Conscious Choices Lead to Less Intervention
Labor and delivery is a natural process that can be enjoyed. “It’s not something to be afraid of,” says Mel Campbell, author of The Yoga of Pregnancy. “It’s a wonderful and beautiful experience. We need to remember that the body is designed for giving birth.”
Natural childbirth uses few or no artificial medical interventions such as drugs, continuous fetal monitoring, forceps delivery or episiotomies (cuts to enlarge the vaginal opening). According to the U.S. Centers for Disease Control (CDC), 32.7 percent of deliveries were by Cesarean section in 2013—most performed in situations where a vaginal birth would have posed a relatively low risk to the health of mother and child. Entirely natural childbirth is now rare here compared with other countries, but that wasn’t always the case.
In 1900, 95 percent of all U.S. births took place in the home; when more moved to hospitals here in the early 20th century, midwives still typically handled the delivery in other countries, sometimes without a doctor present. In America, obstetrics became a profession and a doctor-attended birth in a hospital was promoted as a safer alternative. By 1938, half of domestic births took place in hospitals, and by 1960 it rose to 97 percent. Currently, midwives attend less than 8 percent of births here, and fewer than 1 percent occur outside a hospital.
Natural labor and delivery in a hospital is possible, but, “It’s hard to have an unmedicated birth in many hospitals if you don’t know your rights, understand your physiology and have a doula by your side helping you avoid unnecessary interventions,” says Ina May Gaskin, a pioneering midwife and author of Ina May’s Guide to Childbirth. Key factors to discuss include fetal monitoring, intravenous tubes and the option to eat or drink during labor.
Benefits of Home Births
Women choose home births and homey birthing centers because they labor there more comfortably, feel more in control of the process and can more easily avoid interventions. Many moms seek out a midwife’s services because they don’t want to repeat the conventional hospital experience that accompanied their first baby’s arrival.
Most births should be viewed as a natural life process instead of a potential medical emergency.
~Abby Epstein, The Business of Being Born
When actress Ricki Lake gave birth to her second child in her home bathtub with the assistance of a midwife, she felt empowered by doing it on her own terms. “Giving birth wasn’t an illness, something that needed to be numbed. It was something to be experienced,” she says.
When women let their bodies naturally lead, labor can last as little as 20 minutes or as long as two weeks, and the spectrum of pain intensity is equally broad. A healthy prenatal lifestyle that prepares a mom-to-be for a natural physical, emotional and spiritual experience of childbirth is highly beneficial.
“Pregnancy’s not the time to overexert yourself; let go of the temptation to overachieve and instead practice breathing and mindfulness,” advises Campbell. “If you’re experiencing morning sickness, try to embrace it and how it serves you. By doing so, you’ll be more in tune with your body. These lessons are gifts you can take with you into labor.”
By 2006 Cesarean delivery was the number one surgical procedure in American hospitals.
~U.S. Centers for Disease Control
She reminds women that the baby is always getting nourishment from all that mom eats and breathes in, and also feeds off of her feelings and emotions. “The more we can feel at peace with ourselves and incorporate the baby into our being, the more we feel a connection and union,” she says. “It’s vital that you let your body’s innate wisdom be your guide and respect any cues it may give.”
Campbell guides expectant mothers through a yoga practice that embraces the changes occurring each trimester. For example, a more physical practice in the second trimester utilizes the surge of energy to build stamina and strength, while opening the heart, hips and pelvis.
Complementary relaxation techniques for labor include breathing practices, visualization, meditation and massage. When a mother isn’t connected to monitors and tubes, she’s free to experiment with positions and props such as balls, bars and pillows, plus a warm shower or bath. If a hospital birth is planned, Gaskin notes that labor often slows once a woman leaves the comfort of home, and recommends laboring at home as long as possible.
There is a great deal of fear and ignorance about allowing labor and birth to proceed without disturbance. Rates of routine intervention are so high, most nurses and physicians rarely see a fully natural birth.
~Ina May Gaskin
There is no way to predict the course of labor and delivery when women let nature take the lead. Campbell, a mother of three, says, “I tried to focus on the intention of what I wanted for my birthing experience, while also surrendering expectations, knowing that I would have whatever type of birth I was supposed to have.” She adds, “The breath is the most important thing—it keeps us in the moment, helps us to relax and supports us through labor.”
While the home birth option is important to America’s new generation of trailblazing women, it’s also significant on a macro level. Gaskin explains, “It’s hard for staff to change routine practices in hospitals but home births make innovation possible.” Home births demonstrated that women don’t require routine episiotomies and have shown how maternal mobility and position changes can help labor progress and free badly stuck babies (earlier methods often injured mother and child).
Gaskin has found, “Wherever and however you decide to give birth, your experience will impact your emotions, mind, body and spirit for the rest of your life. No one should have a home birth who doesn’t want one, but it must be one of the choices.”
Meredith Montgomery publishes Natural Awakenings of Mobile/Baldwin, AL (HealthyLivingHealthyPlanet.com).
A Mother’s Guide to Natural Childbirth
BY MEREDITH MONTGOMERY
Determining the best birth setting for a mother necessitates sound planning. If an unmedicated birth is a goal, these insights may help in making decisions.
Home birth takes place in the comfort of home, typically with the assistance of a midwife, and is suitable for a healthy woman with a low-risk pregnancy. She is able to wear her own clothing and eat as she pleases. Because monitoring of mother and baby is done intermittently, she is free to move around.
Confirm the midwife’s training and experience; ask how many home births she’s attended and which obstetricians she consults. Discuss the signs and symptoms that might necessitate a move to the hospital and how quickly it can be done. While a midwife’s fee is often far less than the cost of a hospital birth, not all insurance companies cover home births.
A birth center provides personalized, family-centered care in a homelike environment for healthy women. Practitioners follow principles of problem prevention, sensitivity, safety, appropriate medical intervention and cost-effectiveness. A midwife typically delivers the baby, but the collaborative practice team also includes obstetricians, pediatricians and other specialists. Mothers experience personal freedoms similar to a home birth, and tubs for water births are usually available, plus other birthing props such as squatting bars, stools and balls.
The center should be accredited by the Commission for Accreditation of Birth Centers. Inquire what the protocol for care will be if complications arise, learn what the center’s charges for care cover and confirm if the family’s insurance policy will pay for the services provided.
A hospital generally has access to the latest medical technology, making it a preferred option for medium-to-high-risk pregnancies. With proper preparations, an unmedicated birth is possible in this traditional setting. Investigate their rates of Cesarean births and episiotomies and the determining parameters.
To allow for an active labor, request intermittent fetal monitoring, avoid intravenous fluids and ask about the availability of birthing props. Become familiar with hospital policies, such as who can be in the delivery room and whether the baby will stay with mom after the birth. If a nurse midwife is not on staff, consider hiring a doula to assist in preparing for and carrying out the family’s birth plan.
Conscious Childbirth Resources
The Yoga of Pregnancy Week by Week: Connect With Your Unborn Child through Mind, Body and Breath
by Mel Campbell
Natural Hospital Birth: The Best of Both Worlds
by Cynthia Gabriel
Ina May’s Guide to Childbirth
by Ina May Gaskin
by Ina May Gaskin
Your Best Birth
by Ricki Lake and Abby Epstein
The Business of Being Born
a film by Ricki Lake and Abby Epstein
Mothering Magazine’s Having a Baby, Naturally
by Peggy O’Mara