Modern Birth Research Articles

Special Issue: After the Scientific Revolution: Thinking Globally about the Histories of the Modern Sciences

Abstract History of science today needs to fully escape from the categories and narrative frameworks created during the Cold War formation of the discipline. Most problematic is the portentous notion of science conceived as a uniquely European world-historical singular that founded modernity. The idea of a singular historical birth of science in the portentous singular, this article argues, is not a natural fact of world history, but a very recent conceptual invention that continues to do negative historiographical work. The idea of a history of modern science which takes as its starting point this imagined birth of singular science in the world-historical event called the “Scientific Revolution” is more problematic still. To move forward in a more globally conscious direction, our historiography needs to become comfortable rejecting this Cold War understanding of singular science, along with its origin story in the so-called Scientific Revolution of the early modern period. The result will be a new historiographical space where the global histories of the modern sciences in all of their diversity can be explored. In order to frame the contributions to this project offered in this volume, this introduction traces in outline the rise and fall of the classical early modern birth of singular science paradigm. It also suggests reasons why this framework has come apart in recent years and the new paths forward emerging out of its ruins.

Roy Porter Student Prize Essay Figuring Pictures and Picturing Figures: Images of the Pregnant Body and the Unborn Child in England, 1540-c.1680.

SummaryBirth figures, or print images of the fetus in the uterus, were immensely popular in midwifery and surgical books in Europe in the sixteenth and seventeenth centuries. But despite their central role in the visual culture of pregnancy and childbirth during this period, very little critical attention has been paid to them. This article seeks to address this dearth by examining birth figures in their cultural context and exploring the various ways in which they may have been used and interpreted by early modern viewers. I argue that, through this process of exploring and contextualising early modern birth figures, we can gain a richer and more nuanced understanding of the early modern body, how it was visualised, understood and treated.

The Birth of a Nation

An artist who wants to portray Nat Turner's 1831 revolt has choices to make about how to approach the sources. The artist could turn to Thomas R. Gray's The Confessions of Nat Turner (1831) and use it much as Steve McQueen used Solomon Northup's Twelve Years a Slave (1853) in his 2013 film, treating Gray's work as the urtext of what happened in Southampton, Virginia, in 1831. Or the artist could, as Charles Burnett did in his documentary Nat Turner: A Troublesome Property (2003), see the varied sources on the revolt as ultimately inconsistent and produce an American Rashomon (1950), set in antebellum Southampton. Or the artist could try to stick close to the sources but also be allowed absolute freedom to imagine scenes and situations consistent with but never described in the sources, as William Styron did in his Pulitzer Prize–winning novel The Confessions of Nat Turner (1967). Nate Parker, the man responsible for the modern Birth of a Nation, took none of these approaches. Like McQueen's Twelve Years a Slave, Parker's heroic story of America's most famous slave rebel is inspired primarily by a single text: Gray's Confessions of Nat Turner. Unlike McQueen, who taps the most interesting stories from Northup's narrative, Parker finds his central text incomplete. Parker uses these omissions as an opportunity to imagine the back stories that never made it into print. For example, Turner commented, at the beginning of Gray's Confessions of Nat Turner, that when he was young, he had marks on his body that his parents told him were signs that he was “intended for some great purpose” (p. 7). Parker accepts that the young Turner had these marks and imagines a scene where elders in the community consecrate him in an African coming-of-age ritual.

L’émergence de la mécanique obstétricale : de Lucy à Homo sapiens

The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation.

Experimental Clinical Medicine and Drug Action in Mid-Seventeenth-Century Leiden.

Leiden University boasted one of the most popular and influential medical schools of the mid-seventeenth century, drawing hundreds of students from across Europe. These students participated in the revival of frequent clinical instruction, anatomical and chymical experiments, and even tests of supposed disease-causing substances and remedies on living animals and humans. Comparing records of cases from the hospital clinic with the professors' treatises and student-authored disputations shows that old and new theories of disease and drug action were hotly contested and often tested, including the claims of the leading professors at the school. Though notable exemplars of their work received sharp criticism and rejection from contemporaries and subsequent generations, Leiden students and professors united chymistry, postmortem autopsy, anatomical experiments, and clinical tests, often aiming at discovery. They enacted one, perhaps ephemeral, instance of experimental, clinical medicine well before its putative modern birth.

“It is challenging… oh, nobody likes it!”: a qualitative study exploring Mozambican adolescents and young adults’ experiences with contraception

BackgroundBy focusing upon formal sex education programmes, the Mozambican government has significantly enhanced the general health of adolescents and young adults. However, when it comes to contraception, little is known about how adolescents and young adults actually behave.MethodsBased upon a qualitative study in two settings in Maputo province – Ndlavela and Boane – this paper explores the knowledge and practices of contraception among adolescents and young adults. A total of four focus group discussions, 16 in-depth interviews, four informal conversations, and observations were equally divided between both study sites.ResultsDiscrepancies between what adolescents and young adults know and what they do quickly became evident. Ambivalent and contradictory practices concerning contraceptive use was the result. As well, young people had numerous interpretations of risk-taking when not using contraceptives. These inconsistencies are influenced by social and medical barriers such as restricted dialogue on sexuality among adolescents and young adults and their parents and peers. Additionally, ideas about indigenous contraceptives, notions of masculinity and femininity, misconceptions and fear of the side effects of contraceptives, make people of all ages wary of modern birth control. Other barriers include imposed contraceptive choice – meaning no choice, overly technical medical language used at clinics and the absence of healthcare workers more attuned to the needs of adolescents and young adults.ConclusionsAdolescents and young adults have numerous – often erroneous – opinions about contraception, leading to inconsistent use as well as vague perceptions of risk-taking. Moreover, social norms and cultural gender roles often contradict and hinder risk-avoiding behaviour. Therefore, in order to improve young people’s health, policymakers must address the reasons behind this ambivalence and inconsistency.

A qualitative study of how caseload midwifery is constituted and experienced by Danish midwives

Objectivethe aim of this study is to advance knowledge about the working and living conditions of midwives in caseload midwifery and how this model of care is embedded in a standard maternity unit. This led to two research questions: 1) What constitutes caseload midwifery from the perspectives of the midwives? 2) How do midwives experience working in caseload midwifery? Design and settingphenomenology of practice was the analytical approach to this qualitative study of caseload midwifery in Northern Denmark. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Participantsthirteen midwives working in caseloads were observed during one or two days in the antenatal clinic and were interviewed at a later occasion. Findingsbeing recognised and the feeling of doing high quality care generate high job satisfaction. The obligation and pressure to perform well and the disadvantages to the midwives׳ personal lives are counterbalanced by the feeling of doing a meaningful and important job. Working in caseload midwifery creates a feeling of working in a self-governing model within the public hospital, without losing the technological benefits of a modern birth unit. Midwives in caseload midwifery worked on welcoming and including all pregnant women allocated to their care; even women/families where relationships with the midwives were challenging were recognised and respected. Key conclusionscaseload midwifery is a work-form with an embedded and inevitable commitment and obligation that brings forward the midwife׳s desire to do her utmost and in return receive appreciation, social recognition and a meaningful job with great job satisfaction. There is a balance between the advantages of a meaningful job and the disadvantages for the personal life of the midwife, but benefits were found to outweigh disadvantages. Implications for practiceIn expanding caseload midwifery, it is necessary to understand that the midwives׳ personal lives need to be prepared for this work-form. The number of women per full time midwife has to be surveilled as job-satisfaction is dependent on the midwives׳ ability of fulfilling expectations of being present at women׳s births.

Effects of the 2001 Extension of Paid Parental Leave Provisions on Birth Seasonality in Canada

It is well known that there exists a strong seasonal pattern in births and that the pattern differs across geographic regions. While historically this seasonal pattern has been linked to exogenous factors, modern birth seasonality patterns can also be explained by purposive choice. If birth month of a child is at least partially chosen by the parents then, by extension, it can also be expected that this can be influenced by anything that changes the costs and benefits associated with that choice, including public policy. This paper explores the effect that the 2001 extension of paid parental leave benefits had on birth seasonality in Canada. Overall we find strong results that the pattern of birth seasonality in Canada changed after 2001, with a notable fall in spring births and an increase in late summer and early fall births. We discuss the potential effects of this unintended consequence, including those related to health and development, educational preparedness and outcomes, and econometric modelling.

The birth bed: A qualitative study on the views of midwives regarding the use of the bed in the birth space.

There is a growing body of evidence to show that the birth environment can influence women's experiences of labour and birth as well as midwifery practice. A common feature of the modern birth space is the bed. Knowledge about how the use of the bed shapes clinicians' perceptions and attitudes is limited. The aim of this paper is to describe midwives' perceptions of the birth bed. Qualitative descriptive design. Fourteen midwives from one Queensland maternity unit participated in digitally recorded and transcribed interviews. Thematic analysis was used to analyse the data set. Four themes were identified. The first, described beliefs that using the bed formed part of women's childbirth expectations. A second theme, captured midwives' perceptions that the bed was also an object required to safely undertake their work. The third theme described how others commonly worked to ensure the woman stayed off the bed. Lastly, there was evidence that whilst wanting to avoid the use of the bed, some were reluctant, fearing potential reprimand. The themes highlight differences in how the midwives conceptualised the use of a bed within a birth space. While some avoided the use of the bed altogether others would only conceive of women moving off the bed if everything was 'normal'. How the bed was culturally constructed appeared to dictate clinical practice. Reflecting on the meaning of an object, such as the bed, is important if clinicians are to fully understand how the birth environment influences their practice and thus women's experiences of labour and birth.

Effects of the 2001 Extension of Paid Parental Leave Provisions on Birth Seasonality in Canada

It is well known that there exists a strong seasonal pattern in births and that the pattern differs across geographic regions. While historically this seasonal pattern has been linked to exogenous factors, modern birth seasonality patterns can also be explained by purposive choice. If birth month of a child is at least partially chosen by the parents then, by extension, it can also be expected that this can be influenced by anything that changes the costs and benefits associated with that choice, including public policy. This paper explores the effect that the 2001 extension of paid parental leave benefits had on birth seasonality in Canada. Overall we find strong results that the pattern of birth seasonality in Canada changed after 2001, with a notable fall in spring births and an increase in late summer and early fall births. We discuss the potential effects of this unintended consequence, including those related to health and development, educational preparedness and outcomes, and econometric modelling.

The effect of differing patterns of childhood body mass index gain on adult physiology in American Indians.

Identifying groups of individuals with similar patterns of body mass index (BMI) change during childhood may increase understanding of the relationship between childhood BMI and adult health. Discrete classes of BMI z-score change were determined in 1,920 American Indian children with at least four non diabetic health examinations between the ages of 2 and 18 years using latent class trajectory analysis. In subsets of subjects, data were available for melanocortin-4 receptor (MC4R) sequencing; in utero exposure to type 2 diabetes (T2D); or, as adults, oral glucose tolerance tests, onset of T2D, or body composition. Six separate groups were identified. Individuals with a more modern birth year, an MC4R mutation, or in utero exposure to T2D were clustered in the two groups with high increasing and chronic overweight z-scores (P < 0.0001). The z-score classes predicted adult percent fat (P < 0.0001, partial r(2) = 0.18 adjusted for covariates). There was a greater risk for T2D, independent from adult BMI, in three classes (lean increasing to overweight, high increasing, and chronic overweight z-scores) compared to the two leanest groups (respectively: HRR= 3.2, P = 0.01; 6.0, P = 0.0003; 11.6, P < 0.0001). Distinct patterns of childhood BMI z-score change associate with adult adiposity and may impact risk of T2D.

The evolution of the human pelvis: changing adaptations to bipedalism, obstetrics and thermoregulation.

The fossil record of the human pelvis reveals the selective priorities acting on hominin anatomy at different points in our evolutionary history, during which mechanical requirements for locomotion, childbirth and thermoregulation often conflicted. In our earliest upright ancestors, fundamental alterations of the pelvis compared with non-human primates facilitated bipedal walking. Further changes early in hominin evolution produced a platypelloid birth canal in a pelvis that was wide overall, with flaring ilia. This pelvic form was maintained over 3-4 Myr with only moderate changes in response to greater habitat diversity, changes in locomotor behaviour and increases in brain size. It was not until Homo sapiens evolved in Africa and the Middle East 200 000 years ago that the narrow anatomically modern pelvis with a more circular birth canal emerged. This major change appears to reflect selective pressures for further increases in neonatal brain size and for a narrow body shape associated with heat dissipation in warm environments. The advent of the modern birth canal, the shape and alignment of which require fetal rotation during birth, allowed the earliest members of our species to deal obstetrically with increases in encephalization while maintaining a narrow body to meet thermoregulatory demands and enhance locomotor performance.

Early Modern Birth and the Story of Gender Relations

In the 1970s and 1980s birth stories proliferated. The poet Sharon Olds celebrated lying down, sweating and shaking in ‘The Language of the Brag’. The novelist Margaret Atwood described ‘every muscle in the body tight and moving, as in a slow-moving shot of a high-jump’. Black activist Nikki Giovanni sat in a hospital bed and cried. Historians can read in these accounts the expansion of confessional writing, or the confidence and demands of second-wave feminism, or the Western technologization of childbirth and its fierce critique. Nor did these writings lack immediate predecessors: Otis Burger's less than prim 1950 account of hospital birth ended with driving home in an old Ford: ‘How astonishing to be thin! Still rather flabby, of course, but thinner than I had realized’.1 The 1970s and 1980s also made for the rise of women's history. The grand historical story about childbirth that resulted goes something like this: Once women laboured among other women. Then – for good or ill, depending on whether you lean towards the history of obstetrics or the history of midwives – science thought they should do otherwise, that doctors should intervene, and along came forceps and chloroform. Mothers became patients. Eventually birth moved from the home to the hospital. Obstetricians experimented with twilight sleep, and epidural, and Caesarean section. Fathers came in from corridors and waiting rooms. Today, all across the world, one mark of being fully modern is the delivery suite. Whether a woman labours in Beijing or Bhopal or Bradford, birth is a medical event and hospital is its location. Advocates of homebirth, meanwhile, push back against the reigning confidence in hospital medicine, and applaud a less interventionist past.

Too old to have children? Lessons from natural fertility populations

Is it possible to construct an age curve denoting the ages above which women are biologically too old to reproduce? We constructed a curve based on the distribution of female age at last birth in natural fertility populations reflecting the ages above which women have become biologically too old to have children. The median age at last birth (ALB) for females is ∼40-41 years of age across a range of natural fertility populations. This suggests that there is a fairly universal pattern of age-related fertility decline. However, little is known about the distribution of female ALB and in the present era of modern birth control, it is impossible to assess the age-specific distribution of ALB. Reliable information is lacking that could benefit couples who envisage delaying childbearing. This study is a review of high-quality historical data sets of natural fertility populations in which the distributions of female age at last birth were analysed. The studies selected used a retrospective cohort design where women were followed as they age through their reproductive years. Using a common set of eligibility criteria, large data files of natural fertility populations were prepared such that the analysis could be performed in parallel across all populations. Data on the ALB and confounding variables are presented as box and whisker plots denoting the 5th, 25th, 50th, 75th and 95th percentile distribution of the age at last birth for each population. The analysis includes the estimation of Kaplan-Meier curves for age at last birth of each population. The hazard curve for ALB was obtained by plotting the smoothed hazard curve of each population and taking the lowest hazard within a time period of at least 5 years. This lowest hazard curve was then transformed into a cumulative distribution function representing the composite curve of the end of biological fertility. This curve was based on the data from three of the six populations, having the lowest hazards of end of fertility. We selected six natural fertility populations comprising 58 051 eligible women. While these populations represent different historical time periods, the distribution of the ages at last birth is remarkably similar. The curve denoting the end of fertility indicates that <3% of women had their last birth at age 20 years meaning that almost 98% were able to have at least one child thereafter. The cumulative curve for the end of fertility slowly increases from 4.5% at age 25 years, 7% at age 30 years, 12% at age 35 years and 20% at age 38 years. Thereafter, it rises rapidly to about 50% at age 41, almost 90% at age 45 years and approaching 100% at age 50 years. It may be argued that these historical fertility data do not apply to the present time; however, the age-dependent decline in fertility is similar to current populations and is consistent with the pattern seen in women treated by donor insemination. Furthermore, for reproductive ageing, we note that it is unlikely that such a conserved biological process with a high degree of heritability would have changed significantly within a century or two. We argue that the age-specific ALB curve can be used to counsel couples who envisage having children in the future. Our findings challenge the unsubstantiated pessimism regarding the possibility of natural conception after age 35 years. No external funding was either sought or obtained for this study. There are no conflicts of interest to be declared.

Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood.

Emerging research raises questions that synthetic oxytocin during childbirth may alter the endogenous oxytocin system and influence maternal stress, mood, and behavior. Endogenous oxytocin is a key component in the transition to motherhood, affecting molecular pathways that buffer stress reactivity, support positive mood, and regulate healthy mothering behaviors (including lactation). Synthetic oxytocin is widely used throughout labor and postpartum care in modern birth. Yet research on the implications beyond labor of maternal exposure to perinatal synthetic oxytocin is rare. In this article, we review oxytocin-related biologic pathways and behaviors associated with the transition to motherhood and evidence supporting the need for further research on potential effects of intrapartum oxytocin beyond labor. We include a primer on oxytocin at the molecular level.

Characteristics of Kenyan women in a prospective cohort study who continue using subdermal contraceptive implants at 12 months

ObjectiveSubdermal contraceptive implant continuation has not been well studied in Africa. We conducted a secondary data analysis to compare baseline characteristics of Kenyan women who continued to use the subdermal implant at 12 months to those who did not. Study DesignKenyan women aged 18–24 years who presented to a family planning clinic for short-acting hormonal contraception were offered a two-rod subdermal implant instead. Participants were followed for 12 months after initiation of their contraceptive method. Statistical analysis included Pearson's chi-square or Fisher's exact tests for comparisons of proportions. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to determine factors associated with continuation. ResultsEighty-six (89%) of the 97 women who chose the implant were followed for 12 months. Of these women, 68 (79%) continued to use the implant. None of the factors we examined had a statistically significant association with continued use of the implant. Duration of intended use was the only strong factor; 83% of women with 3+ years of need continued using the implant, compared to 56% of those with shorter needs (Risk ratio = 1.48, 95% CI = 0.94–2.31). No substantive continuation differences were found when comparing other participant characteristics including months with their current partner, personal desire and partner preference for future children, previous use of modern birth control and other factors. ConclusionHigh implant continuation rates were noted regardless of previous use of modern birth control, partner preference for children or baseline concern for menstrual change. ImplicationsContraceptive use in Africa continues to focus on short-acting contraceptives despite the proven superior efficacy of long-acting reversible contraceptives in other settings. The high subdermal implant continuation among Kenyan women in this prospective study, regardless of baseline characteristics, supports the need for increasing access and future research in this population.

Fertility, parental investment, and the early adoption of modern contraception in rural ethiopia

What triggers initial shifts to fertility limitation as populations undergo socioeconomic development remains poorly understood. Alternative models emphasize the social contagion of low fertility ideals, or the individual perception of economic and/or fitness benefits to fertility limitation. Few micro-level studies in communities experiencing the earliest stages of the demographic transition are available. In a previous study, we found little support for the role of social transmission through friendships and spatial networks in explaining contraceptive uptake in rural Ethiopia, where contraceptive prevalence is low (<20%). Here, using data from the same population, we investigate the possibility that early contraceptive uptake is best understood as a manipulation of parental investment in response to local environmental change. We used data on >800 women which recorded fertility, birth spacing and offspring survivorship. We first investigated whether ever-users and non-users differ in their reproductive behavior and success prior to contraception use. We then conducted a within-women analysis to investigate the impact of contraceptive uptake on reproduction and child survivorship. Women who have experienced higher fertility and higher child survival adopt modern contraception sooner rather than later, and contraceptive use among early adopters is predictive of greater birth spacing. However, contraceptive uptake does not have an impact on offspring survivorship. Our data provide support for the idea that preferences for low fertility emerge in response to increasing competition between offspring. The study has implications for our understanding of the emergence of local fertility norms and the spread of modern birth control.

Facial attractiveness and fertility in populations with low levels of modern birth control

Evolutionary models of human mate choice generally assume that physical attractiveness has evolved through sexual selection, i.e., it has been associated with higher mating opportunities and subsequent reproductive success across our evolutionary history. Here we investigate whether facial attractiveness is related to fertility in order to understand the extent to which selection can operate on attractive traits in modern populations. We used data from two populations where the prevalence of modern birth control methods is low and thus unlikely to disconnect mating opportunities from reproductive success: men and women from contemporary rural Senegal and men from the West Point Military Academy in the USA who graduated in 1950. We found that facial attractiveness negatively predicts age-specific reproduction in both sexes in Senegal and is independent from lifetime reproductive success in men from the USA. Overall, the results suggest that facial attractiveness is not under positive selection and raise questions about methodological approaches currently used to assess attractiveness.

The Evolutionary History of the Modern Birth Mechanism: Looking at Skeletal and Cultural Adaptations

The Evolutionary History of the Modern Birth Mechanism: Looking at Skeletal and Cultural Adaptations

A founder's reflections

This essay reflects on the past, present, and future of biopolitics, starting with the academic interest in the link between biology and politics. Examples of primitive adumbrations of this approach appear throughout academic history; however, the modern roots of biology and politics began in the 1960s. This reflection traces biopolitics from its modern birth through the 1990s, and considers future research endeavors related to biology and politics.