When it comes to childbirth, vaginal delivery is often assumed to be the best thing – women have, after all, done it for thousands of years.
谈及生产,顺产似乎总被认为是最佳的生产方式--毕竟,女性用这种方式生产已经延续几千年了。
But natural birth actually comes with risks, including tearing, haemorrhage and incontinence for the mother and injuries to the baby during labour.
但是顺产其实也是有风险的,对妈妈们而言可能会出现会阴撕裂、产后大出血、大小便失禁等问题,宝宝也可能在生产过程中受到伤害。
So why is it that the vast majority of pregnant women are only being warned about the risks of Caesarean sections?
那么为什么对于大多数的怀孕女性,医生仅仅警告她们剖腹产的风险呢?
This could now change, as the Royal College of Obstetricians and Gynaecologist is to discuss the current view of vaginal birth as the default option for childbirth in the UK.
这一现象现在要改变了。因为英国皇家妇产科学院要对生育孩子时默认选择顺产的方式进行研讨了。
Now they will consider whether there's merit in routinely discussing the relative risks and benefits of vaginal birth and Caesarean section with pregnant women.
现在他们要探讨是否应该告诉产妇顺产和剖腹产的相对风险和益处,并将此作为一种工作流程执行下去。
While both Caesarean section and vaginal birth are considered to be relatively safe in high-income countries, each features its own set of risks. How such risks are perceived and valued may vary considerably between health professionals and women themselves.
尽管在高收入国家,剖腹产和顺产都很安全,但是也依旧有各自的风险。对于医护专业人员和产妇自身,对风险的感受和评估可能有很大的不同。
UK hospitals still treat vaginal birth as the default birth mode for most women, despite its risks and the fact that the National Institute of Health and Care Excellence (NICE) has recommended that there should be some room for choice.
对于大多数产妇来说,英国各大医院仍将顺产作为默认的生产方式,尽管英国国家卫生与临床技术优化研究所已经建议要为产妇提供选择空间。
While up to 95 per cent of UK women aim for a vaginal birth in their first pregnancy, only around 75 per cent achieve this.
英国女性在生育头胎时,有95%的人表示想进行顺产,但是只有75%的人能如愿。
Some 21 per cent experience an emergency Caesarean section during labour, which is not as safe as a planned one. A further substantial proportion of women experience important complications of vaginal birth. These include an 8 per cent postpartum haemorrhage rate, 1 per cent blood transfusion rate, and a 5-6 per cent third-degree tear rate (40 per cent suffer some degree of tearing). One in six women end up having an operative vaginal birth, such as use of forceps, which is associated with faecal incontinence and pelvic organ prolapse in later life.
在生产中,有21%的人接受了紧急剖腹产手术,这远没有计划好的剖腹产手术安全。还有很大一部分产妇在顺产时,出现了严重的并发症。这其中有8%的人出现了产后大出血,1%的人要输血,5-6%的人三级撕裂损伤(40%的人出现一定程度的会阴撕裂损伤)。有六分之一的产妇在顺产时需要器械辅助,比如使用了产钳,这会导致以后的生活中出现大便失禁和盆腔器官脱垂的问题。
This leaves little more than half of first-time mothers experiencing an uncomplicated spontaneous vaginal birth. This is a considerable number which illustrates why women aiming for a natural birth may need to know that such attempts could involve a medical intervention or complications.
结果,生育头胎的产妇仅有一半的人数可以顺利进行顺产。这一百分比也正说明了为什么想要自然生产的女性需要知道过程中可能会出现的医疗干预及并发症。
In this light, the alternative of a planned Caesarean section may be tempting.
从这一角度看,替代顺产的剖腹产手术好像很诱人。
While not risk-free, it appears to be similar to that of of a planned vaginal birth in the short term and – with a slightly higher risk of respiratory problems at birth – may be even safer for the baby.
但这也不是一点儿风险没有的。在短期看来,剖腹产和计划好的顺产很相似——只是在手术时,呼吸系统出现问题的概率略高一点儿——但是对于孩子来说,剖腹产整体更安全。
However, the scarring from a section will make each future pregnancy more risky as it can affect the development of the placenta, resulting in increased risks for the mother of developing major bleeding and hysterectomy, although this is rare. There is also some concern that babies born by Caesarean could be at higher risk of developing asthma.
但是,剖腹产后留下的伤疤对于以后再次怀孕是有风险的,因为这会影响到胎盘的发育,也会增大产妇出现大出血和切除子宫的可能性,当然这种可能性不高。通过剖腹产出生的孩子也更容易患哮喘病,这也有些令人担忧。
Since women will value these risks differently, informing them of the merits of both options would empower them to decide what matters most to them.
由于不同的人对风险的评估也不同,所以告知产妇这两种方式的优缺点,才能让他们根据自己的情况和需要来决定。
For some that will be the opportunity to experience labour and the benefits of vaginal birth, for others it will be the option of a more controlled and predictable Caesarean birth.
对一些人来说,他们乐于享受生产过程,阴道生产也对他们很有利;对于另外一些人而言,他们倾向于选择剖腹产,更好控制,也更易于预测。
But in reality things are more complicated. If potential risks of vaginal birth are routinely discussed with all women, Caesarean section rates in UK hospitals are likely to rise further.
但是,实际情况远比这复杂。如果医院常规地告知了产妇顺产的风险,英国各大医院剖腹产的比例必然会升高。