Natural childbirth
Encyclopedia
Natural Childbirth is a philosophy of childbirth
that is based on the notion that women who are adequately prepared are innately able to give birth without routine medical interventions. Natural childbirth arose in opposition to the techno-medical model of childbirth that has recently gained popularity in industrialized societies. The term "natural childbirth" was coined by obstetrician Grantly Dick-Read
upon publication of his book Natural Childbirth in the 1930s, which was followed by the 1942 Childbirth Without Fear.
At the onset of the Industrial Revolution in the 19th century, giving birth at home became more difficult due to congested living spaces and dirty living conditions. This drove urban and lower class women to newly available hospitals, while wealthy and middle-class women continued to labor at home. In the early 1900s there was an increasing availability of hospitals, and more women began going into the hospital for labor and delivery. In the United States, the middle classes were especially receptive to the medicalization of childbirth, which seemed to promise a safer and less painful labor. In fact, the ability to labor without pain was part of the early feminist movement. With this change from primarily homebirth to primarily hospital birth came changes in the care women received during labor: although no longer the case, in the 1940s it was common for women to be routinely sedated and for babies to be delivered from their unconscious mothers with forceps (termed by Dr. Robert A. Bradley as "knock-em-out, drag-em-out obstetrics"). Other routine obstetric interventions have similarly come and gone: shaving of the mother's pubic region; mandatory intravenous drips; enemas; hand strapping of the laboring women; and the 12 hour monitoring of newborns in a nursery away from the mother.
Beginning in the 1940s, childbirth professionals and mothers began to challenge the conventional assumptions about the safety of medicalized births. Physicians Michel Odent
and Frederick Leboyer
and midwives such as Ina May Gaskin
promoted birthing center
s, water birth
, and homebirth as alternatives to the hospital model. Some research has shown that low-tech midwifery provides labor outcomes as good as or better than those found in hospital settings with fewer interventions, except for a small percentage of high-risk cases.
ing) and breastfeeding is more likely to be enjoyable and successful.
Instead of interventions, a variety of non-invasive methods are employed during natural childbirth to aid the mother, since they do not to carry the inherent risk of medical procedures. Many of these stress the importance of "a mind-body connection," which the techno-medical model of birth tends to ignore. Pain management
techniques other than medication include hydrotherapy
, massage
, relaxation
therapy, hypnosis
, breathing exercises, acupressure for labour, TENS, vocalization
, visualization
, mindfulness
and water birth
. Other approaches include movement and different positions (i.e. using a birthing ball
), hot and cold therapy (i.e. using hot compresses and/or cold packs), and receiving one-on-one labor support like that provided by a midwife or doula
. However, natural childbirth proponents maintain that pain is a natural and necessary part of the labor process, and should not automatically be regarded as entirely negative. In contrast to the pain of injury and disease, they believe that the pain of childbirth is a sign that the female body is functioning as it is meant to.
Some methods used to augment labor without medication require that the woman is an active participant in the birthing process. They include frequently changing positions and walking. Birth positions favored in natural childbirth - including squatting, hands and knees, or suspension in water - contrast with the popular lithotomy position of a medicalized birth (woman in hospital bed on her back with legs in stirrups), which has consistently been shown to slow and complicate labor . Methods to reduce tearing (instead of an episiotomy
) include managing the perineum
with counter-pressure, hot compresses, and pushing the baby out slowly.
, the Bradley Method
, Brio Birth, CAPPA, ICEA, Hypnobabies.) to prepare for a natural childbirth. Several books are also available with information to help women prepare. A midwife or doula may include preparation for a natural birth as part of the prenatal care services. However, a study published in 2009 suggests that preparation alone is not enough to ensure an intervention free outcome
epidurals; 55% had their membranes ruptured; 53% received Pitocin to stimulate labor progress; and 52% received episiotomies.
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
that is based on the notion that women who are adequately prepared are innately able to give birth without routine medical interventions. Natural childbirth arose in opposition to the techno-medical model of childbirth that has recently gained popularity in industrialized societies. The term "natural childbirth" was coined by obstetrician Grantly Dick-Read
Grantly Dick-Read
Grantly Dick-Read was a British obstetrician who is regarded by many as the father of natural childbirth movement. He dedicated his life to educating expectant parents about the benefits of giving birth naturally, with as little intervention from obstetricians and health professionals as possible...
upon publication of his book Natural Childbirth in the 1930s, which was followed by the 1942 Childbirth Without Fear.
History
Historically, most women gave birth at home without emergency medical care available. The "natural" rate of maternal mortality - where nothing is done to prevent maternal death - has been estimated at 1500 per 100,000 births. In the United States circa 1900, before the introduction and improvement of modern medical technologies, there were about 700 maternal deaths per 100,000 births (.7%). (However, natural childbirth advocates recognize the importance of emergency medical intervention, which can avert maternal or neonatal death.)At the onset of the Industrial Revolution in the 19th century, giving birth at home became more difficult due to congested living spaces and dirty living conditions. This drove urban and lower class women to newly available hospitals, while wealthy and middle-class women continued to labor at home. In the early 1900s there was an increasing availability of hospitals, and more women began going into the hospital for labor and delivery. In the United States, the middle classes were especially receptive to the medicalization of childbirth, which seemed to promise a safer and less painful labor. In fact, the ability to labor without pain was part of the early feminist movement. With this change from primarily homebirth to primarily hospital birth came changes in the care women received during labor: although no longer the case, in the 1940s it was common for women to be routinely sedated and for babies to be delivered from their unconscious mothers with forceps (termed by Dr. Robert A. Bradley as "knock-em-out, drag-em-out obstetrics"). Other routine obstetric interventions have similarly come and gone: shaving of the mother's pubic region; mandatory intravenous drips; enemas; hand strapping of the laboring women; and the 12 hour monitoring of newborns in a nursery away from the mother.
Beginning in the 1940s, childbirth professionals and mothers began to challenge the conventional assumptions about the safety of medicalized births. Physicians Michel Odent
Michel Odent
Michel Odent is a retired medical doctor. He was born in France in 1930 and studied medicine at Paris University. He is known for his role in the natural childbirth movement and for promoting water birth...
and Frederick Leboyer
Frederick Leboyer
Frederick Leboyer is a French obstetrician, best known for his 1975 book, Birth Without Violence, which popularized gentle birthing techniques, in particular, the practice of immersing newly-born infants in a small tub of warm water — known as a "Leboyer bath" — to help ease the transition from...
and midwives such as Ina May Gaskin
Ina May Gaskin
Ina May Gaskin, CPM, has been described as "the mother of authentic midwifery."-Family:Gaskin was born to an Iowa Protestant family . Her father, Talford Middleton, was raised on a large Iowa farm, which was lost to a bank not long after his father’s accidental death in 1926...
promoted birthing center
Birthing center
A birthing center or centre is a healthcare facility, staffed by nurse-midwives, midwives and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches. By attending the laboring mother, the doulas can assist the midwives and make the birth easier. The midwives monitor the...
s, water birth
Water birth
Water birth is a method of giving birth, which involves immersion in warm water. The immersion can mean giving birth to the infant in the water or using it as a tool during the labor process. Proponents believe that this method is safe and provides many benefits for both mother and infant,...
, and homebirth as alternatives to the hospital model. Some research has shown that low-tech midwifery provides labor outcomes as good as or better than those found in hospital settings with fewer interventions, except for a small percentage of high-risk cases.
Psychological aspects
Many women consider natural birth empowering. A woman who is supported to labor as she instinctively wants to, is a woman who will likely feel positive about her birth experience and future parenting skills. Her baby is more able to be alert and placed on her skin (promoting maternal bondMaternal bond
The maternal bond is typically the relationship between a mother and her child.While it typically occurs due to pregnancy and childbirth, it may also occur between a woman and an unrelated child, such as in adoption...
ing) and breastfeeding is more likely to be enjoyable and successful.
Alternatives to intervention
Research has estimated that up to ninety-five percent of women can safely give birth without medical interventions (including, but not limited to, epidurals, caesarian sections, vacuum extraction, and forceps). Therefore, the midwifery model of care, which usually holds a more holistic approach to labor and delivery, tends to avoid such routine interventions (which can lead to complications for both mother and infant) when used for the sake of convenience, and rely on medical tools only when they are deemed absolutely necessary to ensure safety .Instead of interventions, a variety of non-invasive methods are employed during natural childbirth to aid the mother, since they do not to carry the inherent risk of medical procedures. Many of these stress the importance of "a mind-body connection," which the techno-medical model of birth tends to ignore. Pain management
Pain management
Pain management is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists,...
techniques other than medication include hydrotherapy
Hydrotherapy
Hydrotherapy, formerly called hydropathy, involves the use of water for pain-relief and treating illness. The term hydrotherapy itself is synonymous with the term water cure as it was originally marketed by practitioners and promoters in the 19th century...
, massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...
, relaxation
Relaxation technique
A relaxation technique is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of anxiety, stress or anger...
therapy, hypnosis
Hypnosis
Hypnosis is "a trance state characterized by extreme suggestibility, relaxation and heightened imagination."It is a mental state or imaginative role-enactment . It is usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary...
, breathing exercises, acupressure for labour, TENS, vocalization
Speech production
Speech production is the process by which spoken words are selected to be produced, have their phonetics formulated and then finally are articulated by the motor system in the vocal apparatus...
, visualization
Mental image
A mental image is an experience that, on most occasions, significantly resembles the experience of perceiving some object, event, or scene, but occurs when the relevant object, event, or scene is not actually present to the senses...
, mindfulness
Mindfulness (psychology)
Modern clinical psychology and psychiatry since the 1970s have developed a number of therapeutic applications based on the concept of mindfulness in Buddhist meditation.-Definitions:...
and water birth
Water birth
Water birth is a method of giving birth, which involves immersion in warm water. The immersion can mean giving birth to the infant in the water or using it as a tool during the labor process. Proponents believe that this method is safe and provides many benefits for both mother and infant,...
. Other approaches include movement and different positions (i.e. using a birthing ball
Birthing ball
A Birthing Ball or Labor Ball is a large air–filled rubber ball that a woman can sit on during labor. A birthing ball allows the woman to rock back and forth seated on a softer surface. A woman on a birthing ball may need a labor support person to keep her steady. A birthing ball may be especially...
), hot and cold therapy (i.e. using hot compresses and/or cold packs), and receiving one-on-one labor support like that provided by a midwife or doula
Doula
A Doula is someone who provides non-medical support to women and their families during labour and childbirth, and also the postpartum period. The term can also be used to describe other supportive roles for other life events such as abortion, death and more....
. However, natural childbirth proponents maintain that pain is a natural and necessary part of the labor process, and should not automatically be regarded as entirely negative. In contrast to the pain of injury and disease, they believe that the pain of childbirth is a sign that the female body is functioning as it is meant to.
Some methods used to augment labor without medication require that the woman is an active participant in the birthing process. They include frequently changing positions and walking. Birth positions favored in natural childbirth - including squatting, hands and knees, or suspension in water - contrast with the popular lithotomy position of a medicalized birth (woman in hospital bed on her back with legs in stirrups), which has consistently been shown to slow and complicate labor . Methods to reduce tearing (instead of an episiotomy
Episiotomy
An episiotomy , also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labor. The incision, which can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic , and is sutured...
) include managing the perineum
Perineum
In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...
with counter-pressure, hot compresses, and pushing the baby out slowly.
Preparation
Some women take birth education classes (such as LamazeLamaze
The Lamaze Technique, often referred to as Lamaze, is a prepared childbirth technique developed in the 1940s by French obstetrician Dr. Fernand Lamaze as an alternative to the use of medical intervention during childbirth...
, the Bradley Method
Bradley method of natural childbirth
The Bradley Method of natural childbirth is a method of natural childbirth developed in 1947 by Robert A. Bradley, M.D. and popularized by his book Husband-Coached Childbirth, first published in 1965...
, Brio Birth, CAPPA, ICEA, Hypnobabies.) to prepare for a natural childbirth. Several books are also available with information to help women prepare. A midwife or doula may include preparation for a natural birth as part of the prenatal care services. However, a study published in 2009 suggests that preparation alone is not enough to ensure an intervention free outcome
Prevalence of medical intervention in the U.S.
A recent study revealed the rates of medical intervention in childbirth in the U.S. found that 93% of mothers used electronic fetal monitoring; 63% usedepidurals; 55% had their membranes ruptured; 53% received Pitocin to stimulate labor progress; and 52% received episiotomies.
Additional reading
- Simkin, P. (1992) "Just another day in a woman's life? Nature and consistency of women's long term memories of their first birth experience." Birth 19:64-81.
- Sakala, C., M. Corry, and H. Goer. (2004) Vaginal Birth and Cesarean Birth: How Do the Risks Compare? New York: Maternity Center Association. Full report available at http://www.maternitywise.org
- Thompson, Craig. (2005) Consumer Risk Perceptions in a Community of Reflexive Doubt Journal of Consumer Research Full Paper Available at: http://gatton.uky.edu/courseweb/99/JCR%202005-09%20Thompson.pdf
- Durand, Mark A. (1992) The Safety of Home Birth: The Farm Study American Journal of Public Health Full Paper Available at: ://www.thefarm.org/charities/mid.html
See also
- Childbirth positionsChildbirth positionsThe term childbirth positions refers to the various physical postures the pregnant mother may assume during the process of childbirth...
- Early postnatal hospital dischargeEarly postnatal hospital dischargeA definition that has been used for early discharge from hospital after childbirth is discharge of mother and baby within 48 hours of the birth....
- Hypnotherapy in childbirth
- Squatting positionSquatting positionSquatting is a posture where the weight of the body is on the feet but the knees are bent either fully or partially . In contrast, sitting, involves taking the weight of the body, at least in part, on the buttocks against the ground or a horizontal object such as a chair seat...