Gentle Birth — Give an Easier Way-Out to Your Infant
The concept of gentle birth considers what birth is like from the baby’s point of view. It attempts to minimize the stress and trauma experienced by the infant as he passes through the birth canal and thus make his entry into the world more pleasant. Types of gentle birth include Leboyer delivery, underwater birth, and birth without interventions.
A Leboyer delivery incorporates several techniques that make birth a more soothing experience for the infant. This type of delivery was devised by Frederick Leboyer, a French obstetrician, and popularized in his book Birth Without Violence. Dr. Leboyer originated the concept of gentle birth. He felt that birth is a traumatic experience for the newborn and that certain routine delivery procedures increase the trauma. Otherwise, why do babies cry and look so unhappy at birth? In his view, the infant moves from a peaceful womb through the “assault” of labor into a world of bright lights and loud voices. He is held upside down, his cord is cut, and he is immediately removed from his mother. Dr. Leboyer stated that a newborn’s senses are very acute and that he perceives the intense sensations of birth, often very vividly.
Even if your caregiver does not “practice Leboyer techniques,” he may agree to incorporate some of the aspects that appeal to you. Following is a description of a gentle birth:
- The room is dimly lit, allowing the baby to adjust slowly to the light. The bright lights that are normally used in delivery rooms are blinding to the eyes of a baby who has been in semidarkness for 9 months. Think about what it is like to be in a dark room for a while and then to suddenly have bright lights directed at your face. It is no wonder that babies shut their eyes tightly.
- To keep the baby from becoming chilled, the temperature of the birthing room is adjusted for the baby’s needs, rather than for the hospital staff’s comfort. Talking is kept to a minimum or a whisper. Loud voices and exclamations may seem deafening to the new baby’s ears.
- As the baby emerges from the birth canal, he is gently lifted up and placed onto his mother’s bare abdomen for skin-to-skin contact. He is not held upside down by his feet, which would straighten his spine, a position exactly opposite of the one he had in utero. He is not stimulated to cry, but allowed to begin breathing spontaneously. His mother can gently soothe him through massage or stroking. His nose and mouth are not suctioned unless they need to be.
- The cord is not cut until it stops pulsating. This allows the baby to continue receiving oxygen-carrying red blood cells, which decreases his chance for anoxia. The cord is also not clamped immediately after birth, which means that the baby does not have to be rushed into breathing, since he is still receiving oxygen from his mother via the cord. The transition from intrauterine life to breathing on his own is much easier for the baby.
- The baby is then given to the father, who can place him in a warm bath to simulate a return to the security of the womb. Many babies completely relax and stop crying while they gently float in the water. The baby is then dried, wrapped, and given to his mother.
Some of the arguments against Leboyer delivery are that the baby is allowed to be cold, that the inadequate lighting interferes with the assessment of the baby, and that the father may inadvertently drop or drown the baby in the bath water. Opponents of delayed cord cutting argue that the baby receives extra rod blood cells, which causes increased jaundice. However, unless the newborn is held below the level of the placenta or the cord is “milked” (compressed and stroked toward the baby), equal amounts of blood enter and leave the baby while the cord is pulsating.
Caregivers who specialize in Leboyer deliveries and have kept statistics have found no increase whatsoever in infection, heat loss, undetected distress, or other complications attributed to gentle-birth procedures. Since the parents are intimately involved during this type of birth, bonding may be encouraged more than in a non-Leboyer birth, and the parents’ competence at caring for their new baby may be enhanced.
Interestingly, many of Leboyer’s techniques are slowly being incorporated into regular birthing room routines. For example, caregivers no longer hold babies upside down by their feet, but instead, deliver the infant up onto the mother’s abdomen. Babies are being born more alert, since women are taking less medication. These alert babies do not need to be stimulated or “spanked” at birth. Most babies today are being welcomed into the world more gently, with their comfort in mind.
Some women have taken the concept of gentle birth one step further by choosing to deliver their babies underwater. Just as laboring in warm water has been found to promote relaxation, making the contractions less painful and more efficient, delivering while still in the water can reduce the stress of birth, making it easier for both mother and baby.
In this type of birth, the woman rests in a tub of water heated to around 98°F. After the baby is born, he is gently lifted from the water and handed to his mother, or he is lifted out of the water by the mother herself. According to proponents of this method, the physiological mechanism that causes the baby to breathe is not stimulated until the baby’s skin is exposed to changes in temperature and air pressure. Therefore, the baby does not take his first breath until after he is removed from the water. He continues to receive oxygen from the placenta through the umbilical cord.
The concept of birthing underwater originated in France, at the Pithiviers Maternity Unit, headed by Dr. Michel Odent. After learning of Dr. Leboyer’s techniques. Dr. Odent created an atmosphere in which a gentle birth could be accomplished. Women could labor and deliver however they felt most comfortable. He began by gradually removing the traditional obstetrical technologies, which he felt created barriers between the parents and child. He incorporated the use of dimmed lights and reduced noise, and had the staff remain out of the way unless needed. In finding their most comfortable labor and birthing positions, women began opting to get into the tub of water provided for them. Underwater birth became a natural outgrowth of these efforts. Dr. Odent saw that delivering in this manner reduced the trauma of birth to its minimum, and he began actively promoting birth underwater. Over the years, his name has become almost synonymous with underwater birth.
According to Barbara Harper, RN, an author and expert on underwater birth, being in water helps some laboring women to relax so much that fear and resistance are almost totally eliminated, allowing for the easiest delivery possible. Sometimes, women get into the tub just to labor and the birth happens before they can get out. Another benefit of waterbirth is that it causes the perineum to be more elastic, reducing the chance of tearing and the need for episiotomies. Dr. Odent reported that in 100 waterbirths he attended, there were no episiotomies and only 29 cases of superficial tearing.
Women who experienced birthing underwater felt that it allowed them to be more in tune with their bodies and to work with the labor process more effectively. They stated that delivering in this manner gave them the opportunity to really “give birth,” rather than “being delivered.
Many doctors feel that the risks of waterbirth are too great. They state that the chance of a baby drowning, however slight, prevents this from being an acceptable procedure.
Waterbirth is available in certain areas in the United States. If you are interested in this type of delivery, begin by checking with the nearest birth center.
Birth Without Interventions
A birth without interventions, one in which the woman is allowed to do whatever feels best during labor and delivery, is a truly natural birth. In other words, the woman acts instinctively to birth her baby. For example, she may instinctively choose to kneel on all fours during parts of her labor and to squat while pushing the baby out. Because there are no interventions (other than listening to the baby’s heart rate with a fetoscope or doptone), her positions and movements are not restricted by any tubes, wires, or medications. The woman feels free to make whatever noise is comforting to her, and she is not rushed by anyone’s schedule to “get the baby out.”
Because doctors are trained in a medical setting, the majority of them have never witnessed a natural birth, one without any interventions. They are trained to see birth as a medical event, something that requires managing and regulating. Women who experience a birth without interventions usually do so with a midwife, either in a birth center or at home.
Most advocates of natural, or “instinctive,” birthing do not teach a method of childbirth, such as patterned breathing techniques. Instead, they encourage a woman to look within herself for the resources to cope with labor. Dr. Michel Odent has stated that when laboring women follow their instincts, there is “almost nothing to teach.” In his words, “One simply cannot help an involuntary process; one can only disturb it.”