Birthing Choices

with a solid 99% of those children born in hospitals, leaving less than one percent being born at home or birth centers.[1] Quite often, expecting mothers head into the delivery room without any idea of what to expect or what their options are. While there are not any statistics to tell us exactly how many women are dissatisfied with their birthing experience, if you go to any pregnancy forum you will find a host of women looking for options.

First, it is important to preface the following information with the statement that there is no one right way to have a baby; natural, pain-free, and/or cesarean – the goal is to have a baby. If at the end of your pregnancy there is a baby, or babies, the new mother has succeeded, no matter how they came into the world.

delivered by a doctor, there are still quite a few options. The most loudly debated decision is natural vs. pain-free, but there is also the options of care provider – the expecting mother does not have to go with a doctor, and in fact 8% of expecting mothers choose a midwife. Which is the best depends on the priorities of the expecting mother. In the case of low-risk pregnancies, the infant mortality rate is the same, with doctors and midwives, and whether the infant is born at home with or in a hospital.[2] It is very important to understand that the expecting mother can have a midwife, and still have her baby in the hospital .

Unfortunately, even with low-risk pregnancies there can be emergencies where immediate access to medical care can mean the difference between life and death. If the expecting mother feels safe having her baby without a doctor, there are quite a few pluses about hiring a midwife. The pro-side for midwives is as follows - women who hire midwifes are more likely to breast feed, and less likely to suffer post partum depression and midwife’s are less likely to perform episiotomies (a procedure where the doctor cuts the vagina to prevent tearing) and cesareans.[3]The reasons behind these particular statistics is complicated, but in addition to the previous information, women who have their babies with the assistance of a midwife are less likely to receive an epidural.

On the pro-side, for a doctor, is that doctors are trained to aide in the birthing of both normal, and complicated deliveries, and can perform an emergency cesarean if the situation warrants it. The question an expecting mother needs to ask herself before choosing a care practitioner is how worried she is about complications and how important a natural, vaginal birth is to her. Once again, either choice is okay, as long as the mother is happy with her choice.[4] In other words, the doula stays with the mother during the labor, start to finish, and takes care of both small and large details of the birthing process, allowing the prospective mother and father to focus entirely on the important task set before them. Furthermore, doulas are well trained in the options an expecting mother is faced with, and will advocate for the mother during her labor and after.

These choices include, but are not limited to, whether or not to take Lamaze, have an epidural, use a birthing ball, have a water birth, etc. Lamaze is a technique that is beneficial to new mothers, but not necessary. Lamaze International promotes ‘healthy, natural, and safe approaches to childbirth’, and backs up their beliefs with medical science and historical evidence. They have six main beliefs, but the three that would influence an expecting mother’s decision the most would be:

• “Let labor begin on its own.” It is not entirely coincidental that as the number of women who are having their labor induced has risen, so has the rates in cesareans.
• “Walk, move around, and change positions during labor.” Gravity is a laboring mothers friend,
• “The more you move around, the shorter your labor will be.” This one ties into another one of their care practices, which is to avoid giving birth on your back.
• “Avoid interruptions that are not medically necessary.” Lamaze International believes that fetal monitoring, in a normal low-risk pregnancy, is not necessary and medical statistics are beginning to back up their beliefs.[5]

To further their goals, Lamaze offers classes the expectant mother, and her coach, can take early in the pregnancy that will teach breathing techniques, and educate mother and coach about what to expect, and what can be done.

A slightly more controversial option in regards to labor and delivery is the whole ‘natural or not’ debate. There are two types of pain relief offered during childbirth, an epidural and a spinal block. If a pain-free labor is chosen, there will be little choice of which is received; that is the anesthesiologist’s choice. The use of pain relief is the popular choice, with 61% of American women choosing this route.[6] However, after the mother is given an epidural she will be bedridden until the epidural is removed and all feeling returns to her legs; in other words she cannot move around or sit on a birthing ball. The big issue, for most women who have gone both ways, is that some women feel very disconnected during the labor and are frustrated with the longer recovery time. There are also some statistics, which have been argued over, showing women who have had epidurals are more likely to need cesareans.

Regularly sitting on a birthing ball, during pregnancy, strengthens core muscles, aiding in the reduction of labor and delivery time, and in regaining muscle tone after delivery. In addition, birthing balls are wonderfully helpful during the labor process; sitting on a birthing ball allows gravity to do its job and helps the baby ease into the birthing canal. While this decision seems like an obvious one, on the con side the birthing ball is less and less attractive the further into deliver the expecting mother gets; never forget that having a baby is the most exhausting work anyone could ever do.

and can be made even better by proper research and forethought. With just a little education, we can ensure that every mother has the best birthing experience possible. Luckily, we live in a world where options are available.

[1] BabyCenter.com. (2012.) Surprising facts about birth in the United States. Retrieved 9 February 2012 from http://www.babycenter.com/0_surprising-facts-about-birth-in-the-united-states_1372273.bc?page=3

[2] Time.com. (2009.) Doctors vs. Midwives: The Battle Rages On. Retrieved 9 February 2012 from http://www.time.com/time/health/article/0,8599,1898316,00.html.

[3] GlobalMidwives.org. (2007.) Home Birth Safety. Retrieved 9 February 2012 from http://www.globalmidwives.org/files/Article-homebirth-safety.pdf.

[4] Dona.org. (2012.) What is a doula? Retrieved 9 February 2012 from http://www.dona.org/mothers.

[5] Lamaze.org. (2012.) Lamaze Healthy Birth Practices. Retrieved 9 February 2012 from www.lamaze.org/Default.aspx?tabid=90

[6] CDC.org. (2008.) Epidural and Spinal Anesthesia Use During Labor: 27-state Reporting Area, 2008. Retrieved 9 February 2012 from http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_05.pdf