2 - A Narrow Escape

Summary

Why is birth so dangerous, even today, with modern medicine? Through historical anecdote and a contemporary case history we explore this question, discussing the process of birth and what can go wrong. By thinking about who is in control of labour – is it the mother or her fetus? – we think about how a couple might prepare for birth. The challenge posed by birth makes us look to human evolution for answers, and we describe the insight it gives into birth in some low-resource settings around the world. We tackle the question of the rising numbers of caesarean sections around the world and the possible consequences. Although it may be widely believed that a smaller baby would mean a less difficult birth, we go on to explore the risks of being small for the survival of the baby alongside new research revealing how the mother’s body limits the growth of her baby inside the womb. We discuss whether the growth of the fetus is set by the genes which the mother or the father have passed on, mother’s size, or her environment. This leads to how the fetus develops and what controls this, the focus of the next chapter.