As your pregnancy progresses, you will need to start thinking about your birth plan and labour delivery options. Women have a choice of two types of births: natural and operative. To make sure you're informed on your options, here is what you need to know about the natural birthing options available to you.
What is Natural Birth?
Essentially, natural birth (or vaginal birth) is the idea that the baby comes down the birth canal as the result of uterine contractions (labour) and out of the vagina without assistance from an instrument such as forceps or a vacuum or the use of pain-relief medication.
However, there's a whole spectrum of definitions to what "natural" is. Technically, induction of labour is not a natural birth even if it results in a vaginal delivery, but many people define natural birth as any time the baby comes out of the vagina. The modern definition of natural birth means no medical interventions as in not taking pain medications or getting an epidural.
In contrast, operative births occur when the baby is assisted out of the vagina with an instrument or via cesarean section which is an operation performed through an abdominal incision whereby the baby is extracted directly from the uterus via an incision.
Natural birth in Hong Kong is relatively low but rising, the Matilda Hospital recorded a rate of 42.5% natural births this past year, compared to 32.19% natural births in 2017. The rising trend of natural births can be attributed to mothers becoming more aware and cautious with what happens to their bodies. The choice to have unmedicated birth is due to the concern about the complications where there is medication involved and they don't want to assume the risk.
Why is Natural Birth Popular?
Many women consider natural birth more empowering as they have greater control over their birthing process. As labour and delivery are different for every pregnancy, the benefits may differ too. Here are some of the most discussed:
- Faster recovery
- Earlier walking (unless provided with epidural)
- Leaving the hospital sooner
- No major incision in the abdomen (which requires a longer recovery)
- Less pain, although some lacerations of the vagina can be intensely painful
- Less risk of excessive bleeding
- Less chance of infection and scarring
- Less risk of blood clots
- Earlier bonding and breastfeeding for the baby
- Less baby breathing difficulties because the lung fluid is squeezed out by the birth process
- Exposure to mother's microbiome improves immunity for baby
- Subsequent vaginal births are generally easier and faster
However, like with anything, natural births do come with some risks, mainly:
- Tearing and episiotomies that can cause significant pain and burn for months
- Large babies do more damage and might not fit through the birth canal; this raises the risk of shoulder dystocia, operative deliveries, even cesarean section after hours of labour
- Shoulder dystocia (when head delivers but the shoulders get stuck behind the pubic bone) can cause bone breakage or neurologic problems if it is not quickly corrected
- Vaginal births cause more urinary leakage and bowel trouble (but cesarean sections don't always prevent this problem as the pregnancy itself and the foetal weight pressing down on the nerves for 40 weeks can also affect the bladder and bowels)
Natural Birth vs Cesarean Section.
In the past 2- 3 decades, elective cesarean section has also grown in popularity.
As modern medicine has improved, the risks associated with cesarean sections have decreased, which is why some women would rather schedule their birth and avoid the uncertainty of spontaneous labour. However, risks with cesarean sections persist:
- You are more likely to have a repeat cesarean section, which may be more challenging to perform due to scarring. In fact, mothers with a caesarean scar were 24 times more likely to develop a rare condition known as morbidly adherent placenta than those with an unscarred uterus
- Three times the risk of death compared to a natural birth
- Risk of uterine rupture in a subsequent pregnancy if labour ensues before a repeat cesarean can be performed
Risks and Precaution
There are times when a cesarean section is essential for either maternal or baby's well-being.
Situations such as multiple births, malpositions such as breech (feet first), transverse position (horizontal), placenta previa (placenta overlying the cervical opening), placenta accrete (placenta burrowing into the uterine muscle layer) all require medical intervention to ensure the delivery of the baby is safe.
The decision to birth naturally is a personal one. Whether you opt for a natural birth or not, your delivery and labour should be what's most comfortable for you. Pregnancy is not black-and-white; sometimes, things don't go to plan. The best way to prepare is to be educated and have a birthing plan in place.
To find the right choice, you should discuss all your options and concerns with your healthcare practitioner. At OT&P, we also provide hypnobirthing classes to educate mothers-to-be seeking a peaceful pregnancy, labour and delivery.