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Childbirth in a hospital is often difficult to consider as a good experience, still far from ideal. And what should a perfect birth look like, good for both the baby and the mother? And what should be changed so that Polish women could give birth in the best possible way?
You dream about being cared for and respected during yourchildbirth . Unfortunately, confronting these dreams with reality is often painful. Old habits, routine, lack of knowledge or good will mean that many hospitals still give birth to a wrong childbirth. It turns out, however, that not only those in labor want changes. Also doctors, especiallymidwives , based on scientific research and experience from other countries, postulate that the birth should finally be different in our country - not only in single, unique hospitals, but in every ward childbirth. For that to happen, the whole approach to childbirth has to be changed. Not to treat it as a process of extractingbabyfrom a woman's body - as soon as possible and with the use of all available medical means - but as a fundamental event in the life of not only the mother giving birth, but most of all the child being born. It is not only obstetricians who should work on welcoming them well. You should look at childbirth on many levels - you should also appreciate its physiological and psychological side.
What a childbirth, such a lifetime
Without orders, prohibitions and unnecessary pharmacology "What childbirth, so all life" - these words of Dr. Odenta became the motto of the scientific conference "Optimal birth - challenges of modern obstetrics", which took place last autumn in Wrocław. Dr. Eva Gundberg from Sweden spoke about how the quality of childbirth affects later life. According to her, a pregnant woman should get to know the midwife and doctor and be able to talk to them freely. The doctor and midwife should give each patient as much time as she needs. It is important to talk to her in a positive way, building a good attitude towards what is going to happen. They should support, not frighten. Many hospitals treat women as birthing machines - they are incapacitated by orders and prohibitions, often left to themselves. Hospitals are introducing more and more technologies and procedures, such as the administration of oxytocin to induce labor, too frequent CTG monitoring, and internal examinations. Meanwhile, everythingit can be organized in a different, more friendly way. Labor should begin naturally, it must not be artificially induced by oxytocin. "Childbirth is an initiation of a woman's strength," says Dr. Gundberg. - Rush is then unnecessary and harmful.
Intimacy during childbirth, above all
A woman should give birth in conditions of intimacy. This is often a marginalized problem, meanwhile, according to Dr. Fromenta's privacy is absolutely essential. All mammals employ a strategy of avoiding being watched when giving birth to their young. Also, a woman, when she has full intimacy, is more relaxed and natural - then she behaves spontaneously, which has a positive effect on the birthing process. So it's time to finally eliminate the relics in the form of delivery rooms, where the beds are separated only by screens. Each giving birth should have a separate birthing room. The task of the staff is to make her feel at home in it, to make it as comfortable as possible and not to be afraid of the hospital. It is important that the room is in warm colors, that it is warm and cozy. A woman can turn on the music she likes, decide on the lighting intensity, etc. In the first stage of labor, she can drink water and even take liquid food.
She should not be alone, but in the company of people close to each other - her husband, doula (doula - from Greek - is a woman "who serves"; nowadays doule are women who professionally - physically and emotionally - support a woman in labor, accompanying her her also in puerperium) or friends - who will support her.
Each staff member who comes to the mother in labor should introduce themselves first, and each time inform what activities they want to do and for what purpose. that there are as few of these people as possible: a midwife, a doctor, if students - it's one or two. Too many assistants destroy the atmosphere of intimacy.
It is the woman who is most important in childbirth
A woman in labor must be free to move around in labor and behave in a way that suits her best. None of the modern-minded midwives and obstetricians question the fact that it is best to give birth in a vertical (vertical) position rather than lying down. Therefore, all midwives should learn to accept the baby in these positions, and delivery units must be equipped and organized to facilitate this.
Before the pushing phase, however, usually takes from several to several dozen hours, during which the giving birth should be under the care of the staff. When the labor is uneventful, it is usually the midwife, not the doctor, that the delivery person is. Unfortunately, often instead of becoming distracteddiscreet and kind care for the woman in labor, the midwife only controls her, while the care and control are two completely different concepts and models of behavior.
The woman in labor is connected to the CTG device too often, which immobilizes her and forces her to lie down. In some hospitals, almost every birth is monitored in this way, and there is no justification. Meanwhile, instead of CTG examination, it would often be enough to use a handheld fetal heart rate detector, i.e. a traditional obstetric headphone, to assess whether the child has breathing difficulties.
Too often those in labor are also examined internally, which is unpleasant and painful. According to Dr. Eva Gundberg, women should avoid this discomfort and have a gynecological examination no more frequently than every 4 hours. It is not the only way to assess the progress of labor - the midwife can also do it during external examination, i.e. by touching the birthing belly.
No rush, but also no anesthesia
When parte contractions begin, usually the midwife or doctor will tell the woman to lie on the bed and press - three times in one contraction. It is almost standard that suddenly it becomes very nervous: the woman in labor is urged, forced to push "on command" in order to push the baby out as quickly as possible. It is also - according to the participants of the Wrocław symposium - unjustified and inappropriate action. The woman in labor should not be rushed - she should push when she needs it, and not because the midwife tells her to. Above all, however, she should choose the position in which she wants to go through the phase of partych contractions. The research shows that most women spontaneously assume positions typical for mammals, e.g. on all fours. In this position (the birth canal is then in a vertical line), strong pressure is often not needed at all - the baby's head rolls slowly, gradually, without sudden rush. At this point, the woman in labor and her child should be surrounded by: silence, peace and discreet light. Bright lighting is unnecessary, much less nervous shouting.
According to the doctors present at the conference, epidural anesthesia, which is needed only in exceptional circumstances and for medical indications, is also abused. Its use can be easily reduced, they say, if pregnant women see a midwife. Such a midwife should build a sense of inner strength and self-confidence, skillfully reduce the fear of childbirth and teach them natural methods of coping with pain. Only if it were so, the model of care for a pregnant woman should change - so that she had her own individual midwife before delivery. Because group meetings at the birthing school (usuallypaid, and therefore not available to everyone) are unlikely to be enough, especially since some of these schools do not so much build a sense of self-confidence in their students as prepare them for hospital procedures.
The first hour is the holy hour
When the baby is completely in the world, he should immediately be close to his mother. Everything else is not important now! You absolutely shouldn't suction the child's airways - it is a very traumatic procedure, not used any more in modern obstetrics. Even the observation of the baby for Apgar assessment can be done while lying next to the mum. After the assessment, the baby should lie naked on his mother's body, covered with a nappy or blanket. Also, the umbilical cord should not be cut too early - only when it stops pulsating, can it be cut by the child's father or someone on the staff.
In the third stage of labor, when the mother gives birth to the placenta, the baby is to be with the father - he should also hold it to his naked breast. After the placenta is born, the baby returns to its mother and should be at her breast for at least an hour. The first hour is the holy hour - during it, the baby is prepared for life. It sucks on the breast for the first time. It has been shown that a newborn baby placed close to the breast can instinctively move towards it and grasp the nipple! Even then, the baby makes contact with his mother - both the skin-to-skin contact, as well as the visual one. According to the German prenatal psychologist Dr. Ludwig Janus, the future emotional and social development of the child - his relationship with the world and other people - depends to a large extent on eye contact with the mother. Therefore, mother and child can never be separated. Even when a premature baby requires intubation, this can be arranged to ensure that it is close to the mother.
Immediately after birth, the baby should be with mum, skin against skin. Nothing is more important at this point! Procedures, tests, measuring - they must be carried out in such a way as not to separate the mother and the newborn.
Don't separate mother and baby!
The beliefs from years ago that a newborn does not feel fear or pain are untrue. Contemporary scientific research contradicts this. Therefore, habits and procedures need to be changed so that childbirth is as traumatic as possible. Prenatal psychologists argue that unfriendly, traumatic childbirth has far-reaching consequences, causing the nascent human being to feel unwanted, alien, unnecessary - and shaping such attitudes as aggression in the future. Doctors often do not understand the importance of childbirth, believe that the type of delivery does not matter much - that's why they use proceduresaccelerating and "facilitating". It is worth changing this approach - not to treat childbirth only as one way or another of pregnancy termination, but as a special event that determines the future life of the person born into the world.
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