Is a natural birth important?

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The question abounds in women’s groups, on social media and over coffee where women try to make a position and justify it to each other, and possibly to themselves. It is really important to consider what evidence says but to put it into context of the Australian Health Care system. So to answer the question is, yes, it’s important but not at the expense of the health of mother and baby.

I find it interesting that we trust our bodies to breath, to digest food and our hearts to beat, but we don’t trust our bodies to birth. The dialogue around birth has become increasingly negative over the last decade with many women being told that they need to have various interventions as they will not be able to birth, or because of risk to their babies. Where in fact, evidence demonstrates that we are going too far, we are inducing labour at massively increased rates, with the outcome being more Caesarean sections without improving rates of stillbirth. Along with these increases in intervention there are also increases in birth trauma with one in three women indicating that their birth was traumatic, more so emotionally than physically with around 1 in 10 women needing significant support due to post traumatic stress disorder.

We must restore the balance, without swinging too far the other way. The evidence shows that midwifery continuity of care is the best possible mechanism to assist. A known midwife watches mother and baby physically and emotionally from early pregnancy until 6 weeks post birth. This is important not only to support women in birth physiology but also to make sure that a balance is maintained to ensure safety is maintained throughout. A known midwife is best placed to detect and remedy problems because the intimate knowledge and connection allows detection of the smallest changes making this model incredibly well placed to support physiological birth for as long as possible but with the knowledge that the course can be changed if an issue arises. Midwifery continuity of care has been shown to reduce stillbirth by at least 16%.

The question of, is it important to have a natural birth is generally followed by ‘but WHY is it important?’ The answers are complex but revolve around the hormonal and biological processes that are part of the physiology that surrounds birth.  For the mother, the hormones include oxytocin, beta-endorphins and prolactin all which are produced when a woman labours natural and all which impact bonding, love for baby, maternal mental and emotional wellbeing and breastfeeding.  We are also gaining more understanding and knowledge about the complex but important role of biological imprinting that occurs during a natural labour and birth.  This impacts the baby’s initiation and continuation of breastfeeding and may also be strongly linked to the biome that the baby develops impacting its immune system and a range of other developmental impacts.  We grow every day in understanding around these important, complex, interrelated factors that lead us to recognise that we should be, where appropriate and safe, focusing on natural birth.

However, finally, we must also realise that in a range of situations natural birth is not safe.  We recognise that the physical and emotional safety of mother and baby must be taken into consideration when all decisions are made.  We are fortunate to be in a country where interventions, such as caesarean’s, are readily available and safe.  This does mean though that there is a potential for “too much too soon” – rather than “too little too late” and that intervention rates rise, without any improvements in outcomes.  Women’s choice and the emotional safety of mum is integral to the decision-making process and therefore the chance to sit down and talk all the options through is a critical part of the birth planning process.

Natural birth is important – but not at any cost.  We must ensure that the woman and baby remain at the centre of all education and all decisions in order to maximise the wellbeing and growth of every new family.

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