It makes no difference if it's your first baby or your fifth. That precious moment when you see your infant for the very first time is miraculous. Perhaps it's true that with your first child you want everything to be “just so,” but many times, first-time mothers find themselves on the obstetrician's track and before long, nine months have gone by and you're about to deliver a baby on the hospital's schedule and with a pitocin drip to help you progress. For many women this is fine, but for others who want to make the experience their own, it's not. No matter what your choice is, knowledge is always power. Explore your options in our brief guide, then arm yourself with further reading. You'll be holding your little darling in no time.
The Bradley Method
In 1947, Robert Bradley, M.D., developed this method of childbirth after observing the way animals go into an extremely relaxed state — a state similar to sleeping — when they give birth. The method emphasizes few or no drugs and little medical help during labor and delivery. The method also stresses good diet and exercise during pregnancy, teaches deep relaxation techniques to manage pain and educates the mother's husband or partner in order for him to be an effective coach. Classes generally last eight to 12 weeks and are held for the mother and father (or other birthing partner). Both participants learn the deep breathing abdominal methods specific to the Bradley Method, and mothers learn relaxation skills to use during labor as well as various positions for labor and birth. For more information about the Bradley method, contact the
American Academy of Husband-Coached Childbirth at 800-4-a-Birth or visit the website at bradleybirth.com.
Certified Nurse Midwives
Recent data recorded by the National Center for Health Statistics (NCHS) shows that the number of midwives attending births nationwide has increased dramatically in the past few decades. A study of trends in the attendance, place and timing of births in the United States from 1989 - 97 shows that seven percent of births were attended by midwives rather than doctors — up from nearly four percent in 1989.
According to the NCHS, 95 percent of midwife-attended births involve a certified nurse midwife (CNM) rather than a lay midwife. CNMs provide the same prenatal care as physicians, developing prenatal profiles and providing urinalysis as well as any necessary cultures. They most often attend births in a hospital or birthing center. To locate the birthing facilities in Middle Tennessee that work with CNMs, see the Middle Tennessee Birthing Directory located on pages 31 and 32 in this issue.
Lay midwives typically have no formal medical training, but often apprentice with an experienced midwife for a number of years. Lay midwives attend births at home or in a birthing center, working to develop a relationship with the mother-to-be to ensure that she has the birth experience she desires.
To further your support base during your birth experience, you may choose to employ the assistance of a doula.
“Doula” is a greek term that means “mothering the mother.” The three terms “doula,” “childbirth assistant” and “labor assistant” are used interchangeably to describe the types of services doulas provide.
In the belief that the way you give birth affects the rest of your life, the doula’s goal is to support both parents at each of their own comfort levels. A recent study published in The American Medical Journal suggests there are substantial benefits to including the assistance of a knowledgeable labor support person during birth. According to the study, labor is often less complicated, less painful and of a shorter duration when a labor assistant is present.
Doulas are typically certified by Doulas of North America (DONA) or the International Childbirth Education Association (ICEA). For more information, call DONA at 888-788-DONA or the ICEA at 952-854-8660; or visit dona.org or icea.org.
The most common option for expectant women, an epidural numbs the pain of childbirth via anesthesia and is usually administered once the mother has achieved “active labor” (about three to four centimeters dilation). The anesthesiologist asks the mother to lie on her side or sit up in a hunched position, and a local anesthetic is used to numb the area before a medium-gauge needle is placed between the spinal cord and outer membrane of the back. Once the needle is in, a thin catheter tube is threaded through and the needle is removed. The anesthesia takes about 10 minutes to work; pain relief is substantial.
How each woman “takes” to her epidural varies. In the best scenario, leg control remains allowing for effective pushing ability. The medication can sometimes be quite strong, resulting in a loss of sensation in the lower part of your body. Be sure to discuss your epidural with your obstetrician beforehand.
Based on research by Grantly Dick-Read, M.D., in the first half of the 20th century, hypnobirthing involves self-hypnosis during labor to eliminate what Dick-Read called the “Fear-Tension-Pain Syndrome.” The laboring woman learns to enter a state of deep calm, reducing anxiety and pain while staying alert and awake for her child’s birth.
“People think hypnosis is some kind of mind control,” says local hypnobirthing and Bradley method instructor Jeannie Casey, “but it’s really a lot like the Bradley method. There’s a similar deep level of self-relaxation.”
Hypnobirthing is typically taught as a four-week course; both the mother and the birth partner attend. The main benefits, Casey says, are a faster labor and less pain. “It makes the contractions manageable. The beauty of it is, the more you practice, the deeper you can go faster — and the longer you can stay there.”
Introduced in the early 1950s by French obstetrician Fernand Lamaze, this method of natural childbirth employs the use of controlled rhythmic breathing, progressive relaxation techniques and concentration on specific focal points to block sensations of pain.
The main objective of Lamaze is to teach new moms that birth is a normal, human process that need not be feared. Women and their birth partner(s) are taught that they can have a direct impact on how they deal with the pain and discomfort of childbirth. By learning what to expect, they are able to build confidence in their abilities and bodies.
Usually started in the seventh month of pregnancy, Lamaze classes are scheduled in six-week sessions, concluding a few weeks before the due date. For more information and a list of local instructors, visit lamaze.org. ϑ
Janet Pinkerton is a mother and writer residing with her family in Nashville.
What About Water Birthing?
by Jessica H. Carlyon, MBA, CD, CLE
one are the days when doctors held newly born infants by their heels and gave them a good smack on the behind. Today’s births are often much kinder and gentler, and many women gratefully and wholeheartedly embrace this trend. Some, in an effort to experience the pinnacle of peace and serenity at their births, choose to have their babies in water.
Benefits of Water Birth
Today there are thousands of midwives and obstetricians all over the world who attend women as they give birth in water.
Mary Ann Richardson, a local certified professional midwife, attends women who give birth at home, many of whom choose to deliver in water. In fact, Richardson herself believes so strongly in the benefits of water birth that she provides a birthing tub as an option for her clients.
“Sometimes it is frustrating as a midwife to realize you can’t take away the intensity of labor for a woman; but when I help a woman down into the water and watch her melt, it is a supreme relief for everyone — especially the mother. Water during labor is like a really cheap epidural,” she says.
Richardson also feels that the process of water birth is much gentler for both mother and baby than a regular birth. She believes the buoyancy of the water helps ease the pressure from the baby’s head on the mother’s perineum as it is birthing. “It just seems that I see less tearing and a faster recovery with my water birth clients,” she adds, “and I am also awed by how water seems to facilitate the bonding between mom and baby. Babies born in the water seem so much more calm, trusting and alert.”
Risks Associated with Water Births
But water birth has had its share of criticism as well. In recent years, many have begun to question whether human babies were meant to be born underwater.
Ina May Gaskin, world-renowned midwife and lead midwife at The Farm in Summertown, Tenn., (for more information visit thefarm.org) says she and her colleagues are glad to service their clients who desire water birth. “Laboring in the water is so beneficial. In my experience, 70 percent of women will respond to water during their labors in such a way as to make the desire for pain meds non-existent,” Gaskin says.
But Gaskin has concerns when it comes to water birth, too. “It’s all in how it’s done,” she stresses. “Let’s face it, human babies are meant to be born into air; so if we’re going to do water birth, then we need to do it safely. The important factors for a safe water birth include a sterile environment, the right water temperature and immediate air for the baby’s lungs.”
Gaskin feels, however, that despite the necessary safety precautions, water birth is here to stay. She believes the awareness of and demand for water birth will continue to grow in the United States, and she looks forward to the day when women can get whatever they want (water birth included) even in a hospital environment.
To Waterbirth or Not to Waterbirth?
Many professionals feel that water birth has been and will continue to be a safe and enjoyable birthing alternative. Others, however, see it as a probable departure from the natural order of things and believe air to be the most natural destination for a birthing baby.
Despite the controversy, water continues to be a powerful force for birthing women. It calls to them with its warm, relaxing and peacefully surreal environment. With both the pros and cons in mind, each birthing woman must decide what is right for her and her little bundle. ϑ
Jessica Carlyon is a freelance writer and mother of five children. She is the co-owner of 9 Months & Beyond, LLC — a company providing birth-, breastfeeding- and parenting-related products and services.