What is an active birth?
The Active Birth Movement was founded in 1982 by Janet Balaskas. The main function since then has been educational, providing conferences, lectures, workshops for parents and professionals, as well as training facilities for Active Birth teachers. The Active Birth Movement is now international,and has had geat success in stimulating change. It is run entirely by women like Janet Balaskas, who have rediscovered childbirth through their own experiences. They are women who have chosen to get off the obstetric delivery table and to give birth instinctively. Consequently they pass on what they have learnt to others and through their work they are creating a new tradition of womanly wisdom, helping women to regain their autonomy as childbearers.
Janet Balaskas - 'New Active Birth'
An Active Birth is the way that a woman behaves when she is following her own instincts and the physiological logic of her body.
You're in control of your body, rather than the passive recipient of an 'actively managed' birth on the part of your attendants
Janet Balaskas - 'New Active Birth'
The question "what is an active birth?" can be answered on many levels. First and foremost, an active birth is not a medical event which is 'actively managed' by professionals.
From the beginning of pregnancy, it involves a true partnership between you and your birth attendants. This empowers you to be an active participant in your pregnancy and birth, rather than a passive patient. For this you need to be well informed about all your options.
The goal is to avoid the unnecessary or routine use of drugs and interventions. It also means having the knowledge and wisdom to recognise when they are needed and how best to use them to minimise any risks or potentially harmful side effects.
You do have a wide range of choices at your disposal, which includes both holistic and medical options. Understanding how they all work, will enable you to make the best decisions at the time for you and your baby, to be actively responsible, empowered and involved in all aspects of your care.
"... the woman gives a cry that seems one of astonishment, jubilation, pain and triumph - perhaps also of ecstasy - mingled in one great shout.The baby's head slips through, and then the whole body tumbles onto the cloth that is spread to receive it.
Immediately the woman looks down, scoops up her baby, and lifts it to her breast: "I can't believe it! It's incredible! Don't cry, little one! My baby! My baby! Fantastic! Incredible!" she exclaims over and over again, eyes shining and wet with tears, laughing and crying at the same time.
She is in her husband's arms and he is kissing her. Nobody intrudes. He kisses the baby's foot, then his wife again. He is crying with the joy and wonder of it too.
This is what birth is like for some women, this is what birth can be."
Michel Odent 'Birth Reborn'
Janet Balaskas writes:
THE BENEFITS OF AN ACTIVE BIRTH
When you are free to move and choose comfortable, supported upright positions in labour such as standing, walking, kneeling, sitting or squatting there are a number of significant advantages. This is an area of childbirth which has been well researched. There are numerous studies which confirm the following benefits.
LESS PAIN
Contractions tend to be less painful when you are upright than if you were lying down. This is because the uterus naturally tilts forward during a contraction. When you are upright and leaning forward you help the uterus to do it's work without resistance.
Reclining positions oppose gravity, and the resulting resistance makes contractions less efficient and more painful. Being upright will not take away the pain, but it may mean that you can cope better so that you are less likely to need painkillers or an epidural, although it's wise to keep an open mind and to feel free to ask for medical pain relief if you need it.
MORE OXYGEN TO THE BABY
There is a much better blood supply to the placenta when you are upright, compared to lying down. When you are up and moving you will breathe better, and therefore more oxygen will go to your baby. In a reclining or semi reclining position, the weight of the heavy uterus at full term (approximately 20 lbs!) rests on the large internal blood vessels that supply the uterus.
This compression may, over time, reduce the blood flow to the placenta resulting in the baby getting less oxygen. When a baby is short of oxygen there is a risk of what is known as a ‘foetal distress’ developing -- a common reason for a caesarean section or the use of forceps or ventouse to deliver the baby quickly.
When you are upright and leaning forward, there is no compression of the internal blood vessels, your baby receives plenty of oxygen and will cope better with the labour and birth. Having an Active Birth is a way to prevent foetal distress and to reduce the need for medical interventions.
OPTIMAL POSITIONING
Your natural movements combine with gravity to help your baby into a good position for birth. This prevents malpresentations (when the baby gets into a less favourable or awkward position) and reduces the need for interventions.
MORE EFFECTIVE CONTRACTIONS
The weight of your baby’s head and body puts even pressure from above on the cervix and stimulates dilation. This may result in a shorter labour. In reclining positions there is less pressure on the cervix from the baby’s weight. Uneven pressure on cervix results in slower dilation and more likelihood of an 'anterior lip' (when the front lip of the cervix is slow to dilate at the end of labour).
MORE SPACE FOR YOUR BABY
When you are upright the back wall of your pelvis (the sacrum) is free to move. It has a slight pivotal action which allows the pelvic canal to widen and adjust to the shape of the baby's head as is descends. Lying on your back or semi-reclining, prevents any movement of the sacrum and reduces the space available for your baby significantly.
Less space means more pressure on the pelvic joints and nerves and this increases the perception of pain. Being upright allows more space for your baby and therefore reduces pain, especially back pain, in labour.
In the second stage, when you are ready to give birth, it is still a good idea to stay upright. Lying down may be tempting if you are tired, but it will be less productive. Choosing a kneeling , supported squatting or standing position will help you to use your energy most effectively while you are pushing and will help your baby to be born more easily.
MAXIMUM SPACE FOR YOUR BABY
In upright positions, where you are not resting your weight on your sacrum, your pelvis can open to it's widest. The space available for your baby to be born through the pelvic outlet is --amazingly -- up to 28% wider than it is in a reclining position.
EASIER TO PUSH
In upright positions gravity pulls while you push. The baby’s angle of descent is easiest - down and out. In reclining positions the pelvis is horizontal so that you need to push 'up hill' and against gravity making the baby's descent more difficult.
MORE POWER
Aided by gravity the uterus can exert maximum force making bearing down more efficient and shortening the second stage. When a woman gives birth lying down, the bearing down force is made less efficient and this can prolong the birth.
LESS RISK OF TEARING
In upright birthing positions the perineum (the fleshy bit between the vagina and the anus) can expand evenly so that the baby’s passes through more easily and this reduces the risk of tearing.
YOU AND YOUR BABY IN OPTIMAL CONDITION
Minimal or no use of medical interventions reduces the risk of common side effects, so that your baby is alert, responsive and undrugged at birth. You are both full of natural hormones which promote bonding and attachment. You are likely to feel proud, empowered and satisfied with yourself and to recover quickly.
Even after your baby is born and you are enjoying the pleasure of holding him or her in your arms for the first time, there are important advantages to sitting upright:
You can hold and position your baby more easily for the first contact with the breast and for the first sucking. The baby beginning to breastfeed soon after birth will stimulate the uterus to contract and prevent excessive bleeding.
While you are welcoming your baby and the first breastfeed begins, gravity will be helping your placenta to separate and your uterus to contract down efficiently. This reduces the need for Syntometrine.
Fluids drain more effectively from the uterus when you are upright, reducing the risk of infection.
YOU AND YOUR PARTNER
At the end of the day you are likely to feel exhilarated and empowered by the whole experience. You and your baby will share very high levels of oxytocin and endorphines, the hormones that make you fall in love with each other for ever!
Partners are often actively involved in giving both emotional and physical support during an active birth. This sharing of the birth experience can be very fulfilling and memorable and is a good start to becoming a parent and beginning your life together as a new family
How do babies benefit from active birth?
The risk of fetal distress is reduced.
There are fewer side effects from drugs or interventions.
Labour and birth are potentially quicker and usually uncomplicated, so that the baby's birth is not traumatic.
The baby is likely to be born in optimal condition
Bonding after birth and the first breastfeeding are facilitated and the baby is welcomed in a gentle and loving way.
You are likely to feel good and recover well from the birth, which makes caring for your newborn baby easier.
How you can benefit from an active birth?
In these positions your body is at a good angle for your baby to move down through your pelvis most easily, helped by the pull of gravity. Your baby's head then presses down on the base of the uterus, encouraging it to open or dilate by stimulating the contractions. This means that your labour will be more efficient and is likely to progress better. On the other hand lying down when you are in labour reduces the pressure from the baby's head and can slow things down.
Being free to move and choose your own positions has some other advantages too. Its easier for your uterus to do its work, so the contractions tend to be less painful than if you were lying down. This will help you to manage the pain better so that you are less likely to need painkillers or an epidural, although you should feel free to ask for pain relief if you need it.
Freedom of movement helps your breathing to become more spontaneous and to flow more freely. This also encourages the free expression of sound which helps to modify the pain.
There is also a better blood flow to the placenta when you are upright. This is because there is less compression on the internal blood vessels from the weight of the heavy uterus. Your baby receives plenty of oxygen and will cope better with the labour and birth. When a baby is short of oxygen in labour there is a risk of what is known as 'fetal distress' , a common reason for emergency caesareans.
In upright positions your pelvic joints are able to be more mobile than they would be if you were lying down. This allows an increase in the pelvic diameters, so that the internal shape of the pelvis can expand to accommodate the baby's head as it descends through the pelvis in labour.
During the birth itself, the diameters of the pelvic outlet widen by up to a third more than they would if you were semi reclining or on your back. This makes more space for your baby to come out and makes giving birth much easier.
Even after your baby is born and you are enjoying the pleasure of holding him or her in your arms for the first time, its a good idea to sit upright so that you can position your baby well for the first contact with the breast. Then, while you are welcoming your baby and the first breast feed begins, gravity will be helping your placenta to separate and your uterus to contract down efficiently.
Partners are often actively involved in giving both emotional and physical support during an active birth. This sharing of the birth experience can be very fulfilling and memorable and is a good start to a new relationship and a new family.
At the end of the day you are likely to feel exhilarated and empowered by the whole experience. Both you and your baby will have very high levels of oxytocin, the hormone that makes you fall in love with your baby for ever!
