Labour. It’s the one thing on every pregnant woman’s mind, no matter how far along she may be. What will it feel like? How much will it hurt? How long will it take? The truth is, none of these questions can be answered until the birth itself. One thing expectant mothers can control, however, is there approach to the labouring process, through the use of calm birthing preparation techniques..
Setting realistic expectations
Much of the ability top remain calm during labour and birth revolves around understanding and accepting the unpredictability of the labour process. The experience can differ substantially from labour to labour and, even if you have given birth before, you may find subsequent deliveries are vastly different from each other. While opinions differ, a common preference today is for a ‘natural birth’: a drug free, tear free, physiological (unassisted, vaginal) delivery. If this is a mother’s preference, it is important that she is aware of the true statistical likelihood of that occurring and a plan accordingly.
The statistics on ‘natural birth’
In Australia, approximately 50% of women in their first labour will give birth via a physiological or ‘normal’ delivery. Approximately 35% will need a Caesarean section, and 15% will need assistance with either forceps or ventouse (vacuum). Approximately 40% of women who labour will request an epidural for pain management and, once this is administered, there is an increased likelihood of intervention. The reason for this is that, despite the epidural providing excellent pain relief, it can affect contraction quality, blood pressure and ability to push. All of these side effects create the potential for further interventions such as syntocinon (the drug to aid contractions), foetal distress and increased likelihood of an assisted delivery.
Approximately 90% of women who have a vaginal birth, either assisted or unassisted, will sustain a tear or cut (episiotomy) and while bad tears (third degree or greater) are rare, there is generally some notable discomfort during the healing process. What these numbers tell us is that, while the chances are good for a ‘natural’ birth, this will not be possible for every woman.
Calm through preparation
For those who would like to try to have a ‘natural birth’, without medical intervention, without drugs or an epidural, and have little-to-no tearing, preparation is the key to maximising the chances at success. Hypnobirthing methods, which are taught in the lead-up to childbirth, have been shown to decrease the need for pain relief, decrease anxiety leading up to the birth, produce calmer babies and increase natural delivery rates.
To decrease the chance of tearing and the need for episiotomy (‘cutting’) the Epi-No perineal trainer has been shown to be effective and is not known to affect long term bladder and pelvic floor tone. Whilst neither hypnobirthing or the Epi-No guarantees a completely natural birth, they are safe, practical and may be the difference between an interventional and non-interventional delivery and all the potential after-effects, including effects on future delivery choices.
This article was written by Dr Peter Jurcevic, Mama You've Got This Obstetrician Expert and one of Melbourne’s finest Obstetricians and Gynaecologists, providing private services at Frances Perry House. He has been advocating for calm birthing options for more than 18 years and has seen first-hand the enormous benefits they provided his own partner at the births of their three children. Dr Peter Jurcevic presents at Mama You've Got This Pregnancy Class.