‘In a nutshell, active birth means being upright during labour. You don’t have to walk around for hours, you just need to use items like birth balls, mats, chairs, a bath, even straps hanging from the ceiling to support yourself if you squat – anything that helps you to not lie down. At the birthing centre I used to work at in London, we didn’t even have beds in the rooms – and it worked. [Although women could lie down after the birth!] The supportive environment we provided, plus all the equipment, meant that we had an epidural rate of just six per cent. [Because of its numbing effect, having an epidural rules out active birth.]
‘The “active” bit only really comes into effect once you’re four centimetres dilated, having minute-long contractions every five minutes. Before this stage, I recommend that women get some rest, eat a carbohydrate-packed meal and really build up their strength so that they’re as physically prepared as they can be for what lies ahead.
‘Giving birth while lying down is seen as the traditional way to have a baby but, actually, years and years ago, women would generally give birth at home in a squatting position. It’s only relatively recently that labour has become something to be done in a hospital with doctors. This was when birthing women became “patients” and, while this has aided medical advancement and saved lives, it also meant that birth became a medical experience, rather than being seen as something that’s completely natural.
‘In fact, research shows that being upright can lead to a quicker, easier labour. Meanwhile, lying down can be uncomfortable and counterproductive, because it tilts the pelvis upwards, meaning that the baby has to be pushed against gravity. The pelvis is also not as open as it would be if the woman were upright. If you are in an upright position, not only is the pelvis open, but the baby can place more pressure on the cervix, meaning that it may dilate more easily – it’s all
common sense, really.
‘Another important benefit of active birth is the fact that that it can sometimes decrease the chance of foetal distress. If you’re lying flat, the baby can put pressure on the major vessels running through your abdomen, which can potentially slow the baby’s heart rate. But, of course, if you or the baby are suffering complications, that is when the situation becomes medical and you will probably need to lie down so a doctor can intervene.
‘So, if all’s going well and an epidural’s off the cards, what sort of pain relief can you have? Well, firstly, the simple fact that you’re able to move around helps – shifting positions can lessen back pain. You can use a Tens machine, which delivers pulses into your back via little sticky pads and which you can intensify during contractions via dials. There’s also Entonox – gas and air – which is fine to have if you’re moving around, and many women find water, for example lying in a bath, to be therapeutic, too.
‘Many women choose active birth because it gives them control over how their baby enters the world. We are built to give birth, and it’s empowering for women not to have to act like a patient in a hospital, wearing a medical gown. Not being given a choice in what position they adopt can be distressing for women – in fact it can lead to a negative experience of birth as a whole, even if it’s complication-free. Hospitals in Dubai are definitely becoming more receptive to the active birth concept and many now have birth balls and mats.
‘There are two other important factors in active birth: firstly, husbands are much more able to get involved, be it through helping you to get into different positions, or maintaining constant, level eye contact, or massaging your back. Men are actually wonderful to have on hand – they are very encouraging and positive, and I’ve seen many get their wives through the labour.
‘Another important thing is environment. The hormone that makes the uterus contract, oxytocin, flows a lot better when you’re relaxed. If you’re stressed, your adrenaline levels will be high, and this actually stops the production of oxytocin so your labour slows down. That’s why we try to make the room as comfortable and homely as possible: hiding the oxygen and suction behind a curtain, having nice duvets, dimming the lights – plus I always recommend that women bring their own pillows and clothes.
‘At the end of the day, it’s about making an informed choice based on all the “fors” and “againsts” that you’re given. Whatever way you choose to give birth, make sure you do it under your own steam – and remember to specify it all in your birthing plan so that your obstetrician and midwife are as prepared and able to help you as they can possibly be.’
Dru Campbell is head midwife at Health Bay Clinic (04 348 7140).