Your natural birth choices

By Dr Stas Vashevnik, Consultant Obstetrician, Glengarry Private Hospital

Many women want a natural birth – or at least as natural as possible. But what you might consider a ‘natural’ birth might be very different to what your doctor, friend or sister might consider a natural birth.

Do you mean no pain medication and no intervention unless medically necessary, or do you simply mean you’d prefer a vaginal delivery?

Whatever it is, a good obstetrician should support your wishes as much as possible and discuss any concerns you have during your regular prenatal appointments. Here are some points you may like to address:

Vaginal birth

Most women do want to deliver vaginally, no matter how nerve-racking the prospect is. There is plenty of scientific evidence to suggest a vaginal birth may be preferable for both the mother and baby. For example, it usually means a quicker recovery for the mum and babies receive ‘good’ bacteria when they pass through the birth canal.

Nevertheless, sometimes a caesarean may be necessary to ensure safe delivery of the baby and for the health of the mother. If you have had a caesarean previously and you’d like to have a vaginal birth this time, ask your obstetrician about a VBAC.

Little or no pain medication

The typical medical pain relief options include a spinal epidural, the nitrous oxide and oxygen ‘gas’, or a pethidine or morphine injection. It is completely up to you if you choose to have one of these, or not.

Non-medical pain relief options include massage, a warm bath or shower, meditation, hypnotherapy, acupuncture, TENS machine, light bouncing and rocking on a labour ball, aromatherapy, heat packs, walking, and swaying your body. Some of these, such as hypnotherapy, will need researching well before the birth. Also ask your midwife for their suggestions while you’re in labour.

Little or no delivery intervention

Many women are eager to have a natural delivery without aids and, again, this is up to you. Typical delivery assistance or delivery intervention includes forceps and vacuum suction. These methods are used when the baby is in an awkward position, if the mother is exhausted from a lengthy delivery or if the fetal heart rate increases or decreases significantly. The majority of births happen without aids.

The other time you may encounter intervention is when labour needs to be brought on. Typically, labour starts on its own and is known as ‘spontaneous labour’ but an induction is needed for medical reasons, such as when a pregnancy has progressed beyond full-term or if the baby is in distress.

Episiotomies

An episiotomy is a cut below the vagina to make the opening larger for the baby. Obstetricians’ opinions vary in this regard. Some perform very few – if any – while others do believe it is a good option in certain circumstances. Ask him or her in what situations they perform episiotomies, what is associated with tearing and what the recovery and risks are.

Plans for the placenta and umbilical cord

Sometimes women like to delay the clamping of the umbilical cord and some women like to take the placenta home with them. Check with your hospital to see what their guidelines are.

What you can bring to the hospital

Would you like to bring your own clothes, music, aromatherapy or other labour aids to calm you down and keep pain at bay? Check with your doctor or hospital beforehand to find out what is and isn’t permitted.

Women should have choice and control over their birthing experience, but sometimes there are urgent medical situations that divert the best laid plans. Discuss what these may be with your obstetrician and see if there are any suitable alternatives.

Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.

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