Childbirth is very different today from what it was some years ago. Even today, in rural areas, many babies are lost to septicemia, tetanus, eclampsia, or rhesus blood group incompatibility. All of these conditions can be taken care of by modern medicine. Freed from the shackles of the above problems, birth can be safe and okay

Unfortunately, birth in a hospital does not follow a natural course. It may be safer, but in many ways, it can still be an ordeal for the woman

The obstetrician usually has his or her own yardstick of how long labour should be and if the actual process differs from this, drips and drugs are given to make a woman fit into this timetable. (We even know of a case where a caesarean was performed because the doctor was going to be out of the country on the expected date of delivery!)

The same hospital attendant is seldom present right through the labour so a woman may have a different nurse looking after her every time the duty changes. This can be very disconnecting for the patient, especially if the hospital does not allow family members to be by her side

In a hospital, a woman is often repeatedly subjected to internal vaginal examination, a practice that is unpleasant to the mother and which also runs the risk of introducing infection. This would carry with it the general risks that go with infections

Consequently, one experiences in the urban setting today an increasing feeling of birth being dangerous. This unease comes from an alarming rise in caesarean births and also many traumatic normal deliveries

A woman who has a so called ‘normal delivery’ may have had labour induced and thus experienced abnormally strong contractions, she may have had an epidural injection to have a painless delivery, forceps may have been used at the time of birth. At the end of this, can one say she had a normal delivery?

What exactly is a normal and natural delivery? In a normal birth, the process should be allowed to unfold naturally. A woman in labour should be made to feel relaxed and at ease. Birth should not be induced before time unless letting the pregnancy continue poses a threat to the mother’s life or the child’s life.

When the baby is ready to live outside the womb, that is, when it is ready to breathe all by itself and feed by itself, labour begins. When this happens may be in variance to the estimated date of delivery by a week or two. The doc date of delivery is a calculation based on average and should not be taken to be date of appointment: individual variations, like the difference of the number of days between menstruations can influence the time of ovulation, and consequently the time of birth. This is not taken into account. Neither is the fact that a woman may have an irregular menstrual cycle or that she may conceive when she is sexually stimulated, thus negating every calculation.

It is important to remember that nature has gifted fertility to most women. Surely, along with fertility nature must have also gifted the ability to give birth.

The female pelvic structure is designed so that three of its joints open up and spread apart at birth. Besides, a woman’s pelvic bones are broader than a man’s. The female pelvic is heart shaped, whereas a male pelvic is apple shaped.

At birth, the baby first passes through the cervix or mouth of the womb and then makes its way through the vagina. The vagina is made up of folds and is therefore capable of unfolding, just like the pleats in front of the saree. As the baby passes through the vagina, it opens up to make way for it. The more relaxed a woman keeps the muscles of the vaginal passage, the less tension the baby’s head encounters during birth.

The cranial or head bones of the baby are not fused so as it negotiates the birth canal, they mould to the size of the vaginal passage. They can also ride over each other if necessary. The bones come back to their original shape after birth. It is because this moulding of the baby’s bones that some babies are born with funny bumps on the head, which smoothen out in a few days.

An interesting fact is that uterine contractions and their associated pads form a very short part of the total process of labour. For instance, if you have one minute contractions every five minutes, it will mean that in one hour you will have 12 minutes of contractions and 48 minutes without them. At the start, contractions could be every 15 minutes and last for 30 seconds. So in one hour you would have only two minutes of contractions..

The mother’s body also releases hormones in order to be able to give birth. Oxytocin hormones bring on contractions or labour pains. Endorphin hormones are also often released in an undrugged lasbour. They give a mother a feeling of well being and are natural painkillers.

To allow optimum endorphin release, it is important a mother be made to feel comfortable in her environment and in the people they are around her at this time. She should be free to have someone from house with her. It could be a spouse, a parent, a friend, anybody. She should be given positive support by the doctor, staff, and others around her. If she is constantly given a negative report of her labour – for instance if she is told she is dilating: or that it will take a long time and a long labour may put her baby in distress or that its better to have a caesarean because the baby is big, or the cord is around the neck (the cord is often loosely around the neck without any adverse effect) – it can make her feel something is dramatically wrong. Such negative feedback can mentally prepare her for and make her desire a caesarean. Hence, positive encouragement in labour is very essential.

Incidentally, it is only if the cord is wound tight around the baby’s neck that it can be life-threatening. If this is so, it can be easily detected because the baby’s heartbeat will fluctuate from its baseline heartbeat.

The importance of positive feedback is now recognized all over the world. That is why one of the WHO recommendations for childbirth states: “The well being of the new mother must be ensured through free access of a chosen member of her family during birth and throughout the postnatal period. In addition, the health team must provide emotional support.”

FEMINA, NOVEMBER 15, 1996, PAGE 70-71

NUTAN PANDIT

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