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Approaches to Childbirth
As modern society increasingly comes to accept childbirth as a natural
process, you will find a growing number of options available for giving birth.
Doctors have learned how to eliminate most of the pain associated with
childbirth.
Every day they use technological intervention in problem deliveries
to save thousands of babies who might otherwise not have survived.
But until
recently, such advances turned childbirth into an impersonal procedure in many
hospitals, and mothers and fathers had little say in how the birth was managed.
Today most doctors accept that you have choices that allow you to decide how
much medical intervention you want during labor and the birth itself. Many women
have a more positive experience when they have a say in their care, including
how and where to give birth. Studies have shown that these women feel more
fulfilled in the birthing process and suffer from less
depression afterward, regardless of whether their labor was easy or
problematic, long or short.
The time to start thinking about childbirth is in the early stages of your
pregnancy.
You'll need time to research the possibilities, look into the costs
and insurance coverage, and choose a practitioner, birth center, or hospital.
Although you cannot decide everything in advance, you may find it helpful to
talk matters over with your partner, medical advisers, family, and friends.
As you consider various approaches to childbirth, keep in mind those issues that
are most important to you.
A MANAGED BIRTH
Some mothers feel safer and less anxious if their birth is closely managed and
controlled by their caregivers, with technical support readily available. You
may know in advance that you want medication for pain relief.
Or you may be
advised to have a particular kind of pain reliever if your baby's birth is being
induced.
Your doctor may recommend a cesarean before
you go into labor for a variety of reasons.
If your baby assumes a footling
breech or transverse presentation, for example, surgery may be advisable.
Doctors encourage medical intervention as well when mothers have certain medical
conditions, such as hypertension,
kidney disease, or active genital herpes.
NATURAL CHILDBIRTH
 Natural
childbirth methods are again making their way back into the mainstream. Part of
this revival is due to the fact that hard scientific research has now
substantiated the efficacy of these disciplines. For example, studies have shown
that by replacing drugs with acupuncture and herbs, practitioners can reduce
anxiety and pain while naturally speeding up labor. But more than just proving
that they work, these holistic methods of childbirth have proven to work with
the body's natural processes, not in opposition to them, a fact that sets them
apart from more clinical procedures.
Besides natural birth is an umbrella term that refers to giving birth without
medication and intervention from doctors nurses. In its strictest
interpretation, this approach rules out such procedures as induction,
acceleration of labor, artificial rupture of the membranes, continuous
electronic fetal monitoring, use of forceps or vacuum extraction, or cesarean
section. Natural childbirth relies on support and encouragement from the doctor
or midwife, and your birthing partner.
Breathing and relaxation techniques may help you to manage the pain, and
eliminate the need for medication.
If natural childbirth appeals to you, treat it as an ideal. If unforeseen
complications arise, however, or your labor is painful or prolonged, you should
be prepared to seek the advice of your caregivers.
ACTIVE CHILDBIRTH
 This
is a form of natural childbirth, but it is often taught as a separate method to
couples. Active childbirth involves moving around in the early stages of labor,
which may increase the speed with which the cervix dilates. It also alleviates
the tension that can build when you are sitting or lying down simply waiting for
the next contraction.
When contractions become stronger, your partner or a birth companion supports
you physically - for example, in a squatting position. Delivering a baby while
lying flat on your back has real disadvantages: it inhibits the supply of oxygen
to the baby and it requires that you push against gravity, instead of letting
gravity help you deliver the baby.
The room used for active childbirth is typically equipped with chairs, beanbags,
and furniture of different heights. These items become tools that allow a
laboring woman to find a variety of comfortable positions and to keep moving for
as long as she wants.
PSYCHOPROPHYLAXIS
Made widely popular in the West through the work of Fernand Lamaze, this
technique was first practiced in Russia. Psychoprophylaxis prepares the mind for
labor and birth, using carefully worked out breathing exercises that help reduce
and distract from the pain. Some teachers of prenatal classes combine this
training with relaxation techniques that suppress pain, prevent fear-induced
tension, and aid the birthing process. Critics of this approach argue that it it
better for a woman to work with her body and actively use the pain of
contractions to help labor along.
Click here, for more on Lamaze Classes.
WATER BIRTH
 Many
women find relaxing in a tub of warm water a good way to cope with labor
contractions, a factor that led some women to stay in the tub throughout labor
and delivery.
Professionals have questioned the advisability of giving birth in water because
of the (very small) risk of the baby's drowning. A theoretical risk also exists
of introducing infection once the membranes have ruptured. But many mothers who
have tried it have found it a positive, loving way to bring their baby into the
world. It is under appraisal for safety and is available in only a limited
number of centers.
THE BRADLEY METHOD
Dr. Robert Bradley adopted many of the same theories as Dr. Grantly Dick-Read.
His method emphasizes the father's role as coach, based on the belief that the
father's active participation is vital to the childbirth experience. Couples
learning the Bradley method often attend classes much earlier in the pregnancy,
some starting as soon as the pregnancy is confirmed.
Dr. Bradley believes that the special breathing techniques used in other methods
can lead to exhaustion, dizziness, hyperventilation, and possibly a decrease in
oxygen to the fetus. Instead, he believes a woman should continue to breathe
normally through labor and on to delivery. The coach's role is to constantly
monitor the woman's relaxation and redirect her to find the relaxation state if
he notes tension. Click here for more
on Bradley method.
WHICH IS BEST FOR YOU?
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Water births are not widely available, but many hospitals and birth
centers will be able to accommodate your wishes for other types of birth.
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Your health and that of your baby must be the determining factors in any
decisions you make. If you are
healthy and the
pregnancy is normal, you will have the most freedom of choice.
A woman who
has developed a condition such as preeclampsia
or placenta previa, or who
has a history of complications will be more limited.
Read as much as you can about your options and talk to friends about their
experiences. When you talk to prospective physicians, this should be one of the
topics you explore together.
Finally, hospitals and birthing centers often offer their own childbirth
preparation classes. These classes usually include information on
exercise, nutrition,
breathing, position, movement and relaxation
methods for use in labor and delivery, information regarding hospital
procedures, medications, anesthesia, alternative complementary therapies,
newborn care and the postpartum period.
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