Friday, November 11, 2011

What is natural childbirth?

This is a re-post from my old blog.  

In this journey that John and I have been on, we have discovered that natural childbirth is something that both of us are very passionate about.  There is a huge amount of research supporting natural childbirth.  It is my goal here to explain some of the choices that John and I are making as parents.  I intend to provide statistics and article links as needed.  If I ever say something that you doubt or want more information on, please ask.  Sometimes talking about these subjects can be difficult as everyone makes their own choices.  My intention is not to insinuate that anyone who chooses to birth differently is wrong or a bad mother.  

So, what IS natural childbirth? 

Natural childbirth is a term that is often used to refer to an epidural-free labor.  Having an epidural-free labor is a very important component, but it isn't the whole picture.  In order to have a natural labor, the mom must be able to fully relax, remain undisturbed, eat, drink, move freely, be allowed to deliver or 'push' in any position, AND remain unmedicated.  

If a woman is not fully relaxed, her body is able to stall labor.  Mares in foal are the same.  If they feel like they are being watched, they will stall labor for hours or days until they feel safe and alone.  The question for me is, how do you relax in a hospital setting?  Does constant monitoring by strangers and frequent internal examinations make you feel relaxed?  Read this blog post on why internal exams don't tell you anything useful.  The opposite of relaxation is tension.  Tension can intensify pain and make it very difficult to accept and work through pain.  Is it possible to remain undisturbed in a hospital?  

Most hospitals have rules on mothers not being allowed food or water while in labor in case they need to go under emergency anesthesia.  This is a two-fold issue.  First is the rate of women who do end up with emergency surgery.  In America, the cesarean rate is 32%.  This rate is unusually and unnecessarily high.  More on that later.  The second issue at hand is why food and drink is important during labor.  Labor is an athletic event lasting hours and days.  It is physically exhausting.  It is an endurance event.  Would you deny a marathon runner sustenance?  How would you expect your horse to perform in an endurance race if he is not allowed food or drink?  How far would he make it before he HAD to stop?  What if you were in an athletic event that doesn't allow you to quit?  You MUST continue through to the end?  Is it fair to set yourself up for failure by not providing your body with nutrition?  

Moving freely during both first and second stage labor is important for a number of reasons.  First is that movement and being upright allows the baby to begin its descent through the pelvis.  Movement and remaining upright also help to speed labor.  Its simple physics.  Gravity is working with you to get things moving.  This is a pretty simple concept, however it is often thwarted by hospital protocol and interventions as well.  The most common thing that takes away the ability to move freely is an epidural.  You are physically unable to remain upright or mobile when given an epidural.  

Being able to deliver or 'push' in any position is a key in natural childbirth.  Most people picture a woman delivering a baby on her back in a bed.  We have been conditioned to think this is the normal way to deliver.  The truth is, delivering a baby on your back is not normal at all!  When on your back or reclined, you are putting pressure on your coccyx which decreases the size of the pelvic opening.  I don't have to tell you why that is not an aid in birthing a baby!  Reclining also requires the baby to make an extra turn to get out of the pelvis and through the birth canal.  The baby is headed just a little lower than the vaginal opening and frequently tears the mother's perineum.  If a woman is allowed to push on her own terms, she will invariably push upright in a standing, squatting, or hands and knees position.  All of these positions allow for the baby to make an easier exit with less pain and tearing for the mother.  Again, an epidural makes this decision impossible.

The most important factor in a natural childbirth is avoiding drugs.  Epidurals are not the only medical intervention that should be avoided to achieve a natural birth, but they are the most common.  The Epidural rate in America is between 50-90%, depending on who you ask.  Another form of medical intervention to avoid is induction.  The rate of inductions is between 20-40%.  The reasons for avoiding inductions are numerous.  First, they often encourage out a baby who is simply not ready to be born.  Our NICUs are fuller than ever largely due to preterm babies.  Second, induction makes labor very intense and painful for mom.  It gives her contractions that are much stronger and closer together than natural contractions.  This often leads to an epidural, which then slows labor, often putting the baby into distress and ends up leading to an assisted deliver or even an emergency Cesarean section.  This cascade of intervention (another article here and here) is totally avoidable if we would just allows our bodies to work naturally.  Trusting your body is so key in birth.  In addition to the effects an epidural have on mom, we need to consider how they effect baby.  The biggest problem babies encounter after a drugged birth is difficulty breastfeeding.

Topeka Birth center has a Cesarean rate ranging between 3-9% since 2002.  Several local home birth midwives have Cesarean rates under 4%.  According to the CDC article I linked above, The rate of cesareans has increased over 50% in the last decade.  What does all of this tell us?  Something is wrong with the way we are treating births.  Birth is not a medical emergency.  Birth is normal.  Birth is natural.  We need to be proactive in our own care to ensure that we remain in control of our own births and avoid interventions that complicate the process.  

The biggest secret about birth is not that it is painful, but that women are strong. 

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