The choices for childbirth
Women today want to be in control of their health, including the birth of their children, and the medical profession has generally responded enthusiastically to changing desires and needs. The “choices” for childbirth have never been greater, nor our wishes more paramount. Most of us want to have our children more naturally, and this option is available, at home and in hospital.
The modern natural birth
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Most women would like childbirth to be as natural as possible: they want the process of birth and delivery to be familiar so they don't feel nervous or afraid; they like to have a calm, friendly atmosphere, in which they're allowed to take up the positions that are most comfortable for them and there's no undue pressure to take pain-relieving drugs; and they prefer to avoid any unnecessary medical intervention. Female bodies are well designed for giving birth; the soft tissues of the birth passage open so that a baby is gently squeezed out. Breathing and relaxation techniques can make birth even easier to manage, and most women now have plenty of chances to learn these techniques.
Most of the natural childbirth philosophies include some form of psychological re-learning to help you reduce your expectation of pain and raise your pain threshold. Learning special breathing techniques is usually central to the philosophy. There are slight variations in the different types, but all teach you intense concentration on breathing patterns and the ability to relax your body at will. The best way to experience a totally natural birth is in a dedicated centre or at home, but most general hospitals now accept that women want to give birth in the position they find most comfortable.
The modern managed birth
Normal pregnancies and uncomplicated births are almost entirely managed by teams of midwives and, although they may take place in hospital, the trend is towards less medical intervention. In a managed birth, labour is actively controlled for the safety of both mother and baby. A highly controlled birth in hospital is essential for some women who may have complications during pregnancy, labour, and birth - if you're expecting twins, for example.
In a hospital setting all the modern obstetric procedures are available, whether your birth is complicated or not. Epidural anaesthesia is literally on tap and electronic fetal monitoring may be necessary. Consequently, medical intervention is more common in hospital: there are more inductions and Caesareans, and the use of forceps or ventouse is more common. Although these practices are of course helpful in the percentage of births in which intervention is needed, it's now recognized that the routine use of them isn't justified (see Issues to think about). However, most women find a hospital setting makes childbirth the event they expect it to be, and they feel more secure there. Amenities such as birthing pools are now available in most hospitals.
Home birth
In many European countries healthy women may choose to have their baby at home if their pregnancy has been straightforward. In the United Kingdom, some doctors encourage women to have a home birth, even with a first baby, but in the United States it's more difficult. Arranging a home birth in the UK can still be tricky, and you do need to be very sure it's the best option for you. Always keep an open mind about transferring to hospital if things aren't going well.
Some doctors may feel that a home birth isn't as safe as a hospital birth. But there's always some risk attached to giving birth, and statistics have proved that in some circumstances a hospital birth can actually be less safe than a planned home birth. Unplanned out-of-hospital births can be extremely dangerous, though, whether it's a teenager trying to conceal an unwanted pregnancy or a couple who don't manage to get to the hospital in time, so their baby is born on the way.
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Posted 16.11.2010
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