Almost 4 million babies are born in the United States each year. The infant mortality rate has dropped to about 7.6 deaths per 1,000 live births, although this remains higher than some other developed nations. Still, in the early twentieth century it was estimated that 35–40 percent of all American families experienced an early death. Today fewer than 1 in 10,000 dies in childbirth. Public health concerns, nonetheless, focus on increasing prenatal care and nutrition in at-risk populations like teen pregnancies or mothers dealing with substance abuse.

Most births occur in hospitals, but expectant parents have a variety of options from which to choose. One-stop birthing rooms have replaced many of the multi-stage, multistep labor, delivery and recovery units. These rooms create an environment that intends to make the birth experience more welcoming. Besides having all the technology and monitors of hospitals, other options include a jacuzzi or tub for those who want to be immersed while in labor and even delivery as well as kitchens and subdued lighting for the room. These environments also bring the father/ partner and other family members into the birth process.

Techniques of birth vary in American culture. Mothers often prepare themselves—with the help of their spouse or a birthing partner—through systems of training, usually focused on relaxation and breathing techniques. Such techniques, often named after the individuals who developed them, include the Lamaze, Bradley Odent, Kitzinger Psychosexual Approach and the Active Birth Method. Classes provide the instruction, support and education for the expectant parents.

Most Americans do not like to tolerate pain, so a variety of options exists to endure, avoid or manage the pain. For some, hypnosis, acupuncture, reflexology aromatherapy homeopathic remedies such as St. John’s wort and Bach flower, or water provide the relief sought. For others, medications ease the various stages of labor and delivery Narcotics such as Demerol and Stadol are common drugs provided, but they may affect the babies. Nitrous oxide or other inhalant anesthetics may be given during delivery More common are local anesthetics, in particular the epidural, an anesthetic injected into the space outside of the spinal cord’s outer membrane.

Home births with family members present and a doctor or a midwife attending as well as underwater births attract a number of pregnant Americans. Nevertheless, what American women demand are options in the birthing process.

The length a woman can stay in the hospital following a normal delivery however, has been a subject of intense debate. Gone are the days when new mothers would spend a week in the hospital for a vaginal delivery and two weeks for a Cesarean. Insurance companies, in particular managed-care organizations, dictate the length of stay following most births. It took a federal act to allow new mothers a 48-hour stay.