By Sister Lilian for Baby City © 2016
Just about every woman says she wishes for a natural birth, even though many doubt that they will be able to have one. First, one needs to differentiate between normal and natural – because for most women, this is believed to be one and the same thing, although in modern birthing terms, nothing could be further from the truth.
The common definitions of normal include ‘according to an established norm, rule or principle’ and ‘conforming to a type, standard or regular form’. Natural, on the other hand, is explained as ‘present in or produced by nature’, ‘of, relating to or concerning nature’, ‘faithfully representing nature or life’ and ‘not produced or changed artificially’.
Various sources also define natural in other interesting ways, such as ‘established by moral certainty or conviction’. Used as a noun, a natural describes ‘one who has all the qualifications necessary for success’ or ‘one suited by nature for a certain purpose or function’. In fact, this could be the definition of a woman giving natural birth!
Birth is generally referred to as a ‘normal’ delivery when the baby was born vaginally, no matter what medical procedures, positions and protocols were implemented. And so, a woman usually gives birth in a hospital environment and the feeling is of a medical procedure rather than a life event; she could have her labour induced before contractions started spontaneously; she could mostly be on her back or in a semi-reclining position during labour and birth; she would in all probability have continuous electronic monitoring with electrodes attached to her belly, inhibiting mobility; internal examinations, though performed less frequently nowadays, are still done quite regularly; she would very often have some form of medical pain relief like an analgesic injection or an epidural; if labour was not induced it might still be augmented with induction medications via a drip; an episiotomy might be done; instrument delivery with vacuum or forceps is a possibility; the umbilical cord will mostly be clamped and cut within seconds of the birth; and the newborn baby is often examined before any lengthy contact between parents and baby takes place. All this, but if Baby emerged vaginally, it would still be recorded as a ‘normal’ birth!
On the other hand, the characteristics of a natural birth are as follows:
• Birth partners will be selected by the couple
• It is usually midwife-led, as midwives are the most experienced natural birth practitioners
• Labour and delivery take place either in an active birth unit, specialised midwifery clinic, or at home
• A couple’s preferences are taken into account at all times on a consultative basis, with emphasis being placed on advice and information to enable the best birth choices
• In accordance with the latest research, internal vaginal examinations are not routinely done, and midwives read all the many other signs of progress of labour
• Electronic Fetal Monitoring (EFM) is done intermittently, not with constant attached instrumentation
• Eating and fluid intake during labour is made possible according to the woman’s preference
• Movement and upright positions are encouraged in labour and delivery
• Natural pain relief methods are offered and encouraged as opposed to medical pain relief
• The atmosphere in the birthing room will be private, serene and calming; lighting will be low and sounds muted
• Episiotomy (a cut made into the perineum), to create a wider vaginal outlet, is unusual
• Children and other attendants are not excluded as a policy matter
• The umbilical cord will be allowed to pulsate for at least three minutes, or preferably until pulsation ceases spontaneously, before it is cut
Referral to an obstetrician or hospital will be made if major interventions become necessary; and so, if responsibly practiced, natural birth is a safe and desirable birthing option. It is also a woman’s right to birth in this fashion.
Immediately after Baby is born, the whole ‘natural’ experience will continue to differ from ‘normal’, in these key ways:
• Baby will mostly be delivered directly onto the mother’s abdomen and given the chance to wriggle up to her breasts
• The mother-baby-father triad will be allowed as much time as needed to bond
• Latching to the breast as soon as possible will be encouraged, but in a non-directive fashion
• Observations, measurements and scoring of Mother and Baby will only be done when suitable to the mother, if mother and baby are fine after birth
• Small tears at the vaginal outlet will not unnecessarily be sutured, so that they can heal better
• Prolonged skin-to-skin contact between Mother and Baby will be encouraged
In an era when very few women have experienced a truly natural birth, and are strongly influenced by dramatic stories told by friends, the media, many birth practitioners and even their own mothers, it takes some adjusting to the thought that birth could and should be different to the ‘normal’ scenario sketched above. And yet, many women instinctively do believe it would be possible if they contemplate the age-old ways of birthing with Mother Nature. Women need to know and believe that at the very least, 90% of them and their babies are built for natural birth! If labour is allowed to unfold naturally, many physiological processes will unfold to ensure that women cope well, and that it is precisely unnecessary medical intervention that often leads to ‘complications’. They also need to know that complications seldom arise from one moment to the next in labour, and that a good midwife, and mostly the mother herself as well, will notice signs requiring help in good time.
So, what are the benefits of ‘natural’ birth?
• Going into spontaneous labour means that your baby is optimally ready to be born and will adapt far more easily and be at far less risk of problems like respiratory conditions, low blood sugar and inability to regulate his temperature (hypothermia)
• Baby’s brain cell and neuron development are far more advanced with spontaneous term labour, as opposed to early elective induction or C-section
• The relaxed atmosphere can make labour progress easier and faster
• You often get to establish a relationship with the midwife before the birth, and get daily check-ups afterwards
• Normal hospitals often focus on efficiency, while natural births focus on the mother’s needs and preferences, helping her feel special and less anxious
• Moms feel empowered; they decide what position to deliver in, when to eat, and whether to walk around
• There is freedom and privacy; Moms cans strip if they like, or walk around the garden, if there is one
• The umbilical cord will not be immediately clamped and severed; this means Baby gets more of his rightful blood supply with less anaemia afterwards; he also receives a natural boost of stem cells which would otherwise not reach his system in early clamping
• There is less retention of the placenta and far less risk of serious post-birth bleeding
• The more familiar-feeling environment is comforting; and afterwards Mom can relax in her own environment and bed, if she gave birth at home, or is discharged much sooner, which is usually the case
• Mom and Baby are never separated
• Breastfeeding gets off to a far easier and more successful start
• Visitors and family members are allowed – even for the birth itself, if you want that!
• Mothers feel that their birth was easier, that they recover faster, and say that they have a calmer baby and less early parenting challenges like colic, crying and reflux