What is Natural Birth?

Happy father kissing his pregnant lover's belly

Also known as a straightforward birth, or to midwives as a normal birth, a natural birth can mean slightly different things. Some see the main criteria as being a vaginal birth, while the most widely used definition is a vaginal birth using no pain relief or intervention (although using gas and air generally still constitutes having a natural birth).

Natural birth is generally considered to be one with no intervention at all, using neither induction in the early stages, nor forceps during delivery, or an injection to deliver the placenta in the third stage of birth. The things that almost certainly never fall under the remit of a natural birth are: epidural, episiotomy, caesarean or general anaesthetic.

The term ‘natural childbirth’ was coined by obstetrician Grantly Dick-Read in his ground-breaking 1930s book of the same name Natural Childbirth. The concept of birthing in a natural way has grown in validity over the years to become a common objective for many families. As birthing intervention, medication and hospital-based births have become more prevalent over time, many have felt that natural births are empowering and a way of staying in control of your body as well as being more connected to your baby when it arrives.

Natural births can be achieved in hospital, at home, during water births and breech deliveries. In place of anaesthetics and other medical assistance there are some tried and tested coping techniques that assist in calm and healthy births, mainly using mind-body connections. They include massage, water birth, mindfulness techniques, breathing exercises and self-hypnosis. Movement techniques and support from loved ones or and/or midwives during birth are also important.

Having a natural birth can be important to women and their families due to a number of reasons, including religious and personal beliefs, a fear of medication or hospital settings, a previous bad experience with birth intervention or a desire to feel in control of the birth. Even if someone has previously had a caesarean, they can opt for a natural vaginal birth in subsequent deliveries.

Early labour and your birthing partner

When you first go into labour it’s important to do things that will keep you feeling calm and self-assured. Even if you’re planning on going into hospital, you should try to stay at home as long as you can in a setting that comforts you. You could walk around the garden, take a bath, have a nap in between contractions, or do something that you enjoy until contractions become regular. This is usually when they last 30-60 seconds and occur every five minutes, but your midwife will advise you.

Throughout labour, it’s also key to have emotional support from someone who is calm and that you know and trust. This could be your partner, your mum, best friend or a midwife – the choice is yours and you should get them involved in your birthing plans in order for them to help you to remain focused and speak to medical professionals about your choices. This leaves you to focus on things like breathing techniques, getting in the right mindset and being as comfortable as possible.

Let your hormones do the work

Hormones act just as strongly in labour as they do in pregnancy, and knowing how to promote positive childbirth hormones lets things work as they should. During labour your body produces oxytocin, a hormone that makes the uterus contract strongly and regularly. Remaining upright helps with the production of oxytocin but feeling afraid, anxious, embarrassed or angry can inhibit it, so learning how to deal with these feelings helps the birth along hugely. We explain how you can do this below.

Likewise, endorphins – which are hormones that provide a sense of well-being – are nature’s own pain relievers, helping you to cope with contractions. If you can learn to let go and allow your hormones to work for you then your body will function at its best. There are a number of techniques that can help with this and afford a sense of calm and empowerment to having a natural birth.

All in the techniques

There are multiple techniques available for allowing a natural, painless birth that you can use on their own or in combination.

1. Movement
Changing position regularly and keeping moving is a recognised method for encouraging straightforward, natural birth. It helps your baby to move into the correct position for birth and through the birth canal, as well as helping you deal with contractions. This can be achieved through walking around between contractions, showering (which can also help cool you down), rocking and swaying the hips, going up and down stairs or using a birthing ball to remain mobile and keep your torso upright. These all contrast with the traditional lithotomy position where a woman is in a hospital bed on her back with legs in stirrups, which has consistently been shown to slow and complicate labour.

2. Water birth
The soothing power of water has multiple benefits. It acts as a form of pain relief, helps to support your weight – particularly good if you’re getting back pain – and allows you to move more freely during the birth. Birthing in water is definitely a more natural method. You can either just labour in the birthing pool or also birth in there as well, which has the added bonus of reducing the risk of perineal tearing, due to increased blood flow and allowing a more relaxed birth. It is also a comforting transition from the womb, for the baby to be born in water.

3. Hypnobirthing
An approach that encompasses many of the natural birth techniques is hypnobirthing. A form of self-hypnosis, it teaches mums-to-be to use deep relaxation, breathing, visualisation and fear release techniques during labour. Similar to meditation, it’s one of the best ways of avoiding anxiety and allowing your hormones to work effectively in relieving pain and allowing your uterus to contract. Part of an approach known as family-centred care, with hypnobirthing there’s an emphasis on the active role of the birthing partner. Couples learn the techniques together and the approach sees the birth as a bonding experience.

Hypnobirthing is versatile – even if it turns out you can’t have a natural birth due to complications, you can still use the techniques to have a calm delivery. Procedures like having a caesarean or epidural can be distressing, but focusing your mind by using self-hypnosis distracts from them and allows you to focus on a positive birth. The skills learnt can also be used after birth to ward off stress and anxiety in everyday life.

4. Massage
Massage in the early stages of labour has been shown to help the release of all-important endorphins and reduce anxiety. If you’re feeling frightened, the touch of someone you’re close to can also reassure you. Being gently massaged during contractions may act as a welcome distraction to help you cope with the pain, although it’s important to communicate with your partner and ask them to stop if the massage is uncomfortable or not helping. A good area to focus on is the back and shoulders, and your birthing partner can create a rhythm with the massage strokes to promote beneficial breathing rates. Gentler foot or hand massaging also provides comforting closeness.

5. Warm and cold compresses
Using hot and cold compresses during labour can be an effective form of pain relief. Hot packs do so by increasing the blood flow to an area, while cold packs decrease the blood flow. Placing a hot pack at the base of your tummy helps minimise cramping, in the way you might use a hot water bottle on period pains. Hot packs can also be relaxing when placed at the back of the neck. Cold packs can relieve back pain when placed at the bottom of the spine.

Overcoming obstacles

Even if you’ve previously had a caesarean, you could still have a natural birth the second time around and thereafter, depending on certain factors. In fact, vaginal birth after C-section (commonly referred to as VBAC) can be achieved in 60-80% of cases.

It may be that you missed out on a natural birth first time round and want to try again. Other reasons to go natural after a C-section are a shorter recovery time, more involvement in the birth or because you want a large family and to avoid multiple caesareans. You should of course listen to your doctor’s advice on whether VBAC is right for you, as some ladies with a high-risk uterine scar or a large baby won’t be able to have a natural birth after caesarean.

If you find out your baby is breech you may think it will put pay to your plan of having a natural birth. However, studies show that hypnotherapy is very effective in turning a breech baby. Even if you haven’t been to any hypnobirthing classes yet, there are specialists who can address specific issues, teach fear release techniques and promote visualising the baby turning, which actually really works.

If you’re considering a natural birth but still have concerns about what could go wrong, birthing centres in hospitals, such as midwife led units, are a good middle ground between a home birth and delivery ward. Here mums who’ve been assessed as having a low-risk birth can go to labour naturally if they wish. But, medical intervention is close at hand if needed, which is good to know if something doesn’t go according to plan and you need to be flexible with your birthing choices.

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