Giving birth is all about choice. Becky Dickinson explores different ways to deliver.
As your pregnancy draws to an end, childbirth becomes an increasing, sometimes daunting reality. Deciding how to give birth is one of the most important decisions you will need to make while your baby is still inside you.
To the uninitiated, the options can seem as bewildering as the array of different pushchairs on the market. But just as there is no ‘one travel system fits all,’ neither is there one correct way to give birth. From living room floor to surgeon’s table, aromatherapy to epidural, there are more ways to bring a baby into the world than you can shake a Clear Blue stick at. Here are just a few of the options.
It seems somewhat superfluous to refer to a natural process like childbirth as ‘natural.’ Yet, in the case of labour, it means giving birth vaginally without medical intervention. Its advocates believe birth is a normal, healthy part of life, not a medical procedure. During a natural birth the woman can move around and try out different positions, using breathing exercises and relaxation techniques in place of drugs. This can have the advantage of feeling more relaxed and in control. Natural births can be extremely empowering. However, for some women it can be hugely disappointing if things don’t go to plan. Clare Shepherd from Clapham, London, says, “I’d set my heart on this beautiful drug-free experience, but after 40 hours in labour, I was exhausted and my baby was distressed. I ended up having an epidural and forceps delivery. Afterwards, I couldn’t help feeling I hadn’t done it properly.’’ Although many women aspire to a natural birth, it’s important to realise they are not always possible and intervention is never a mark of failure.
HypnoBirthing is a birth education programme that teaches simple self hypnosis, relaxation and breathing techniques. HypnoBirthing is based on the belief that pain is not necessary and that a woman’s body is perfectly designed to give birth. HypnoBirthing aims to free women from the fear and tension that often surrounds childbirth and to enable the pelvic muscles to relax. For the best chance of success, it’s necessary to practise the techniques well in advance of the due date. Kerry Woodcock from London says, ‘’HypnoBirthing kept me feeling calm and in control throughout labour. The contractions were no problem at all. It gave me a better understanding of the physical and psychological aspects of childbirth. I would advise every mother-to-be and her partner to try HypnoBirthing even if they intend to use drugs.”
Once the preserve of home births and midwife units, water births are becoming increasingly mainstream and many hospitals now have birthing pools. Larger than a normal bath, pools are deep enough for the woman to be immersed – with space for a partner or husband to jump in too if desired! Being in warm water can help a woman’s muscles to relax, which can reduce pain and speed up labour. Research suggests that being in water can also reduce the risk of tearing to the perineum. According to a Which? survey in 2013, about 30% of women giving birth in England used water or a birth pool for coping with labour pain, and 6% of women gave birth in a pool. Many women feel that giving birth in water provides their baby with a more gentle transition to life outside the womb.
In the UK, around one in four babies are delivered by an abdominal operation. There are two kinds of caesareans: planned (elective) and unplanned (emergency). A planned caesarean is arranged in advance, usually for medical reasons such as the baby being in an awkward position, or the mother having a high risk condition. Unexpected problems can also develop during or before labour which means the baby needs to be born quickly by emergency caesarean. This is usually done using spinal anaesthesia, but in some cases a general anaesthetic may be necessary. A c-section involves major abdominal surgery and recovery can take several weeks or longer. While caesareans can sometimes be the safest means of birth, some babies may retain fluid in their lungs which would have been squeezed out in the birth canal. It is still possible for a woman who has had a caesarean, to give birth vaginally in the future.
For some women, the thought of giving birth without drugs is akin to having a wisdom tooth extracted with a pair of pliers. Fortunately, pain relieving drugs are available. The most common form of pain relief of is Entonox (gas and air) which is inhaled through a mouthpiece and can take the edge off contractions.
Analgesics such as pethidine and other opiates provide a stronger dose of pain relief. Pethidine is usually given by injection into the buttocks. It can help women relax and cope with the pain of labour. It can also cause drowsiness and some women find it makes them feel nauseous or out of control. If given too close to delivery, pethidine may make the baby sleepy and slower to feed. Total, or almost total, pain relief can be given in the form of an epidural. Epidurals and spinal blocks are regional anaesthetics administered by an anaesthetist. A small tube is inserted via a needle between the vertebrae in the lower back.
Epidurals produce a loss of sensation, although pressure can still be felt. These medications can make it difficult to push at the end of labour, so there is an increased chance of having an instrumental birth, such as a forceps or ventouse delivery. About 1 in 100 women experience a severe headache following an epidural. More serious complications are rare.
For healthy women with a low risk pregnancy, a home birth can offer a safe, relaxing and comfortable environment in which to give birth. Women who have a home birth are more likely to have continuity of care and get to know the midwife during the pregnancy.
Louise Richmond from Woking, Surrey says, “my first daughter was born in hospital and although I couldn’t fault the delivery, the post natal ward was awful. It was hot, noisy, busy and impossible to sleep.’’ Louise decided to have her second baby at home. She says, “We hired a pool and fortunately Ava was born without any complications. The best thing was being able to get into my own bed afterwards. It was a lovely start and really helped us bond. The midwife even cleared up the mess!’’
If complications arise during a home birth, mother and baby will be transferred to hospital by ambulance. For low risk women having a second or subsequent baby, a home birth is thought to be as safe as a hospital delivery. However, for low risk women having a first baby, a home birth is slightly less safe than a hospital birth. Women who are at increased risk of complications will be advised against a home birth.