Women, when they are in an environment that supports them and are with people who trust them, will birth exactly as they need to in order to birth their babies. We have forgotten that we remember. I have also learned that women have a very strong desire to be among people who are happy and who have a lot of trust in them. I live and work in a place where women say that birth is so important they should not waste the opportunity. And they say that birth is something that one should “get into,” and is not something that one simply must “get through.” Imagine a place where women talk about their stories over and over, because they had such a great time, instead of a place where women fear birth.
— Candace Whitridge
Where you choose to birth your baby is one of the biggest decisions that you will make.
Women give birth easier and faster when they feel safe. Different hormones are released when a woman feels safe to help her birth as to when she feels the ‘fight or flight’ response and feels the need to be alert or feels afraid. So the environment you choose is very important. In order to birth easily, you must feel safe wherever you choose to birth.
Everything else that happens, and the relationship you have with those caring for you, is affected by your choice of birthplace — Childbirth educator, Sheila Kitzinger
Things that you might like to consider when choosing a place to have your baby.
Movement – Can you move around?
One of the most important things to make labour easier and to lower intervention is to have the freedom to move around. When women are in an environment that allows them to move around freely they will usually adopt several different positions, particularly during the second stage of labour.
Being able to move can assist babies to get into the right position to enter the world naturally. Many women are told they require an emergency caesarean after having an epidural because the baby is not in the right position. What they don’t understand is that if they where able to move then there is a good chance that their contractions would have turned the baby into the correct position.
You might also feel the need to labour on your hands and knees, so check if the hospital or birth centre has something that you can put on the floor for you to have a clean soft surface. If they don’t you can always take your own.
By taking up the squatting position you can enlarge the pelvic opening by as much as 20 to 30%. Due to the fact that many Australia women don’t spend much time squatting, this is a good thing to practice during your pregnancy to help strengthen you thigh muscles. Deep squatting is not recommended in 2nd stage of labour due to perineal tears. It is best to take up a supported squat, either holding onto your birth partner(s) or onto an object to avoid this problem.
In women the coccyx, or tailbone, is hinged in order to increase the dimensions of the pelvis during labour. Lying down, leaning back or sitting on your backside means the potential size of the pelvic outlet is reduced by up to 30 percent.
Gravity helps in an upright position and you are far more in control. When you lie down, the muscles of your uterus have to work harder as you are pushing your baby up hill. This can cause fatigue and may deprive your baby of oxygen.
Lying on your back with your vagina exposed was introduced to make it easier for care providers to get a better view. Being in this position can cause many women to also ‘seize up’ because they feel so exposed which results in the biggest cause of intervention, failure to progress!
Giving birth in an upright position you can expect a shorter labour, you are less likely to request drugs, tear or need to have your labour speeded up. Women in an upright position also report feeling more satisfied and in control of their birth experience.
If you feel tired during your labour and need to rest, it is advised to lie on your side, as this doesn’t prevent your coccyx bone from opening.
Pregnant women should not be put in a lithotomy position (on their backs) during labour and delivery. They should be encouraged to walk about during labour and each woman must freely decide which position to adopt during delivery. – World Health Organisation recommendations
Feeling safe – Women give birth easier and faster when they feel safe.
Oxytocin is the major hormone responsible for creating contractions during labour in response to these contractions your body releases endorphins. These endorphins are your natural pain relievers.
If you become scared or anxious during labour, your body will release adrenaline, and its job is to slow down or stop your labour until the present danger passes. This effect occurs because adrenaline reduces the levels of oxytocin in your body, slowing contractions. Adrenaline will also work upon your cervix to stop it from dilating and in some cases it will reverse the work you have already done and begin to close it. This was very handy when we use to live outside with other large hungry animals and not so helpful now we have hospitals with strict time frames.
Visit the birthing space that you plan on giving birth in and check that you feel safe there; this goes for hospital, birth centre or home. Remember it is never too late to change.
Privacy – Will you have privacy?
A woman’s body might also release adrenaline in response to feeling that she has a lack of privacy
A great way to create privacy is to labour in the bath or shower. Labouring on the toilet is also great as it puts your pelvis in the perfect position and people are conditioned to give people their privacy when they are in the toilet and the limited space will reduce the numbers of people in attendance.
Lighting – Can you dim the lights?
We naturally like to give birth in a similar environment that we made the baby in. Check that you can make the room darker: dim the lights, close the curtains, draw the blinds.
Eating – Will you be allowed to eat food during labour if you wish?
During labour you will be doing the hardest, most physical and most rewarding job of your life. Denied energy (food) your muscles cannot do a proper job, especially your uterus. Many hospitals refuse women food and drink in labour “just in case” you need a a ceasearen, but with general anaesthetic so rarely used today it is not a very good reason to starve a women during labour. If you are planning on giving birth in a hospital it is best to take your own food.
Water – Will you have access to a shower or bath during your labour?
Many women feel instinctively drawn to water during pregnancy and when in labour. Warm water can be very soothing, and while it will not take the pain away completely, it will soften it and make it more manageable. The safety of labour and birth in water is well-demonstrated and may not have so much to do with what the water does as what the water represents. Basically, a mother who is labouring or birthing in water is much harder to interfere with. Regardless if she is in a bath or shower, she can’t easily be fitted with tubes and belts or jabbed with needles. The low rates of intervention for women who labour and give birth in water are testimony to this. It may also be that doctors and midwives, in the presence of a women who feels secure and is labouring in a self-possessed manner, feel less inclined to interfere.
Ball – Will you have access to a swiss ball if you desire?
The use of a large gymnastic rubber ball can be very helpful in labour. You can lean over it, sit on it and rotate your hips, even bounce on it between or during contractions to help the baby come down. Sitting on a ball is helpful when strapped to a continuous foetal monitor as you are able to move within a small space.
Sound – Will the staff tell you to be quiet in labour?
You should be encouraged to make whatever noise youe want. Noise is normal and acceptable, and you should feel that you have privacy to be noisy.
Drugs – Will you routinely be offered drugs for pain relief?
If you want to birth without these, it helps to choose a place and care provider who will not offer these to you when you are in the middle of a contraction, or at ANY TIME in your labour/birth unless medically indicated. Even better choose a birth environment where pain reliving drugs are limited like a birth centre or home birth.
Birthing Stool – If you want to use a birthing stool, do you have access to one?
A birthing stool is a stool which has been specifically designed for use during childbirth. It allows you to sit or squat while giving birth and can be very helpful if you are feeling fatigued. The birthing stool is also very helpful for vaginal breech births.
Photo Credit: http://www.flickr.com/photos/bellymotherbaby/ / CC BY-NC-SA 2.0