- Women's Health
Preparing for Childbirth - Your Choices
Your choices: hospital birth, birth center birth or home birth
Childbirth practices, like other aspects of family life, are molded by the society of which mother and baby are a part. In large Western nations, childbirth customs have changed dramatically over the centuries. Before the late 1800s, birth usually took place at home and was a family-centered event. The industrial revolution brought greater crowding to cities, along with new health problems. As a result, childbirth began to move from home to hospital, where the health of mothers and babies could be protected. Once doctors assumed responsibility for childbirth, women's knowledge about it declined, and relatives and friends were no longer welcome to participate.
By the 1950s and 1960s, women began to question the medical procedures that came to be used routinely during labor and delivery. Many felt that frequent use of strong drugs and delivery instruments had robbed them of a precious experience and were often not necessary or safe for the baby. Gradually, a natural childbirth movement arose in Europe and spread to the United States. Its purpose was to make hospital birth as comfortable and rewarding for mothers as possible. Today, most hospitals carry this theme further by offering birth centers that are family centered in approach and homelike in appearance. Freestanding birth centers, which operate independently of hospitals and offer less in the way of backup medical care, also exist. And a growing number of women are rejecting institutional birth entirely and choosing to have their babies at home.
Natural childbirth tries to overcome the idea that birth is a painful ordeal that requires extensive medical intervention. Throughout history, cultural attitudes had taught women to fear the birth experience. An anxious, frightened woman in labor tenses muscles in her body, turning the mild pain that sometimes accompanies strong contractions into a great deal of pain.
A typical natural childbirth program consists of three parts:
Classes - Expectant mothers and fathers attend a series of classes in which they learn about the anatomy and physiology of labor and delivery. Natural childbirth is based on the idea that knowledge about the birth process reduces a mother's fear.
Relaxation and breathing techniques - Expectant mothers are taught relaxation and breathing exercises aimed at counteracting any pain they might feel during uterine contractions. They also practice creating pleasant visual images in their minds instead of thinking about pain.
Labor coach - While the mother masters breathing and visualization techniques, the father or another supportive companion learns to be a "labor coach". The coach assists the mother by reminding her to relax and breathe, massaging her back, supporting her body during labor and delivery, and offering words of encouragement and affection.
Positions for delivery - When natural childbirth is combined with delivery in a birth center or at home, mothers often give birth in the upright, sitting position rather than lying flat on their backs with their feet in stirrups as was the custom for hospital delivery for many years. When mothers are upright, labor is shortened because pushing is easier and more effective. The baby benefits from a richer supply of oxygen because blood flow to the placenta is increased. And since the mother can see the delivery, she can track the effectiveness of each contraction in pushing the baby out of the birth canal. This helps her work with the doctor or midwife to ensure that the baby's head and shoulders emerge slowly, which reduces the chances of tearing the vaginal opening.
Is it just as safe to give birth at home as in a hospital?
Home births are becoming more popular for the following reasons. Mothers who choose home delivery do so because they want birth to be part of their family life. In addition, most want to avoid unnecessary medical procedure and exercise greater control over their own care and that of their babies than hospitals typically permit. Although some home births are attended by doctors, many more handled by certified nurse-midwives who have degrees in nursing and additional training in childbirth management.
So, it it safe to give birth at home as in a hospital? For healthy women who are assisted by a well-trained doctor or midwife it seems so since complications rarely occur. However, when attendants are not carefully trained and prepared to handle emergencies, the rate of infant death is high. For mothers at risk for any kind of complication, the appropriate place for labor and delivery is the hospital, where life-saving treatment is available should it be needed.
For your and your unborn baby's safety, any home birth plan should be discussed fully with your doctor prior to home delivery.