In a time when one in three women are having major abdominal surgery to give birth, the question arises as how should expecting women attempt to birth vaginally? Examining a recent study conducted on the impact of vaginal and caesarean births on children’s health, the rate of spontaneous vaginal birth for nearly 500,000 women was 38%.
How can it be that only 38% of women are birthing physiologically - meaning vaginally without any interventions or pain meds of any kind, without induction? With all the advancements and state of the art technology currently available for birthing women in Western developed countries, how has this become the norm? The reality is we have an excessive use of medical procedures. Interventions, in an otherwise complication-free, low-risk healthy labour and birth, lead to complications. This is known as the iatrogenic effect. Technology isn’t saving healthy babies and mothers but doing harm. What was once beneficial is proving to create problems. This is not to say that caesareans aren’t life saving, but caeserean birth rates are far higher than necessary. The World Health Organization states that caesarean rates shouldn’t exceed 10-15%.
With this drastic reduction in normal physiologic birth, care providers recognize the impact on a mother’s and newborn’s health, both in the short and long term. Research continues to show the detrimental effects connected with the unrestrained use of medical technology during healthy labours. Maternal health professionals are well aware of the outcomes and attempts are being made to reduce interventions, inductions and caesarean sections. Yet rates continue to climb. The caesarean rate in the Lower Mainland reported by Fraser Health is at 40%.
sources: 1, 2, 3.
Many birthers now expect medical interventions. Hearing other birthers’ stories, with one in three of their friends, co-workers or family members having caesareans, they believe this to be a very likely possibility for themselves. This is termed the nocebo effect.
So, what can be done to optimize a normal vaginal birth? First, what are the benefits to birthing physiologically for mother and baby?
improved satisfaction with birth experience
minimal postpartum pain
quick recovery from the birth
reduced likelihood of postpartum depression
improved maternal-infant attachment
empowering; creates a feeling of being invincible and powerful, buildds confidence & self-esteem
babies are alert & show interest in breastfeeding; no disruption or delay in initiating feeding
effective respiratory transition for the baby
effective gut colonization that helps to prevents auto-immune disorders such as allergies, asthma, etc in the baby
reduced likelihood of iatrogenic harms to baby corelated with interventions
brain development: natural childbirth triggers the release of a protein in a newborn’s brain that improves brain development and function in adulthood. This protein (UCP2), which regulates behaviors related to memory, learning, spatial awareness and stress response, is released as the hippocampus is stimulated in the birth canal (not in caesarean birth)
What exactly does physiologic birth mean?
spontaneous onset & progression of labour
biological and psychological conditions that promote effective labour
vaginal birth of the infant and placenta
normal blood loss (500 ml)
facilitates optimal newborn transition (skin to skin contact) and keeping the mother and infant together in first hours post birth
early initiation of breastfeeding
'The hormonal physiology of childbearing has evolved over millions of years to optimize reproductive success. There’s a cascade of hormones occurring in birth that optimize survival for mother and baby, promotes successful breastfeeding, and initiates secure bonding. An optimal hormonal orchestration provides ease, pleasure, and safety during this time for mother and baby.’
‘Undisturbed birth represents the smoothest hormonal orchestration of the birth process, and therefore the easiest transition possible; physiologically, hormonally, psychologically, and emotionally, from pregnancy and birth to new motherhood and lactation.’
source: Sarah Buckley, MD
Report on Hormonal Physiology of Childbirth
Recognizing the benefits of physiologic birth, how can you optimize one? Some women choose to give birth naturally because they love the challenge. Others find great satisfaction in working hard and “getting the job done.” Many women are eager to avoid anything that might harm their babies or themselves. But the most compelling reason to choose natural childbirth is a universal one. Women know how to give birth without machines, epidurals, and fear. Why natural childbirth? The more important question might be “Why not?”
‘Choosing to give birth naturally does not mean that interventions will not be needed or that complications will not occur. Nature's plan for birth includes pleas for help when help is needed. Choosing natural childbirth means that women prepare for the birth of their babies confident in their own ability to give birth, being willing to feel contractions, and finding comfort in response to what they are feeling. It means that they will be surrounded by family, friends, and professionals who will encourage them to trust their inner wisdom. It means that wherever they give birth—hospital or home—they will have the freedom they need to respond to their contractions.’
source: "Why Natural Childbirth?"
Journal of Perinatal Education
The Doulas of Vancouver asked their clients to share their tips for how they prepared for a natural birth experience. Below are their gems of wisdom!
During your Birthing Time
Right support team.
People whom I could trust would keep me and my baby safe so I could let go (my partner, my mom, my doula, and the midwife were so important to me).
When I hit that scary moment where I was like “I can’t do this,” my doula was beside me, calm and supportive saying “You can, you are doing it.”
Music, dim lights, aromatherapy.
Our doula arrived and immediately helped me get the lights dimmed and set a calm, dark, peaceful environment. She was instrumental in helping our living room feel like a sacred space.
Being at home.
Being in my own home, knowing I didn't have to get into a car at any point and go to a hospital really helped me. Of course I was happy to know that should the need arise we had access to a really good hospital and I have heard many accounts of positive hospital experiences. Still for me, the safety and comfort of my home helped me a lot.
I think having a home birth is the best way to avoid unnecessary interventions. BC has amazing outcomes for home birth and midwives and doulas are so awesome!
If you are comfortable with it, try for a home birth, or at least labour at home as long as you can. At home you are in your own safe, comfortable space, with no restrictions on movement and eating, and only your chosen support people around you.
I had baths in the early labour phase and once the pool was set up I got to enjoy floating and soaking in the warm water. I can't describe how much water helped. It just felt amazing.
The hot water from the shower beating down on my back helped me to deal with the intensity of back labour.
I can’t imagine giving birth without a birthing pool. It takes the edge off contractions and allowed me to get rest between contractions. It helped me to feel comfortable and supported.
Freedom of movement.
In the safety of my home meant I could move however I wanted. I got to the point that I couldn't stay in the pool and have the water birth I had planned on because I just had to move.
My body instinctually moved in all sorts of ways that helped give me relief and helped move my labour along.
Eating & Drinking.
Drink labourade!! Making it is a great task to keep yourself occupied while you’re in pre-labour, and it is yummy and rejuvenating while you are in labour. I also find there is something comforting about drinking something I made as preparation
I liked fruit, nuts, snack balls, my electrolyte drink and cheese. It helped fuel my labour.
My team being my doula, my husband and two midwives were amazing at helping me when I needed help, being there for me, making gentle suggestions, but I was always running the show. No one gave me orders. They were just always there for me and it felt wonderful.
If you’d like to learn more, Debra Woods, one of the Doulas of Vancouver, teaches a very informative class, Ecstatic Birth Seminar, which incorporates preparation to birth naturally.
Preparation is paramount to protect natural birth. Education regarding the healthy instinctual process of labour and birth, the use of non-pharmacological comfort measures for pain relief, the continuous care of a birth doula, having ‘low intervention’ medical care providers such as midwives, who support physiologic birth, and choosing a low tech. low stress birth setting are all important aspects to consider, in order to optimize a natural birth experience. We hope your birth journey goes well and your experience is fulfilling and positive.
In the end I didn't have the tranquil, ecstatic birth I had read about. It was intense and at times it felt too intense to handle. But I wouldn't describe it as painful. I'm so happy I felt everything and was present for the journey. I wouldn't change a thing and can't wait for another home birth experience.
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