choice of birth setting

1. CHOICE OF BIRTH SETTINGS

3.  A medical facility, often associated with a hospital, that is
designed to provide a comfortable, homelike setting during
childbirth and that is generally less restrictive than a hospital
in its regulations, as in permitting midwifery or allowing
family members or friends to attend the delivery.

4. Homebirth is, woman-centered birth. It takes place in the woman’s own territory, and she
makes the important decisions about who will attend her, whose advice she will follow, in what
positions she will labor, what interventions she will accept, what she will eat, and what she will
wear. Pregnant women and their families choose to give birth at home for many reasons. There
has been a small but significant increase in the number of homebirths in the past decade,
though only about 2 percent of the nation’s births currently occur in the home

5.  * The mother determines the birth atmosphere.
* Birth attendants are considered invited guests.
* No encounters with strangers or unfamiliar
places.
* Less chance of illness due to exposure to
hospital-borne infection
* No awkward moves from room to room.
* Few or no routine interventions.
* No separations from the people and setting
that empower her.
* No arbitrary separations of mother and baby.

6.  Client's must assume a greater level of responsibility
for their own health: physical, mental and spiritual.
This requires active ongoing participation in decision
making in all aspects of their care, and a willingness to
accept the consequences of those choices and
decisions.
 Since the hospital is the currently socially acceptable
location for birth, choosing otherwise may result in
negative judgments and lack of support.
 Cesarean Sections, forceps deliveries are not available
at home, transport is necessary for these and other
medical interventions.
 Personal arrangements must be made for postpartum
care, such as meals, housekeeping, child care etc.
 The cost of a home birth may not be covered by the
client's insurance.
 Analgesics are not readily available with a home birth.

7.  HIGH RISK PREGNANCY
 PREMATURE ABOUR
 NOT PREPARED
 COMPLICATIONS

8.  The birth center is a homelike facility existing
within a healthcare system with a program of
care designed in the wellness model of
pregnancy and birth.
 Birth centers are guided by principles of
prevention, sensitivity, safety, appropriate
medical intervention, and cost effectiveness.
 Birth centers provide family-centered care for
healthy women before, during and after
normal pregnancy, labor and birth.

9. Birth centres may also be described as any one of the following:
•community maternity units
•maternity hospitals
•midwife-led units
•maternity homes
•birthing centres

10.  The facility is usually only provided for pregnancy and birth events.
 In a birth center, pregnancy and birth is considered a natural and
healthy process.
 During pregnancy and birth, women arc encouraged to take charge
of their own health care.
 It provides an alternative to parents not comfortable with home
birth, yet do not want to give birth in a hospital.
 It has many of the same advantages as home birth, such as greater
parental control, non-interventive obstetrical care, freedom to eat
and move during labor, and to give birth in any position, and to
have any number of family and friends attend the birth.
 The parents are usually encouraged to bring family members to their
prenatal visits.
 It offers personalized care at much lower costs than traditional
hospitals.
 In most centers, parents can meet the entire staff prior to the birth.
 The rate ofCesarcan and forceps deliveries is less than hospital.

11.  Rigid screening criteria often eliminates healthy
mothers, i.e.; VBAC, mother over 35.
 The mother is still moved to birth center during
labor, and still labors away from the home
environment.
 Many centers have rigid rules concerning
transporting of the mother to the hospital i.e.;
prolonged labor, ruptured membranes. Mother
may have to be moved during labor.
 There are usually no pediatricians on staff if
the baby has special needs after the birth.
 The mother cannot remain at the birth center
for a two or three day rest; discharge is usually
within four to 24 hours.

12.  Birth centres are a kind of halfway house between
home and hospital. They offer a relaxed
atmosphere, but are also well-equipped and
staffed with highly skilled midwives. Birth centres
can offer facilities which may not be available in
local hospital, such as:
 comfortable, low-tech birthing rooms
 complementary therapies
 family accommodation
 birth pools

13.  Deep Water immersion causes buoyancy which makes her
movements in water very easy, very comfortable, she has her
own private space, reduced pain perception inhibits stress
hormones release, releases positive endorphins which
reduces blood pressure. redistribution of blood causes better
uterine perfusion, makes contractions more efficient and
leads to a shorter labour For the baby: baby is in amniotic
fluid in utero, delivers in a similar liquid medium so the
transition to land/air is gentler and are born calmer. Since the
mother has had no pharmacological pain relief, the baby
suckles better, lactation is successfully established bonding
is better.Babies do not breathe under water in normal
circumstances because of various factors.
 The prostaglandin E2 SURGE which occurs 24 hours prior to
the onset of labour, inhibits fetal breathing movement, and
hence babies do not breathe under water.The dense taste
buds in the larynx recognizes fluid at the back of the throat,
closes the glottis, thus causing swallowing in stead of
aspiration into the lungs.

14.  Warm water is soothing, comforting, relaxing.
 In the later stages of labor, the water has been shown to increase the woman’s
energy.
 The effect of buoyancy lessens a mother’s body weight, allowing free movement
and new positioning.
 Buoyancy promotes more efficient uterine contractions and improved blood
circulation resulting in better oxygenation of the uterine muscles, less pain for
the mother, and more oxygen for the baby.
 Immersion in water often helps lower high blood pressure caused by anxiety.
 The water seems to reduce stress-related hormones, allowing the mother’s
body to produce endorphins which serve as pain-inhibitors.
 Water causes the perineum to become more elastic and relaxed, reducing the
incidence and severity of tearing and the need for an episiotomy and stitches.
 As the laboring women relaxes physically, she is able to relax mentally with
greater ability to focus on the birth process.
 Since the water provides a greater sense of privacy, it can reduce inhibitions,
anxiety, and fears.

15.  have Herpes: Herpes transfers easily in water, so should
discuss this risk thoroughly with health care provider.
 baby is breech: Though water birth has been done with
bottom or feet first presentations should discuss this risk
thoroughly with health care provider.
 have been diagnosed with one of the following: excessive
bleeding or maternal infection.
 having multiples: Though water births have been successful
around the world with twin birth, should discuss this risk
thoroughly with health care provider.
 If preterm labor is expected: If a baby is pre-term (two weeks
or more prior to due date), water birth is not recommended.
 If severe meconium: Mild to moderate meconium is fairly
normal. Since meconium floats to the surface in a tub, your
health care provider will watch for it and remove it
immediately, or help you out of the tub. Meconium usually
washes off the face of the baby and even comes out of the
nose and mouth while the baby is still under water. If the
water is stained and birth is imminent, the woman can lift her
pelvis out of the water to birth the infant.

16.  Natural Childbirth Methods
Natural childbirth claims to benefit both the
mother and the baby, giving the mother more
control over her experience. Advocates claim that
a baby born naturally is more alert at birth and
because it does not have drugs in its
bloodstream, the mother and baby will bond
more easily. Natural childbirth can take place at
home, or in a hospital with a birthing center, with
staff specifically trained for the purpose.
 Today, the role of midwives has regained
popularity, and their service is made available in
most hospitals. There has also been a revival of
home births, and men are now becoming actively
involved in the birthing process.

17.  Lamaze Method
Lamaze, or Lamaze-Pavlov, was the first
popular natural childbirth method in the
1950s, and is still one of the most popular
childbirth classes today. Breathing exercises
and concentration on a focal point are
practiced to allow mothers to control pain
while maintaining consciousness. This
allows the flow of oxygen to the baby and
to the muscles in the uterus. A partner
coaches the mother throughout the birthing
process.

18. Read Method
The Read method, named for Dick
Read, is a technique of breathing that
originated in the 1930s to help
mothers deal with apprehension and
tension associated with childbirth.
This natural childbirth method uses
different breathing for the different
stages of childbirth.

19.  LeBoyer Method
The LeBoyer method stresses a relaxed
delivery in a quiet, dim room. It attempts to
avoid over-stimulation of the baby and to
foster mother-child bonding by placing the
baby on the mother's abdomen and having
the mother massage him or her immediately
after the birth. Then the father washes the
baby in a warm bath.
 Bradley Method
The Bradley method is called father-coached
childbirth, because it focuses on the father
serving as coach throughout the process. It
encourages normal activities during the first
stages of labor.