5 minute read
FOCUS ON: BIRTH OPTIONS
FOCUS ON Birth
AS YOU PREPARE TO WELCOME YOUR NEW ARRIVAL, WE LOOK AT THE DIFFERENT CHOICES WHEN IT COMES TO LABOUR
As your pregnancy draws to an end, your thoughts will inevitably turn towards the delivery, quite possibly with a mixture of excitement and dread. While some women can’t wait to experience this everyday miracle, others are consumed by anxiety. Yes, childbirth is messy and it hurts and quite frankly anyone who says otherwise is either lying or showing o . But honestly, you won’t care because it’ll also be the most wondrous, most exhilarating and most memorable day of your life. From living-room floor to operating theatre, aromatherapy to epidural, there are many ways to bring a baby into the world.
HOME BIRTH
If you’re healthy and your pregnancy is low risk, home can o er a safe and comfortable place to give birth, with a familiar midwife at your side. Some women also like to hire a doula. In England, around one in 50 babies are delivered in a home birth and for low-risk women who have already had their first child, it’s thought to be as safe as a hospital delivery. If complications arise, you and your baby will be transferred to hospital by ambulance.
MIDWIFERY UNITS & BIRTH CENTRES
For those who would like a non-medical setting but don’t want a home birth, then midwifery units and birth centres, which are designed to feel more like home than a hospital, can be a perfect ‘halfway house’. Women who give birth in midwifery units and birth centres are less likely to end up having intervention, like forceps or ventouse, than women who give birth in hospital. However, if your centre isn’t attached to a hospital, you won’t be able to have certain kinds of pain relief, such as an epidural, and you may need to be transferred if complications arise.
HOSPITAL BIRTH
During a normal hospital delivery, midwives provide the majority of care. If labour progresses smoothly, you’ll be able to move around, try out di erent positions and use breathing exercises and relaxation techniques. However, you’ll be safe in the knowledge that doctors, anaesthetists and other professionals are on hand if you or your baby need extra support or pain relief. This can be especially reassuring for first-time mums.
CAESAREAN SECTION
Around one in four babies are delivered by caesarean section in the UK. This might be a planned c-section due to known pregnancy complications, or an emergency c-section due to problems that arise during labour, meaning the baby needs to be born quickly. This is usually done using spinal anaesthesia, but in some cases, a general anaesthetic may be necessary. Although c-sections are sometimes perceived to be the ‘easy option’, they involve major abdominal surgery and recovery can take several weeks or longer. Consultant gynaecologist, Mrs Pradnya Pisal from London Gynaecology says, “Caesareans are not without risks, such as infection in the wound or the lining of the uterus, heavier bleeding than vaginal delivery, deep vein thrombosis, and injury to organs such as bowel or bladder, especially if there’s history of previous surgery.”
In addition, babies are more like to be admitted to neonatal intensive care following a c-section birth. Mrs Pisal adds, “Ideally, we recommend vaginal birth unless there’s a very good reason to avoid vaginal delivery.”
WATER BIRTH
In England, around 30 per cent of women use water or a birth pool for pain relief, and around six per cent of women actually give birth in a pool. Being in water during labour can help you relax and make the contractions seem less painful. Megan Rossiter is the founder of birth-ed, which runs hypnobirthing and antenatal classes throughout the south east. She says, “Birthing in water can encourage a baby into an optimal position, reducing tearing and the chances of intervention such as speeding up labour with a hormone drip or the chance of instrumental birth. Occasionally, women may find that using the pool in early labour slows things down.” Many women feel that giving birth in
water provides their baby with a more gentle transition to life outside the womb. The midwife will have waterproof equipment to monitor the baby’s heartbeat and a mirror to check the baby as they emerge. As the baby is brought gently to the surface, they’ll continue to get oxygen through the umbilical cord until they meet the air.
HYPNOBIRTH
Hypnobirthing is a birth education programme that teaches simple self hypnosis, relaxation and breathing techniques with the aim of dispelling fear and tension and helping the pelvic muscles to relax. It’s based on the belief that pain isn’t necessary and that a woman’s body is perfectly designed to give birth. For the best chance of success, you’ll need to practise the techniques well in advance. You can use hypnobirthing methods to help you feel calm and in control, both at home and in hospital.
If you have any concerns relating to Covid-19 and your birth plan, your midwife or maternity team can o er advice and support. PAIN RELIEF Even if you plan to breeze through labour with a scented candle and some Mozart, it’s good to prepare for every scenario. Babies are notorious rule breakers and there’s no shame in asking for something stronger...
TENS machines Standing for transcutaneous electrical nerve stimulation, a TENS machine sends small electrical currents into your back via a pair of electrodes. This is thought to reduce the number of pain signals. Although a TENS machine can be useful during early labour, it’s unlikely to make a di erence later on.
Gas and air Also known as Entonox, this is a mixture of oxygen and nitrous oxide gas that’s inhaled through a mouthpiece, so you can control it yourself. It doesn’t stop the pain, but can make it more manageable. There are no harmful side e ects, although some women can feel sick or sleepy. In this case, you can simply stop using it.
Pethidine Usually injected into your thigh or buttock, pethidine is an opiate that provides stronger pain relief than gas and air and can help you to relax; it does make some women feel drowsy or nauseous. It isn’t recommended if you’re close to the pushing (second) stage of labour as it may make the baby sleepy and slower to feed.
Epidurals If you’d prefer not to feel a thing, an epidural is your best bet. Anaesthetic is injected into your lower back, into the space around the spinal cord, providing almost total pain relief. Epidurals can also be used for caesarean sections or an instrumental birth. If you have an epidural, your baby’s heart will be continuously monitored and you’ll have a drip inserted into your hand or arm and a catheter inserted into your bladder, giving a more ‘medical’ feel to your baby’s birth. About one in 100 women experience a severe headache or feel sick following an epidural, but more serious complications are rare.
