Definitions

natural-childbirth

natural childbirth

Any of the systems (e.g., the Lamaze method) of managing birth without drugs or surgery. All begin with classes to teach pregnant women about the birth process, including when to push and what breathing and relaxation techniques to use at which stage. The goal is to reduce fear and muscle tension, which can increase the pain of labour, and to make the mother an active participant in the process. The father or another partner usually attends the classes with the mother and coaches her during the birth. Seealso midwifery; obstetrics and gynecology.

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Natural Childbirth is a philosophy of childbirth that is based on the notion that women, who are adequately prepared, are innately able to give birth to their chlld, without external intervention.

History

Historically most women gave birth at home, without medical intervention. These births were generally attended by a midwife, local family physician, or members of the birthing woman's family. In the early 1900s there was an increasing availability of hospitals, and more women began going into the hospital for labor and delivery. In the United States, the middle classes were especially receptive to the medicalization of childbirth, which promised a safer and less painful labor.. With this change from primarily homebirth to primarily hospital birth came changes in the care women received during labor: although no longer the case, in the 1940s it was common for women to be routinely sedated and for babies to be delivered from their unconscious mothers with forceps (termed by Dr. Robert A. Bradley as "knock-em-out, drag-em-out obstetrics"). Other routine obstetric interventions have similarly come and gone: shaving of the mother's pubic region; mandatory intravenous drips; enemas; hand strapping of the laboring women; and the 12 hour monitoring of newborns in a nursery away from the mother.

Beginning in the 1940s, childbirth professionals began to challenge the conventional assumptions about the safety of medicalized births. Physicians Michel Odent and Frederick Leboyer and midwives such as Ina May Gaskin pioneered birthing centers, water birth, and safe homebirth as alternatives to the hospital model. Research has shown that low-tech midwifery provides labor outcomes as good as those found in hospital settings with fewer interventions, except for a small percentage of high-risk cases . Today natural childbirth is taught through a variety of childbirth classes and books.

Physical Aspects

Natural childbirth aims to maximize the innate birth physiology and laboring movement of healthy, well-nourished women.

For the mother, a natural birth increases the probability of a healthier postnatal period and an easier recovery due to fewer post-operative discomforts. This is because a woman who has given birth with minimal intervention is less likely to have to recover from major abdominal surgery (caesarean section), instrumental delivery (by forceps or ventouse), cutting of the perineum (called episiotomy), bruises from IV lines, or severe headache or backache (a possible and well-documented side effect of epidurals).

For the infant, a natural birth reduces the exposure to narcotics and drugs that augment labor. A natural birth also reduces the likelihood of needing to separate the infant from its mother after birth. This is important, as immediate skin-to-skin maternal contact and breastfeeding in the first hour after birth increases the likelihood of successful breastfeeding for a longer duration.

Psychological aspects

Many women consider natural birth empowering. A woman who is supported to labor as she instinctively wants to, is a woman who will likely feel positive about her birth experience and future parenting skills. Her baby is more able to be alert and placed on her skin (promoting maternal bonding) and breastfeeding is more likely to be enjoyable and successful.

Other women consider natural birth to be primitive and unnecessarily painful. Many women report less anxiety surrounding the birthing process when they know medical intervention and pain relief will be available.

Alternatives to Intervention

A variety of methods are implemented during natural childbirth to aid the mother.
Pain management techniques other than medication include:

Methods to augment labor without medication include:

  • Changing positions frequently
  • Remaining in an upright position to increase pressure of the baby on the cervix
  • Walking or going up and down stairs
  • Acupuncture

Methods to reduce need for episiotomy:

  • Manage the perineum with counter-pressure .
  • Hot compresses
  • Pushing the baby out slowly

Preparation

Some women take birth education classes such as Lamaze or the Bradley Method to prepare for a natural childbirth. Several books are also available with information to help women prepare. A midwife or doula may include preparation for a natural birth as part of the prenatal care services.

Prevalence of Medical Intervention in the U.S.

A recent study revealed the rates of medical intervention in childbirth in the U.S.:

• Electronic fetal monitoring- 93%

• Epidural use- 63%

• Had their membranes ruptured- 55%

• Received oxytocin to progress labor- 53%

• Received episiotomies- 52%

References

Simkin, P. (1992) "Just another day in a woman's life? Nature and consistency of women's long term memories of their first birth experience." Birth 19:64-81.
Sakala, C., M. Corry, and H. Goer. (2004) Vaginal Birth and Cesarean Birth: How Do the Risks Compare? New York: Maternity Center Association. Full report available at http://www.maternitywise.org
Thompson, Craig. (2005) Consumer Risk Perceptions in a Community of Reflexive Doubt Journal of Consumer Research Full Paper Available at: http://gatton.uky.edu/courseweb/99/JCR%202005-09%20Thompson.pdf
Durand, Mark A. (1992) The Safety of Home Birth: The Farm Study American Journal of Public Health Full Paper Available at: ://www.thefarm.org/charities/mid.html

See also

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