What is a modern or a modern birth?
Is a vaginal delivery superseded by the ‘natural caesarean’?
Who is the modern woman?

We now live in the age with the desire to be ‘perfect’ in our body-image and instantaneous gratification. Dr Google tells us everything instantly and upgrades are always better.

In terms of pregnancy and childbirth, perfection is now the aim, with a beautiful baby and body after delivery. Young women are now unhappy that in spite of a vaginal delivery with a healthy baby, she feels that ‘things down below’ are not the same and she is unable to attain her pre-pregnancy body shape and weight.

In terms of medical practice around the world, many doctors in low income countries have the perception that what is done in high income countries is always better. This is often done without consideration of what is actually available (or not available) in the local infrastructure or health care system such as unreliable mains electricity, no adequately trained health professionals especially in rural areas and suboptimal equipment.

In many parts of Africa, there is now a high cesarean section rate without a corresponding improvement in maternal mortality/morbidity and perinatal outcomes. An instrumental delivery is not performed as it is ‘bad’ because it ‘damages the mother and baby’ – Dr Google says so. Even for women with obstetric fistulas, there is a high cesarean section rate – to deliver a stillborn baby low in the maternal pelvis increases morbidity and has a significant impact on the woman’s future fertility.

As a fistula surgeon working in many low-income countries, my desire for the modern birth in these areas, after a delivery, is for someone to say “mother and baby are well.”