Dr Asma Khalil, consultant obstetrician and fetal medicine specialist at The Portland Hospital, discusses alternative birthing options
The birth of your child is a special experience that will be individual for every mother, but in each case, a truly life-changing event. Developing a plan ahead of labour and reviewing the different options available can help to ensure it’s both a memorable and enjoyable experience.
Active birth
What is it?
During an active birth, mothers are encouraged to take control of their bodies and move around freely. They usually adopt upright positions during both labour and birth, instead of delivering in bed while on their back. An active labour might involve birthing balls and cushions to allow for comfortable sitting and kneeling, or items such as ropes, which can help support a squatting position.
What are the benefits?
Studies have found that an active birth can make the process of labour easier, more efficient and less painful. For example, upright positions can help to work with the force of gravity, and squatting positions can widen the pelvis outlet for the baby.
Is it right for me?
An active birth is all about listening to your body, so there may be elements you wish to incorporate into your birth plan, even if you don’t decide to choose this option for delivery. Many antenatal classes incorporate elements of the active birth philosophy into their agendas, so make sure you ask about it during your sessions. Active birth techniques are particularly useful in women who are not using other types of pain relief in labour, but they can also enhance the experience of women using other pain relief, including Entonox (gas and air), injections of morphine or pethidine, or an epidural.
Hypnobirthing
What is it?
In recent years, we have seen an increase in the demand for hypnobirthing – or the use of hypnosis during labour. Hypnobirthing can help you feel calm and relaxed during labour, and more confident in the birthing process. It’s a form of self-hypnosis that triggers a physical and mental state of deep relaxation.
What are the benefits?
Expectant mothers may find the whole experience calmer and more relaxed, and they may feel more in control throughout.
Is it right for me?
The hypnobirthing technique can be modified to suit every woman. If a mother is interested in approaching the birth with this technique, I usually advise she researches hypnobirthing early on in her pregnancy, as with more practice it usually comes more easily when required. Even women who have an epidural for pain relief can still benefit from continuing to use hypnobirthing techniques.
Water birth
What is it?
A water birth, where a woman spends much of her labour in a pool of water at body temperature, can provide a relaxing environment during labour. Some women will spend much of their labour in the pool, but come out of the water for the birth; others will stay in the pool to deliver their baby there. However, sometimes hours submerged in the pool can become uncomfortable, and might prevent the mother from staying mobile, so we usually advise women to enter the pool once they are at least 4cm dilated.
What are the benefits?
The relaxing nature and feeling of weightlessness in water can, in many cases, ease the pain during labour, and is therefore a natural option for mums-to-be who are wary of medical intervention, as contractions are often more manageable. It is also much easier to move around and change into different positions. Often the woman’s partner will get into the pool, too, to support her.
Once your baby is born, it needs to be lifted with its face out of the water so it can breathe – your midwife will do this or help you to do it yourself, if you prefer. This is because the oxygen supply from the placenta will stop at some stage soon after the birth, and because baby’s circulation at birth changes its lungs must therefore fill with air.
Is it right for me?
It is important to note that water births are suitable only for low-risk pregnancies, as the water can make it more difficult for your doctor to assess the baby’s wellbeing by monitoring its heartbeat. However, some maternity units have telemetry which allows your baby’s wellbeing to be monitored, even when you are in the water. Epidurals are also not suitable for mothers who choose to give birth in water, as they require the mother to be connected to a drip; there would also be a risk of infection getting into the place where the epidural has been inserted in her back.
Water births might not be for everyone, so if you find the experience too uncomfortable, feel free to leave the pool at any time and consider the other options available to you.
There are a range of options out there for mothers-to-be; however, the most important thing is that it works for you. I always urge expectant mothers to research their options and raise any concerns with your network of professionals, who are all there to support you in bringing your child into the world safely and, as far as possible, on your own terms.
Dos and don’ts!
Do
– Think about what will make you most comfortable and relaxed.
– Make sure you attend antenatal classes before developing your plan, as they will help give you some ideas.
– Remember that birth plans are rarely the same – there is no right or wrong!
– Keep a record of your birth plan, and make sure you share it with your midwife or consultant.
– Keep an open mind. Make a plan that suits you but be prepared to consider your options if things change during labour.
Don’t
– Make your birth plan too prescriptive. It should only be a guide, so don’t put pressure on yourself to follow it exactly.
– Leave out your birthing partner.
– Forget to ask questions! It’s important parents feel confident, and the more you know, the more you will feel reassured.
