SingaporeMotherhood | Baby & Toddler
December 2011
Gearing Up For A Natural Birth
Birth conjures up different images for different people. The media and society send messages about how birth is difficult and painful. On the flipside however, more stories are emerging about how birth can be beautiful and serene. What is natural birth, and how can you set yourself up for one?
Defining ‘Natural Birth’
For some women, having a natural birth means having a vaginal birth regardless of whether other procedures are involved. For others, ‘natural’ birth refers to drug-free birth that may involve interventions such as artificially rupturing the water bag; yet others speak of natural birth as birth that is completely free of interventions.
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Shaping Your Birth Experience
One important element to shaping your natural birth is to be aware of your own beliefs about your body’s design and the birth process. You are the key player in your birth drama, you bring your baby into the world. Your doctor is the lifeguard who will attend your birth and provide medical help if needed. It is not helpful to think that your doctor ‘delivers’ the baby; actually, you do!
1. Trust your body. Your body has been perfectly designed to sustain your baby through pregnancy, and to give birth. We live in a technological age and many of us have lost confidence in our bodies’ capabilities, believing that our bodies are somehow ‘inadequate’. Learn to trust in your body wisdom and your inner resources.
2. Trust in the age-old process of birth. Birth is a physiological process, coordinated by hormones and other biological systems working in synchrony.
Your Caregiver
Your doctor’s personal philosophy and attitudes towards birth interventions greatly influence whether and how quickly he recommends a procedure.
A doctor may have an expectant management approach towards birth, preferring to wait and watch for problems and intervening when a problem arises. A single intervention upsets your labour’s natural and hormonal rhythm, setting off the tendency for further interventions, in a snowball effect.
Alternatively, a doctor with an active management style would intervene as labour progresses, steering the labour towards a certain outcome, within fixed limits. In practice, a particular doctor will fall somewhere between either management style.
Expectantly-managed births tend to have fewer interventions. If you want a natural birth, choose a doctor who leans towards expectant care. Being cared for by someone who has similar expectations as yourself means that communication difficulties and disappointment with your birth are less likely.
LABOURING NATURALLY
The following are common labour scenarios that take place in hospitals all over the world. Read on for ways to manage them.
Common Labour Scenario #1: Baby’s late!
Faced with the discomforts of late pregnancy, you wonder about artificially inducing labour. Try not to. Triggering the start of labour usually begins a domino effect of interventions, leading to a medically-managed labour and birth. To ensure a natural birth, let labour begin spontaneously, and avoid procedures that are not medically necessary. Discuss options with your obgyn and ask for alternatives.
Common Labour Scenario #2: Coping with Contractions
You may not be able to stay completely calm and still during active labour. Nevertheless, maintaining a coping ritual that you repeat with every contraction may help you through labour. Your ritual could be a mental image, an affirmation, or a rhythmic movement such as swaying on a birth ball.
Common Labour Scenario #3: Positioning Yourself
The most common labouring positions in hospital have the mother lying on your back or semi-sitting. This prevents the mother’s tailbone from opening outwards to give the baby more space to descend. Other labour interventions such as induction, electronic fetal monitoring or intravenous fluids restrict your mobility and keep you in bed. Work with your caregiver to find a compromise that helps you remain mobile and facilitate labour progress. Staying upright and mobile can help your baby to descend more easily.
Common Labour Scenario #4: To Push Or Not?
In most births, when the mother reaches full cervical dilation, those around her will exhort her, cheerleader-style, to hold her breath, strain and push as hard as she can, for a fixed count or for as long as possible. This kind of pushing (also known as ‘purple pushing’) reflects the heightened sense of excitement in the delivery room, but is not in line with natural birth.
LABOURING IN STAGES
Coping With Labour Intensity: Staying Positive
Once labour has actually begun, you will probably feel contractions. Instead of pain, think of these labour sensations as rushes – your body is doing the work it needs to do for your baby to be born. In maternity care, contraction timings and cervical dilation are used to gauge labour progress. However, labour progress is more than numbers! In labour, your body is undergoing many changes in preparation for birth, many of which cannot be measured numerically.
Labour contractions are different from the pain of injury; they say “let go, your baby is coming…”. Instead of resisting every contraction, relax deeply through the rushes, and go with the rhythm of your labour.
You can also learn birth methods such as HypnoBirthing® and the Bradley Method®. These teach relaxation and breathing techniques, and offer approaches to labour that affirm natural birth.
Position & Mobility
Staying upright and moving around during labour encourages labour progress. Upright positions are gravity-enhancing. When upright, your baby’s head applies steady pressure onto the cervix, triggering effective contractions.
Certain positions also enlarge the pelvic cavity, allowing the baby to pass through more easily. In situations where the baby is positioned less favourably for birth, some positions allow him more room and maneuverability.
Pushing Your Baby Out
When you are in the second stage, and your baby is descending, gentle birth advocates suggest bearing down with your uterine contractions; adding your own energy to your body’s efforts enhances the effectiveness of contractions. Bear down spontaneously and work in tandem with your body!
BE INFORMED, PLAN YOUR BIRTH
Communicate with your doctor and those supporting you during birth about how you want the birthing phase to go. Do this before labour begins.
Doula and mother of five Catherine Soon shares, ‘”Be well-informed and empowered. Attend prenatal classes run by private companies and know that you have options.”
The knowledge and ideas you gain from reading up help you shape your goals for your birth. From there, you are able to create a birth plan to outline your preferences and wishes. Your birth plan is a fluid, work-in-progress. As you clarify and discuss ideas with your doctor and birth team, be flexible and prepared to write a few drafts.
For those who may not meet you before labour begins, your birth plan highlights your individual preferences. This is particularly crucial if you wish to have a labour that is different from the usual hospital labour.
Labour Support
Many mothers who had natural births say that the presence of continuous emotional and psychological support in labour was the biggest factor that contributed to them having a natural birth.
As you plan your natural birth, bear in mind that how you approach labour, the choices you make at every crossroad in labour, and how you give birth, are influenced by your attitude. As Samantha, homebirth mother to three children, says, “Get in the mindset that you WILL have a natural birth, not simply TRY for a natural birth.”
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