To give birth actively means to believe in yourself, in your ability to give birth to a child. It requires courage and shared responsibility, but active childbirth gives a mother many benefits and satisfaction.
It may not be a way of giving birth that every woman can cope with, and it is probably not possible in many Polish maternity wards, but under favorable circumstances, you can give birth actively also with us. And the advantages of such a birth and the benefits it gives to the mother andbabycannot be overestimated. A trend in obstetrics, promoting the idea of the so-calledactive childbirth , emerged in the West in the 1980s as a rebellion against medicalized inpatient delivery. Fundamental for the supporters of this method of giving birth is the belief that a woman - equipped with instinct, self-confidence and a natural biological mechanism of birth - is able to give birth on her own, without all this hospital and medical machinery. What's more, the woman in labor has a decisive influence on the course of labor, because her instincts tell her best what to do.
When is active childbirth possible?
Before we write what an active childbirth can look like and what advantages it has, let's list one basic, necessary condition to make it possible: the woman in labor has the right attitude, andthe midwifeaccepts this birth. The very desire to be able to decide about her own birth has almost every woman - none of them wants to be incapacitated, and expects that the staff will take her opinion into account. But to give birth actively is not enough. You have to have faith and confidence in your own strength, a deep inner conviction: "I can do it, I can do it". But even if a woman knows that active childbirth is something for her - she will not do much if she does not find an ally "on the other side", that is, in a hospital or even in the person of one midwife. So you have to make an effort to find a midwife who supports and prompts you, but does not impose your will. Such midwives exist, as well as hospital wards - and there are more and more of them, although they are still a minority.
ImportantAdvantages of an upright birth
- the cervix opens faster
- uterine contractions are more regular, effective and less painful
- the head is inserted into the birth canal more easily and precisely
- breathing is easier because breathing is easy and deep (lying down isimpossible)
- the child is oxygenated better
- the need for painkillers is reduced, because effective breathing reduces the pain sensation
- anxiety and tension are reduced - the freedom to choose a position reduces the stress level, less adrenaline is released that inhibits contractions
- pushing is easier; the birth canal is directed downwards, so the child moving through it is additionally affected by the force of gravity
- the lower opening of the bone pelvis widens, because the tailbone tilts back by approx. 30 percent. relative to its lying position
- the risk of perineal tears is lower, because during the eruption of the head of the tissue around the perineum, they stretch evenly
- delivery time is reduced by up to 35 percent.
Prepare for active childbirth in the birthing school
Looking for friendly people and a place for childbirth should be looked for at the stage of choosing a childbirth school. Because although the assumption is that a woman can give birth alone, because a natural mechanism will work at the right moment, it does not mean that you do not need to prepare for an active birth. It is worth enrolling in a birthing school for several reasons. In order to give birth actively, you also need to be aware of what will happen, so it is important to know about it. Plus, the more we know, the less we fear what awaits us. At birthing school, you can also learn different exercises to strengthen the body, learn how to breathe during contractions, and try out different birthing positions - all of these are important skills that will come in handy. But a good school can do more - it can build a woman's self-confidence, convince her that she is able to give birth in this way. This faith often has to be built from scratch. Where to get it, if for years everything was decided by the staff? Many people, initially skeptical, realized that you can experience childbirth differently.
- My husband and I met two birth schools - says Ewa from Warsaw, mother of one-year-old Gabrys. - The aim of the first one was to make us the least troublesome “clients” of the hospital: obedient, easy-going. It was only the second school that opened our eyes to what is so obvious - that during childbirth I am the most important and it depends on me what the delivery will look like. A midwife is important, she has to offer advice and help, suggest, but cannot impose anything on me. It was at school that I met a wonderful midwife with whom I gave birth to Gabrysia. I am very happy that I could give birth as I wanted.
Active childbirth, which is what?
In active labor, the woman is the center of attention. By listening to yoursbody, reads what her instincts tell her and follows her needs.
Movement and position selection. The woman in labor decides for herself whether she will lie down, walk or enter the bathtub. Throughout her labor - both in the 1st and 2nd stage - she can assume the position that is best for her at the moment: the most comfortable, the least painful or beneficial for other reasons. He changes them spontaneously, subconsciously, as many times as he wants. He often chooses vertical positions, i.e. positions in which the birth canal points downwards. The force of gravity is then used, which causes the baby's head to press harder on the cervix, accelerating dilation, and during the pressure period, it helps the baby descend into the birth canal. There are many variants of such positions, for example standing - with the arms hanging around the partner's neck or on ladders, crouch (the partner can sit on a chair and support the woman under her arms), elbow knee etc. In addition to the position in active labor, movement is important: walking and even dancing. The birthing rooms are equipped with devices that facilitate the most favorable positions and forms of movement, e.g. ropes and ladders supporting the body vertically or large balls on which the birthing child can roll in circles with her hips. Movement helps to cope with the pain of spasm, but also plays another very important role - in the early stages of labor it helps the baby to position itself correctly in the birth canal. Due to the circular movements of the pelvis made by the mother, the baby "screwed" into the birth canal. In many hospitals there is freedom of movement in the first period, but when the pressure begins, the woman in labor must return - often against her will - to the bed and lie down. And this is not a good birthing position, because the baby pushes itself "uphill". Uterine contractions struggle to overcome the force of gravity that pulls the baby down to the mother's spine, and the compressed vena cava disrupts circulation, often causing the baby to become hypoxic. Delivery is longer and the efforts of the mother and baby are much greater than in the vertical position.
The woman makes decisions and gives an answer. In active childbirth, the whole environment - a midwife, doctor, or husband - is focused on providing maximum relief to the mother in labor. She is the most important. If she asks for a back massage - for those accompanying her, this request is an order, when she wants to kneel and CTG needs to be done, the midwife does not order the woman in labor to go to bed, but kneels next to the woman and puts the camera sensor to her stomach. During childbirth, a woman may make sounds: scream, gasp, cough, and no one has the right to criticize this. A wise and patient midwife accepts such behavior because she knows that pain accompanies labor anddoes everything to ease it. The subjectivity of the mother in labor means taking her opinion into account in every case - a midwife or a doctor does not make a decision without her knowledge, let alone against her will. If a woman cares about the protection of the perineum, the staff will make every effort to ensure that it is so. But being active also means taking responsibility for what happens. A woman must be aware that by acting one way or the other, in making decisions related to childbirth, it causes one effect or another. Sometimes, despite the best will of both parties, the situation surpasses the woman in labor - then she should trust the advice of the midwife or doctor and rely on their experience.
Nature instead of pharmacology. A woman who decides to have an active childbirth gives up pharmacological painkillers. He does not need them, because he can cope with pain differently - through skilful breathing, movement, massage or immersion of the body in water. Also, at least by definition, other medical agents, such as synthetic oxytocin, which stimulate uterine contractions and accelerate cervical dilatation, are also unnecessary. In active labor, taking upright positions has a similar effect - the baby's head presses against the cervix from above, accelerating its opening. In addition, natural oxytocin is released without interruption, because a woman who feels safe does not feel fear, and it is fear and stress that inhibit the production of oxytocin. Such labor is faster than that of the supine, because the woman in labor works all the time: during contractions, she takes a position in which she can relax the body best, and uses the intervals between contractions to rest and regenerate strength.
Supportive midwife. Let us repeat: there will be no active labor without a midwife who accepts this type of accompaniment and is able to help her. It is not only a matter of kindness and goodwill, but also skill. Certain techniques need to be mastered in order to receive a baby while the woman giving birth is squatting or standing. A midwife should be patient, warm, trustworthy and accepting, even when it is not what is considered normal. He must be able to create a friendly atmosphere and a sense of security - only then can the woman in labor fully open herself up and surrender to her instincts.
You must do itListen to what your intuition advises
Active childbirth is a concept popularized by Janet Balaskas - the author of the book of the same title (Warsaw, 1997). It is a delivery during which, using her biological abilities and instincts, the woman in labor actively helps her baby come into the world, thus influencing the length and safety of the birth. According to Balazkas, childbirth is a conditionmind - a woman must be convinced that she can give birth herself, that the knowledge of how to give birth is hidden deep within her, and that at the right moment the mechanism of birth will work. A woman in labor contacts her body and follows its needs. Active and aware, she knows her goal and does everything to achieve it.
What does this give a woman
Childbirth is a short but intense and important experience. If the woman's opinion was not taken into account during childbirth, and reduced to the role of the "subject" of medical procedures, she may have difficulty accepting herself as a mother, and even with self-esteem. In turn, a well-lived childbirth can help her reach maturity and give her strength to experience motherhood. - Sometimes when I read what some births look like, I am happy that mine was different - says Ewa. - I could do what I needed, nobody made me lie down for hours, nobody tied me. I had an influence on what was happening. It made me really feel that I was giving birth to my baby. I had a sense of strength and self-confidence - this is the best thing that can happen to a woman in the first days of being a mother.
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