- \n
- Life expectancy<\/u> in Slovenia has exceeded 80 years and is one year above the EU-28 average, while highly educated residents live longer and in better health than those with the lowest level of education.<\/li>\n
- Neonatal mortality<\/u> is an indicator of the accessibility and quality of healthcare in general. In Slovenia, it is among the lowest in OECD countries, at 1.6 neonatal deaths per thousand live births. Slovenia also ranks among the more successful countries regarding maternal mortality<\/u> in the period from 2009 to 2011 (the three-year average rate is 1.5 maternal deaths per 100,000 live births). <\/li>\n
- Population vaccination coverage<\/u> for childhood diseases is an indicator of the population’s inclusion in preventive programs and is equal to the EU average in Slovenia; specifically, 96% of the population is vaccinated against diphtheria, tetanus, and pertussis (same as the EU), and 95% against measles (94% in the EU).<\/li>\n
- Indicators showing regional health differences<\/u>, along with other health determinants, also speak to the accessibility of preventive and treatment programs. According to OECD data, Slovenia has the lowest share of people among all EU countries who could not afford healthcare for financial or other reasons. We are among the 17 European countries that provide healthcare to all their residents. However, due to the crisis and subsequent unemployment, health inequalities between individual population groups and regions have begun to deepen in Slovenia as well. At least part of these differences can be attributed to reduced access to healthcare (Ministry of Health of the RS [MZ RS], 2015a). <\/li>\n<\/ul>\n
However, in Slovenia, we lack research on the satisfaction of women who give birth with a chosen midwife at home, in a maternity hospital, or in a birth center compared to the existing care provided in the Slovenian healthcare system. The practice in most Slovenian maternity hospitals is that a woman gives birth with the midwife currently on shift. Only the Kranj maternity hospital offers the possibility of giving birth with a chosen midwife who has a contract with the Kranj Hospital for Gynecology and Obstetrics. Women contact this midwife themselves, and she comes to give birth with them at BGP Kranj (Kranj Hospital for Gynecology and Obstetrics [BGP], n.d.). Trbovlje General Hospital has also listened to laboring women who want their birth to be managed by a midwife they trust and choose themselves. Thus, they enable a self-pay service where a woman chooses her own midwife (Trbovlje General Hospital [SB Trbovlje], 2015). There are also women who decide on a home birth with a chosen Slovenian or foreign midwife. Slovenia lacks separate statistics regarding labor augmentation, induction of labor, perineal injuries, and premature birth in physiological pregnancies compared to pathological pregnancies. If we wanted relevant statistics, tertiary centers would have to keep separate statistics, as only then would they be competitive with smaller maternity hospitals that generally only deal with physiology, while all pathological pregnancies are sent to tertiary centers (e.g., Ljubljana or Maribor). <\/p>\n
- \n
- Increase access to healthcare that most reliably supports the physiology of birth<\/em><\/strong>, i.e., to midwives, birth centers, and doulas. Pregnant women in Slovenia have very good access to healthcare. Their pregnancies are managed by gynecologists, and they are referred to tertiary centers if necessary. Thus, they have dual care, making gynecologist visits more frequent and the management of their pregnancy in-depth and precise. However, we can see that gynecologists and obstetricians are the ones dealing with pathological pregnancies and participating in the birth. Midwives, who are the responsible health professionals for managing physiological births and also support births that are as physiological as possible, are somewhat pushed to the sidelines in Slovenia. In Slovenia, every pregnant woman is entitled to 10 systematic check-ups and two ultrasound examinations, and individual counseling is also provided. The purpose of preventive check-ups is active health monitoring of the pregnant woman and the fetus. If the pregnancy is not progressing normally, the gynecologist decides on additional examinations. The first examination is performed by a gynecologist by the 12th week of pregnancy. Subsequent systematic check-ups are roughly in the 24th, 28th, 35th, and 40th weeks of pregnancy. The other five systematic check-ups in the 16th, 32nd, 37th, 38th, and 39th weeks of pregnancy are performed by a graduate midwife or a graduate nurse trained for independent work<\/u>. If there is no graduate midwife or graduate nurse trained for independent work employed in the gynecological team, these examinations are performed by the gynecologist (MZ RS, 2015b). Since there are no midwives\/graduate nurses trained for independent work employed in Slovenian gynecological clinics (within maternity hospitals, health centers, or independent gynecological clinics) who could perform these examinations (nursing staff is mostly just for administration), all examinations are performed by gynecologists. According to the Rules on the implementation of preventive healthcare at the primary level from 1998, last updated in 2015, we should work in Slovenia to ensure that women have greater access to midwives during pregnancy and receive midwifery care. Research further shows that contact with a midwife during pregnancy has a positive effect on the outcome of pregnancy and birth, even in the case of a pathological pregnancy. At last year’s fourth birth conference in Maribor, titled Ancient Wisdom and Modern Science of Birth, Jesenice Maternity Hospital also presented. Among other things, they said that every first Monday of the month they have a discussion about physiological birth with a gynecologist, pediatrician, and midwife. Since the beginning of 2015, midwives have also been running a clinic where they perform 5 midwifery examinations, as dictated by the Rules on the implementation of preventive healthcare at the primary level, for healthy pregnant women in the 16th, 28th, 35th, 37th, and 38th weeks of pregnancy. They also check urine, and if they detect changes, they refer the pregnant woman to a gynecologist. Otherwise, they talk to her and give her further instructions. After physiological births, they also perform rounds themselves. Such a way of working requires the support of leaders in the system, employees, and users of health services. This requires more staff with appropriate knowledge and experience and additional premises where this midwifery activity could be carried out. As healthcare workers with easy access to knowledge, we must ensure that we (re)shape our existing systems to positively influence the culture of birth and thus change practice to what is proven to be a better and safer choice for pregnant women, laboring women, newborns, and others involved in the birthing process. In any case, staffing shortages must be addressed first. <\/li>\n
- Support the quality of work of everyone involved in the birth process, support initiatives to improve the quality of maternal and child care and for physiological processes in healthy women and newborns and, when safe, in those with special needs. <\/em><\/strong>In the continuation of the master’s thesis, it will be stated why it is important to routinely enable skin-to-skin contact even during C-sections or, if the mother is unable, to enable this for the father. <\/li>\n
- Develop and implement care experiences, birth outcomes, and women’s opinions on the quality of treatment. <\/em><\/strong>It would be necessary to prepare surveys on women’s satisfaction with treatment during pregnancy, birth, and the postpartum period.<\/li>\n
- Develop and publish options for using safe websites that allow pregnant women access to relevant information<\/em><\/strong>. The author of the master’s thesis also strives for this, collecting and organizing relevant articles on the topics of pregnancy, birth, the postpartum period, and midwifery via the Facebook network under the name Moja babica and on the website mojababica.si<\/a>. <\/li>\n
- Promoting breastfeeding and maintaining the Baby-Friendly Hospital designation. <\/em><\/strong>With the Baby-Friendly Hospital<\/em> initiative, the National Breastfeeding Committee encourages breastfeeding for the good health of mothers and children (UNICEF, n.d.).<\/li>\n
- Support public education and informing<\/em><\/strong> women, the public, journalists, and others about the value of physiological birth processes for the health of women and newborns.<\/em><\/strong><\/li>\n<\/ol>\n
Zadok (2016), in her preparation of couples for birth, uses a board where participants write down associations related to birth. Positive words like child, expectation, and blessing appear on the board. But more typical are words like pain, fear, loss of control, and death. These associations stem from childhood, as birth is always presented to us as suffering, and the media portrays it that way. Awareness, humility, patience, and dedication are four interconnected elements that help women in birth preparation start trusting their bodies and gain appropriate knowledge and confidence. A woman who does not feel safe or perceives danger will likely have a long and painful birth. We healthcare workers are the ones who must enable women in the delivery room to feel safe and trust us. Support and a sense of security make birth faster. Fear and anxiety, however, slow it down and make it more painful. During birth, emotions and the environment influence the secretion of hormones that have a major impact on labor. A woman who does not feel safe will secrete a lot of adrenaline; birth will therefore be slow and painful. Muscles contract under the influence of adrenaline, and all energy goes to our limbs. The body is also more sensitive to pain. Adrenaline secretion helps us avoid danger, and we must ensure that as little as possible is secreted during birth. A woman who feels safe in the environment where she is giving birth will secrete oxytocin and endorphins, which will help her labor progress beautifully. Muscles are relaxed under the influence of these hormones, and energy is sent to the uterus, which further increases oxytocin secretion (Durham, 2016). To prevent adrenaline secretion in the delivery room, we must ensure that the woman feels safe, loved, and protected, that she has a sense of control and people by her side who offer support. We must also provide her with privacy. <\/p>\n
Until about the 16th century, what happened regarding childbirth did not differ much between nations and cultures. We can infer about birth far back in history mainly from preserved figurines, paintings, and traditions. Most often, laboring women are shown giving birth in any of the upright positions and being supported. The hieroglyph meaning to give birth represents a squatting woman. Until the mid-18th century, the use of a birth chair was very widespread. Women most often gave birth in a home, familiar environment, surrounded by other experienced women. One among them had the role of a midwife. Midwifery knowledge traveled from generation to generation, mostly through oral tradition. Unfortunately, at that time, despite having more experience than other women, midwives often did not have enough knowledge to ensure the survival of the mother and child, especially when a perinatal complication arose. They were completely helpless when the baby got stuck due to a wrong position and the mother could not push it out herself (Hrovat-Kuhar, 1995). Mortality for both laboring women and newborns was very high. Mothers also died in large numbers from the consequences of preeclampsia, heavy bleeding, and postpartum fever. Conditions for childbirth improved rapidly with the development of medical science, but they also brought a changed birth position (Wagner, 2008). To give those helping at the birth a better view, laboring women had to lie on a bed. This was also necessary due to the use of a new invention \u2013 forceps, which helped many babies into the world. The lying, passive position became firmly established in the 19th century. From then on, all laboring women lay down, not just those who needed an intervention (Hrovat-Kuhar, 1995). <\/p>\n
![\"givingbirth-ancient-egypt\"](\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\")
<\/p>\nPhoto 1<\/a> and Photo 2 <\/a> <\/p>\n
Michel Odent is an obstetrician who dares to speak out loud about the importance of skin-to-skin contact after birth, breastfeeding in the first hour after birth, and how important it is for birth to be as natural as possible. Many consider him controversial because of this. It is hard to agree that he is controversial in the eyes of midwives. In his book Do we need midwives?, he talks about how the increased medicalization of birth means that women are losing the ability to give birth, which has potential harm for humanity. It is a rhetorical question. What is the role of the midwife in a world of medicalized birth? In an interview for The Telegraph, he says the ideal scenario for birth is a quiet, dark, warm space, with a companion and a midwife who understands the physiology of birth and the woman’s needs. Melatonin, or the sleep hormone, plays an important role in the birthing process, which was discovered in July 2014, so any light in the delivery room is disruptive. This is the complete antithesis of most births in maternity hospitals, which too often involve overly bright, overcrowded delivery rooms, insufficient staff, and hectic environments. All this threatens the natural process of birth, which is why births are too often completed operatively (with the help of vacuum or C-section) (Woods, 2015). <\/p>\n
To change birth practice globally, we must approach the matter systematically:<\/strong><\/p>\n
– the more people are exposed to relevant information about midwifery and gentle birth, the more they will take it as the norm;<\/em><\/p>\n
– attitudes are formed in childhood, so we must ensure that children are exposed to these ideas;<\/em><\/p>\n
– experiences influence change: if we encourage people to try something themselves, it is much more effective than just telling them about it;<\/em><\/p>\n
– we must be impartial when providing information, as this will make us more credible;<\/em><\/p>\n
– it is necessary to talk about birth with partners, parents, grandparents, and everyone involved in the birthing process, not just the woman, as these people influence her decisions;<\/em><\/p>\n
– reflecting on past decisions and their outcomes helps us think more logically about why something happened and reduces the possibility of wrong assumptions (Wickham, 2000).<\/em><\/p>\n
If we want to provide quality midwifery care, we must design protocols rationally, reasonably, and based on findings and research, so that we do what is best for mothers and newborns. We must design them together with the users of our care. <\/p>\n
Read more:<\/p>\n
The Wisdom of Childbirth – Michel Odent<\/a><\/strong><\/p>\n
- Support the quality of work of everyone involved in the birth process, support initiatives to improve the quality of maternal and child care and for physiological processes in healthy women and newborns and, when safe, in those with special needs. <\/em><\/strong>In the continuation of the master’s thesis, it will be stated why it is important to routinely enable skin-to-skin contact even during C-sections or, if the mother is unable, to enable this for the father. <\/li>\n
- Neonatal mortality<\/u> is an indicator of the accessibility and quality of healthcare in general. In Slovenia, it is among the lowest in OECD countries, at 1.6 neonatal deaths per thousand live births. Slovenia also ranks among the more successful countries regarding maternal mortality<\/u> in the period from 2009 to 2011 (the three-year average rate is 1.5 maternal deaths per 100,000 live births). <\/li>\n
![\"givingbirth-ancient-egypt\"](\"https:\/\/mojababica.si\/noviteta\/wp-content\/uploads\/2025\/07\/givingbirth-ancient-egypt.jpg\")
![\"9c4036d7b19078cd244d61d255609c85\"](\"https:\/\/mojababica.si\/noviteta\/wp-content\/uploads\/2025\/07\/9c4036d7b19078cd244d61d255609c85.jpg\")
<\/p>\n![Photo 1<\/a> and](\"https:\/\/s-media-cache-ak0.pinimg.com\/564x\/d4\/1e\/0a\/d41e0a466eb14ed0ddcf11695ab38c97.jpg\"){kind=link}
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