The Choices in Childbirth - Part One Modern Birth

Over the past few decades, women have been taking greater control of their own health. In many cases, members of the medical profession have responded enthusiastically to the changing desires and needs of women, and the "choices" in childbirth have never been greater, nor our wishes more paramount. Today, most of us ask to have our children more naturally, and this option should be available to all of us, whether the birth is at home or in hospital. But we shouldn't ignore the benefits a managed birth can provide, particularly when childbirth doesn't go as smoothly as expected.

THE MODERN MANAGED BIRTH

The modern managed birth (high-tech birth hospital) came out of a justified concern for the mother baby, and from increased medical knowledge of d' physiological aspects of birth. In a managed birth, labour is actively controlled so that it fits into what is perceived as being normal (this perception can differ, however, depending on the hospital and the obstetrician).

A managed labour is the norm for most hospital births and it is essential for some women who may have complications during pregnancy, labour and birth - an anticipated breech birth, for example. You will attend antenatal clinics in hospital, and you may well be seen by different doctors and midwives at each visit, which can lead to discontinuity of care.

In this setting, too, you are most likely to experience medical intervention involving some of the most modern procedures in obstetrics." With this kind' of labour, epidural anaesthesia is literally on tap and electronic fetal monitoring is standard. Your attendants will notice very small changes in your baby s condition and may be pressured to act on them. Consequently, with this type of birth there are more inductions and Caesareans, and more frequent use of forceps.

Although these practices are beneficial to a percentage of births where intervention is needed, the routine use of them often cannot be justified by hard evidence. So women who want to have complete control over their deliveries may feel very strongly about their use Other women clearly believe a hospital setting makes childbirth the event they expect it to be, and would feel cheated, nervous or even second-class if they didn't have an obstetrician in attendance with high-tech equipment available close by.

THE MODERN NATURAL BIRTH

It seems a paradox that you have to request a natural birth but even today you may find that childbirth is still dominated by obstetricians and a few old-fashioned midwives. However, if you make your preferences known early, a natural birth can be arranged. It is reasonable for women to want to have a natural birth in which there is no fear because the whole process of birth and delivery is familiar; where there is no unnecessary medical intervention; where there is a calm, homely atmosphere; where mothers are allowed to do anything they desire ? to take up any positions that are most comfortable; and not be under pressure to take pain-relieving drugs. Female bodies are well designed for giving birth; all the soft tissues of the birth passage can open up so that a baby is gendy squeezed out. But breathing and relaxation techniques can make birth even easier to manage, and a number of natural childbirth philosophies advocate these techniques.

Although there are individual differences, all birth philosophies share one common aim ? to enable women to give birth in the way they want. They emphasize the need for intense concentration on breathing patterns and the learned ability to relax your body at will. The best way to experience a totally natural birth is in a dedicated centre or at home.