Friday, August 20, 2010

My recommendations for achieving a natural birth

I am the mother of two boys. Both were born at home as this is where I felt most comfortable birthing. Both were very different experiences. I realise since having Niwha recently that in order to have a gentle, natural birth with no drugs and no intervention good preparation is necessary. These are my recommendations for achieving the natural birth you want no matter where you choose to birth.

Preparation:


1. Health and fitness – walking, swimming, pregnancy yoga and pilates, good whole foods. Limit sugar intake. Raspberry leaf (after 4-5 months), nettle teas (or a pregnancy tea that has both).

2. To ensure your baby is in a good position, sit upright with pelvis straight or tilted slightly forward. During labour, use an upright, even leaning forward position.

3. Watch videos of natural, positive births – search Hypnobirthing or Gentle birth on You Tube. Visualise your own birth – see it exactly as you want it to happen.

4. Practice breathing – breathing to fully relax, breathing long, slow and deep to assist you through contractions. Birth breathing – practice while having a poo – breathe in, as you breathe out, breathe down your back, imagining your breath is actually coming out your vagina. See the Hypnobirthing book for more detail.

5. Massage (or get your partner to) your perineum with almond, rosehip or st John’s wart oil every night for 6-8 weeks before your due date. See the Pink Kit or Hypnobirthing book for more detail on how to do this.

6. Avoid listening to any negative stories of birthing. Simply ask the person talking to tell you all about it after you have birthed your baby.

7. Research all the choices you have during your birthing.

8. Write a birth plan with your partner – have your ideal as well as what you are willing to compromise if you experience pressure from your medical attendants.

9. Ensure you have a lead maternity carer who will support your birth plan – you can change LMC’s at any time!

10. Remember that your due date is just a guess date. Your baby may take more or less time to grow to a point where they are ready to come into the world. Induction paths the way to greater often easily avoidable intervention.
Dealing with the pressure to induce – are you healthy and well? Is the baby still moving? Ask your LMC to monitor you and your baby more closely. If you receive huge amounts of pressure compromise by having a scan to check the baby – particularly the fluid around the baby. Ask that they do not estimate the size of your baby! They often get this very wrong with large overestimations and being told you’re having a 9-10lb baby can psych you out! A big baby is a healthy baby and if they are in the optimal position they will be no harder to birth!
If your waters have broken statistics show that there is an increased risk of infection after 18 hours. You may receive pressure to induce after 24 hours or less. Again, avoiding this will give you a great chance of having a natural birth. I was willing to go for 48 hours taking all the necessary precautions and using high doses of Vitamin C and taking Echinacea to boost the body’s defences against infection. After 48 hours I was willing to consider antibiotics, not induction. In the meantime use every natural induction method – walk, walk, walk, visualise your cervix opening, have a hot curry or take cod liver oil to get your bowels moving, use acupressure or acupuncture (this is often very effective!)

During Labour:
1. Use Naturo pharm Pre-birth. Rescue remedy to stay calm and relaxed.
2. Stay active. Move with and between contractions – see the New Active Birth book. Relax, laugh, eat, drink, go to the toilet.
3. Visualise and use affirmations to stay focused on the outcome you want and being relaxed. See Hypnobirthing for affirmations or make up your own – say them in the present (not future) and use only positive language.
4. Use water! Ideally a birthing pool that you can also birth in. Hot water takes pain away, helps you deal with the pressure in your lower pelvis and softens your vagina so it can stretch better.
5. Hot towels on your lower back (hang them over a oil column heater, they don’t need to be wet). Partner massage on the dimples on your lower back. Light touch massage – see hypnobirthing book – releases endorphins.
6. Use your breathing techniques, breathing up into your abdomen with every contraction. Remember that a contraction only lasts for a short amount of time. You can breathe through it and get a rest afterwards. During the final opening stage, before the baby is ready to move out of the birth canal contractions are closer together. You may say something like ‘I can’t do this any more’. Tell your partner that this means you are close to birthing your baby and not a sign that you need intervention! When you notice yourself saying this celebrate in the knowledge that you are close to meeting your baby.

Dealing with the pressure to receive interventions:
One great question to ask (or have your partner ask) whenever an intervention is suggested is ‘Is this a medical emergency?’ If not then intervention can be avoided.
State in your birth plan that you do not want to be ‘offered’ any pain relief or other intervention. State that you do not want other medical staff wandering into your room. Some anaesthetist’s walk in and say they are leaving soon so if you want an epidural you better have it now!! This is not true as there is always an anaesthetist around for emergencies. I’ve heard it said that for every ‘extra’ person in the room you can add an hour onto your labour! You have the right (and your partner) to ask unnecessary people to leave your birthing space.
Hold onto your waters! If your waters haven’t broken some LMC’s want to break them to get things moving. This is unnecessary and can cause problems. Many baby’s break their waters as they are born (or you or your LMC can break them as the baby is being born). Your baby will come in it’s own time – stay relaxed, rest (on your left hand side or in a slightly reclined position), eat, drink and trust your body and your baby.
Remember that every drug you have goes through to your baby. It can affect their breathing and ability to breastfeed. Birth is your child’s first experience in the world. It affects them personally in either a positive or negative way. There is soooo much you can do to make it a positive experience for your baby and yourself. If you are one of the 5% of people who really need medical help, then that is what we are privileged to have available here.

Recommended reading during pregnancy and early parenthood:

Liedloff, Jean. (1975) The Continuum Concept. In Search of Happiness Lost.
This is an absolute classic in the alternative parenting world. Jean’s writing style is really difficult but it’s a must read before you have kids.

Mongan, Marie. (2006). Hypnobirthing: The Mongan Method.
Highly recommended. Fantastic, beautiful, gentle and empowering way to birth your baby. 95% of women who use this method have natural, gentle birthing experiences.

Balaskas, Janet. (????). New Active Birth. A concise guide to Natural Childbirth.
Great book for staying active before and during labour and preparing to birth your baby naturally.

La Leche League International. The Womanly Art of Breastfeeding.
The bible for breastfeeding! La Leche League is an International group of volunteers who support and educate on breastfeeding and related things. Borrow this from your local LLL group – brylin@ihug.co.nz and linda@guru.net.nz are two LLL leaders in Dunedin. Ask to see a Lactation consultant before you leave the hospital regardless of how it’s going. If at home and you’re not convinced it’s perfect, go into the hospital and see the consultant or visit a LLL leader.
Remember that only a small percentage of women actually can’t breastfeed. Don’t give up, get help and only use formula as a last resort. Many women express full time if their baby can not breastfeed, instead of resorting to formula.

Weed, Susan. (1986). Wise Woman Herbal for the Childbearing Year.
Very 80’s book! Great natural, herbal remedy’s for every pregnancy, birth, infant related issue.

Gethin, Anni & Macgregor, Beth. (2007) Helping your baby to sleep: Why gentle techniques work best. Finch Publishing.
This is a great book for parents who want to make going to bed and sleeping a gentle and positive experience for their baby. Dr William Sears books are also recommended.

Also see my other blog posts for information on Raising a Nappy Free Baby and Baby Wearing.




1 comment:

Sarah Stewart said...

Great post - will pass on to my student midwives...when I get them next year :)