. She didn’t know about the first hospital’s action until her husband was told by a reporter.

Question 34

What is the most common obstetric intervention?

Answer 34

Electronic Fetal Monitoring (EFM) A process where electronic instruments are used to record the heartbeat of the fetus and contractions of the mother's uterus

Question 35

When was Electronic Fetal Monitoring (EFM) introduced? What did EFM promise?

Answer 35

Was introduced in the late 1960s EFM promised that it would reduce (by half) the incidence of: 1. cerebral palsy 2. mental "retardation" 3. peri-natal mortality

Question 36

Describe how useful EFM is as fetal surveillance technology?

Answer 36

- interpretations of fetal heart tracings are highly subjective - there is very little agreement among experts as to the interpretation of “non-reassuring” tracings - “false-positive” predictions of fetal distress are almost guaranteed - USING IT INCREASES C-SECTION RATES

Question 37

Increased use of EFM results in what?

Answer 37

higher c-section rates, without improving outcomes for babies

Question 38

If there is a late deceleration on a fetal heart monitor (EFM) what could this possibly indicate?

Answer 38

Could indicate fetal distress if late decelerations are repetitive or severe

Question 39

What does it mean when EFM is referred to as the "tool to blame"?

Answer 39

EFM is commonly used in BRAIN INJURY LITIGATIONS. used by expert witnesses who testify as when (the exact moment, based on the tracings) the baby sustained irreversible neurological injury Heavily relied upon to support counterfactual claims that a poor outcome (e.g., brain injury) could have been avoided

Question 40

Is the prevalence of Cerebral Palsy (CP) positively correlated with C-section rates?

Answer 40

NO. There is no correlation of CP cases increasing as c-section rates have increased over time. Think about the graph (blue and red line).

Question 41

What is counterfactual reasoning?

Answer 41

Reasoning about "what might have been” Is the basis for assigning blame for harmful outcomes or giving credit for beneficial out comes Often takes the form of if/then statements or questions (ex. “If you had been paying attention, you wouldn’t have gotten hurt.” OR “If Alice had not been treated with the experimental drug, would she have survived?”)

Question 42

What does counterfactual reasoning rely on?

Answer 42

It relies on COUNTERFACTUALS = mental representations of alternatives to the past, often activated automatically in response to negative affect

Question 43

Counterfactual reasoning can be highly problematic because of what bias?

Answer 43

HINDSIGHT BIAS (the "knew it all along" way of thinking)

Question 44

Describe hindsight bais

Answer 44

the “knew-it-all-along” effect - Knowing that an event (outcome) has occurred increases its perceived predictability (or perceived likelihood) - It is accompanied with over-confidence in the certainty of one’s judgements: people are unaware of the effect that outcome knowledge has on their perceptions of predictability - Situations that (after the fact) lend themselves to straightforward causal explanations evoke greater hindsight bias than situations that are more ambiguous

Question 45

What is hindsight bias linked to?

Answer 45

linked to the availability heuristic (which allows us to think quickly by relying on information that comes to mind fast or is most available to us ---> often incorrect)

Question 46

Is it common for cerebral palsy to be caused by birth asphyxia?

Answer 46

No. This is a myth. It is not very common for CP to be caused by birth asphyxia (lack of oxygen and blood flow to the brain) Most acute severe hypoxia follow intrapartum hypoxic events like uterine rupture or placental abruption, not CP.

Question 47

Are CP causes well understood?

Answer 47

CP’s causes are NOT well understood but most are thought to preceded labour and birth (genetic, inflammatory, preterm)

Question 48

What is a major cause of caesarean escalation?

Answer 48

Cerebral palsy

Question 49

Is there an association of elective or emergency caesarean with CP outcomes?

Answer 49

No

Question 50

How does the occurrence of CP differ in western and resource-poor areas?

Answer 50

Trick question - the occurrence of CP is the same in western and resource-poor settings

Question 51

Define: Intrapartum mortality

Answer 51

the number of babies dying during labour or birth (death of an infant after the onset of labor but BEFORE they are born)

Question 52

Define: Infant mortality

Answer 52

the death of an infant before their first birthday.

Question 53

Define: Neonatal mortality

Answer 53

defined as the death of a newborn on or before 28 days postpartum (aka: death within the first month)

Question 54

Define: Stillbirth

Answer 54

A baby who dies inside the womb (can start 3 months before birth or during birth) A death of an infant during the first 6 months is a miscarriage, not a stillbirth.

Question 55

What stage of child mortality has stayed consistent for least developed countries over time?

Answer 55

Early neonatal mortality (1 week post birth)

Question 56

What stage of child mortality has DECREASED the most for least developed countries over time?

Answer 56

Child mortality (anything after 1 year)

Question 57

___________ babies account for >80% of neonatal deaths

Answer 57

SMALL newborns

Question 58

What are some explanations for a baby being born small at birth?

Answer 58

- born preterm (<37 weeks) - small-for-gestational age

Question 59

What is the CAUSE and FIGHT for preterm birth, infections, and hypoxia (low levels of oxygen in your body tissues)

Answer 59

These things CAUSE babies to die during birth The FIGHT to decrease this is to provide medical care

Question 60

What are the societal factors of neonatal mortality?

Answer 60

- Status of women - Conflict (War) - Dictatorships - Famine SOCIETAL factors ---- cause ----> INDIVIDUAL factors

Question 61

What are the individual factors of neonatal mortality? What could be done to fight this?

Answer 61

- Malnutrition - Birth spacing - Poverty - Physical wellbeing - Psychological wellbeing - Education INDIVIDUAL factors -----cause----> COMPLICATIONS DURING BIRTH TO FIGHT: Contraception? Counselling? Education?

Question 62

What are the complications during birth that cause neonatal mortality? What is one thing that could be done to fight this?

Answer 62

Preterm birth Infections Hypoxia FIGHT: medical care?

Question 63

What is the difference between number of causes vs. number of levels of casualty?

Answer 63

Number of causes = A --> X, B---> X, C---> X (each factor has it's own unique effect on the outcome, so there would be 3 SEPERATE causes: A, B, & C) *pretty easy model to understand VS. Number of levels of casualty = A --> B ---> C ---> X *more complex model because each of the factors leads to one another

Question 64

What can be gathered from the model depicted in Figure 8, Lawn et al. 2009?

Answer 64

- presents a sequence of steps for how medical care may be provided during birth in an attempt to MITIGATE the complications once they occur - includes factors that may influence whether or not medical care is provided - does NOT look at what caused the complications themselves, does not look at how to prevent complications from occurring in the first place

Question 65

What does working memory allow us to do?

Answer 65

allows us to actively hold in mind and manipulate (limited amount of) information

Question 66

What brain region is working memory linked to?

Answer 66

linked to prefrontal cortex (PFC) functions

Question 67

What are the 2 specific functions of the prefrontal cortex that is involved in working memory?

Answer 67

1. The dorsolateral prefrontal cortex (DLPFC) (thinking about how things relate ONE AT A TIME) 2. The lateral prefrontal cortex as a whole (LPFC) (thinking about how multiple things effect one another at the SAME TIME)

Question 68

What is relational complexity?

Answer 68

The number of relations that need to be considered simultaneously within working memory

Question 69

What part of the brain is linked to the Number of causes model (A --> X, B---> X, C---> X)?

Answer 69

The dorsolateral prefrontal cortex (DLPFC) Thinking about relations one at a time (ex. expectations) *When there are multiple relations that need to be considered simultaneously, DLPFC is no longer sufficient

Question 70

What part of the brain is linked to the Number of levels of casualty model (A --> B ---> C ---> X)?

Answer 70

The rostrolateral prefrontal cortex (RLPFC) Becomes activated when relational integration is necessary. When 2 relations must be considered simultaneously

Question 71

When does the ability of relational integration occur roughly in child development? Is this unique to humans?

Answer 71

- Occurs fairly late in child development - It is unique to humans

Question 72

________ relations max in working memory

Answer 72

2

Question 73

Compare Area 10 and Frontal Lobe in humans vs. chimpanzees

Answer 73

Area 10 takes up almost DOUBLE the % of the brains surface in humans than in chimpanzees VS. Frontal lobe takes up about the SAME % of the brains surface in both humans and chimpanzees.

Question 74

RLPFC is the lateral portion of __________

Answer 74

Area 10

Question 75

Relational integration in working memory takes a lot of _____________?

Answer 75

Takes a lot of time for evolution to achieve Takes a lot of time for children to achieve Takes a lot of (thinking) time for us as adults to achieve

Question 76

What do statistics show about helmets not improving safety?

Answer 76

Making helmets mandatory does not improve safety: * but it does reduce the number of people biking (e.g., through bike rental programs) What does improve safety is * separated bike lanes * greater number of people biking (“safety in numbers”)

Question 77

Whats an example of an issue addressed primarily by prevention measures?

Answer 77

ex. deaths from lung cancer in developed countries

Question 78

What are examples of issues addressed primarily by mitigation measures?

Answer 78

ex. neonatal mortality in low-income countries ex. biking injuries in Vancouver (**mitigation = means to reduce the severity of issues happening)

Question 79

Associative memory has the power to either _______ or _________ our thinking

Answer 79

HELP or HINDER

Question 80

What is chunking?

Answer 80

Grouping of items based on meaning or previous established associations. ***How associative memory can help working memory Chunking can be applied in all areas: language, perception, motor skills, memory, thinking Conceptual chunks that are already present in our associative (long-term) memory are determined by what we are exposed to. **STORIES serve as helpful chunks to be able to remember things

Question 81

Do stories help us understand multi-level causality?

Answer 81

Yes, stories can help us understand complex multi-level causality, BUT stories can also obscure the complexity and hinder understanding

Question 82

Why are we more likely to come up with some counterfactuals but not others?

Answer 82

- levels of causality (e.g., prevention vs. mitigation) - perceived ease of mutability!! ^Ex. hanging one action (or one individual) is relatively easy to imagine, while changing our society or environment (roads, laws, women’s status) is relatively difficult to imagine - fluency heuristic + attribute substitution (the ease with which we can imagine something changing --> the most effective thing that can be done) * the model (of causality) the majority of stories promote

Question 83

If if you plan a hospital birth, are you more or less likely hemorrhage?

Answer 83

MORE women are significantly more likely to hemorrhage in the hospital than at home

Question 84

Think about the spectrum of childbirth experience, and list the spectrums of different births.

Answer 84

* Scheduled C-section in a hospital * Hospital birth with an obstetrician * Hospital birth with a family doctor * Birth center birth with a certified midwife * Home birth with certified midwife * Home birth with traditional birth attendant (traditional midwife) * Freebirth or unassisted/unattended childbirth

Question 85

About 1/3 of home births in the US have “other” listed as birth attendant on their birth certificates. What does this "other" likely mean?

Answer 85

That it was a freebirth and there was no attendent or midwife involved. *considered to be a growing trend

Question 86

Freebirth is often portrayed in the media as what?

Answer 86

often presented by the media as ‘deviant’ behaviour

Question 87

What are the motivations for considering free birth? Are the motivational factors complex or pretty simple?

Answer 87

Some motivations include: - fear of hospital - traumatic last birth at hospital - fear or experience of coercion in hospital - risks of contracting COVID - access to water birth - birth partner excluded - distance to hospital/no transport there - lack of childcare - previous fast labour the motivations for considering freebirth are complex and multifaceted

Question 88

Are lesbian, bisexual, pansexual, and queer women more or less likely to have considered freebirth than heterosexual people?

Answer 88

They are MORE likely to consider freebirth

Question 89

Hospital births involve ___________ knowledge, while freebirthing involves _____________ knowledge.

Answer 89

medical knowledge visceral knowledge

Question 90

What is authoritative knowledge?

Answer 90

credible information repository of scientific knowledge constructed by members of a scientific community over a period of time. *the knowledge that counts *depends on the setting and participants

Question 91

What is unique to scientific knowledge, that distinguishes it from both traditional midwifery and medical knowledge?

Answer 91

its reliance on STATISTICS

Question 92

What are some examples of what scientific knowledge involves?

Answer 92

Hormones Neural systems Physiology

Question 93

Prior to the 1900s, _________ had been used in obstetrics to produce uterine contractions. What did this do?

Answer 93

oxytocics were used (a substance or drug that speeds up labor by stimulating the uterus to contract) The use of oxytocics were used to: - speed up labor - cause abortion - reduce post-partum hemorrage

Question 94

oksys (Greek) = “__________”; tokos (Greek) = “___________”

Answer 94

oksys (Greek) = “SWIFT”; tokos (Greek) = “BIRTH”

Question 95

An ___________ had been used as oxytocic for centuries.

Answer 95

extract of ergot fungi

Question 96

When and how was oxytocin discovered?

Answer 96

In the early 1900s, it was discovered that an extract of the posterior lobe of the pituitary gland from OXEN produced powerful contractions of the uterus in pregnant cats and dogs.

Question 97

_____________ eventually replaced the use of fungus ergot in obstetrics.

Answer 97

Pituitary extract (“pituitrin”) THEN... the chemical structure of oxytocin was identified (in 1953), and then artificially synthesized. The synthetic oxytocin has been sold as proprietary medication since.

Question 98

Describe endogenous oxytocin

Answer 98

naturally occurring oxytocin produced by the body. - Synthesized by oxytocin-producing cells in the hypothalamus!!! - Stored and secreted by the POSTERIOR PITUITARY GLAND - Acts as a hormone in the body (released in the blood stream) - Acts as a neurotransmitter (signalling substance) in the brain ----> Oxytocin-producing neurons in the hypothalamus also release oxytocin throughout the brain

Question 99

What are some of the brain areas where endogenous oxytocin is released?

Answer 99

Released in a number of subcortical structures: - NAcc (nucleus accumbens) - Amygdala - Hippocampus - Brainstem

Question 100

Excluding birth and breastfeeding, when do people release most oxytocin?

Answer 100

when they feel secure and placid

Question 101

Oxytocin as the “______________”

Answer 101

SHY HORMONE Michel Odent says: “Birth is an involuntary process and one cannot help an involuntary process. The point is not to disturb it.”

Question 102

Describe the involuntary processes during the first stage and second stage of labour

Answer 102

“Going in labour” and “First stage” of labour: - involuntary contractions of the uterus - involuntary release of oxytocin, prostaglandins, and other hormones “Second stage” of labour - could be completely involuntary - could be a COMBONATION of involuntary contractions and voluntary “pushing” efforts

Question 103

How does adrenaline either speed up or slow down the birth proccess?

Answer 103

- can slow down labour during birth’s “first stage” (dilation) - can speed up labour during birth’s “second stage” (fetal expulsion

Question 104

What does adrenaline supress?

Answer 104

suppresses oxytocin

Question 105

Is birth really an involuntary process?

Answer 105

For the most part, yes.

Question 106

Is it really impossible to help birth’s involuntary processes?

Answer 106

It IS possible by: - Avoiding conditions that decrease the release of oxytocin - Provide conditions that increase the release of oxytocin

Question 107

Birth is a spontaneous process: One ____________ voluntarily produce a spontaneous process. But one _______ voluntarily disturb it

Answer 107

CANNOT CAN

Question 108

What things tend to decrease the release of oxytocin?

Answer 108

- Bright lighting - Noise - Discomfort - Feeling frightened - Unpleasant, painful sensations - Tension - Questions, interruptions - Being observed ^^ aka the things that should be avoiding during birth

Question 109

What things tend to INCREASE the release of oxytocin?

Answer 109

- Dim lighting * Peace and quiet * Comfort * Feeling safe * Pleasant touch * Relaxation * No interruptions - Not being observed ^^aka the things that should be prioritized during birth

Question 110

How long does it usually take for the placenta to be birthed after the baby?

Answer 110

Placenta is usually born within half an hour after baby

Question 111

At what stage of birth does oxytocin reach it's peak?

Answer 111

During the third stage - when the placenta is being born.

Question 112

What stage of labour is specifically sensitive to disurbance?

Answer 112

The third stage (birth of placenta) This stage is particularly sensitive to disturbance and PRESENTS THE GREATEST RISK FOR POST-PARTUM HEMORRHAGE. (ex. conversations, congratulations, photos, phone calls, everyone touching the baby)

Question 113

For a method to be termed scientific, what does the method have to be based on?

Answer 113

a method of inquiry must be based on empirical and measurable evidence subject to specific principles of reasoning

Question 114

The scientific method for obtaining knowledge is defined by its reliance on what 3 things?

Answer 114

* Observation * Measurement * Experiment

Question 115

How is the current scientific method towards childbirth limited?

Answer 115

The extent that being observed alters the process of human childbirth ---> the scientific method in its current form is limited in how much knowledge it can yield about UNDISTURBED birth - Observation and measurement change what we observe and measure - However, introspective observation may be different (to some extent)

Question 116

Finish the following sentence that is now known to be a myth: Human babies are born helpless and underdeveloped because human pregnancy is shorter compared to the pregnancies of other mammals to allow our babies to _______________________________________________________.

Answer 116

be born before their HEAD GETS TOO BIG to pass through the birth canal. now there is evidence about energy/metabolic reasons that determine the length fo gestation.

Question 117

Traditional midwifery tends to emphasize....

Answer 117

1. LOW-TECH SOLUTIONS: where two ways of doing something are thought to exist, choose the one that involves less technology (ex. instead of baby placed on hard scale its put in a cloth hammock to be weighed) 2. VARIABILITY AND UNIQUENESS (rejection of medical norms)

Question 118

Why do midwifes find the pinard horn to be more effective?

Answer 118

The Doppler (electronic device to hear the fetal heartbeat) often transmits a lot of noise and gets confusing. SOUNDS ARE MORE CLEAR AND UNDERSTANDABLE WITH PINARD.

Question 119

What are some examples of medical norms that are rejected in traditional midwifery?

Answer 119

- How long pregnancy should be - Speed of dilation (Phase 1) - When it is too early to push - When to start pushing - How long Phase 2 should be - How long can pass between water breaking to baby born - How long Phase 3 should be

Question 120

Unassisted birth is the cultural ideal among some cultures. What are some examples of cultures where this is the norm?

Answer 120

- San (!Kung) hunter-gathers of South Africa - Angagen people, Papua New Guinea - Bariba people, Benin (North Africa)

Question 121

What are some theories as to why there is involvement of people other than the mother and baby during childbirth, even though having other ppl contradicts scientific knowledge?

Answer 121

1. Provide mechanical assistance during birth that increased our species’ survival chances (i.e., it improved birth safety) 2. Increase the bond between the baby and those other people who were involved in the baby’s birth (i.e., it increases the child’s survival chance by creating additional substitute parents) 3. Decrease the bond between mother and baby for purposes that may benefit the survival of the group

Question 122

What is the birthing ritual amongst the Sioux?

Answer 122

At the time of baby’s birth, four men would grab the corners of the blanket on which the woman was lying, lift the blanket, and hold it up from the ground They do this in order to attain the warrior ideal: - prevent any immediate contact between the newborn and the earth - prevent any intimate contact between the newborn baby and its mother