So, you’re thinking about the big day. Hoping for a ‘natural’ birth experience, yet for any number of reasons, a home birth is not an option and you’re wondering if this is even a possibility for you. Maybe the ‘natural’ birth visions ingrained in your mind are of hippies dancing around the mom-to-be in fields of sunflowers. A hospital is where you will be delivering, like so many in this country. Yes, even for you, a ‘natural’ birth can be in your future. Maybe you’re excited and looking forward to the event, or more likely, you’re on the spectrum of scared. Maybe just a bit; or even all out, “OMG! How am I going to do this?” This is completely natural and normal; so don’t fret.
The rates of C-sections are steadily climbing, and with a national rate at higher than 30% of women having sections; this is a real concern for many. Lots of factors have been sited for this high rate including: lessening support systems for women to birth vaginally (like continuous labor support or ideal positioning and movement during labor), various medical interventions (such as the use of Pitocin), the rush for many to ‘just section’, today’s legal/medical landscape which forces doctors to practice ‘defensive medicine’ in an attempt to avoid law suits, or the increasing belief that C-sections are safe and without risks. Even in light of all this, there are ways to help your chances of avoiding one.
With the epidural rate in the 90 percentile for some regions, it may seem impossible to not have epidural pain relief. Hold on. Trust me, it isn’t impossible. Whether your hope is to labor drug free or to hold off ‘as long as possible’ here are some tips to help the odds of achieving your birth plan and getting what you want for your BIG day. (If I can do it, anyone can! For my third birth, I finally got to have my dream drug free experience, even after being induced with Pitocin.) You may have noticed ‘natural’ (in quotes), this is because there is no one correct way to have a natural birth experience. Everyone differs and everyone’s needs and desires for their day is different.
Before the Big Day- Tips to Help You Get What You Want:
- Educate yourself. You need to be knowledgeable about what you want for the baby’s birth, i.e. preferences to avoid pain medicines, episiotomies, side effects from various meds, etc. Understanding the birth process, as well as the pros and cons of your choices is key to making better decisions.
- Interview prospective doctors/midwives prior to pregnancy or early on. (Though don’t be afraid to switch later if need be.) Pick a provider who supports your plan. Believe me, there are many out there who have their own agenda in mind. How do you do this? Ask around. Ask other moms, doulas, lactation groups and such for a referral. Ask about their C-section rates and rates of episiotomies. Chances are a high C-section rate is a good warning sign. If your doctor isn’t supportive or you have concerns, move on.
- Consider a doula. Make sure you have a solid, knowledgeable, calm (very important, think the opposite of the panicking dad) support system. Hint: not all moms of the moms-to-be or dads make ideal coaches. And that is alright. Let them participate at their own ability and comfort level. With a doula this is possible. Research has shown that in many hospitals, less than 10% of nurses’ time is actually spent with the laboring mom, so don’t depend on nurses to be your coach. Having a doula has shown to decrease the length of labor, decrease the rate of C-sections and epidurals, increase the families overall satisfaction with the birth and a slew of other great benefits. (OK, so I’m a bit biased here. Seriously, if it wasn’t for my doula, I would never have made it during the birth of my son.)
Tips for the Big Day- Achieving a ‘Natural’ Birth:
- Labor starts on its’ own. (It’s not medically induced with meds.) There are natural ways which are often used to help kick start labor including sexual intercourse, nipple stimulation, castor oil inductions, walking, etc. (The extent to which they work is debatable by many, though I’ve seen them work.) Talk to your doctor or midwife.
- Stay home as long as possible! I can not stress this enough. If everything is fine and you/baby have a clean bill of health and your waters are intact, hang out at home. Even if your waters are broken and are clear, there is still the ability to labor at home for some time. Typically, labor is not a quick process, lasting an average of almost 8 hours for first time moms. I always advise my moms and dads to not stress about popping the little munchin’ out on the floor.
- You should be encouraged (and allowed) to move however you want. Walking upright in the first stage of labor, the dilation stage, has been shown to reduce the length of labor. This sometimes can take a bit of negotiation when in the hospital due to the requirements of fetal monitoring (see previous point about staying home). I often ask for a portable monitoring unit, though many hospitals don’t have these; help mom to move even with all the monitor cords (this is not always ideal); or even work with the nurse to have intermittent monitoring to allow mom time to labor on the toilet or elsewhere.
- Avoid the use of routine medical interventions, which are only to be used when there’s a real medical need. (This includes augmentation with Pitocin, breaking the waters manually, etc.)
- It is essential to have continuous support, both emotional and physical throughout your entire labor. (See previous point about considering a doula. Some insurance companies are even now covering the use of doulas.)
- Pushing shouldn’t be done while you’re flat on your back. (Think about it; this routine procedure doesn’t make sense. It goes against the laws of physics; you know, that thing called gravity.) They found the pushing stage to be shorter, a reduction in assisted deliveries (forceps/vacuums), and a reduction in episiotomies in upright positions.
- Momma and baby need to be kept together after birth. No routine separation immediately after birth for this and that. This helps to establish not only breastfeeding, but a strong emotional bond.
¨ Check out childbirthconnection.org for more information about laboring, C-sections and a whole bunch of other stuff.
¨ To find out more about doulas or to locate one in your area, check out: dona.org, findadoula.com, or doulanetwork.com.
¨ For more information and videos about natural birth, check out givingbirthnaturally.com, ncbi.nlm.nih.gov/pmc/articles/PMC1595040/ (great article), or lovenaturalbirth.com to name just a couple. Do an internet search to find resources tailored to your needs.
¨ Check out midwife Ina May’s book titled Ina May’s Guide to Childbirth (One of my favorite books and the one which motivated me to try for a ‘natural’ hospital birth.)
About the Author
Kelly Whitehead is a birth doula, a birth advocate, and a high-risk scientist mom who wrote High-Risk Pregnancy- Why Me? Understanding and Managing a Potential Preterm Pregnancy (www.hrpwhyme.com) to help others during a tough pregnancy. She is also a spokesperson for Sidelines National High Risk Pregnancy Support Network. Her passion is to help families through pregnancy and birth to help them achieve their dreams during this special time. (Live in the Northern New Jersey area and interested in contacting her about being your doula? Email her at [email protected] for more information.)