Birth Options

No matter what current trends are one of the most frequently asked questions couples have is about the options available to them for birth and which will be best. It will depend on one’s pregnancy, how labour unfolds, the health of both mom and baby and then a little on where one lives and what facilities are available, but generally speaking the following are one’s main options from which one can choose what suits one best:

This is the option most women know of and expect. Vaginal birth is given following labour, with or without intervention like induction, episiotomy, vacuum delivery, forceps and/or medical pain relief.

Birth is given in a maternity facility. The delivery room seems a little like an operating theatre but increasingly women can also ask for individual needs to be respected, like greater freedom to move around in first stage, a more upright birthing position and less automatic intervention like episiotomy.

This is quite simply giving birth at home with the help of a midwife in private practice. It should only be considered in uncomplicated pregnancies.

Women mostly choose this option after a disappointing hospital experience in a previous labour, due to anxiety about hospitals in general or because they want a birth that is more of a natural experience than a medical procedure. Family and friends can be involved and the relaxed atmosphere and familiarity of the environment often make labour progress more easily.

An experienced midwife generally takes care of first stage needs as well as delivering baby. Most work in conjunction with an obstetrician whom they can call on if any complications or risks arise. Natural pain relief options are encouraged and as medical intervention and procedures are not possible, moving to hospital will be necessary if you change your mind during labour about the need for assistance.

One can either use water simply for pain relief as needed throughout labour and then go on to have a ‘dry’ birth, or deliver one’s baby in water.

One needs an experienced practitioner (usually a midwife) to assist and the birth can take place at home (in a hired birthing pool) or in an Active Birth Unit. Generally pain is less and the labouring mom-to-be feels more relaxed, which means that labour progresses more rapidly and coping skills are greatly improved.

The water needs to be kept warm for long enough which can be a logistical problem. Water birth is safe if excellent hygiene precautions are adhered to and regular checks are done of both mom and baby’s condition.

Baby can be born into the water and gradually floated to the surface, but once the umbilical cord has stopped pulsating or baby has started breathing (which occurs as soon as the air medium is reached), baby’s head must not be submerged again.

An Active Birth Unit is a pleasant home-like suite in which a private and occasionally a hospital midwife will deliver your baby. Being within a hospital or close by, any emergencies that arise can be treated rapidly.

Natural or active birth is a form of vaginal delivery but includes more natural options like giving birth in an upright position (kneeling or squatting), water birth, moving around during first stage of labour, not having a routine episiotomy and often only having a specially chosen midwife in attendance with a doctor on call.

The emphasis is on the fact that this is your birth and that you have support to make it as special as possible.

Baby is born either in an elective (pre-planned) operation, or in response to an emergency towards the end of pregnancy or during labour, although the former is the only optional one.

South Africa is one of the only countries that readily sanctions Caesarean birth as an option. Most of the rest of the world and almost all pregnancy and birth books discuss Caesarean section as a response to labour complications.

One might have spinal anaesthesia and be conscious throughout the procedure or have a general anaesthetic which is more usual in emergencies situations. Caesarean section is major abdominal surgery and the delivery of a baby all-in-one, but is mostly a safe procedure for mom and baby