The impact of technology on childbearing

Abstract

Technology has become part of everyday life; this also includes healthcare. Childbearing is a good example of the increasing use of technology. Technology is presumed to be positive, increasing safety in childbearing. In many cases the use of technology is needed and has beneficial effects. But what started to be used in certain specific indications, quickly came to be used in most pregnancies and births on the premise that what is beneficial to few must be beneficial to many if not to all, although this was never borne out through research. The increasing use of technology has led to the medicalisation of childbirth, with one intervention leading to another in what is known as the cascade of intervention. This indiscriminate use of technology during the process of childbearing raises many questions. Most technological innovations have been introduced without any research as to their safety, efficacy and reliability; their current widespread use makes research difficult to carry out on both logistic and ethical grounds. Other issues concern autonomy and informed choice, beneficence and non-maleficence. In childbearing these are complicated by the fact that the effects of any interventions are not only for the mother but also for the baby. Some interventions have effects beyond pregnancy and labour, and may have long-term consequences. Technology has raised expectations of “the perfect baby”, which can cause emotional difficulties when this is not so. This expectation can make society less inclusive and less supportive to those who have different needs. Technology is expensive, and although some technology is needed, overuse leads to higher expenses without a corresponding decrease in mortality and morbidity rates. This leads to questions regarding justice and fair allocation of available resources. As more finances are channelled into technology, other resources which can be cheaper but as effective are neglected. The social aspect of childbearing is usually perceived as not as important as the medical and technological aspects, and consequently not enough attention and resources, including financial, are given to it. Childbearing is not only a health event, but also a life event; therefore the human aspect should not be underestimated. Technology can displace this human aspect by becoming the focus of the whole process rather than an aid. Technology in childbirth can be life-saving; it should be used when needed, in well-defined circumstances rather than routinely simply because it is available.