Barbara Harper is a former nurse who went on to form Global Maternal/Child Health Organization and Waterbirth International following the births of her children. She lectures around the world on maternity care reform and describes gentle birth like this:
“A gentle birth begins by focusing on the mother’s experience and by bringing together a woman’s emotional dimensions and her physical and spiritual needs. A gentle birth respects the mother’s pivotal role, acknowledging that she knows how to birth her child in her own time and in her own way, trusting her instincts and intuition. In turn, when a mother gives birth gently, she and everyone present acknowledge that the baby is a conscious participant in his or her own birth. The experience empowers the birthing woman, welcomes the newborn child into a peaceful and loving environment, and bonds the family.”I love this description of a gentle birth because on the one hand, it seems so simple and obvious that we should be respectful and gentle with the two main participants in any birth: mother and child. Yet, on the other hand, it highlights for me how rarely this happens in our high-tech culture and how difficult it is for many women to achieve a gentle birth.
What are some simple, practical suggestions for a gentle birth?
1. Preparation
In the past, preparation would have probably included talking to older experienced women in your community: your mother, grandmother, aunts, older sisters, and probably witnessing a birth or two before you had to do it yourself. Nowadays, some key aspects for preparation are:
- choosing a childbirth educator that trusts birth and brings a positive attitude to their classes
- taking care of your body: getting adequate rest, exercising, eating well
- remaining open-minded and flexible about how your birth might unfold
- taking an honest hard look at your attitudes, beliefs and fears about birth
The human body is designed with some wonderful pain management chemicals called endorphins that are triggered by the contractions of the uterus. The stronger the contractions, the more endorphins are released. Working in direct opposition to endorphins is adrenaline. Adrenaline is triggered by fear and stress. It prepares us for the fight or flight response by tensing our muscles for action. It is the anti-thesis of staying relaxed and letting your endorphins do their job. One key way to help a laboring woman cope with pain is to keep her relaxed and confident. This can prove difficult if she is surrounded by busy attendants, beeping machines, scary looking resuscitation equipment and ticking clocks.
3. Freedom to Move
It is vital that a woman be able to move about during labour, to adopt whatever position she needs to birth her baby instinctively. Lying on her back is more painful and unlike more upright positions (kneeling, squatting or leaning on furniture or a support person), she is working against gravity to deliver baby. Moving around during labour helps baby to readjust and descend and keeps mother actively participating in the process.
4. Quiet
Keeping the birth room quiet is essential. Partners, support people and birth attendants must respect the mother’s need to focus. Each woman deals with contractions in her own way but it’s absolutely important that she be able to concentrate. Quiet also fosters a sense of intimacy and baby’s transition into a world full of sound is much less jarring.
5. Low Light
Turning the lights down or off has much the same effect as turning down the volume. Mother feels calmer and more relaxed. The room becomes comforting and intimate. Baby is more relaxed and alert, able to open his eyes and look at his mother without the glare of bright lights in his sensitive eyes.
6. Continuous Labour Support
Studies (M. Klaus, and others) have shown that maternal satisfaction and birth outcomes are much better when the mother is not left alone to labour. Mothers who were given continuous interactive labour support had 50% fewer surgical births, requested painkilling medication 60% less often than the others, and also had much lower incidence of interventions such as forceps or vacuum deliveries.
7. Labour Starts on its Own
Despite technological advances and extensive research, it is still difficult to determine exactly when conception may have occurred or to determine the perfect moment when labour will start. Due dates are calculated using educated guess work based on a menstrual cycle of 28 days. Only 15% of women have a 28 day cycle. It is fair to say that at this point, with our limited understanding of the natural processes at work, it is very presumptuous to think we know better than Mother Nature. Induction is common enough in America (36%) to have created ample opportunities for research. This research has shown that to artificially initiate labor for any but the most critical medical reasons is to create an unnecessary and potentially serious risk to mother and baby.
8. The First Breath
Until the baby takes her first breath, she is receiving oxygenated blood from her mother through her umbilical cord. Cutting the cord too quickly after delivery forces baby to abruptly begin breathing air on her own for the first time. By delaying cord cutting, baby can gradually take breaths while still receiving precious oxygen from mom. And should baby need some extra stimulation to breathe on her own, a gentle rub will usually do the trick rather than hitting or slapping.
9. The First Caresses
The newborn should be handed to mother immediately after birth. Babies benefit from skin-to-skin contact and are reassured by their mothers’ loving touch. Mothers are eager for these first caresses too: she may be experiencing feelings of loss over the end of her pregnancy, she may be relieved that the hardest part of the birth is behind her and excited to meet her child. Fathers can get in on the skin-to-skin touch right away as well and it might be the first moment when the baby becomes “real” to him. These early moments of holding and touching baby help to bond all three.
10. The Baby at the Breast
The minutes after birth is the best time to get baby started breast-feeding. Suckling gives babies immense comfort and after a brief period of alertness, baby will often sleep, exhausted from her efforts during the birth. The earlier you can start baby on the road to nursing, the more chance of success. Breastmilk production increases with demand, colostrum (the nutrient rich, high protein first milk) helps get baby through until mother’s milk comes in and the act of nursing releases oxytocin in mom which stimulates contraction of the uterus (preventing hemorrhaging) and magnifies those lovey-dovey feelings for mama.
11. Bonding & Attachment
Time together as a family to get to know each other after the birth is especially important. Separating mother and baby is extremely stressful for both and should be avoided. In a gentle birth the mother is awake and aware, highly conscious, energized by having given birth, and extremely eager to spend time with her child—touching, feeling, resting or sleeping together. The newborn needs and wants the comforting presence of its mother, her warmth, touch, sound and smell. After a gentle birth most mothers experience an incredible exhilaration that helps them to overcome their exhaustion. A gentle birth does not involve baby being left in a bassinet in a nursery far from her family.
As Harper herself indicates, this list isn’t a prescription or a set of rules, but rather an approach to birth that each woman must customize herself, taking into account her own values and beliefs to achieve a gentle birth whether at home or in the hospital.
Adapted with permission from Barbara Harper's Gentle Birth Choices
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