February 23, 2004

How to have a "blissful" birth

The proven way to ensure that you have the best chance of a normal, natural birth is to find a good midwife for your pregnancy and birth care. The evidence, reported in The Cochrane Library of Randomised Controlled Trials, shows overwhelmingly that it is the attitude, practises and philosophy of the primary caregiver that will shape the final outcome for mother and baby, on the day of the birth. It is not (sadly) the mother who dictates what happens during those hours, but the responsible health professional who will make the decisions that influence the final outcome.

The main difference between midwifery and obstetric care is that midwifery works from the assumption that birth is a normal event for women. It has many variations according to the mother’s responses, needs and bodily reactions and it generally goes well, if left alone. The obstetric model, based on a medical philosophy, views birth as a potential disaster that requires careful surveillance and well timed intervention. Midwifery is reactive (when there is a problem, then act) whereas obstetrics is proactive (in case there is a problem, let’s act now).

When women labour well, discovering their own inner strengths and using their own instinctive responses, there will almost always be a supportive midwife in the background. She may not be doing much, just acknowledging that the woman is doing well, occasionally listening to the baby, keeping a low profile and making sure that disturbances are kept at bay. In these circumstances, women release the necessary hormones for a straightforward labour: high levels of oxytocin for strong, effective contractions and high levels of endorphins to ease the labour pain, help her stay focussed and remain calm.

A woman does not need to study, to learn breathing techniques, practice relaxation strategies, exercise religiously or pay for tuition to achieve a good birth outcome. She does need to find a good midwife, one who trusts women to discover their own ways of giving birth and who is comfortable with the process. This midwife will not need to offer rescue through various means such as drugs or special relaxation techniques: she will make sure that appropriate measures for improving comfort, such as abundant warm water, heat packs, soft cushions, suitable chairs or other furniture are handy during labour, should the mother want to use them. This midwife will not lead (“I think you should ....”, “I would advise that...”, “If I was you I would...”, “in my experience...”) but may offer ideas, drawn from her experience (“some women find that...”, “how would you feel about trying...”, “have you considered...”) that enable the woman to stay at the centre of the event.

Finding such a midwife is not easy. Most will be working in the community, offering home birth services or as part of a community based team that can provide care in the hospital or at home, depending on the woman’s needs. Some will be working in hospitals, most often in Birth Centres but also in labour wards. Hospital based services often place limitations on how a midwife can work, which can be frustrating for woman as well as the midwives themselves, and learning how to “get around the protocols” is an important skill for women to learn during the pregnancy.

Every time you hear, or read, of a woman who has had a “blissful” birth, check who was the lead caregiver - it will most likely have been a midwife. Obstetricians rarely, if ever, feature in such accounts.

Pregnant women often need the full nine months to mentally prepare for becoming a mother. These days, the full nine months might also be needed to find appropriate care so that birth is the joyous and fulfilling event that nature intended. Instead of wasting time on learning how to “breathe” (a ridiculous concept - women already know how to perform this basic function!) or to “relax”, spend time in seeking out a decent midwife - the results are far more predictable, and the evidence will support your choice.

Posted by andrea at February 23, 2004 02:28 PM

Comments

Peace be with you in your quest for beautiful birth and truth as well as to all of us who seek the same.

Posted by: Toshia Parker on February 24, 2004 01:53 AM

Comments

How dare you credit a caregiver/midwife with the 'success' of the birthing experience!

If a woman experiences joyous, uncomplicated childbirth it is solely because SHE has managed her physical, mental, emotional and spiritual state, NOT because some external source has guided her to do so.

Your work is poorly researched and insidiously dangerous to birthing women. I suggest you study the safety, effectiveness and success rate of unassisted birth before you continue to pronounce midwifery as the 'proven way to... normal, natural birth'.

Posted by: Minjarrah on November 2, 2004 09:32 AM