Eight years ago, when the first edition of this book was published, we told you that the two trends in childbirth were moving in opposing directions. They still are. One trend is the growing number of hospitals providing homelike accommodations, including Jacuzzis and microwaves, plus the more than 140 out-of-hospital birth centers (with more than 40 in the works), which numbered in the dozens only a few years ago.

The other trend is high-tech childbirth. We've had routine IVs, labor induction, and Cesareans for years. Now there's a growing emphasis on tests and procedures of all kinds. It starts early in many parts of the country, with pregnant women of all ages being encouraged to undergo prenatal testing. It continues with the use of the electronic fetal monitor (EFM) during labor for 75 percent of women (and before labor for some), as well as the ubiquitous ultrasound offered routinely in at least three ways (scans, Dopplers, and external EFMs).

And in the last eight years, the Cesarean rate has increased from one in five births to nearly one in four. However, the good news about Cesareans is that the rate has begun to drop, due primarily to the increase in the number of vaginal births after previous Cesareans (VBAC).

What about homebirths, the defenders of all-natural, no-interference pregnancies? They have shrunk even more in the last eight years from 2 to 3 percent of all births to less than one percent today, according to a 1991 report from the National Center for Health Statistics. However, high tech is present in some homebirths, too, with the use of the Doppler instead of the traditional low-tech fetoscope. (Both are hand-held devices used to listen to the fetal heart tones, but the fetoscope doesn't use ultrasound.)

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