Content Warning: This episode includes mentions of miscarriage, pregnancy loss, pregnancy complications, traumatic birth experiences, and other potentially disturbing topics related to childbirth, pregnancy, and the postpartum period.
In Act 3 of our pregnancy series, we arrive at the big moment: childbirth. We begin the episode with a closer look at one of the most commonly performed surgeries around the world: the cesarean section. Exploring how this procedure went from rare to everywhere reveals some of the larger medical trends shaping the childbirth experience in nuanced ways. Then, we take a step back to ask “what is actually happening in labor?” Journeying through the labor and delivery process contraction by contraction gives us the opportunity to examine what is happening in our bodies during this crucial time and how things might not go according to plan.
Check out the full video for this episode on YouTube!
| History | Biology |
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| Wolf, Jacqueline H. Cesarean section: An American history of risk, technology, and consequence. JHU Press, 2018. | Antoine, C. and Young, B.K., 2021. Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of Perinatal Medicine, 49(1), pp.5-16. |
| Antoine, Clarel, and Bruce K. Young. “Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly.” Journal of Perinatal Medicine 49.1 (2021): 5-16. | Bienstock, J.L., Eke, A.C. and Hueppchen, N.A., 2021. Postpartum hemorrhage. New England Journal of Medicine, 384(17), pp.1635-1645. |
| Boley, J. P. “The history of caesarean section.” Canadian Medical Association Journal 32.5 (1935): 557. | Keag, O.E., Norman, J.E. and Stock, S.J., 2018. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS medicine, 15(1), p.e1002494. |
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| Dunsworth, Holly, and Leah Eccleston. “The evolution of difficult childbirth and helpless hominin infants.” Annual Review of Anthropology 44.1 (2015): 55-69. | Dahlke, J.D., Mendez-Figueroa, H., Rouse, D.J., Berghella, V., Baxter, J.K. and Chauhan, S.P., 2013. Evidence-based surgery for cesarean delivery: an updated systematic review. American journal of obstetrics and gynecology, 209(4), pp.294-306. |
| Gómez-Robles, Aida, et al. “The evolution of human altriciality and brain development in comparative context.” Nature Ecology & Evolution 8.1 (2024): 133-146. | ACOG Committee on Obstetric Practice. 2018, reaffirmed 2023. Mode of Term Singleton Breech Delivery. ACOG Clinical Practice Guideline Number 745. |
| Harcourt-Smith, William EH. “The origins of bipedal locomotion.” Handbook of paleoanthropology 3 (2007): 1483-1518. | Grobman, W.A., Rice, M.M., Reddy, U.M., Tita, A.T., Silver, R.M., Mallett, G., Hill, K., Thom, E.A., El-Sayed, Y.Y., Perez-Delboy, A. and Rouse, D.J., 2018. Labor induction versus expectant management in low-risk nulliparous women. New England Journal of Medicine, 379(6), pp.513-523. |
| Lurie, Samuel. “The changing motives of cesarean section: from the ancient world to the twenty-first century.” Archives of gynecology and obstetrics 271 (2005): 281-285. | Betran, A.P., Ye, J., Moller, A.B., Souza, J.P. and Zhang, J., 2021. Trends and projections of caesarean section rates: global and regional estimates. BMJ global health, 6(6), p.e005671. |
| Pavličev, Mihaela, Roberto Romero, and Philipp Mitteroecker. “Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma.” American journal of obstetrics and gynecology 222.1 (2020): 3-16. | M., 2011. Classifications for cesarean section: a systematic review. PloS one, 6(1), p.e14566. |
| Rosenberg, Karen, and Wenda Trevathan. “Birth, obstetrics and human evolution.” BJOG: an international journal of obstetrics and gynaecology 109.11 (2002): 1199-1206. | Morton, R., Burton, A.E., Kumar, P., Hyett, J.A., Phipps, H., McGeechan, K. and de Vries, B.S., 2020. Cesarean delivery: Trend in indications over three decades within a major city hospital network. Acta obstetricia et gynecologica Scandinavica, 99(7), pp.909-916. |
| Rosenberg, Karen R., and Wenda R. Trevathan. “Evolutionary perspectives on cesarean section.” Evolution, Medicine, and Public Health 2018.1 (2018): 67-81. | Torloni, M.R., Betran, A.P., Souza, J.P., Widmer, M., Allen, T., Gulmezoglu, M. and Merialdi, |
| Rosenberg, Karen R. “The evolution of modern human childbirth.” American journal of physical anthropology 35.S15 (1992): 89-124. | Gedefaw, G., Demis, A., Alemnew, B., Wondmieneh, A., Getie, A. and Waltengus, F., 2020. Prevalence, indications, and outcomes of caesarean section deliveries in Ethiopia: a systematic review and meta-analysis. Patient safety in surgery, 14, pp.1-10. |
| Sewell, Jane Eliot. “Cesarean section–a brief history.” A brochure to accompany an exhibition on the history of cesarean section at the National Library of Medicine 30 (1993). | Maskey, S., Bajracharya, M. and Bhandari, S., 2019. Prevalence of cesarean section and its indications in a tertiary care hospital. JNMA: Journal of the Nepal Medical Association, 57(216), p.70. |
| Yang, Bin, et al. “Daytime birth and postbirth behavior of wild Rhinopithecus roxellana in the Qinling Mountains of China.” Primates 57 (2016): 155-160. | Kolås, T., Hofoss, D., Daltveit, A.K., Nilsen, S.T., Henriksen, T., Häger, R., Ingemarsson, I. and Øian, P., 2003. Indications for cesarean deliveries in Norway. American journal of obstetrics and gynecology, 188(4), pp.864-870. |
| Zeveloff, Samuel I., and Mark S. Boyce. “Why human neonates are so altricial.” The American Naturalist 120.4 (1982): 537-542. | Cross, S.N., Greenberg, J.T., Pettker, C.M., Raab, C.A. and Illuzzi, J.L., 2019. Indications contributing to the decreasing cesarean delivery rate at an academic tertiary center. American journal of obstetrics & gynecology MFM, 1(2), pp.165-172. |
| Frappaolo, A.M., Logue, T.C., Goffman, D., Nathan, L.M., Sheen, J.J., Andrikopoulou, M., Wen, T., D’Alton, M.E. and Friedman, A.M., 2023. Cesarean delivery trends among patients at low risk for cesarean delivery in the US, 2000-2019. JAMA Network Open, 6(3), pp.e235428-e235428. | |
| Corbetta-Rastelli, C.M., Friedman, A.M., Sobhani, N.C., Arditi, B., Goffman, D. and Wen, T., 2023. Postpartum hemorrhage trends and outcomes in the United States, 2000–2019. Obstetrics & Gynecology, 141(1), pp.152-161. | |
| Ende, H.B., Lozada, M.J., Chestnut, D.H., Osmundson, S.S., Walden, R.L., Shotwell, M.S. and Bauchat, J.R., 2021. Risk factors for atonic postpartum hemorrhage: a systematic review and meta-analysis. Obstetrics & Gynecology, 137(2), pp.305-323. |
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One thought on “Episode 170 Pregnancy: Act 3”
Help! Half-way through this podcast it stopped playing with 1 hour left giving me an error message saying, “Playback error. This episode appears to be in a format we can’t play…” I’m using an Android, Samsung phone and using Pocket Casts for my podcasts. All my other podcasts are working. Have you changed something? I will be very sad not to be able to listen to your podcasts anymore! And sad not to be able to listen to the end of this one.