Childbirth Options

Known Benefits of Water Labour & Waterbirth

Posted on Aug 15, 2009 in Birthing, Childbirth Options | 0 comments

Known Benefits of Water Labour & Waterbirth

Facilitates mobility and enables the mother to assume any position which is comfortable for labor and birth Speeds up labor Reduces blood pressure Gives mother more feelings of control Provides significant pain relief Promotes relaxation Conserves her energy Reduces the need for drugs and interventions Gives mother a private protected space Reduces perineal trauma and eliminates episiotomies Reduces cesarean section rates Is highly rated by mothers – typically stating they would consider giving birth in water again Is highly rated by experienced providers Encourages an easier birth for mother and a gentler welcome for baby Placing a pool of water in a birth room changes the atmosphere immediately. Voices get softer, the mother stays calmer and everyone becomes less stressed. The effect of buoyancy that deep water immersion creates allows spontaneous movement of the mother. No one has to help the mother get into a new position. She moves as her body and the position of the baby dictate. Movement helps open the pelvis, allowing the baby to descend. When a woman in labor relaxes in a warm deep bath, free from gravity’s pull on her body, with sensory stimulation reduced, her body is less likely to secrete stress-related hormones. This allows her body to produce the pain inhibitors-endorphins-that complement labor. Noradrenaline and catecholamines, the hormones that are released during stress, actually raise the blood pressure and can inhibit or slow labor. A laboring woman who is able to relax physically, is able to relax mentally as well. Many women, midwives, and doctors acknowledge the analgesic effect of water. Thousands of these mothers state they would never be able to consider laboring without water again. from Waterbirth...

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Water During Labour & Birth

Posted on Jul 15, 2009 in Birthing, Childbirth Options | 0 comments

Water During Labour & Birth

Options for labour and birth have expanded over recent years. You can choose between different health care providers and different birth places. You can choose an active birth, a Leboyer birth and now you can choose a waterbirth. The use of water has become increasingly popular as a way of avoiding a high tech birth both in hospital and at home. While the use of water during labour is common place, giving birth to a baby under water is more controversial. A woman can use water during labour and birth in a number of ways. These include: A shower Hot towels Submerging in a bath Submerging into a deep pool of water Some women feel very comfortable in the water during labour and decide to stay in the water to give birth. Giving birth under water raises many questions – How safe is it? Does research support waterbirth? Does water provide effective pain relief? What precautions should be used if a woman labours and/or gives birth in water? Water, as with many issues during pregnancy and birth, is not very well researched. There needs to be a lot more research before we can accurately answer these and other questions. Some evidence however, is slowly gathering from around the world on the use of water during labour and birth. In the future we will know a lot more. Waterbirth concerns many people. One common fear is that the baby will drown if born into water. The baby born into water has a diving reflex that helps prevents the inhalation of water into its lungs. Once the baby is exposed to air the receptors in the baby’s face trigger the baby’s breathing. Because of these factors, once the baby is born into water it should be brought gently to the surface and the baby’s face must not be resubmerged under the water. To make sure that the baby does not get cold after the birth – the baby’s body can stay under the water and the baby’s head can be dried with a warm towel. If the baby is well he/she can stay with the mother in the water. Whether or not to permit the placenta to be born in the water is another controversial issue. There are some theoretical risks to remaining in the water, however none have ever been proven. Some health care practitioner encourage women to leave the water for the third stage of labour while others are happy for women to remain in the water. If bleeding after the birth seems excessive the woman would be asked to leave the water. I have heard that using water during labour is helpful, can you explain the reasons why? Using water during labour and birth encourages: Reduction in pain Greater mobility that comes with buoyancy Induces relaxation Reduction in abdominal pressure Softening effect on the perineum and vulva can promote stretching during crowing Gentle entrance into the world for the baby One of the most common finding of research is that many women find that being submerged in water enables them to relax and they find the pain of labour lessens. In one study, where women used water during labour only, they found that 80% of the women reported that they would like to use water next time they were in labour. I like the idea of using water during my labour. I would like to know if it is safe for my baby to be born underwater? Until more research is completed, we cannot say with any accuracy whether there are any risks associated with the use of water during labour and birth. The limited evidence that is available so far indicates that waterbirth is thought to be safe so long as some simple, sensible guidelines are followed. These guidelines include: A skilled practitioner in waterbirth is available The pool or bath has been thoroughly cleaned and rinsed A normal labour and birth is expected. The use of water is not appropriate if a woman has a fever, there is meconium in the waters, the baby’s heart rate...

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Birth Choices – what is right for you?

Posted on May 19, 2009 in Birthing, Childbirth Options, Featured, Maternity Care Options | 0 comments

Birth Choices – what is right for you?

Today we have more choices than ever about how we birth. We have the choice of using a doctor or midwife for our practitioner. We have the choice of birthing in the hospital or at home. We can choose who is present at the birth. We can choose to hire a doula. We can choose between a multitude of prenatal classes ranging from hospital-run classes to private classes in Lamaze, the Bradley method or Birthing From Within. We can enroll our older children in Sibling Preparation classes, we can take prenatal yoga or prenatal pilates, we can bring music, pillows and massage oil to the hospital. We can choose to labour in the tub or the shower or on a birth ball. We can play cards or go for a walk. We can birth squatting or standing or via elective cesarean. We can even write up elaborate detailed lists of all of our preferences and give this Birth Plan to our practitioners. Faced with all of these choices, how do you know what is right for you? How do you know that the choices you made before the big day will still be right when labour starts – especially if you are a first time mom? Choice, in general, can be a double-edged sword. On the one hand, it is empowering and enriching to be given the opportunity to have a say in what happens to us. On the other, given too many choices or inadequate information to help in our decisions, the process of choosing can cause stress, anxiety and even guilt and depression. And when it comes to birth, it can give the misguided impression of control. Relinquish Control (even those subconscious thoughts…) The first thing you can do on your journey towards the right birth for you is to forget about those fantasies of your ideal birth. We all do it: we all have a vision in our heads of the way we hope our birth will proceed. These visions are rarely realistic (unless you imagined in your ideal birth that you would be half-naked on your hands and knees in a roomful of strangers). Birth is a dynamic process and we cannot control what happens. The woman who is determined to get her epidural before she’s finished with the hospital admitting desk may deliver baby at home in the bathroom attended by her partner. The woman who preaches natural birth from before conception may end up with a complication, or labour induction and a cesarean delivery. We’ve all read these stories and hoped it wouldn’t be us. But it could be. So the first step is to let go. Read everything you can get your hands on Knowledge is power. If you aren’t a reader, ask questions. Ask all the mothers you know what their experience was like. Ask your practioner all those nagging questions you’re afraid to speak out loud. Explore all the birth possibilities there are. Don’t shy away from those topics that you hope you won’t have to face (like having a long, drawn out back-labour or requiring a cesarean). Don’t write off ideas that are new to you (like homebirth, or hiring a doula). The more you can understand about the way labour progresses (or sometimes doesn’t) and the way labour is managed (or sometimes mis-managed), the better the chance that you will be able to play an active part in the process. Be Flexible (but know your limits) That is, be prepared to change your mind. Something that seemed right before birth may no longer be fitting during birth. Hell, something you asked for during one contraction, may not be what you want during the next. Accept the fact that you may need to revise your thinking in the face of new information. However, if at any time, you are uncomfortable with the care you are receiving, be confident that it is okay to assert yourself or have some intervene on your behalf. By trusting your instincts and your birth team, you’ll know when to stand your ground and when...

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Is homebirth safe?

Posted on Apr 15, 2009 in Birthing, Childbirth Options | 3 comments

Is homebirth safe?

The most recent studies have shown that with healthy pregnancies free of complications, planned home births attended by trained midwives are as safe as hospital births. There are some VERY important distinctions made in the above statement. Studies of home birth look at: Low Risk women Families who have planned ahead of time to have their birth at home and prepared for it. This does NOT include births that happened so fast that paramedics were called or mom delivered at home alone. Home births attended by trained professional midwives. These studies make no claim as to the safety of unassisted home birth, precipitous home birth or home birth for women who do not meet the criteria for being low risk. Please note the overall findings of a study on home birth reported in the Canadian Medical Association Journal, including some very important benefits of home birth: “there were fewer interventions during labour, including electronic fetal monitoring, induction of labour, episiotomy and cesarean section; women were more likely to have an intact perineum and fewer maternal infections and were no more likely to have third-degree or fourth-degree tears or postpartum hemorrhage; and there were no significant differences in perinatal mortality, 5-minute Apgar scores and meconium aspiration syndrome, as compared with women intending to deliver in hospital who were assisted by physicians or midwives.” – Régis Blais, Are home births safe? CMAJ 2002;166(3):335-6 There is a wealth of information available on this subject: Check out our articles & research...

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Recipe for a Gentle Birth

Posted on Mar 6, 2009 in Birthing, Childbirth Options, Featured | 0 comments

Recipe for a Gentle Birth

Have you ever wondered what exactly people are talking about when they say “gentle birth”? From the way our culture talks about birth, there doesn’t seem to be much about it that is gentle. This week, I’ve been re-reading Barbara Harper’s Gentle Birth Choices – A Guide to Making Informed Choices and would like to share with you some of her suggestions for a birth that’s gentle on mom and baby. Barbara Harper is a former nurse who went on to form Global Maternal/Child Health Organization and Waterbirth International following the births of her children. She lectures around the world on maternity care reform and describes gentle birth like this: “A gentle birth begins by focusing on the mother’s experience and by bringing together a woman’s emotional dimensions and her physical and spiritual needs. A gentle birth respects the mother’s pivotal role, acknowledging that she knows how to birth her child in her own time and in her own way, trusting her instincts and intuition. In turn, when a mother gives birth gently, she and everyone present acknowledge that the baby is a conscious participant in his or her own birth. The experience empowers the birthing woman, welcomes the newborn child into a peaceful and loving environment, and bonds the family.” I love this description of a gentle birth because on the one hand, it seems so simple and obvious that we should be respectful and gentle with the two main participants in any birth: mother and child. Yet, on the other hand, it highlights for me how rarely this happens in our high-tech culture and how difficult it is for many women to achieve a gentle birth. What are some simple, practical suggestions for a gentle birth? 1. Preparation In the past, preparation would have probably included talking to older experienced women in your community: your mother, grandmother, aunts, older sisters, and probably witnessing a birth or two before you had to do it yourself. Nowadays, some key aspects for preparation are: choosing a childbirth educator that trusts birth and brings a positive attitude to their classes taking care of your body: getting adequate rest, exercising, eating well remaining open-minded and flexible about how your birth might unfold taking an honest hard look at your attitudes, beliefs and fears about birth 2. A Reassuring Environment The human body is designed with some wonderful pain management chemicals called endorphins that are triggered by the contractions of the uterus. The stronger the contractions, the more endorphins are released. Working in direct opposition to endorphins is adrenaline. Adrenaline is triggered by fear and stress. It prepares us for the fight or flight response by tensing our muscles for action. It is the anti-thesis of staying relaxed and letting your endorphins do their job. One key way to help a laboring woman cope with pain is to keep her relaxed and confident. This can prove difficult if she is surrounded by busy attendants, beeping machines, scary looking resuscitation equipment and ticking clocks. 3. Freedom to Move It is vital that a woman be able to move about during labour, to adopt whatever position she needs to birth her baby instinctively. Lying on her back is more painful and unlike more upright positions (kneeling, squatting or leaning on furniture or a support person), she is working against gravity to deliver baby. Moving around during labour helps baby to readjust and descend and keeps mother actively participating in the process. 4. Quiet Keeping the birth room quiet is essential. Partners, support people and birth attendants must respect the mother’s need to focus. Each woman deals with contractions in her own way but it’s absolutely important that she be able to concentrate. Quiet also fosters a sense of intimacy and baby’s transition into a world full of sound is much less jarring. 5. Low Light Turning the lights down or off has much the same effect as turning down the volume. Mother feels calmer and more relaxed. The room becomes comforting and intimate. Baby is more relaxed and alert, able to open his eyes and...

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Rebirth: Maternity Care Alternatives

Posted on Feb 3, 2009 in Birthing, Childbirth Options, Featured, Maternity Care Options | 0 comments

Rebirth: Maternity Care Alternatives

Planning to have your baby in the hospital? You might have to contend with some of the symptoms of an over-burdened healthcare system. Maternity wards can be over-crowded and under-staffed. Hospital stays are getting shorter. And if you happen to go into labour at the wrong time, you could be sent to another city’s hospital because all of the hospitals nearby are at capacity. What if our maternity care system could be over-hauled to relieve the burden? What are the realities? Fewer doctors and nurses Besides the well-publicized shortage of nurses, Canada also faces a shortage of physicians who attend births. Between 1992 and 2004, the percentage of general practitioners who attended births fell from 28% to only 13%. Rising Costs Having a baby in these technological times is not cheap. The average cost for a vaginal delivery is $2,800. For a caesarean, it is closer to $5,000. This does not include the added costs associated with length of hospital stay or neonatal care. With every epidural, there is an added expense for the anesthesiologist and with a BC cesarean rate approaching 30%, costs are rising for maternity care. Shorter Stays An obvious cost-cutting measure is to shorten hospital stays. The average length of stay for a vaginal birth in BC has fallen to only two days. For a cesarean birth, it is less than four days. Women are being sent home to care for newborns within a couple of days of major abdominal surgery. What happened to resting and recovering from birth? How would a new system look? Midwives Midwives are trained specialists in birth. They have usually completed four years of practical training. Their appointments run about fifty minutes (as opposed to the standard ten minutes with your family doctor). They often do home visits in the first week after baby is born to help initiate breastfeeding and to monitor mom and baby. Mothers report excellent continuity of care and higher levels of satisfaction with their births and their care. The midwifery model of care tends to be cheaper than the current medical model. Midwives believe that birth is a natural physiological process. Though trained to spot and mitigate problems, midwives adopt a fairly hands-off approach as caregivers. Births attended by midwives show a lower incidence of epidural use, episiotomy, and cesarean section. The benefits are not just higher maternal satisfaction, but also much lower costs. Homebirth & Birth Centres In the last two hundred years, medicine has managed to pull birth firmly into its clutches. Contrary to all logic, with birth, we take women who are healthy and place them in the hospital as a preventative measure (in case something goes wrong) and then we treat them the same way we treat the sick and injured. Since when is pregnancy a disease? Modern medicine can be thanked for the low incidence of infant and mother mortality associated with birth today. We know more about the human body, more about birth, more about infection. We know to keep wounds clean. We have antibiotics and other modern drugs. We can save moms and babies from situations that would have claimed their lives only 100 years ago. But that does not necessarily mean that birth belongs in hospital. We can transfer our medical knowledge to other places, like the home. Recent studies show that with healthy pregnancies free of complications, planned homebirths attended by trained midwives are as safe as hospital births. For low risk women, we can achieve safe birth at home and reap a dual benefit because there are advantages to birthing where a mother feels safest and most comfortable. We can also find a middle ground instead of polarizing between hospital and home. Imagine the power of a birth centre: birthing in a homelike setting with a midwife, a birth pool, medical equipment tucked out of sight and the potential of a quick transfer to hospital if need be. On the flip side, imagine the benefits for our rural and northern communities that don’t have hospitals have their own. Mothers would no longer have to travel...

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