I get asked this question often. Why choose natural birth?? What does “natural birth” even mean? Does it mean a vaginal birth? An unmedicated birth? An unassisted birth? A birth in a forest stream surrounded by woodland creatures? (I’m just kidding. I don’t get asked that last question *that* often!)
First let’s define some terms.
Most often, when someone says Natural Birth, they are talking about an Unmedicated Birth: without pitocin, epidural, IV narcotics, etc. A Vaginal Birth is used to described any birth where the baby is delivered via the birth canal regardless of medications, interventions, or lack thereof. We in the birth profession also frequently use the term Physiologic Birth. Here we are talking about not only a lack of pharmaceutical interventions, but an avoidance of anything that would interfere with the body’s natural progression of labor, birth and the immediate postpartum period. According to The Journal of Perinatal Education, a normal, physiologic birth includes the following components:
• characterized by spontaneous onset and progression of labor;
• includes biological and psychological conditions that promote effective labor;
• results in the vaginal birth of the infant and placenta;
• results in physiological blood loss;
• facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period; and
• supports early initiation of breastfeeding. (source)
This same article goes on to say “Some women and/or fetuses will develop complications that warrant medical attention to assure safe and healthy outcomes. However, supporting the normal physiologic processes of labor and birth, even in the presence of such complications, has the potential to enhance best outcomes for the mother and infant.” In order to explain this last statement, let’s talk about the difference between the Medical Model of Care and the Midwifery Model of Care.
The Medical Model of Care
The Medical Model for labor and birth is exactly what we would (and should!) expect from a doctor. It focuses on preventing complications, then diagnosing and treating them if they arise. The methods used for this involve early testing, pharmaceuticals and potentially surgical intervention. All of this is considered a method of “managing” the labor in order to avert a poor outcome. This is the same approach we would take to heart health or cancer prevention.
The Midwifery Model of Care
The Midwifery Model is different because it recognizes that pregnancy is not an illness but a normal, natural occurrence in this stage of her life. Therefore, it requires a different approach. This model focuses on maximizing overall health and wellness – physical, emotional and social. The methods used include education, counseling and hands-on care throughout the entire pregnancy. Rather than “managing” the labor, this model “allows” the labor to happen, supporting when and if necessary. Midwives (and doctors who utilize this model of care) are also specially trained to identify any red flags that signal potential complications which would require obstetrical attention. If complications arise, they shift the women to the Medical Model of Care where treatment can take place.
Approximately 85% of pregnancies in the US are low risk. The key to the Midwifery Model is to support these mothers throughout pregnancy, labor and birth in order to keep them in the low risk category unless they absolutely must be moved to a higher risk category. They also work hard to avoid intentionally doing anything that would cause a shift to higher risk. Any medical intervention automatically moves a women to a higher risk category. This is why after administering pitocin or an epidural, hospitals require continuous fetal monitoring. It is due to the increased risk of complications inherent with those medications.
Every intervention, medical or non-medical, also significantly increases the chance of more interventions. Childbirth teachers refer to this as the Cascade of Interventions. I plan to do a post on this someday, but until then, Childbirth Connection has a good explanation of how it works with an example at the end of the article.
So, why natural birth??
Because in most cases, it is the safest option for mothers and babies. As long as a mother is low risk, as ethical professionals, we should be doing all we can do to keep her there. If complications do arise, THAT is what the interventions are for! They can be life saving, and I am so thankful that we have access to modern medicine for labor and birth. Let’s just be sure we save it for when it is needed.