Two trends in middle-class birth in the United States.

This discussion focuses on two important trends in American childbirth that have emerged in the past 30 years, the demand for a perfect baby and the desire for a perfect birth. These two trends are particularly important in the subgroup of middle-class women who have decided on delayed childbearing. Tremendous technological innovations, such as ultra-sound, prenatal genetic analysis, and fetal monitoring, have promoted the perception that physicians can control the prenatal environment and predict the pregnancy outcome. This expectation may lead to bitterness and anger in the event of an adverse pregnancy outcome. In contrast, women and their families have also come to desire more control over the birth experience. If the parents' birth plan is not achieved and their expectations not fulfilled, many parents feel they have not performed well. When the physician acts as a guide in the birth process, parents and physicians together may transcend the conflict to achieve a more satisfactory birth experience.