One of the most common statements I hear in my practice from expectant couples is “We want to have a natural birth”. As their Midwife, it is my job to understand what a “natural birth” means to that particular couple. Over the years I’ve come to realise that a “natural labour” and delivery can mean very different things to a lot of couples.

So I thought this topic was ripe for discussion. Not only should I be aware of what the couple’s take on natural birth is, they should also be aware of how most Obstetricians and Midwives define “natural birth”.

What does “natural” labour and birth mean to most couples?

In developed countries giving birth “naturally” generally holds true to one of the three following definitions:

• Most women agree a natural birth is a vaginal birth with an epidural.
• For many women, it is a vaginal birth, with the possibility of induction of labour, epidural and episiotomy
• For a few it means an unmedicated labour including no pain relief, that is naturally progressing and does not require intervention to move it along, and is a vaginal birth.

What do medical professionals consider a “natural birth”?

Most Obstetricians and Midwives do not refer to labour and birth as natural, but rather, normal. Now, this may seem very judgmental, however, this label refers to the medical progression rather than a societal expectation or “norm”.

A normal labour and birth include:

• A labour and birth that have started and progressed on their own without medical assistance
• Did not require the assistance of forceps or ventouse
• Did not require a caesarian section
• Did not use epidural or spinal analgesia

However this does not mean there is no intervention at all. Technically speaking a normal birth may include the following as well:

• Membranes being artificially ruptured once labour has started to encourage it’s progress
• Use of a syntocinon drip to augment labour
• Continuous electronic fetal monitoring
• Administration of syntometrin to manage the birth of the placenta
• Use of gas and/or air (also called Entonox), opioids such as diamorphine or pethidine for pain relief

A labour and delivery is technically not considered normal if any of the following take place:

• Induction of labour with medication or by having their waters broken
• Use of epidural or spinal analgesia
• The use of forceps or ventouse
• A cesarean section

All of this may seem very systematic and as someone who strives to labour and birth “naturally” it may seem like a very long list. But considering more than half of women in developed countries make use of epidural analgesia and many of those labours were induced does this mean most of us have “abnormal” births? Absolutely not.

Perhaps we have to shift our way of thinking and our expectations when it comes to childbirth and labour.

If your ideal birth is a natural one, make sure you are clear about what your definition of natural means. Then have a frank conversation with your Obstetrician or Midwife to ensure they understand your definition of “natural” and you understand theirs. And lastly, keep in mind, labour and birth are by nature unpredictable, ever changing and always a larger than life miracle. Try to shift your thinking from “wanting” a natural birth to “working towards” a natural birth.

And remember, no matter how well planned, any labour or birth can change in a second and all plans become secondary.

Instead of striving to have a perfect labour and delivery, strive to have a successful one where the expectant parents feel supported, and the outcome is a healthy Muma and baby. Now that’s nature at it’s finest!

Pregnant? Sign up to Urban Hatch’s online antenatal course, HATCH™ to learn how to approach pregnancy and parenthood with comfort and confidence.

Image kindly shared by www.kristaevans.com

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