Our personal birthing plans cannot compete with the fads and fashions that dominate the delivery suite. Only one thing has remained the same in birth - it is the doctor who is in control, writes Deirdre Veldon.
Childbirth is devilish tough. Humans find giving birth exceptionally gruelling; we are the only mammals who instinctively look for help when giving birth.
We have only ourselves to blame. If we hadn't insisted on walking upright and producing smarter babies, we might have found the whole business a little less arduous.
To allow us walk erect, the pelvis became more compact. Our babies now not only have to pass through a narrower space, but must also rotate as they emerge. To further complicate matters, the large skulls we've developed to house our superior intelligence won't fit, so they need to emerge at a relatively immature, soft stage and fuse later.
That's why our infants are born "altricial", or helpless, and require extended parental care, compared with other species whose offspring are able to walk within minutes of being born.
And it's an ongoing battle. Head size might be inclined to grow further in the evolutionary scheme of things, but nature needs to keep it in check, so we can continue to stand up.
American anthropologist Wenda Trevathan remarks: "The result of these conflicting requirements is a species with obstetrical problems and mortality related to birth that is rare among undomesticated animal species."
Aha. So that's what all that huffing, puffing and screaming is all about. Not since a camel was expected to slide through the eye of a needle have we made things so hard for ourselves.
Small wonder then we've gone to such supreme lengths to take the labour out of childbirth. It's something less of a wonder to discover that many of these efforts have had exactly the opposite effect.
To ease delivery, (for whom, you'd have to ask) over the centuries, women have been knocked out, strapped down, stirruped up and had their innards explored with a slew of gruesome gadgets, according to vogue.
In this engaging history of childbirth, Birth, The Surprising History of How We Are Born, Tina Cassidy delves into many of the fads and fashions that dominated the delivery suite, be it the hut, the home or the hospital. She reminds us how quickly new trends become the norm and how birth customs flip-flop overnight, it seems.
Take, for example, the fact that 100 years ago, all women gave birth at home, whereas by the mid-1950s deliveries took place almost exclusively in hospitals.
At one time, midwives reigned supreme in the birthplace. However, their numbers were decimated through witch hunts by those in fear of their awesome sway over life and death. Between 1560 and 1660, up to 200,000 "witches" were tried in Europe.
Half of these were killed. Those targeted weren't all midwives, but by virtue of being older, independent workers, these women fit the profile. About this time, midwives started to be displaced by physicians.
By 1900 in the US, midwifery had lost half its base to doctors.
The medicalisation of childbirth created a nice revenue source for doctors, but it wasn't without its own problems. Hospitals were rife with deadly childbirth fever, or puerperal sepsis, until the mid-20th century, because doctors didn't wash their hands. They simply didn't know they should.
While this omission was killing thousands annually - up to 20 per cent of patients in some hospitals - massive interventions were being practised elsewhere.
Cassidy cites the "system" of a Dr William Goodnell of Philadelphia in the late 19th century. He administered advance doses of quinine - considered an all-purpose preventive - with drugs for constipation, sleeplessness and headaches.
When labour began, the woman would be given an enema and a bath; the doctor then ruptured the amniotic sac, applied forceps, gave the woman ergot to intensify contractions and reduce blood loss.
In the course of her research, Cassidy found a veritable torture chamber of macabre obstetric instruments from large crochet hooks, to craniotomy tools designed to crush or perforate a baby's skull, to the more destructive forerunners of today's forceps. She describes the operation of these instruments with some relish.
The undercurrent here, and throughout Cassidy's book, is that through the ages (mainly male) doctors have used tools and myriad other devices to make their jobs easier.
She writes that before doctors arrived on the scene, women rarely lay on their backs to give birth. Once medics were involved, it was difficult to insist on adopting any other position.
One of the headline childbirth issues - pain relief - has attracted, and often defeated, the most brilliant medical minds of the past few centuries.
Chewing willow bark, drinking whiskey, inhaling ether and chloroform - the latter tested and endorsed by Queen Victoria on the birth of her eighth child - gave way to Twilight Sleep in the early 1900s.
This involved administering a combination of the amnesiac scopolamine with morphine to women in labour, who would fall into a semi-conscious state and remember nothing of the birth. Later came the mighty epidural; tricky, but oh so effective.
Nowadays, with maternal and neonatal mortality levels tiny in most developed countries, we are more likely to be concerned with creating the "perfect birth experience" than our survival.
So we busy ourselves with talk of birth plans, "taking control" and ante-natal classes.
We mull over epidural versus "natural", whether hypnosis or electric currents work better and if Caesarean is an option. We take time choosing music and oils for the delivery suite.
Yet, when the contractions begin, we're happy to put ourselves in the hands of our helpers, just as women have done since ancient times.
Birth, The Surprising History of How We Are Born, Tina Cassidy, Chatto and Windus, London, €19.10.