Preparing yourself for Birth

Presented by The Training and Research Centre for Natural Birth Inc.

There are many things to consider when planning your pregnancy, labour and birth. It is important to remember that there are many options available, and you need to consider your own expectations and birth experience before deciding. For example, the following questions might be asked by you.

Q. Who can be with me during my labour and birth?
Some hospitals limit the number of people allowed in the labour and delivery room. Birth centre or homebirth services will let a birthing mother decide whom she wants to have with her during her birth. This includes fathers, partners, children, their  family members or friends.

Q. What happens during a normal labour and birth in your setting?
The facility or service should tell you how they handle every part of the birthing process. For example, how often do they give the mother a drug to speed up the birth? Or do they let labour and birth usually happen on its own timing? They will also tell you how often they do certain procedures.  For example, they will have a record of the percentage of caesarean births they do every year. If the number is too high, you’ll want to consider having your baby in another place or with another doctor or midwife. Here are some data for your reference:
• They should not use oxytocin (a drug) to start or speed up labour for more than 1 in 10% of women (10%).
• They should not do an episiotomy on more than 1-5% of women (20%). An episiotomy is a cut in the opening of the vagina to make it larger for the birth. It is not necessary most of the time.
• They should not do caesarean sections (c - sections) on more than 1 in 10 women (10%) if it is a community hospital. The rate should be 15% or less for hospitals which care for many high-need mothers and babies.

Q. How does your facility provide for different cultures and beliefs?
Your facility should be sensitive to your culture. They know that mothers and families have differing beliefs, values and customs. For example, you may have a custom that only women may be with you during labour or birth. Or perhaps your beliefs include a religious ritual to be done after the birth. There are many examples that may be important to you. Make sure your facility will accommodate your requests and be sure to notify your doctor or midwife about this before your birth.

Q. Can I walk and move during labour? What positions can I birth in?
It is important to consider this before your birth. Although practices have been slowly changing in Australia some hospitals still require women to remain on a bed for labour, birth centres and homebirths encourage women to walk or move to whatever position makes them comfortable.

Q. How do you help mothers stay comfortable? Besides drugs how do you relieve the sensation of labour?
The people who care for you need to let you know how to help you cope with labour. They should know ways of helping you that do not include the use of drugs. They need to be able to suggest (and make available) alternatives, such as changing position, relaxing in a warm bath, having a massage, using music or walking. These are called comfort measures.
Comfort measures help you handle your labour more easily and help you feel more in control. Make sure the people who care for you will not try to persuade you to use a drug for coping unless you need or request it.

Q. What things does your facility or homebirth service normally do to a woman in labour?
Experts say some methods of care during labour and birth are better and healthier for mothers and babies. Make sure your chosen birth place carers use methods proven by medical research and methods that incorporate your wishes. Here is a sample list of things you might like to think about and discuss with your health care provider.
• Do they only listen to your baby’s heart beat from time to time and not all the time with a machine called an electronic foetal monitor if it is not medically required?
• Do they use I.V. fluids (a needle into your vein to give fluids) routinely? (This is only necessary in a few difficult situations and perhaps if you do not keep yourself well-nourished both before and during your labour.)
• Do they ensure you can drink and eat during labour?
• Do they understand it is not necessary to shave or give you an enema for you to have a safe birth outcome?

A birth centre, hospital, or homebirth service that does not assure these things for most of the mothers should be reconsidered. It is important to remember these things are only guidelines that apply to normal pregnancy, labour and delivery and should not be applied to high-need pregnancies.

Published in byronchild/Kindred issue 3, June 02