With rising C-section rates grabbing headlines, we’ve noticed a swing towards moms pushing for a natural birth. If you’re one of them, here’s what you need to know about natural birth.
We asked two natural birth advocates to guide us through how you can prepare for the best possible outcome for both you and your baby. It all starts and ends with knowledge, education and trusting your instincts.
Educate yourself on natural birth
Zaahida Joel, a WOMBS certified doula and ICEA (International Childbirth Education Association) trained childbirth educator in Port Elizabeth, says this is the most important aspect of your pregnancy and natural birth journey. “When you’re educated, you feel empowered, your mindset is optimal and you know and trust that your body can do this. No one can mess with the conviction and calmness you’ll feel.”
There are various ways to gain this knowledge on natural birth, including antenatal classes through your midwife or hospital, and a childbirth education course with an ICEA-trained childbirth educator. These will cover a wide range of topics, give you the opportunity to meet other expectant moms and have your questions answered. It’s not generally recommended to do your own online research as the source of information often can’t be verified and you may be confronted by horror stories that may cause you stress.
Classes are best attended with your birth partner and you’ll both be given the tools to make decisions. The modules covered in antenatal and childbirth education classes will vary, so ask for a breakdown and find a class that covers your areas of concern.
Choose your natural birth team
Attending antenatal classes will help you decide what kind of support and care you’ll need during the birth. You have various options and don’t need to limit yourself – whatever you feel comfortable with is what’s right. From your birth partner to a midwife, doula, obstetrician and gynaecologist, the people you choose to have around you during the birth will play a major role in how secure and confident you feel.
“The modern midwife is a healthcare professional who undergoes extensive training and specialises in natural, normal birth for low-risk women. Midwives work hand-in-hand with OB/GYNs, who also see you for a few consultations and will operate should you need a C-section,” explains Ingeborg Sonnichsen, from Genesis Maternity Clinic in Johannesburg. She adds that midwife-led care is based on a strong belief that birth is a normal life event. A midwife provides personal, family-centric care.
Research has shown midwives achieve the same outcomes as physicians without disrupting the natural birth process as often. Women who give birth under the care of a midwife are more likely to have:
- Lower rates of C-section births
- Lower rates of induced labour
- Significantly lower rates of third and fourth degree tears from delivery, as well as lower episiotomy rates
- Lower rates of forceps births
- Higher breastfeeding success.
Prepare your perineum
The importance of preparing your body can’t be over-emphasised and just like any other muscle in your body, your vaginal muscles can be exercised during pregnancy so they’re toned and ready for birth. This includes practicing squats and doing Kegel exercises.
An episiotomy or small incision in the perineum may be necessary during the final stages of labour. Following your midwife’s directions as she coaches you on when and how hard to push can also help to prevent tearing.
In the run-up to birth and starting at 34 weeks, you can begin perineal massage to help ready the area for birth and reduce the risk and severity of tearing. “This prepares and strengthens the perineum, increases the elasticity of the perineal tissue and will make you accustomed to the burning and stretching sensation you experience when your baby crowns.” You can use grapeseed, olive or almond oil, and Zaahida recommends the tissue oil incorporated in the Pegasus Homeopathic Maternity Kit. Visit www.pegasuskits.com for more information.
“Hiring a doula to support you during labour and delivery, standing or squatting during labour and breathing as you push will all help prevent and minimise tearing,” adds Zaahida.
Stay off your back
For many women, movies are the only exposure they may have had to labour before going through it themselves. But Ingeborg says it’s important to realise this is not what true labour is like and women need to educate themselves in order to manage their expectations and fear. In the movies, women are usually shown labouring on their backs, which has also become common practise in most hospitals.
However, Ingeborg encourages women to consider the benefits of active labour, where the woman is free to move around and choose positions she feels most comfortable in.
“The traditional supine (on your back) position is a relatively recent development that is falling out of favour because this painful, physiologically dysfunctional way of giving birth, can result in the pelvis losing up to 30% of its capacity to be utilised for birth,” explains Ingeborg.
Active birth also allows women to go through labour and give birth in water or a birthing pool, which provides support and buoyancy, so you can easily change positions in the water.
Breathing throughout labour decreases your perception of pain, clears your mind, relaxes and strengthens your body, and oxygenates your blood and your baby.
Zaahida recommends moms use the simplest breathing techniques – whichever feels comfortable and has a calming effect for you personally. “You don’t want to have to remember complicated methods while trying to relax through labour or even worse, forget how to do your breathing.” She describes the following techniques to practise and try, you can choose the method that suits you best.
Take a comfortable breathe, then let it out while relaxing your whole body. Find a physical item, person, a spot on the wall or anything you can look at as your focal point, and continue with rhythmic breathing as follows:
- Inhale through the nose, exhale through the mouth
- Inhale through the nose, exhale through the nose
- Inhale through the mouth, exhale through the mouth.
You can alter the rate and depth of your breathing in different stages of labour to suit your preferences, add a soft sound like “he”, “who” or “ha” to your exhale, or choose to close or open your eyes.
Most women struggle to maintain deep and slow breathing when a contraction peaks, so at this point, you can quicken and lighten your breathe and do it in and out through your mouth.
Consult your childbirth educator or doula to help you to learn and practise breathing methods that suit you.
Considerable research has been done into fear during labour and how it affects both progress and outcomes. “Fear comes about when we have no knowledge,” says Zaahida. Which takes us full-circle back to the beginning – make sure you attend antenatal classes and ask your birthing team to clarify any questions or concern you may have. Know the possibilities and your options regarding pain control and an emergency situation. For example, if you know that a contraction will never last longer 90 seconds, will that help you cope with them better?
Discuss your fears with your birth partner, your healthcare provider, your childbirth educator and your doula so you can talk through them and come up with a plan together that will help you avoid the outcome you fear.
Have a birth plan
Having your birth preferences written down allows you to rest assured that you have done your best in your capacity.” She cautions that a birth plan is not binding upon anyone and that you must go into labour with the knowledge that sometimes things do not go according to plan. “Embrace that and be willing to go with the flow. Do what feels right for you at the time and what is safest for you and your baby.”
Marianne is a freelance content creator and copy editor. She has been part of the Living and Loving team in various capacities over the last six years, but since becoming a mom to a boisterous boy, she has found a special interest in parenting issues including discipline, education and early childhood development. When not running after, and negotiating with, her three-year-old, you’ll find her experimenting in the kitchen.