Giving birth naturally can be quite an achievement. Natural childbirth is where a pregnant woman experiences labor and delivery without the use of pain medication. A woman’s body is pre-programmed to handle childbirth and the labor pains that come along with it. If women knew all of their options when it comes to giving birth naturally, then maybe the rates at which women receive epidurals would go down. If women were properly educated on the facts of natural childbirth, how they might feel after birth, how their recovery would go, maybe fewer women would be afraid to take this route and begin to feel more empowered.
Women know that there are some risks when it comes to giving birth. Some women can develop complications that need to be addressed and, if possible, corrected. According to the American Pregnancy Association (2012), there are roughly 37 different complications that a pregnant woman could encounter sometime during her pregnancy. The most common complications are RH Negative Disease, Group B Strep, Preterm Labor, Gestational Diabetes and Low Birth Weight. These complications can lead a low-risk woman to being high-risk and needing care that could prevent her from being able to give birth naturally.
For low-risk women, being able to give birth naturally without intervention or medication provides a lot of benefits. One advantage of being able to give birth without medication is mobility. According to Amanda Hardin (2004), “Key factors in a positive birth experience [are] being able to move [around], change positions freely and to give birth in the position chosen by the woman.” The ability to get up, walk around and move about freely is often overlooked. For women with back labor, being able to move around to relieve the pain is essential.
Mobility for women who choose to have medication is almost always non-existent. Since an epidural can cause a decrease in the baby’s heart rate, the woman has to be attached to a fetal monitor to keep track of any changes in the baby’s heart rate. Having a fetal monitor strapped across a laboring mother’s stomach requires the mother to lie on her back, even throughout back labor, and she is told not to move around, change positions or try to lie on her side. On top of that, a woman’s blood pressure has to be continuously monitored and a catheter may need to be placed to keep the bladder empty (Mitchell, 2012). Epidurals are the most common form of medication administered to women who are seeking pain relief during labor. There are two different types of epidurals: regular epidurals and combined spinal-epidural, or “walking epidural.” While an epidural can provide relief to a woman who has had a long labor and needs a break, epidurals do have risks such as sudden drop in blood pressure, numbness and permanent nerve damage, according to the American Pregnancy Association (2012).
Fortunately, there are many ways for a woman to relieve the pain of labor such as using hydrotherapy, like a birthing tub or even sitting in the shower with warm water running, using counter pressure, cold or hot compresses, or even a birthing ball. Some women have even reported using hypnotherapy as their preferred method of relief. Lamaze classes will also teach breathing techniques to help relieve stress and enhance relaxation of contracting muscles. Breathing techniques also help prevent tensing up and fighting against a woman’s natural ability to bring about a birth. The most effective relief will vary from each woman, but the end result is the same.
Another benefit of being able to give birth naturally is the cost. According to the CDC (2009), home births cost about one-third less than what hospital births cost. They are also cheaper than birthing centers. While region does impact the cost of giving birth, who a woman chooses as her caregiver affects cost as well. For example, giving birth at a birthing center in North Texas (2009) can cost about $4,500, which covers everything from prenatal care to post-partum care. Giving birth at home in Illinois can cost about $3,500-$4,000, both using midwives. An average cost of using a midwife as a caregiver is difficult to pinpoint but, “Americans could save $13 billion to $20 billion annually in health care costs by developing a network of midwifery care providers”.
Giving birth in a hospital, on the other hand, is incredibly pricey. According to Heather Hatfield (2012), “Data gathered from 2008 by the Agency for Healthcare Research and Quality shows that the charge for an uncomplicated vaginal birth runs about $9,600.” That price will skyrocket even higher for a woman who chooses to have some type of medication administered to her while in labor. A US Senate bill which was just recently proposed, states that a hospital birth without complications can run anywhere from $9,000-$17,000, depending on region and hospital. This bill states that an average epidural costs $1,000, and that a newborn screening is an additional $1,500-$4,000. Having some type of insurance plan can help alleviate these costs exponentially, but it is extremely important to know what the insurance company will and won’t cover, along with any out-of-pocket costs.
Another great benefit of natural labor and delivery without medication administered is the amount of support from the professionals a woman receives. Having an amazing support team to help you deal with the pains of labor is important for all women. Labor support has three main components: emotional and physical support and advocacy (Barrett, 2010). Emotional support reassures the woman that she is capable of continuing her labor in a positive manner, knowing that her loved one or caregiver is supporting her all the way. “Physical support and comfort measures enhance labor progress and increase satisfaction with the birth experience” (Barrett, 2010). Advocacy is “offering information about the progress of labor, coping methods, or relaxation techniques” (Barrett, 2010).
Having the positive, encouraging support needed to endure labor pains is essential and midwives and doulas are great at providing it. Having a doula present during labor can be quite beneficial too, as they go through special training to provide support for a laboring woman. A doula “refers to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period” (2012). In early labor a family member, partner, or midwife can provide the emotional and physical support needed to help a woman relax and deal with each individual contraction as they happen. As labor progresses and begins to become uncomfortable, a midwife and/or doula can provide the advocacy by helping the laboring woman with different techniques that are designed to provide relief such as the use of a birthing ball or even hydrotherapy.
Experiencing such support in a hospital setting is quite difficult, and more frequently than realized, it just doesn’t happen at all. According to Samantha Barrett (2010), “[A] concern regarding labor support lies within the ability of the professional nurse to provide effective labor support considering the modern institutional birth environment.” A study was performed to try to understand why women ended up choosing to receive epidural medication while at a hospital found that women had been persuaded, both verbal and non-verbal, by the present nurse to get the medication. Some women had said that the nurse told them they wouldn’t be able to make it through labor without receiving an epidural, while others had said that the nurse had placed the medication consent form on a table “just in case.” “This study demonstrates women changed their birth preferences because of … not feeling supported by the nurses” (Carlton, Callister, & Stoneman, 2005).
Establishing a Birth Plan is also a critical item when planning a natural birth. It establishes everything the mother does and doesn’t want. It includes everything from who would be allowed into the room while the woman is laboring, to emergency situations such as C-sections. The woman creates a document stating what kind of music she wants to listen to, if she wants any type of fetal monitoring, if she plans on receiving any pain medication or even if she is open to the idea of medication. It can also be a type of back-up plan in case an emergency arises and needs to be taken to a hospital. The birthing plan would tell hospital staff if the woman would like a mirror placed above her so she can watch the delivery, if she wants to remain awake or not, who she wants in the room with her during the labor and delivery, and even if she would like to hold the baby right after the delivery. While not everything can be accommodated completely, the woman’s caregiver will let her know what items in the mother’s birthing plan will need to be negotiated to ensure the woman has a happy birth experience.
Outside of pregnancy education, a woman should understand some of the feelings she might experience after having a natural birth. Many women have described a sense of empowerment and achievement after giving birth to their child without the use of medication. A study was done in 2001 on seventeen women who had recently given birth within that year. All seventeen women had natural childbirths and expressed how great they felt afterwards. According to Amanda Hardin (2004), “Each woman also expressed a sense of accomplishment and empowerment for having had an un-medicated childbirth.”
Women who gave birth without medications have also said they have a different approach to mothering. According to Paulina Perez (2001), “She will realize that it took hard work to bring this child into the world and it will take hard work to raise this child into an adult.” She continues to say that a woman learns more self-confidence and will realize her own strength and will have a different attitude about “pain, illness, disease, fatigue, and difficult situations” (Perez, 2001).
The recovery process is faster and easier with women who give birth without medication. A woman is able to move about normally, and eat whatever she desires within a matter of hours. A birthing center in North Texas will hold a woman for no longer than six hours after she gives birth to make sure both the child and mother is in stable condition. The woman is advised to “take it easy” for the following two days but is able to do as she pleases, as long as it’s not in excess and won’t cause further issues. A woman who gives birth at home is already where she needs to be and is able to recover just as quickly. On the other hand, a woman who gives birth in a hospital with medication not only has to wait for the medication to wear off before she’s able to move around, and is stuck in the hospital for up to two days or longer while the child is in the nursery being cared for by nurses instead of the mother or father.
The debate of whether or not an epidural increases a woman’s chance of experiencing post-partum depression is ongoing. Some people have said that having a painful delivery increased the chance of post-partum depression, while others have said that an epidural can increase the likelihood of post-partum depression. Every woman’s pain tolerance level is different. Some women can experience higher pain levels than others and still have little-to-none post-partum depression. While it is still up in the air as to what the origin of post-partum depression is, it is unlikely that anyone will be able to link it with epidurals.
Sadly, there doesn’t seem to be an adequate amount of resources available to women who want to know about their birthing options. Most doctors won’t tell women that there are other options out there that they can consider when deciding where to give birth. Unless a woman goes browsing the internet or talks to other pregnant women, she simply won’t know that there are different things for her to choose from.
As fewer women decide to give birth naturally each year, the rates at which epidurals are given are rapidly increasing. Too many stories are being passed around about how painful childbirth is and how epidurals were given to relieve that pain. Childbirth pain is a different kind of pain than the ones received doing day-to-day activities: childbirth pains have an extreme importance. If women can start to remember the significance of those pains and learn to deal and adapt with them, then there’s a good chance of reversing the rates of epidurals. The change won’t happen overnight, but starting with the next pregnancy can make all the difference.
Guest post written and submitted by Heather P. If you’re on Twitter, you can follow Heather P and engage with her there.