Preparing for the Active Natural Childbirth Step by Step eTech Guide 2021
The best training for any sort of hard work is to get fit – super-fit sports women usually have easy and trouble-free labours and natural childbirths. This is in part because they are familiar with the limits to which they can take their bodies.
They feel in control and, having crossed the pain threshold many times during training, are not frightened by the pain they now experience in labour. They remain relaxed and alert and do not panic, and this has the effect of greatly reducing any pain, in that pain is exacerbated by fear and tension. Certainly, therefore, the best training for the hard, physical labour of giving birth is to get fit before pregnancy.
Where You Will Have Your Baby
It should be emphasized, however, that any pregnant woman who attempts a regime of aerobic-type exercises (even if she has previously done so with no ill effects) may put herself and her baby at risk. Gentle relaxation and stretching exercises are ideal. Also, if you have any medical problems you would be wise to discuss the question of appropriate exercise with your obstetrician before you begin.
The specific training for labour, so that the mother is familiar with her own body and what she is going to experience, should begin at least 10 weeks before her baby is due. There are excellent courses run by the National Childbirth Trust, but many large hospitals organize free classes for both mothers and fathers.
Your Choices in Childbirth
When you are planning a pregnancy you have to make three basic decisions:
- Where will you have your baby?
- Which specific training do you wish to do for labor and natural childbirth?
- Which type of analgesic or anaesthesia may you need during labour and natural childbirth?
When you will have your baby While the choice is basically between having your baby at home or in the hospital there are other options: finding a birth centre (these are now being set up in some areas) or opting for ‘shared care’ where your doctor and midwives attend to you in a unit which is part of a maternity wing in the hospital.
Home Confinement A recent study, conducted in the Oxfordshire area, found that 92 per cent of the women questioned would choose to have their babies in the familiar surroundings of their own homes. Since the mechanization of childbirth in the 1950s and the accompanying increase in medical control, most births have taken place in hospitals where doctors often have charge rather than the mother.
While many women fully intend, at the onset of pregnancy, to opt for a home confinement they are often dissuaded: sometimes for medical reasons, but very often, because of the disinclination of their own doctor. However, the situation is changing and mothers-to-be are having a greater say.
A very positive aspect of home delivery is that natural childbirth becomes a social event with your partner, members of your family, and friends giving you help and encouragement in your labor. However, home confinement will almost certainly be inadvisable if you fall into any of the following categories:
- If you have previously had an abnormal labour.
- If you are under 17 or over 42 (in which case the chances of needing a Caesarian section are between 50 and 60 per cent).
- If you have already had four pregnancies (often the first is also considered more risky).
- If you are under-nourished, over-tired, or not in good health.
Practical help and advice on arranging a home confinement can be obtained from both the Maternity Alliance and the Association of Radical Midwives.
A good alternative to giving birth at home is to find a birth centre. The staff are predominantly female and the atmosphere aims to be as ‘homely’ as possible. While everything is done to ensure that the woman in labour is having a happy, social time, back-up services are on hand.
Hospital birth: The overwhelming majority of pregnant women give natural childbirth in a hospital; one particularly positive aspect of hospital confinement, compared to home, is the definite protocol and acceptance of the fact of birth – even in the most enlightened family the reaction of other members of the family to the labouring pregnant woman can be upsetting.
But as far as choosing the hospital goes, there is no substitute for good local information: consult your friends and neighbours about their experiences and ask your doctor’s advice. While you do have the right of referral to any hospital you choose, bear in mind such practical considerations as its location – a long bus or car journey for antenatal visits could be very inconvenient.
The most important thing about having your baby in hospital is to make sure you have somebody with you – your partner, a woman friend or a member of your family – to give you help and encouragement. While everyone in the obstetric team is generally prepared to do their utmost for you and your baby, their overriding concern will be for the baby and so it is important to have someone there concentrating on your needs and helping you decide on suggested procedures.
Having your baby in the hospital may well ensure a pain-free labour because of the availability of anaesthetics; additionally, sich measures as monitoring of the baby’s heart-beat will take place. You may well be given intravenous fluids to stop you from becoming dehydrated and to keep your strength up during labour, and these can be very helpful.
In a rare emergency – for example, extreme fatigue on the part of the pregnant mother or the baby – there is the possibility of a Caesarian section.
A variation on hospital birth that is increasingly available is ‘shared care’ where you are looked after by midwives together with your own, or another, doctor. Labour and delivery take place in hospital, with all the back-up facilities; because your doctor knows your whole circumstances, you and your baby – if there are no complications – may be allowed home after six hours.
The philosophy behind this care is less reliant on technology and routine procedure; inductions are rarely performed, but, should there be an emergency, all the facilities of the hospital are available. Over and above deciding on any particular method for giving birth is the importance of establishing understanding and trust between mother, father (or whoever will be with you at the birth) and the midwife and obstetrician. This is fundamental to the essentially cooperative nature of the birth process and sets the scene for a positive experience.
How You Will Have Your Baby?
Natural Childbirth This is a birth unimpeded by drugs or machinery of any sort. However, natural childbirth when the pregnant mother’s pelvis is too small or where the baby is in a wrong and potentially dangerous position could result in the death of both mother and baby. It is important for all mothers who decide that they wish to remain in control of their labours to understand exactly what the risks are for them and their babies.
Some hospitals encourage this method, some do not. In those that do, there will be all the necessary equipment standing by just in case anything should go wrong. At King’s College Hospital, in London, of the 40% of patients who elect for natural childbirth, only about a quarter of them actually go through with it.
But in Glasgow, where the maternity wing is run by midwives practically all of whom are women, natural childbirth is a truly cooperative venture; about 50 per cent of mothers opt for natural childbirth and about 70% of them can complete the birth in this way.
Much depends on the previous experience of the doctors and the midwives, and whether they can be happy taking part in a cooperative birth or feel that they need to be in control at all times. A study of maternal deaths in any Western country shows that giving birth is not always a benign and serene and safe process for either mother or baby, but certainly, for well over 80% of women in Britain, this is the case.
Active Childbirth simply involves undertaking a training programme for contraction awareness and control so that the delivery happens in the optimum time without side effects on you or your baby. Advocates of active childbirth recommend standing, kneeling or squatting to relieve the pain of labour.
The theory overlaps with that of natural childbirth, both of which emphasize the active participation of the pregnant woman and her partner during labour and delivery. It is advisable training for all pregnant women and if your hospital does not provide them, seek out good antenatal classes through the Maternity Alliance or National Childbirth Trust.
Leboyer Method of Natural Childbirth
Leboyer believes that the first, anguished cry of the newborn often provoked by a slap on the back from a midwife or obstetrician, is entirely unnecessary. It is, he claims, the terrified protest of a bewildered and exhausted baby, for whom birth is quite difficult and momentous enough without the accompaniment of loud voices, bright lights, cold hands and steely equipment, and above all, insensitive handling by medical staff.
The Leboyer method of delivery uses every technique to reduce stress to mother and child: soft, dimmed lights and a warm, cosy atmosphere where staff talk in whispers or work in total silence. When the baby is born, it is immediately placed gently on the mother’s abdomen.
And, contrary to regular hospital practice, the umbilical cord is not cut straight away – which act, Leboyer maintains, provokes in the baby a terrifying sense of imminent suffocation and death, hence the first gasping inhalation and wail fo anguish. Instead, the cord is allowed to continue pulsating (sometimes for as long as five minutes or more) until the natural switchover mechanism from cord to lungs takes place of its own accord.
Michel Odent Method of Natural ChildBirth
By June 1983, Michel Odent, chief obstetrician at Pithiviers Hospital in France, had conducted his one-hundredth delivery underwater. His birthing pool has now become well known and is being tried elsewhere, but is still difficult to find in this country.
Akin to Leboyer in his attitudes regarding the importance of the birth experience for child and mother, and the warm, reassuring atmosphere that should surround the event, Odent does not advise but offers his pool to mothers as something they might like to try during labour. The temperature of the water is 37 C (98 F) and the dimensions of the pool are two meters (six and a half feet) in diameter and deep enough to allow the pregnant woman to change position as she may wish.
Odent believes that the pool facilitates the first stage of labour because of the reduced secretion of noradrenaline and other catecholamines by this method. Also, the effect of water on the nerves, the muscles and vascular action is to help to ease any tension, pressure or pain the pregnant woman might be experiencing. On a psychological level, he has found that even just seeing and hearing the water affects the pregnant woman’s inhibitions and anxiety, relaxing her and encouraging her to cry out and go with her contractions.
Most of the natural childbirths do not actually happen underwater but some do. There is no danger whatever to the infant, however, because the first inhalation and cry are triggered by contact with air. The mother gives natural childbirth in a kneeling position and the newborn child is placed immediately in her arms, allowing instant eye and touch contact.
Contrary to current popular practice, however, Odent does not encourage the father to be present at the natural childbirth. He believes childbirth is a female experience and that an anxious father may well transmit his nerves to the already labouring mother.
Every pregnant woman hopes that her baby will be born within a few hours and with no complications, and natural childbirth. However, every mother-to-be should be aware of the difficulties which can occur and how she and her partner, her midwife and her doctor, can make the best decisions, and make them all the right time so that her baby is born healthy.
For a hospital childbirth, when you first visit the hospital where your baby is to be born, an experienced midwife will show you the labour bed, the labour chair and/or the labour pool. She will discuss your preferences and will probably give you a leaflet detailing the various methods of obtaining pain relief in labour. On this latter consideration, Professor Norman Morris of the Charing Cross Hospital has a very useful and encouraging piece of advice to offer: ‘Just remember you will only have one labour paint at a time and most people can cope with one of anything at a time.’
Gas and Air Machine: You and your partner will both be taught how to use this gas and air machine before labour.
Injections of analgesic drugs: These are individually calculated for each pregnant woman and are administered by the midwife.
Epidural anaesthesia: Midway through your pregnancy you and your obstetrician will discuss what type of analgesic you may prefer and most centres will now provide epidurals if needed. In your discussion with the obstetrician, ask for an explanation of the possible complications, all of which can be remedied providing that you have the immediate, skilled attention of the anaesthetist. Check if you have an epidural you will also have this skilled monitoring available.
The epidural is administered vial a small plastic tube, inserted close by, but not into the spinal canal. An anaesthetic dose is administered half-way through labour and topped up by the midwife as needed. An epidural numbs only the area of the body causing pain, and leaves the mother alert and able to participate actively in the natural childbirth.
An article on Women’s Health: 8th March 2021 on Women’s Day 2021.
Next Article: Pregnancy; Natural Childbirth, Pregnant Woman, Labour and Delivery Process