Full Circle Midwifery

A woman’s guide to understanding normal, healthy birth and how it can improve the health of her baby and her health. Critical information to help women make informed decisions and avoid possibly unnecessary and expensive medical interventions, such as cesarean sections.

CHILDBIRTH TODAY

Since 1996, the World Health Organization has called for eliminating unnecessary intervention in childbirth. Yet in the US, birth interventions have reached epidemic proportions. Sadly, there is a lack of resources available to women to help them achieve their goals of a normal, safe, and healthy birth.

The norm for birth in the US today includes the use of technology andinterventions that are not proven to benefit healthy women and babiesduring childbirth.

More than half of women receive medication to start or speed up their labors. This requires additional monitoring and interventions to treat possible side effects, and can result in increased use of pain medication including epidurals.

One-third of US women deliver by cesarean section, a major abdominal surgery that has the potential for serious short- and long-term health consequences for both you and your baby.1

Often, vaginal birth is not an option for women who have already had a cesarean section.

If a woman receives care that she feels is traumatic or disrespectful, it affects her physical and emotional health, and interrupts the critical early bonding period with her baby.

1 See “Everything You Need to Know about C-Section,” ChildbirthConnection.org, http://bit.ly/1792mQF

COPYRIGHT 2013. AMERICAN COLLEGE OF NURSE-MIDWIVES. ALL RIGHTS RESERVED.

UNDERSTANDING NORMAL, HEALTHY CHILDBIRTH

Normal, healthy birth is a safe process that includeslabor, birth, and the first hour after birth for both themom and her baby. It does not routinely require medical intervention.

Characteristics of normal labor, birth and the first hourafter birth include:

◆Labor starts and progresses on its own.

◆ The process is supported by physical and psychological factors that promote effective labor.

◆ Labor results in a vaginal birth with normal blood loss.

◆ The mother and her baby stay together after birth, with the baby remaining directly on her skin.

◆ Breastfeeding begins right away.

YOUR BABY & YOUR BODY DURING A NORMAL, HEALTHY BIRTH

During normal, healthy birth, your body releases hor- mones that help you labor effectively, cope with pain, and bond with your baby. These hormones also help your baby transition to life outside of the womb, main- tain a normal body temperature, breastfeed successfully, and bond more effectively.

When labor progresses naturally on its own, there is less chance that your babywill have difficulties during labor or thatyou will need a vacuum, forceps, or a cesarean birth.

A normal, healthy labor and birth occur as a result of the mother and baby’s natural abilities. This type of birth is more likely to be safe and healthy because the process occurs without unnecessary interventions.

Some women and babies have complications that require interventions to have a safe and healthy outcome. Supporting normal, healthy labor andbirth continues to benefit these womenand their babies as well.

DISRUPTIONS TO NORMAL, HEALTHY BIRTH

Many things can disrupt the normal process of birth. Some examples to watch for:

◆Medications to induce or speed up labor.

◆Any environment that isn’t private or comfortable, or where people aren’t present to offer continuous support as desired.

◆Time limits on the progress of labor.

◆Restrictions on food and drink.

◆Pain medications, epidurals, or anesthesia.

◆Episiotomy.

◆Cesarean, vacuum or forceps delivery.

◆Early cutting of the umbilical cord before it has stopped pulsating.

◆Separation of you and your baby after birth.

◆Any situation where you feel threatened or unsupported.

HAVING A NORMAL, HEALTHY BIRTH

Many things can influence your ability to have a normal,healthy birth without intervention. These include:

◆Your overall good health and physical fitness.

◆Your knowledge and confidence about birth(including cultural beliefs and practices and what you’ve been taught about birth).

◆Having the chance to make informed decisions about your birth with your healthcare provider.

◆Having access to a healthcare system, healthcare provider, and setting that supports you and helps meet your goal.

CHOOSING THE RIGHT HEALTHCARE PROVIDER

Your healthcare provider, including midwives, canincrease your confidence and address your concernsabout giving birth. She or he should:

◆Be committed to helping you learn about the birth process, while providing you with information so that you can make the best decisions for you and your baby.

◆Allow you enough time to make decisions without feeling pressured.

◆Know how to help you cope with pain in labor without using medications, and should assure your comfort, dignity and privacy.

◆Respect your cultural beliefs and preferences.◆◆Have the education, knowledge, skills, and confidence to help you achieve your goals.

BENEFITS OF A NORMAL, HEALTHY BIRTH

A normal, healthy birth provides many importantbenefits to your baby and you, such as:

◆Achieving better overall health for your baby.

◆Enabling your baby to successfully adapt to life outside the womb.

◆Feeling physically and emotionally well andconfident as mothers.

◆Being better able to respond to your baby’s needs.

In addition to both of you, your family andsociety also benefit from a normal, healthy birth. As more women experience normal labor and birth, the view of birth will change to one of wellness, rather than illness. It also helps to ensure that a woman and her healthcare provider act as partners, sharing decision making and responsibility.

CHOOSING THE RIGHT BIRTH SETTING

The location that you choose for birth should have policies in place to support normal, healthy birth. These policies should allow you to:

◆Go into labor spontaneously and not allow induc- tion of labor or the use of Pitocin to speed up your labor, without a compelling medical reason.

◆Eat and drink during labor, if you want to.

◆Move around freely in labor.

◆Give birth in whatever position you feel comfortable.

◆Receive support from people you choose.

Unless there is a compelling medical reason, there is no need to be attached to an electronic fetal monitor. You should be given the option of having your baby’s heartbeat listened to at regular intervals.

MIDWIVES WORK COLLABORATIVELY TO SUPPORT NORMAL, HEALTHY BIRTH
Midwives are experts in supporting women in normal, healthy childbirth. Together with healthcare providers, policy makers, educators, researchers, and of course women, we are working collaboratively to educate all those impacted by childbirth. As a team, we are leading the way to:

◆Encourage all birth settings to adopt supportive policies.

◆Raise consumer awareness.

◆Increase the availability of midwifery care for all women.

◆Educate all healthcare providers about the benefitsof this process.

◆Continue research efforts to support these goals.

This document was created and approved by the three major midwifery organizations in the United States: American College of Nurse-Midwives,Midwives Alliance of North America and National Association of Certified Professional Midwives.

www.mana.org

www.midwife.org

www.nacpm.org