For as long as I have been involved in birth issues, the term “natural birth” has been thrown around in a number of different tones. Some people think it is the only true way to birth a child while others think it’s a waste of energy when there are medications out there for pain. No one’s opinion is wrong, however what people consider to be a natural birth is to me not as important as a “physiological birth”, which takes the great concepts of natural childbirth but does not limit the birth person to a birth at home, with a midwife and with no medicine involved whatsoever.
So what does it mean to have a physiological birth? Well, many different professionals would define this term in many different ways. To me, a birth doula in Edmonton (Alberta, Canada), for a birth to be physiologic it must first allow the birth person to be in control of every decision and procedure that is done to them. The birther must be entirely in-tune with their body and what it needs in the various stages. They must surrender to the process of birth and allow their brains to shift from logical to primal.
The second portion to this is avoiding the use of medication until truly needed. Now this is the part that starts the feuding over who’s birth was better, but this is why I include until truly needed! In a perfect world, we would start our labours spontaneously, they would progress smoothly and gradually and allow us to slowly cope with the growing intensity, and then birth would happen. For probably 75% of my clients as an Edmonton doula, this is not the case. Birth may start slow and not really progress for days, it may start fast and furious. It may even start via induction of labour due to a medical condition that is jeopardizing a safe pregnancy. Whatever the reason we simply can’t say that all birth starts as it is supposed to, but that doesn’t mean that birth physiology can’t still be a goal of the birth!
A big part of having a physiological childbirth is looking at the way that our bodies were meant to be labouring and birthing and trying to mimic these scenarios as best as possible. For an example, following the birth of your baby most hospitals in my area will administer a standard dose of oxytocin to avoid a postpartum haemorrhage. If you have a birth person who did not use pain medications, went into labour spontaneously and had a very average pushing stage, what often makes the most physiological sense is to leave the couple and their new baby alone, dim the lights, reduce all disruptive factors and allow the birth persons natural oxytocin to take over the job of contracting the uterus. However, as a doula in Edmonton I enter into hospitals who each have on average a 90-95% epidural rate, and epidural use will disrupt that natural oxytocin flow. It’s also not common for birthing people to be left alone to bond with baby while delivering the placenta, which can reduce the natural flow of oxytocin and encourages placental delivery. So in these scenarios, the oxytocin shot is a safe option but still plays on the physiological process involved after birth - it just uses synthetic versions of the hormones that are needed.
The one thing that I wish for when it comes to birth culture is that we move away from viewing birth as a medical process that has to be constantly managed. I want our care providers to feel comfortable leaving the birth as it is until absolutely necessary. I want our hospital rooms to be more ambient and conducive to allowing birth to happen in a natural state. I want doulas to become a normal and common part of the birth team. I have many wants, but at the very core of all of these things is the need for education around how a normal, physiological birth looks and how to get each birth to follow this guideline in absence of medical issues. The norms of the hospital L&D units in my area are starting to progress to what I hope for, but very slowly. As doulas, childbirth educators and other non-medical birth workers, we can help facilitate this
change by simply educating expecting parents on their right to choose and make their own decisions. Slowly, I believe more and more medical professionals will start to catch on!
By Jeanelle Sloan, Certified Labour Doula and Childbirth Educator, Full Circle Doula Collective, Edmonton, Canada. You can learn more about Jeanelle by visiting her site www.dancingdoulajeanelle.com