YES!!! Having a baby may be the most special time in the lives of expectant Moms and Dads, yet it can be heavy laden with anxiety and fear, leaving them feeling helpless and frustrated. The good news is that with the appropriate care and preparation, birth can be celebrated as one of the most powerful and momentous life events that a couple can experience. The journey of pregnancy and birth is often compared to preparing to run a marathon, much of the mental and physical preparation begins months in advance of the actual day of the race.
ROLE OF YOUR MIDWIFE OR DOCTOR/OBSTETRICIAN: Choosing the appropriate health care provider to look after your pregnancy and birth extends beyond their essential midwifery/obstetric experience and skills. A midwife is able to independently provide antenatal and postnatal care and birth women who are categorised as low risk. Referral to Medical Doctors or Obstetricians happens when a higher level of care may be required. According to the World Health Organisation, 85-90% of women are able to birth vaginally [i]. Getting to know your health care provider’s philosophy on natural birth may provide a glimpse of whether their care is the appropriate fit for you or not. Points that will help you to gauge your health care provider’s willingness to support your choice of natural birth may become clearer in their responses to the following:
- What is the overall caesarean section rate vs vaginal birth of their practice over the past year?
- Are interventions such as breaking of waters; induction of labour, and episiotomy a routine procedure for the births that they conduct?
- Find out what are their thoughts on delayed cord clamping and immediate uninterrupted skin to skin care.
- Find out if they are open to the idea of you birthing in an upright position of your choice.
These pointers are by no means a gauge of your health care provider’s competence but rather their willingness to support natural approaches to birth and labour.
INVEST IN A HIGH QUALITY BIRTH PREPARATION PROGRAMME: These classes, often called prenatal or antenatal classes, are usually conducted by a Midwife, Child Birth Educator or Doula. They are designed to empower and equip you with the knowledge, skills and tools to help you navigate the milestones of your pregnancy, birth and parenting journey. Such programmes are especially valuable for first time parents, women who have had previous traumatic birth experiences and parents-to-be who feel “afraid and not ready” for pregnancy, birth and parenting.
The knowledge shared in these programmes often includes:
- Explanation of the hormonal influence and its effects on your body throughout pregnancy, birth and postnatal periods.
- The niggles expected and coping tips.
- Signs of labour.
- Newborn care and feeding .
- The skills taught typically include relaxation and breathing techniques, antenatal exercises such as mindful movement, stretching and basic yoga and how these benefit you.
- Birth positions are discussed and may be practiced. The benefits of these positions are discussed in relation to the physiology of natural labour and birth.
Depending on your health care provider’s advice, you may require more specialised assistance from a pelvic floor therapist and or chiropractor to assist you to strengthen, lengthen and stretch your pelvis floor muscles in preparation for birth.
Mental preparation is equally important as physical preparedness to have a positive birth experience. Unravelling and providing healing opportunities for previous disempowering and negative birth experiences is essential in the overall wellbeing of women and should not be minimised. [ii]
PURPOSE OF YOUR BIRTH PLAN:
Labour and birth is a unique experience for each woman. Usually with the services of your Midwife / Childbirth Educator or Doula, you can put together a personalised birth plan to assist your birth team to understand your needs, areas of vulnerability and strengths with the aim of honouring your wishes and having the birth experience that you desire. Discussing your birth options, pain management and other important aspects relating to your labour, birth and postnatal care can be conveyed to your birth team with your written birth plan. However, take caution of the fact that natural birth is often unpredictable and therefore you must be flexible to change in instances where the health and wellness of you and or your baby is compromised. In such instances where your wishes can not be honoured this must be communicated to you clearly, timeously and unbiasedly. Upon receiving the risks and benefits, as well as the reason for your wishes not being honoured, and if any questions you may have had are satisfactorily answered, your informed consent may be obtained.
THE POWER TOOLS ADVOCATED FOR LABOUR AND BIRTH:
- Birth Affirmations: These are positive, motivating statements which help you to navigate the difficult parts of labour and birth. You may prepare visual or audio affirmations in advance to use in your labour and birth room.
- Steady and Strong wins the race: Natural Labour is a gradual and progressive process when unhindered. It always benefits from a quiet, non-threatening and calm environment. Anxiety and fear may disrupt your natural labour and birth hormones. The Idiom, “A watched pot, never boils,” holds wisdom that lends itself to natural labour. Relax, slow down, breath and move through your labour one contraction at a time. Rest as often as you can throughout your labour between your movements, to avoid exhaustion at the end.
- Water Immersion: Water is a great natural pain modality[iii]. This can be done in a tub of water or simply standing under a shower allowing the warm or cool water to run down the area of your body holding most tension. Speak to your Health Care Provider about the option of a water birth.
- Movement: Dance, swaying of hips from side to side, making big circles with your hips can bring much relief as your baby negotiates your pelvis during your labour process.
- Doula support: These are professionally trained practioners providing non-medical emotional, psychological and physical support to you and your birth partner throughout labour birth and postnatal periods.
- Upright Birth Positions: Positions that favour gravity are effective positions that are intuitive to the physiology of birth.[iv] Avoid lying flat on your back as it DOES NOT support the physiology and is counterintuitive to natural birth. Some birthing positions you can explore are: squatting, lying on your side, standing and even on all fours, find a position that supports you best and listen to the sensations of your body.
- Immediate and uninterrupted skin to skin contact: having your baby on your naked chest immediately after birth while your Healthcare Provider practices delayed cord clamping is documented scientifically to be gold standard care. This coupled together with learning your baby’s hunger cues, will lead to instinctively latching your baby to your breast and successful initiation of breast feeding[v].
The birth of your baby’s head should be slow, controlled and instinctive. Try panting or blowing at this stage instead of pushing and see its gentle effects on your perineum and pelvic floor muscles.
Blog Post by: Evashnee Naidoo
(Registered Midwife-BNAP), Founder of Mama Earth Midwifery Care Center.
Evashnee is available at Thrive Ballito, to book at appointment with her:
073 602 5510 or firstname.lastname@example.org
 World Health Organisation (WHO). 2018 WHO Recommendations: Intrapartum Care for a positive childbirth experience. Geneva.
 Mari Greenfield, Julie Jomeen, Lesley Glover,‘After last time, would you trust them?’ – Rebuilding trust in midwives after a traumatic birth, Midwifery, Volume 113, 2022, 103435, ISSN 0266-6138, (https://www.sciencedirect.com/science/article/pii/S0266613822001863)
 Cluett ER, Burns E, Cuthbert A. Immersion in water during labour and birth. Cochrane Database Syst Rev. 2018 May 16;5(5):CD000111. https://doi: 10.1002/14651858.CD000111.pub4. PMID: 29768662; PMCID: PMC6494420.
 Berta, M., Lindgren, H., Christensson, K. et al. Effect of maternal birth positions on duration of second stage of labor: systematic review and meta-analysis. BMC Pregnancy Childbirth 19, 466 (2019).
 World Health Organisation (WHO). 2020 : Skin to Skin Contact help New-born’s breastfeed. Geneva