So you want a natural birth...
Congratulations! Having a natural birth is one of life's peak experiences, and not to be missed for casual reasons. This is, however, a minority point of view in our American culture, which values drugs of all types, and birth on a schedule. Letting nature take its course, both about when labor begins and ends, and everything in between, is almost always the best and safest option, for both you and your baby. I have participated in over 600 natural births, as mother, birth assistant or doula and, since 1995, as a certified nurse-midwife. I hope to participate in another 600 before I retire!!
The good news is that you come from a long line of birthing women. Your ancestors successfully gave birth. Your body is made to do this work and, while they don't call it labor for nothing (it is some of the hardest work you will ever do), it is also very doable! However, the odds are stacked against you in our current healthcare system, so following are some tips on how to facilitate a positive birth experience.
CHOOSING A BIRTH SITE
If you are low risk (no underlying chronic medical conditions and a healthy lifestyle), you will increase your odds of a natural birth exponentially by planning a homebirth. In the comfort of your own home, a midwife or doctor can guard the natural process from unnecessary intervention, and transport you to a hospital if and when intervention is needed. Several studies have demonstrated comparable outcomes for babies born to low risk mothers with a trained attendant at home, and much better outcomes for mothers (i.e. fewer complications.) Labor is not like a television show, and most complications unfold over an extended period of time. Transport to the hospital is almost never a 911 emergency. Most homebirth midwives have about a 1 in 10 transport rate, and about a 3-5% caesarean rate. Other studies show that labors are on average shorter in the home environment, and more satisfying for the mother and her partner. Breastfeeding rates are close to 100% at 6 weeks postpartum.
If you choose to have a hospital birth (freestanding birth centers do not yet exist in Illinois), find an institution that has lower caesarean and epidural rates. Hire a doula, stay home as long as possible, and eat and drink fluids during labor to maintain the strength of contractions and your stamina to cope with labor pain. The Illinois Department of Public Health makes hospital statistics available, and 2008 numbers were recently released. A few local hospitals came in as follows: Northwestern had a 28% caesarean rate, Illinois Masonic and University of Chicago had 29%, and University of Illinois Hospital had an area low at 14%.
CHOOSING AN ATTENDANT
Interview several providers, and ask them about their statistics and their philosophy of birth. If you get eye-rolling or negative comments when you say you want a natural birth (or a cryptic “let's wait and talk about that when you get closer...”) RUN, don't walk out of that office. What you have set out to do is hard enough, and surrounding yourself with positive people who believe in the same goal and will work hard to help you achieve it, is vitally important. Other warning signs include providers who are antagonistic to the idea of having a doula with you in labor, or providers who do prenatal tests without explaining what they are doing and why. Remember, if you get into a relationship with a provider that does not seem comfortable to you, you can shop around and find someone else, even late in the pregnancy. A doctor or midwife is YOUR employee, and you have the right to find someone you can trust and relax with.
There is an overwhelming variety of classes to choose from. Some focus on techniques for coping with labor pain, while others are broader and“consumer-oriented,” in that they inform parents about current hospital practices and give information about alternatives, encouraging parents to be active participants in their care, and to make informed choices. In general, hospital-based classes tend to tell parents what to expect when they come to the hospital in labor, and are not helpful for those planning a natural birth.
Some classes to consider include those using “Birthing from Within” philosophy, Birthways (a local doula company), or Bradley preparation.
These websites contain a wealth of information about finding doulas and midwives, evidence-based practices in maternity care, hospital caesarean rates, and other helpful resources.
- The Coalition for Improving Maternity Services www.motherfriendly.org
- The Business of Being Born: www.thebusinessofbeingborn.com
- Citizens for Midwifery www.cfmidwifery.org
- Birthlink (A member-based organization in Chicago that helps consumers find maternity services and alternative healthcare.) www.birthlink.com
Sarah J. Simmons, CNM, has owned an independent homebirth midwifery practice, New Life Midwifery Services, on the north side of Chicago since 1997. She serves the greater metro-Chicago area.
Comments or questions may be sent to: sadiejane58[at]sbcglobal.net or 773 588-MAMA (6262.)