Archives

Benefits of Active Birth

Feb29

From Janet Balaskas’ classic book, Active Birth:

“When birth is active–

  • There is less need for drugs.
  • Discomfort and pain are less.
  • The uterus functions better, so artificial stimulants are not usually necessary.
  • Labors are shorter.
  • The supply of oxygen to the baby is improved.
  • There is less need for forceps or vacuum extraction.
  • The secretion of hormones that regulate the whole process is not disrupted.”

Make sure to talk to your care provider about your plan for an active birth. You may have to introduce your attendant to the concept and be assertive about your right to have an active, normal birth.

Overused & Underused Procedures

Feb22

My previous post about a good experience and a healthy baby as well as reading a relevant section in the wonderful new Our Bodies, Ourselves: Pregnancy & Birth book I’m reviewing made me want to post about this topic. There are a multitude of common procedures that are overused in hospitals and that when used routinely actually harm mothers and babies. I also thought about the multitude of evidence based, helpful procedures that are underused in many birth environments despite research indicating that they contribute to better outcomes for both mother and baby. (The use of the terms “overused” and “underused” and the examples below are taken from the OBOS book.)

Overused Procedures–these techniques are often used routinely (instead of appropriately based on true level of need in which case they can be truly helpful and sometimes even save lives) despite clear evidence that overuse is harmful:

  • Induction of labor
  • Episiotomy
  • Epidurals
  • Cesarean sections

Underused Procedures that have been shown to improve birth outcomes as well as to improve women’s satisfaction with their birth experiences include:

  • Continuous one-on-one support from a skilled caregiver during labor (a doula is a professional labor support provider who offers this one-to-one support).
  • Changing positions during labor (especially positions using gravity).
  • Laboring out of bed.
  • Walking during labor.
  • Comfort measures such as water, massage, and birth balls.

To increase your likelihood of satisfaction with your birth experience and of having a normal birth as well as a healthy mother and baby, choose a birth setting and care provider that supports and USES these underused procedures and only rarely, and appropriately, uses the overused procedures listed above.

Satisfaction with Your Birth Experience

Feb16

There are four factors that research have found to make the greatest contribution to your degree of satisfaction with your birth experience (experience or not of pain isn’t one of them!):

  • Having good support from caregivers.
  • Having a high quality relationship with caregivers.
  • Being involved with decision making about care.
  • Having better than expected experiences (or having high expectations).

According to additional research, pain relief only becomes important in relationship to level of satisfaction when expectations are NOT met (so, if you planned for a epidural and didn’t have time to get one, or you expected to cope differently with pain than you did, and so forth).

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When reflecting on these things based on my personal experiences, they seem completely appropriate (including the experience or not of pain–my sense of satisfaction with my own birth experiences has nothing to do with how much or how little pain I experienced or how I interpreted my sensations as painful or not. With both my babies, I had a high level of satisfaction with my birth experiences and in both I had a high quality relationship with my caregivers (family practice physician with the first baby and midwife with the second). During both labors I had very excellent support from my husband (the professional caregivers had little involvement with either of my births). He was so present for me and so able to provide what I needed that I had a sense of us being like one person during labor. Decision making about care also came into play with my satisfaction level. with my second baby particularly, I was completely in control. No one else made decisions about my care. So, it was much more than “involvement in” decision making, but for me, an important component of satisfaction was total control of decision making.

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Finally, I totally identify with the “better than expected experiences.” With my first baby, I was stunned and very pleasantly surprised to arrive at the birth center fully dilated. I had expected to labor for an additional 10 hours or so at the birth center (I was in labor for about 11 when we got there). With my second baby, I was again stunned and also pleasantly surprised to be in labor for a total of 2 hours. While I felt a bit “run over by a truck” by the speed and the intensity of the second labor, I was delighted to have such a quick birth. It was great.

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I also started thinking about what else, personally, would be on my list of things contributing to satisfaction with my birth experiences and I think location is a big one for me. Being in an environment of my choosing and in which I felt safe, comfortable, and respected was very important to my feelings of satisfaction. My second baby was born at home and that was very satisfying to me. I’m sure there are other things that were important, but I can’t think of anything specific right now.

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How about you? What contributed to your feelings of satisfaction (or not) with your birth experience(s)?