What sort of birth do you want?
By Liz Wilkes, My Midwives
“What sort of birth do you want” is a common question many first time mothers-to-be are asked. I am even guilty of asking this and as a midwife I realise how ridiculous it is after the statement comes out of my mouth.
However, I think that there is some merit in women thinking broadly about what they want and what kind of person they are.
The answers I receive fall into a few categories:
“Whatever is best for baby”
Research shows that for most babies a birth that starts on its own, with few drugs, is managed by someone who knows the woman and is confident in physiological birth is the safest option. Generally this sort of birth occurs in midwifery models of care and/or in birth centres. For women where mother or baby are unwell, there may be situations where an induction, or even a caesarean, is the chosen option. But for the vast majority of women – over 80% of women – they can aim for a natural birth knowing that is the best thing they can do for baby.
“I don’t want to feel any pain”
Other women are terrified by pain – and despite education and support, they find that feeling hard to overcome. These women generally want an epidural as soon as they start labour. This must occur in a birth suite and once an epidural is in place the woman needs to have a catheter to drain her bladder (because she cannot feel the sensation to pass urine) and often drugs to keep the contractions regular. This type of birth is more likely to end up with other interventions, such as forceps or ventouse, as the woman cannot feel the sensation to properly push her baby out.
“I want to be induced – I need to know what is happening”
Women who want to plan and make a choice of when their baby is coming often choose to be induced if their baby has not come by a certain date. Whilst this is understandable, research definitely demonstrates that induction is likely to increase lots of other interventions including epidural, forceps and caesarean. Induction is certainly more painful as women do not have the benefit of the natural hormones that occur in labour. As indicated above there are a few reasons why babies do need to be induced including problems with growth or amniotic fluid levels and women in these situations should speak to their care provider.
“I can’t bear the thought of a vaginal birth”
Women who choose a caesarean for these reasons are rare and often have not received appropriate support during pregnancy. Good information about the risks for baby (more chance of breathing difficulties, difficulties breastfeeding, admission to special care nursery) and risks for mother (pain, complications of surgery such as infections and clots and complications of anaesthetic which rarely, but occasionally, include death). Having a caeasarean generally means also having a spinal anaesthetic, a catheter into your bladder and an IV for drugs, fluids and pain relief.
Find out more about My Midwives at www.mymidwives.com.au