1914 – Dr Grantly Dick-Read put forth the theory of natural childbirth
Felt fear caused most childbirth pain
Educated women reproduction physiology and delivery and trained them in breathing, relaxation and physical fitness.
“ Faith eliminates fear”
By 1950s, a prepared childbirth method substitutes new breathing and muscular responses to the sensations of uterine contractions for the old responses of fear and pain.
Offered to expectant mother to prepare physically and mentally
Learns about: normal physical changes, self-care and care of her baby, natural methods of pain relief, gentle exercises, normal processes of childbirth.
Conducted traditionally as part of antenatal education service by midwives, doctors and paramedical staff in hospitals.
Also offered by private instructors and organisations (e.g. Childbirth Education Association and Parent Centres Australia)
Mother is an involved participant in the birthing process
Encouraged to adopt any position she chooses (many prefer natural upright positions)
Special techniques such as deep, yoga style breathing, gentle massage and pelvic rocking are used to relieve pain
Mother may choose to have a totally natural, drug-free childbirth, but also has available to her a variety of pain-relieving medications if required.
Active Birth (cont’d)
Accompanied by a support person who: offer emotional support, supports the mother in the labouring position, give back massages or hot towels – usually they have attended childbirth classes with the mother.
Mother is encouraged to be involved in decisions concerning her labour and delivery.
Emphasis on a full and active participation in a normal and exciting event
‘ Birth without violence’
1975 – Frederick Leboyer published a book advocating a gentle entrance to the world for the newborn.
Subdued lighting, gentle handling, a warm bath and skin-to-skin contact recommended to reduce the trauma of childbirth for the baby.
Benefits said to be a happier baby and strengthened parent-child relationship
‘ Birth without violence’
1980 study of 56 women (Nelson et al, 1980) – compared ‘Leboyer babies’ and conventionally delivered babies and found no advantage in the Leboyer method over gentle conventional delivery, nor any greater risk of danger
No difference in maternal or infant health, infant behaviour at the first hour of life, at 24 hrs, 72 hrs or at 8 months of age, or in the mother’s perceptions of their babies and the experience of giving birth
Only differences was Leboyer mothers had a shorter active labour and they had feelings, 8 months after delivery, that the event had influenced their children’s behaviour
Preferred comfort and familiarity of home without drugs or unwanted interference
Midwife must be state registered, and will screen the mother before agreement
Midwife usually maintains a relationship with a nearby hospital so that, if necessary, the mother can complete her labour in hospital.
Safety Debate – Howe (1988) examined outcomes for 165 women having home births in the south-west of Australia. 84% successfully delivered at home. Of the 16% transferred to hospital for delivery, the rates for assisted delivery and caesarian section were very low.
Located within the hospital grounds but separate from the conventional hospital facilities.
Antenatal care and preparation for childbirth is supervised by a specialist team of midwives
Delivery takes place in the home-like atmosphere of the birth centre and not in the conventional labour ward.
Advantage: satisfy personalised birthing style with full facilities available and close by if needed.
Performed with vaginal birth is unlikely or not recommended.
An abdominal surgery which allows the baby to be lifted out of the uterus.
May occur when there is a lack of progress in labour; when the baby’s head is too big to pass through the pelvis; when the baby appears to be in trouble; or when the mother is bleeding vaginally.
Some obstetricians also operate when the baby is in a breech position, so legs and buttocks would emerge before the head
Rates and Risks
In Australia, climbed rapidly in 10 years from 1 in 5 to more than 1 in 3.
Obstetricians believe it is due to a rise in the number of older mothers, increased obesity rates and a changing ethnic mix.
Longer stays in hospital, higher infection rate for the mother, increased psychological stress which can lead to feeding difficulties and early care giving.