natural childbirth

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 child, without external intervention. The term "natural childbirth" was coined by obstetrician Grantly Dick-Read upon publication of his book Natural Childbirth in the 1930s, which was followed by the 1942 Childbirth Without Fear.

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. At the onset of the Industrial Revolution in the 19th century, giving birth at home became more difficult due to congested living spaces and dirty living conditions. This drove urban and lower class women to newly available hospitals, while wealthy and middle-class women continued to labor at home ^[1]. 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^[2]. In fact, the ability to labor without pain was part of the early feminist movement^[1]. 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.^{[citation needed]}

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 ^[3]. 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-intervention discomforts including recovery 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 due to a possible 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. ^[4]

Psychological aspects

Many women consider natural birth empowering. ^[5] 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^[6].

Other women consider natural birth to be primitive and unnecessarily painful. Some women report less anxiety surrounding the birthing process when they know medical intervention and pain relief will be available.^{[citation needed]}

Alternatives to Intervention

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

• Hydrotherapy
• Massage
• Relaxation therapy
• Hypnosis
• Breathing exercises
• Vocalization
• Visualization
• Mindfulness
• Water birth
• Movement and different positions (i.e. using a birthing ball)
• Hot and cold therapy (i.e. using hot compresses and/or cold packs)
• Having one-on-one labor support, such as a midwife or doula

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

Methods to reduce need for episiotomy:

• Manage the perineum with counter-pressure ^[7].
• 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. However, a study published in 2009 suggests that preparation alone is not enough to ensure an intervention free outcome ^[8]

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% ^[9]

References

See also

• Hypnotherapy in childbirth
• Early postnatal hospital discharge