Birth in the Japanese Context

A qualitative study of the experiences of 20 American women who gave birth in Japan is reported. Five interrelated issues that were important to this group of women emerged from the interview data: a sense of isolation, the need for security, the need to regain control, the need for affirmation, and the need for cultural support. These findings are interpreted within a framework of stress and coping, maternal identification, and cultural adaptation theories. These women were dually stressed by the demands of childbearing and transcultural migration. Implications for clinical practice are suggested.     

Birth Control and a New Birth of Freedom

The author analyzes Griswold v. Connecticut and other recent developments in the birth control movement and explains their significance for constitutional theory. The Griswold case raised the principle of voluntary family planning to the status of a constitutional right. It also recognized the standing of those in the helping professions to assert the rights of their patients and clients. The Court's recognition of a right of privacy and restoration of meaning to the ninth and tenth amendments may be a protection against the increasing threat of a “big brother” society. Recent administrative and judicial decisions emasculating the Comstock laws demonstrate the importance of constitutional checks and balances. The ultimate question posed by the Griswold case is whether it will be recognized that the government has an affirmative obligation to make the exercise of constitutional rights possible.     

Underwater Birth

ObjectiveTo determine potential risks and/or benefits of underwater birth for mother and infant.Data SourcesThe PubMed, Cochrane Library, EMBASE, and CINAHL online databases were searched for relevant English language articles related to research about underwater birth published from 1966 to April 2013. Reference lists of articles retrieved were reviewed to identify additional potentially pertinent publications.Study SelectionTwo randomized controlled trials comparing underwater birth to traditional birth (“on land”) were identified and served as the primary focus of the analysis. One systematic review of water immersion during labor and birth, one systematic review of neonatal risks of underwater birth, and case reports of neonatal morbidity after underwater birth were also identified. Guidelines regarding underwater birth from professional organizations were reviewed.Data ExtractionData from the two randomized controlled trials were extracted and organized under the following headings: author, year, setting, country, study design, sample size, participants, outcomes, findings and comments. Systematic reviews, case reports, and guidelines from professional organizations were summarized.Data SynthesisResearch findings and guidelines from professional associations were evaluated regarding potential risks and benefits of underwater birth to the mother and infant.ConclusionsOnly two randomized controlled trials comparing underwater birth to birth on land have been published. Results suggest minimal benefit of underwater birth to the mother and no benefit to the infant. Both studies were underpowered to adequately evaluate risk of neonatal harm; however, a number of cases of neonatal morbidity have been reported. Based on these findings, underwater birth requires more rigorous study. In the United States, underwater birth is not supported by the American Academy of Pediatrics or the American College of Obstetricians and Gynecologists outside the context of a randomized controlled trial.