More hospitals are promoting mother/baby-friendly initiatives
Childbirth is a very personal experience for every mother and should be a memorable one. There is now a revival towards natural birth with less medicalisation and interventions and women tend to feel a sense of empowerment.
Hospitals are also moving towards mother friendly (normal birth) and baby friendly (exclusive breast feeding) hospital initiatives to improve the childbirth experience.
Spontaneous vaginal delivery occurs when a woman goes into labour naturally and delivers the baby in a normal manner without assistance of instruments or Caeserian section. Natural childbirth involves giving birth with minimal medical interventions.
What improves the chances of normal delivery?
> Having had a normal birth in previous pregnancy
> Pregnancy is low risk with absence of complications
> Woman is not overweight ,which increases her chance of heavier babies
>Maintaining-healthy diet and exercise in pregnancy, to avoid excessive weight gain
> Allowing spontaneous onset of labour > Avoiding induction of labour
Giving birth is a natural process and the human body is designed for it. Advantages of normal delivery include: labour is shorter and pain is less intense, taking pain relief may interfere with normal sensations of pain and pressure of the baby pushing down, the woman feels in control of the birth process as she is aware of the changes in labour, normal birth has a shorter recovery time and shorter hospital stay, baby benefits by receiving protective bacteria from the birth canal which helps build its immune system, birth process squeezes fluid out of the baby’s lungs, lowering the risk of breathing problems at birth, facilitates breastfeeding and bonding as the baby is more alert and sucks well also the mum can feed easily, as she is not in pain.
It also avoids complications of Caeserian section such as risks of anaesthesia, more bleeding than normal birth and infections, besides a painful and longer recovery time. Caeserian section also affects chance of normal birth in future pregnancies and also increases risk of low placenta implantation in future pregnancies.
Medical and surgical interventions include:
> Induction of labour (more painful)
> Continuous fetal monitoring
(reduces mobility)
> Opening the water bag artificially (pains are more intense)
> Use of pain relief like epidural or other pain medications (reduces perception of normal progress of labour)
> Use of drugs to enhance labour pains (more painful and can stress the baby)
> Performing episiotomy ie. a cut in the opening of the birth passage during delivery (more painful in the postnatal period)
> Using instruments to deliver the baby (when medically indicated only)
> Delivery by Caeserian section (only if any risk factor compromising mum or baby)
Choose a team that promotes natural birth and discuss your birth plan. Prepare mentally and physically for a normal birth throughout the course of pregnancy. Attend antenatal education sessions — know about pregnancy and childbirth. Maintain a healthy diet and regular exercise.
Learn breathing and relaxation techniques — Lamaze technique to help in pain management; Teach the partner about how to support the woman during labour with massage techniques — Bradley (husbandcoached) method; use of hypnosis (Dr Grantley Dick Read); water birth (allowed after ensuring a low risk pregnancy); TENS and acupressure (non-medical method of pain relief).
Techniques during labour to achieve natural birth
> Attend the hospital in established labour when pains occur at short intervals (avoid early admission)
> Having a birth companion (Doula – birth attendant or a family member)
> Move around as much as possible during labour
> Eat light and drink well to stay nourished and hydrated
> Use breathing techniques
> Have a hot shower during labour > Use the birthing ball
> Back and shoulder massage
> Avoid artificial rupture of membranes and medications to enhance labour > Avoid epidurals and other pain medications
> Choose a birth position of choice > Avoid episiotomy
> Skin-to-skin contact with the baby soon after birth helps in bonding, breast-feeding and expelling the placenta
Normal birth after Caeserian section can range from 30-70 per cent depending on the maternity unit. It depends on:
> Reason for the previous CSection
> Absence of risk factors in current pregnancy
> Baby lying head down in the womb
> Average baby weight
> Onset of spontaneous labour
> Close monitoring is essential during labour if a woman had a previous Caeserian section, to ensure safety of mum and baby
Dr Josephine Jose is a consultant
in obstetrics and gynecology at International Modern Hospital. (This article has been sponsored by the advertiser)