Active Birth & Gravity

An active childbirth offers a woman about to give birth the freedom to move around and change positions throughout the labour and birth.

In the early 1980s English childbirth educator Janet Balaskas brought to the fore and promoted the concept of birth as being a less of a medical condition to be dealt with on the labour bed and delivery table, and more of an instinctive response to the rhythm of labour. Since publishing her book Active Childbirth in 1983, her teachings have been incorporated into many childbirth education classes throughout the world. Active childbirth encompasses movement and breathing techniques based on Hatha yoga.

The basic premise is that birth is more successful if the woman is in an upright position, either squatting kneeling or on all fours, using gravity.

Preparation for labour involves stretching, pelvic floor muscle exercises and adopting “opening” exercises with help from your birth partner. The pelvic floor group comprises those muscles between the anus and vagina that support your womb, bladder and rectum. During pregnancy, hormones, along with the added weight of pregnancy, puts extra stress on these muscles.

In countries where women are accustomed to flat-foot squatting while doing their daily chores, giving birth in this position comes easily. For many western women, the pelvic floor muscles require a specific work out.

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Pethidine

Pethidine is a powerful sedative drug given by intra-muscular injection, usually into the buttocks. This takes effect within 15 minutes and can last anything from two to four hours. A common side effect is nausea, and sensations of feeling woozy, detached and disoriented.

Often pethidine is combined with an antihistamine to prevent sickness and at times this can amplify wooziness. Some women hallucinate and feel completely out of control. Some analgesic drugs are not recommended for asthma sufferers as breathing can be adversely affected.

Pethidine can drug the baby too, especially if it is administered within five hours before delivery. Although if used within 45 minutes before birth, pethidine is unlikely to have built up in the baby’s system.

Some research suggests that opiate or barbiturate drugs used in childbirth may increase the risk of addiction problems later in the baby’s life.

Epidural

Called an epidural nerve block, this is a drug injected directly into the dura, the outer membrane around the spinal chord.

Epidurals are performed by a trained anaesthetist and take about half an hour to set up. It can provide complete pain relief from the waist down, while allowing you to stay conscious, and can be used as an anaesthetic for a Caesarean section.

Epidurals should not be used if there is abnormally low blood pressure, bleeding from the placenta or anticoagulants are being administered.

An epidural lowers blood pressure and at times other drugs have to be given to counteract this, sometimes causing unwanted side effects. It is important to know that not all epidurals work and complications may occur.

Dosages and techniques vary and women respond differently. Sometimes, the point of injection may need recorrecting, and you will know this as you may feel anaesthetised on one side of your body only. In such a case, the anaesthetist will adjust the insertion point.

Having an epidural may be the onset of a series of other procedures you were not expecting. As it tends to prolong labour, you may be given oxytocin and require continuous foetal monitoring. Without sensation in the lower body, you may lose bladder control and need assistance via a catheter. You may also lose the urge to push and may require forceps or a vacuum extractor delivery.

Your temperature could rise in which case more investigations may be done to ensure you and your baby are not suffering from an infection in which case your baby may be placed under special observation after the birth. There is also an increased risk of having a Caesarean section. After giving birth, many women cannot walk for a few hours, even to the bathroom or shower to clean up.

Research indicates that epidurals may be linked to mother’s post-natal problems such as back ache, migraine and neck ache. On the positive side, many women declare they could not have given birth without an epidural.

Gas & Air

Called entonox, it is a 50/50 mix of oxygen and nitrous oxide (laughing gas). Inhaled through a mask to the face, entonox takes about 30 seconds to be effective. It does not entirely relieve the pain but produces analgesic effects enough to relieve pain during the peak of the contraction. Timing is important and the mask must fit firmly against to face to prevent leakage.

It is believed the entonox does not harm the baby and is cleared from the baby’s system with the first breaths it takes at birth.

Tranquilisers

Tranquillisers may be given to reduce nausea, vomiting and anxiety. The most common is benzodiazephines, also known as Valium. It is known to adversely affect the baby’s breathing, change the baby’s heart rate, interfere with a newborn’s temperature control and cause floppiness. Often a baby affected by Valium is slow to suck. It is also thought the Valium reduces a woman’s ability to recall the labour and birth.

This drug is no longer administered to women during labour in the United States, due to the adverse effects on the baby.

Anaesthetic

Occasionally if there is an emergency situation, it is necessary to have a general anaesthetic. This is usually a low dose as to not affect the baby and so you are only unconscious for a few minutes. It is possible to have your partner in the room and arrange for your partner to hold the baby following birth.

A spinal anaesthesia is an injection into the cerebrospinal fluid in the lower spine to numb from the waist to the knees. It takes effect within five minutes and is therefore useful when time is short. Spinals are considered potentially dangerous because the blood pressure drops, reducing oxygen supply to the baby. It is advisable to lie flat and avoid lifting the head quickly for eight hours following delivery to avoid a post-spinal headache.

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Herbal Tincture

Prepare the following herbal combination: Red raspberry leaf, False Unicorn Root, Nettle (20 ml each), Squaw Vine, St Mary’s Thistle (30 ml each) and Withania (50 ml). Take from the 36th weeks of pregnancy onwards.

Herbal Tea

Both nettle and raspberry leaf teas are uterine tonics and support the kidneys and urinary tract. Both teas strengthen the blood vessels and relieve cramps and painful childbirth.

Jasmine Essential Oil

Aromatherapy stimulates sensory cells in the nose that in turn send messages to the limbic area of the brain to release neurochemicals into the bloodstream.

Jasmine is the aromatherapy essential oil prized for bringing on labour and easing pain. It is highly valued as a meditation oil and is known to enhance focus.

Aromatherapy oils can be used in different ways. In its simplest form, a few drops on a pillow or handkerchief can be effective to uplift and energise. The oils can be blended as massage oil or used in hot and cold compresses during childbirth. Blended with rose and/or neroli, this makes divine massage oil.

Bach Flower Rescue Remedy

Use the Bach Flower essence Rescue Remedy or the Australian Bush Flower Emergency Essence in the six weeks leading up to the birth and hourly during labour. These can be used as antidotes to stress, fear and lack of confidence.

Arnica

Arnica taken in tablet form in the week leading up to the birth will help in pain control and recovery. It relieves bruising to tissue and muscle. Take 30c potency once a day.

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Relaxation

Tension and fatigue tend to increase labour pain. Try to switch off from the pain. In the weeks leading up to labour, try to rest as much as possible. You may choose to eat foods high in carbohydrates to build your energy stores. Continue to exercise gently to maintain your physical strength by walking, swimming or attending yoga.

Get Rest

Childbirth is always described as a most gruelling and physical event. Many women say they feel that they have just run a marathon once they have given birth. It is important to get as much quality rest as possible.

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Water Therapy

Many women have discovered that being immersed in water can be comforting in labour. Lying in warm water increases venous pressure promoting the return of blood to the heart more efficiently. It also enhances cardiac action and slows the pulse rate. Total relaxation in the warmth and comfort of a bath may also help the uterus to contract more effectively. Water counteracts the force of gravity and relieves pressure, reducing pressure felt from inside the body.

TENS

TENS stands for transcutaneous electrical nerve stimulation. A TENS machine is often used as an alternative to epidural to relieve labour pain. A current is passed through lead wires to electrodes pads placed on the skin. The current produces a tingling sensation and is thought to stimulate the production of natural pain-relieving endorphins and enkephalins.

Electrode pads are attached to the woman’s back, abdomen or groin in the first stage of labour and the machine can be operated by a switch mechanism to control the intensity of electrical current with each contraction. An advantage is that the pregnant women can operate and control the level of stimulation herself. A disadvantage is that it can not be used in water.

Clitoral Stimulation

Clitoral stimulation is cited as an effective method of pain relief during labour. While the hospital delivery room may not be the most practical place to trial this method, it can be useful at home in the early stages of labour.

Massage

Massage on the lower back and sacrum increases circulation to the uterus and eases pain. The reproductive system receives blood and nerve supply from lumber 3 and lumbar 4.

Massage on the head, neck and shoulders or feet can induce relaxation and provide both physical and emotional support.

Point Pressure

Acupuncture is known to not only relieve pain and stress but also strengthen contractions and shorten the duration of labour. The advantage of acupuncture is that it is non-invasive and babies are not subjected to ill effects of chemical anaesthetics. If you do not have access to a practitioner, ask your birthing partner to use the following acupressure points:

Spleen 6, Bladder 32, Bladder 23, Kidney 3, Bladder 67, Gall Bladder 21, Stomach 36

Reflexology

Reflexology involves manual pressure applied to the feet or hands to stimulate the release of natural endorphins and other chemicals that help reduce pain.

According to studies in England, regular reflexology treatments from mid pregnancy lead to shorter, easier labours. It is also believed that reflexology stimulates the release of the hormone oxytocin that helps contraction of the uterus.

Some midwives in Australia are familiar with the reproductive reflex points located around the ankles. The point located in the natural depression on the inside of the ankle helps the uterus prepare for birth. In the final month of pregnancy and during labour, you or your partner can massage and stimulate this point.

Hot & Cold Compresses

Hot and cold towels can be used as compresses to help ease pain. By alternating the temperature, it encourages local circulation to the area. Used against the lower back and on the perineum, compresses can also be soaked in herbal water or water with aromatherapy essential oils added.

Compresses are simple to prepare and easy to use. Smaller compresses can be used on the forehead during labour

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