"It’s not that birth is painful, but rather that women are strong."
As opposed to being placed into stirrups, or in the lithotomy position (lying flat on your back), an active birth is where the woman is free to move around during labour. Like most theories it isn't really anything new. Women have known since the beginning of time that having the freedom to choose positions to labour and birth their babies in, will find the sensations of birth more manageable, may progress through their labour more swiftly and may well find the second (pushing) stage easier. There is much research (link please) and evidence based on the positive effects of an active birth.
The whole idea of an active birth unit is to combine the benefits of labouring and birthing outside of the pressure of a hospital environment with the necessary advantage of having immediate and first class medical care at hand should complications arise. We therefore focus equally on the creation of comfortable, private rooms in a peaceful, natural setting and the provision of exceptional obstetric care and emergency facilities. Our goal, long term, includes the education of women on the benefits of natural childbirth, the support of new moms in all aspects of their recently acquired status such as baby-clinics, counselling, breastfeeding support and legal advice, and the fostering of a strong sense of support for women in the community.
How you can benefit from Active Birth
A Shorter, More Efficient Labour
During labour your baby’s head moves slowly down deeper into the pelvic canal as it emerges from the dilating cervix. In these positions your pelvis is at the best possible angle for gravity to help the process. Numerous studies have shown that this is likely to make labour shorter and more efficient.
Being free to move and choose your own positions has some other advantages too. Its easier for your uterus to do its work, so the contractions tend to be less painful than if you were lying down. Freedom of movement, free expression of sound and the natural forward tilting of the uterus helps to modify the pain and are likely to reduce the need for medical pain relief.
Less Risk of Foetal Distress
There is also a better blood flow to the placenta when you are upright and breathing deeply, so that your baby receives plenty of oxygen and there is less risk of ‘fetal distress’ developing. There is no compression of the internal blood vessels as there may be if you lie for an extended period on your back or in the semi-reclining position. Foetal distress is a common cause for a caesarean section or the use of forceps or ventouse to deliver the baby quickly. Blood flow to the placenta and the baby is optimal in upright positions.
More Powerful, Easier Way to Push
In the second stage, when you are ready to give birth, choosing a kneeling, supported squatting or standing position will help you to use your energy in the best way while you are pushing. It is much more effective and powerful to push with the help of gravity and the rotation and descent of the baby’s head is easier.
There is no ideal position for giving birth and this varies from woman to woman. You may use several upright positions during this phase of the birth and can give birth in any one of them.
The supine or reclining position is by far the least advantageous – working against gravity and reducing the space within the pelvis. When you are upright the pelvic joints are unconstricted as they would be lying down and this allows a degree of movement and expansion of the pelvic diameters so that the internal shape of the pelvis can accommodate the baby’s head with maximal space as it descends in labour. In the final stages, the back wall of the pelvis (sacrum and coccyx) are free to move back increasing the diameters of the pelvic outlet to make plenty of space for your baby to come out.
Enjoy Comfortable Skin to Skin & Breast Contact
After your baby is born and you are enjoying the pleasure of holding him or her in your arms for the first time, its a good idea to sit upright so that you can hold your baby ‘skin-to-skin’ and position your baby well for the first contact with the breast. Then, while you are welcoming your baby and the first breastfeed begins, gravity will be helping your placenta to separate and your uterus to contract down efficiently to prevent excessive blood loss.
Partners Can Get More Involved
In an Active Birth partners are often actively involved in giving both emotional and physical support. This active sharing of the birth experience can be very fulfilling and memorable and is a good start to a new relationship as parents and the start of your new family.
An Active Birth usually results in minimal trauma for the baby during the birth process. Generally the baby is likely to be born in optimal condition, bonding after birth and the first breastfeeding are facilitated and the mother generally feels good and recovers well from the birth, which makes caring for the new born baby easier.
Two important elements in an Active Birth are the quiet presence of a supportive midwife and the right kind of atmosphere in the labour room.
The room needs to be comfortable, warm, calm and peaceful so that you have enough privacy and security to let yourself go, to be noisy if you need to and to relax and rest in between the contractions without distractions.
When the lights are turned down low or the curtains are drawn and it is quiet, your body produces high levels of the special hormone called oxytocin which stimulates good strong contractions. You also produce floods of hormones called endorphins, which are natural painkillers and relaxants. Combined with the benefits of being upright, these hormones help you to forget about everything else, to sink into your labour and concentrate on the contractions. Once you can relax with it, labour usually progresses well leading to an efficient second stage and a successful birth for all concerned.
It’s important to understand that labour and birth are involuntary, in that the uterus contracts spontaneously, firstly to open the womb and then to give birth to the baby. All of this happens without your conscious control. It’s not about doing anything and is more to do with relaxing and letting it happen.
From beginning to end the entire birth process is stimulated by these hormones. They are produced by the ‘old brain’ or hypothalamus. We have this in common with all other mammals, and like them, we need to feel safe and protected in order to secrete the birth hormones effectively.
These are the very same hormones we produce when we make love, which is why the renowned French active birth pioneer Michel Odent calls them the ‘love hormones’. Think about the kind of environment you like to be in when you make love, or how mammals usually choose a warm dark and secure place to give birth and you can guess what kind of atmosphere you will need to encourage good secretion of these ‘love hormones’ during labour.
Miraculously, the hormones of birth are also promote love and attachment. In the hours after an Active Birth, both you and your baby will have a huge level of ‘love hormones’ coursing through your bloodstream which will help you to bond and fall in love immediately after the birth.
With The Help of Water
An important innovation in the ideal birthing environment for an Active Birth has been the introduction of water birth pools. These are now becoming much more widely available and many hospitals and birth centres have installed pools. They can also be rented for home births. In addition to gravity, water is another of nature’s elements which has enormous power to support your instinctive resources in labour.
Experience has shown that it’s best to think of using water in mid labour, when you are about 5 – 6cms dilated. Labour is usually very intense at this stage and you may well feel that you need some help – this is the ideal time to enter the birth pool.
After half an hour or so of being in the warm water you are likely to enter a very relaxed state where you can go to a deeper level inside yourself and let go to the power of the more active phase of labour. This is the time to let your body take over, to trust in nature and to surrender to the involuntary forces that are opening your body and bringing your baby to birth.
The warm sensations of the water on your skin will help to modify the pain and the buoyancy of the water relieves you of your body’s weight. This helps enormously to make you more comfortable in upright positions and to conserve your strength and energy. Its much easier, for example to move or to squat in water.
Your partner can sit right beside the pool or even get in with you to massage and hold you. Once in the pool, you are unlikely to notice the world outside the rim of the pool or how much time has passed. It helps you to stop thinking and to be in your body. There is an increase in oxytocin secretion when you enter the water which peaks after about 2 hours, so you may find that contractions become stronger and you reach full dilation within a few hours.
When you feel you are ready to push and give birth to your baby you may decide to leave the pool and have your feet firmly planted on the ground or you may decide to remain in the water for the second stage. Provided there is good progress and no sign of any complication, birth in water can be easier for the mother and gentler for the baby.
After the birth
There is no denying that going through an Active Birth and experiencing the pain of labour is a huge challenge that will probably stretch you to your limits and beyond. In the peak of the experience, just before you are ready to give birth to your baby, you may feel despairing, as if relief will never come. Yet the nature of birth is that pain comes and goes. In between contractions there are intense moments of peace, bliss and even ecstasy.
The moment you are holding your baby in your arms for the first time you are likely to forget almost instantly the pain you have been through to get there. Instead, a feeling of enormous exhilaration may arise. I often think this must be something like the way a mountaineer may feel reaching the peak of Everest and seeing the view at the top for the first time.
However you give birth, producing a baby is an achievement you can be very proud of. While aiming for an Active Birth, it’s important not to forget that the baby is more important than the birth! While birth is very rarely easy and sometimes the challenge is to get through the experience with all the medical help you can get, having an Active Birth is an empowering and life transforming experience for many women. Starting from the basic wisdom that it’s best to keep upright and with a few simple modifications to the environment, I have seen over the years that most women can have a much better experience of birth than they might otherwise have done.
Article by Janet Balaskas , founder of the Active Birth Movement – “Active Birth And Why It Can Make A Difference For Your Birth”