By Sarah Winfrey, CD(DONA)
Today's expectant parents face more daunting decisions than nursery décor. From care providers to childbirth classes, birth options are more abundant than the dirty diapers of the near future. Oftentimes parents simply see themselves as along for the ride through the land of maternity care and birth preparation, when in reality they are the drivers. So take hold of the wheel and steer yourself through an education of the many options available.
Birth Works International is a childbirth process that gives women confidence in their birthing abilities and offers partners a sense of how to support their companions comfortably and safely. Classes are experiential, prepare a mother physically and emotionally, and assist couples in examining beliefs about birth, selecting a care provider, and choosing a birth location where they'll feel safe. Birth Works maintains that all births are unique and doesn't teach a particular method. Families are welcomed in early pregnancy, or even preconception. Classes generally run 10 weeks, in 2-hour sessions. birthworks.org
Birthing From Within is a preparation series based on the book "Birthing From Within" by Pam England and Rob Horowitz. Classes are offered as a homestudy course, with a trained Mentor, or over the telephone with midwife Pam England, who maintains that birth is a rite of passage. "The essence of childbirth preparation is self-discovery" and so it's a "continually evolving process, not a static structure of techniques and knowledge," (http://www.birthingfromwithin.com/philosophy) . Pain is an intrinsic part of childbirth, but can be effectively managed to relieving suffering. Birth partners are trained not as coaches but as "birth guardians or loving partners." Through art and self-exploration students prepare to be initiated into the world of birth and parenthood. bradleybirth.com
The Bradley Method of Natural Childbirth is taught over 12 weeks. Says local instructor Tara Neidich, "statistically, more students are able to birth naturally (without drugs or other interventions) compared to students of shorter classes, with close to 90% of our vaginal births being unmedicated. The classes are limited to no more than 6-8 couples and are typically taught in the home of the instructor, or in your home for a private series. Classes focus on training a partner/coach to assist in labor, relaxation, learning how to work with the natural process, nutrition, exercise, communications, and consumerism. Students exit class confident and aware of all of their options in childbirth, whether birthing at home or in hospital." bradleybirth.com
Hypnobabies is a 6-week complete preparation series teaching the use of real medical hypnosis, with a basis in Gerald Kein's well-known Painless Childbirth. There is also a self-study course offered. Mothers go deep into controlled self-hypnosis for a calm, gentle birth that's more likely to be unmedicated and shorter, with fewer interventions. Birth partners are trained and prepared for an enjoyable experience. Parents overcome negative images about birth, learn to make healthy choices throughout pregnancy and birth, and are taught to be conscientious consumers. The powerful hypnosis scripts used are the same type utilized during surgery by people with life-threatening anesthesia allergies. To see a clip of a peaceful Hypnobabies experience, visit youtube.com and watch Bryson's Birth. hypnobabies.com
HypnoBirthing is a series of five 2 ½-hour birth hypnosis classes, focusing on a "rebirth" of ancient traditions recaptured by obstetrician Dr. Grantly Dick-Read in 1920. Without fear comes the ability to birth naturally without acute pain. Women learn to trust their muscles to work harmoniously as they relax and submit to the birthing process. In a day-dreamy state, mothers still maintain total control of their experience. Pregnancy and pre-birth parenting are also addressed. In 2007, over 70% of HypnoBirthing moms birthed vaginally and without pain medication (hypnobirthing.com).
Lamaze International is a non-profit organization dedicated to promoting health and safety in pregnancy and birth. Classes originated in the 1950's and today go beyond the well-known breathing to focus on the most current research and practices, and to educate families on the normalcy of birth, the ability to find comfort, and the importance of familial and professional support. Lamaze teaches families to trust in the mother's inherent knowledge to birth naturally and safely, in the location of her choice and free from routine medical procedures. Women are empowered to be responsible for their choices and take control of the birthing experience that so profoundly affects them and their families. lamaze.org
While most U.S. births occur in hospitals, it's also an option to birth at home or in a center. In Virginia, homebirth with a certified professional midwife (CPM) became legal in 2005. Women choose this alternative for an unmedicated birth, free from unwanted medical interventions in the comfort of home. Families also often form intimate relationships with the midwife that they see during every hour-long appointment. Says Kim Pekin, local midwifery student about to achieve certification, "I am a participant in a sacred moment...when you get to know a woman and her family over the months of pregnancy, see her in her home, play with her kids, cry with her when she hears her baby's heartbeat for the first time, and see her all the way through this special time in her life, you become personally invested. A midwife is there to witness her victory and share in her joy."
But is homebirth safe? Dr. Marsden Wagner, former World Health Organization director of Women's and Children's Health, writes in a Midwifery Today article that with a trained birth attendant "the home is a perfectly safe place to give birth if you are one of the more than 80 percent of women who had no serious medical complications during pregnancy ("Technology in Birth: First Do No Harm", 2000)." Some argue the safety of hospital births in a country where about one in three women birth by cesarean (http://www.childbirthconnection.org/article.asp?ck=10456). Birth Care midwives, who also run the area's only birth center in Alexandria, have a cesarean rate of less than 4 percent for homebirth clients (http://birthcare.org/safety.htm). Says Wagner, "between 50 percent and 80 percent of births in most American hospitals involve one or more surgical procedures." Homebirth or birth center birthing may be an alternative for women wishing to have a different experience.
Traditionally, women supported women during childbirth. Today's birthing room usually contains a husband and wife laboring alone, with intermittent visits from a nurse or care provider. Some parents though look to others for additional support, comfort, and guidance. Mothers, sisters, aunts, and grandmothers can share their womanly wisdom and create an atmosphere of love for a birthing woman. There are never enough hands at a birth for massaging, fanning, offering drinks, applying cool compresses, and channeling tender support through a gentle touch.
Doulas are another player on some birthing teams. The Greek word doula traditionally referred to one who serves. Today's doulas are trained support who stay with a family for the duration of birth, offering information and answering questions, sharing comfort techniques, and preserving and protecting the woman's birth experience by creating a peaceful environment of emotional encouragement and understanding. Women of all birthing backgrounds with varying birth wishes gravitate toward doulas, and improved outcomes are the consistent results. Several clinical studies show doula support reduces length of labor and the number of complications; lessens negative feelings about one's birth; decreases the need for pitocin, forceps, vacuum extractors, and cesarean; and reduces requests for pain medication (https://www.dona.org/what-is-a-doula/benefits-of-a-doula/). Improved medical and emotional outcomes have even led to the assignment of a new insurance code that may lead to some third-party and Medicaid reimbursements.
WEB ONLY - Holistic Pregnancy Care and Birth Preparation*
Chiropractic care can contribute to comfort in pregnancy and ease in childbirth. Adjustments by doctors of chiropractic release spinal stress caused by misalignments, or subluxations. Such misalignments can affect the entire body's performance. How does this influence the pregnant woman? "Without subluxations the body will function better, have a higher resistance to disease, and express more wholeness (health)," says chiropractor Dr. Jeffrey Bach, owner of Bach Chiropractic and Acupuncture Clinic in Fredericksburg. "That is the essential message of chiropractic. All this is extremely important for the pregnant woman who needs to have her body as healthy and strong as possible in order to handle the rigors of pregnancy and childbirth."
Chiropractic can even assist a breech baby in rotating into a better birthing position. The Webster Technique, a method used to balance the pelvis, works by lessening the effects of constraint in the uterus, allowing baby to position in the best possible way for birth. Not only is there a high success rate among breech babies, but the Webster Technique also benefits malpositioned babies, such as posterior babies and twins, according to the International Chiropractic Pediatric Association (http://icpa4kids.com/about/webster_technique.htm).
Rapsberry leaf tea is another natural method to achieve greater ease in childbirth. Mothering Magazine's "Having a Baby Naturally" states that this most popular pregnancy herb has been used throughout time "to encourage safe, easy childbirth, to speed recovery from birth, and to stimulate milk production afterward (2003)." Raspberry leaf is a tonic touted to tone and relax the uterus, reducing contraction pain and increasing effectiveness and productivity. It also "soothes the kidneys, allays diarrhea, stops hemorage, quells nausea, sedates, and relaxes." Mothering recommends drinking one cup daily in the second trimester and three cups daily in the third.
The Brewer Diet is a nutrition program recommended by many childbirth methods and CPMs. Dr. Tom Brewer began 11 years of research in the 1960's and developed a diet that virtually eliminates the preeclampsia in mothers and prematurity in babies ("Husband-Coached Childbirth, 2008). At the heart of the diet is an increased protein intake, from the RDA of 40-50 grams to 80-100 grams daily. Dr. Brewer recommended using two eggs and four glasses of milk, fairy inexpensive and readily available, as a starting point, which already puts a mother at 32 grams of protein. The diet advocates salt to taste and healthy weight gain without stringent restrictions. Checklists for vegetairan, vegan, and twin diets are offered. To learn more, read the chapter "Nutrition in Pregnancy" found in "Husband-Coached Childbirth: The Bradley Method of Natural Childbirth" (2008), or visit blueribbonbaby.org or home.mindspring.com/~djsnjones/.
*As with all things in pregnancy, check with your care provider first. The author is simply supplying information, not endorsing any of these practices.
Family Childbirth Circle
Head to the Salem Church Library at 7:00pm on the second Tuesday of every month to attend this free meeting for prospective and expecting families, and those with new babies. Area professionals cover topics relating to pregnancy, childbirth, and the newborn period, with time for questions and discussion. Birth partners and babies are welcome! For meeting topics and announcements visit http://birthbeauty.com/childbirthforum.html.
Beyond "What to Expect" - Recommended Reading and Viewing
The Business of Being Born - Executive Producer Ricki Lake and Director Abby Epstein, 2007
Gentle Birth Choices, with DVD - Barbara Harper, 2005
Ina May's Guide to Childbirth - Ina May Gaskin, 2003
Pregnancy, Childbirth, and the Newborn - Penny Simkin, Janet Whalley, Ann Keppler, 2001
The Thinking Woman's Guide to a Better Birth - Henci Goer, 1999
Culpeper Regional Hospital Is Baby-Friendly
Earlier this year Culpeper Regional Hospital became the first and only Virginia Hospital to meet the UNICEF/WHO's criteria and be deemed "Baby Friendly." Cindy Curtis, RNC, International Board Certified Lactation Consultant, and Childbirth Educator at Culpeper writes of the hospital, "mothers...can feel the difference the moment they walk in the doors. A small, close-knit, sisterly staff will welcome you and meet all your needs, helping mothers achieve the birth they desire, whether it be a natural birth with minimal interventions enjoying the Jacuzzi tub and birth ball, or a medicated birth with an epidural. All Culpeper staff, including physicians, have also received specialized training to assist the 85% of our mothers that breastfeed." www.culpeperhospital.com
Vaginal Birth After Cesarean
Once a c-section, always a c-section? Research suggests vaginal birth after cesarean (VBAC) is a safer option for mothers than a scheduled repeat cesarean. The International Cesarean Awareness Network (ICAN) states that elective cesarean (that is, cesarean birth without a true medical cause) is in fact more dangerous. Jill MacCorkle, editor of the ICAN Clarion, writes in her 2002 "Position Statement" that babies born by cesarean have an increased chance of developing life-threatening conditions, and that "the maternal death rate is twice as high for elective cesarean as for vaginal birth (http://ican-online.org/vbac/postion-statement-elective-cesareans-riskier-than-vaginal-birth)." In the case of uterine rupture, previously sited as the major risk of VBAC, the Mayo Clinic maintains that if "you deliver your baby in a hospital equipped to handle such emergencies, rarely is your baby at risk."
The risk of uterine rupture to women with a low transverse uterine incision is 0.2 percent to 1.5 percent, or less than two out of 100 women. Other factors may affect risk, including type of suturing, time since prior c-section, and use of labor-inducing drugs. - The Mayo Clinic's VBAC Guide
For recent studies, advocacy, meeting groups, and more visit www.ican-online.org.