The use of Caesarian section worldwide has increased to unprecedented levels although the gap between higher and lower-resource settings remains. Dr. Allison Wright discusses the controversies between normal delivery vs. intervention and the misconceptions around normal birth. Individual care, not artificial targets, should be the aim in pregnancy. It has been shown that neonates harbor bacterial communities that are undifferentiated across multiple body habitats, regardless of delivery mode. According to the extended hygiene hypothesis, infants born by elective Caesarean section have very low bacterial richness and diversity at four months following birth. Every woman should develop a personalized care plan with her midwife and other health professionals, which sets out her decisions about her care, reflects her wider health needs and is kept up to date as her pregnancy progresses. Dr. Alison discusses the concerns and options in the second stage of labour and also the barriers to instrumental delivery and the role of vacuum delivery. Respectful care is important and and quality and safety in the second stage are prime considerations.
Dr Alison Wright is an NHS and Private Consultant Obstetrician and Gynaecologist. She is also a Vice President of the Royal College of Obstetricians and Gynaecologists where she works within the Global Health division. Particular areas of interest are pelvic floor/bladder problems, traumatic childbirth and also high risk pregnancies including HIV and drugs in pregnancy. She trained in Leeds and in 2003 became a Consultant at Leeds General Infirmary and St James University hospital. In 2008 she moved to London to take up a Consultant post at the Royal Free Hospital.