Ask the Midwife – Benefits of a Normal Physiologic Birth

Q: I am expecting my first child in October, and I am both excited and scared. What can I do to have the best outcome for myself and my baby, and decrease the chance of interventions such as c-section?

A: Congratulations! Our goal is to support you in having the birth you want, with a happy and healthy outcome for mom and baby. First, let’s review normal birth. This process includes labor, childbirth and the immediate postpartum period. Normal birth begins on its own, results in vaginal birth, and the mother and baby remain together after birth, with the baby skin to skin. When labor begins spontaneously, hormones are released that help your body contract effectively and help you cope with pain. There is less of a chance that you will need a vacuum delivery or a cesarean. The hormones of labor also help your baby transition to life outside the womb, including maintaining a normal body temperature and respirations. Benefits of a normal birth process include better health for mom and baby, successful adjustment to life outside the womb, emotional satisfaction with the process and being able to cope well with the transition to motherhood.

It is important to give birth in an environment that feels private and comfortable, with the right support people present. Some women hire a doula for one on one support. Others have family members present. Only you can decide who you need for emotional support and it is worth thinking about ahead of time. Time limits on the progress of labor can lead to interventions. Active labor begins later than previously thought, not until about 6cm of dilation. Avoiding medication in early labor to increase contractions can help you stay on track to have a normal labor. Sometimes women are prevented from eating in labor; this may be a policy if an epidural is desired. Be sure to eat before coming to the hospital. You need the energy. Pain medications alter the course of normal labor but if they are needed they are there to help you through the process. Epidurals can slow labor down, and IV pain medication can make the fetus sleepy. Natural pain relief can include walking, tub or shower, birthing ball, massage.

Your ability to have a normal birth is influenced by many factors, including your overall health and fitness. If you have medical problems complicating pregnancy you are more likely to need induction of labor or other interventions. Often your knowledge base surrounding pregnancy can affect how you get through childbirth. We recommend childbirth preparation classes for first time parents. It is very important that you participate in decision making surrounding birth choices with your provider and feel supported in your decisions. It is also important for you to have the healthcare provider who is right for you; who listens, gives you time to decide, informs you of your options, respects your preferences and is willing to help you achieve your goals.

Finally, the basis of normal birth is to go into labor spontaneously, without using medication to start or speed up labor, unless there is a valid medical reason; to be allow nourishment in labor; to move around freely in labor; to give birth in your position of choice; and to receive the support you need from the people you choose. You should also have the option of having your baby’s heartbeat listened to with a doppler periodically rather that being strapped to a monitor. The majority of women are low risk and have normal pregnancies so are able to have a normal, intervention-free labor. Please ask questions during your pregnancy and birth so you can be fully informed to have the birth experience you want.