Says the marketing manager, “I had a nasty epidural experience when giving birth to my older children. The epidural made the labour process very uncomfortable when the numbness and side-effects kicked in and I could not feel my legs or what I was pushing. I suffered post-epidural effects like vomiting and shivering for the other two labours.”
Though her husband and doctor were not keen on her decision to deliver without drugs, Lee had the final say. While it was an extremely painful, she says it was worth the effort.
“My overall mood was better and I recovered much faster — I could move around almost immediately after giving birth. There was no numbness in my legs or body, no nausea or shivering to deal with and no need for a catheter as I could go to the toilet!”
Delivering without meds
Like Lee, an increasing number of expectant mums are choosing a drug-free labour with minimal medical intervention.
“With more awareness and education via the Internet, more women are empowered and reminded of their ability to birth naturally.”
Notes chief doula Ginny Phang, owner of maternity care provider Four Trimesters, “With more awareness and education via the Internet, more women are empowered and reminded of their ability to birth naturally. It is an innate desire that most women have.”
Adds Dr Tan Toh Lick, a consultant obstetrician and gynaecologist at Thomson Women’s Clinic (Jurong East), “Medication is not restricted to pain relief, but includes medication to start or augment labour, to reduce the risk of infecting the newborn, and reduce blood loss.”
He says that some women want to experience childbirth as a natural process, while others perceive the use of medication as needing help in childbirth. “While natural birth can be attained in many instances, there are occasions where help can bring about a better outcome.”
In developed countries with accessible healthcare, he points out, the lifetime risk of maternal death is 1 in 4,900. In developing countries with scarce medication, this risk is almost 33 times higher, at 1 in 150.
Birthing methods that encourage drug-free birthing
Dr Tan details the following alternative non-drug interventions:
• Induction of labour It’s considered normal term when you deliver from 37 to 42 weeks of pregnancy. As births beyond this time carry a heightened risk of death for the baby, you’ll be advised to induce labour. In Singapore, the hormone prostaglandins is the most common form of induction of labour. For women who wish to avoid drugs, a mechanical method using cervical ripening balloon is offered. If the mum-to-be declines to have labour induced, the pregnancy will need to be closely monitored. For women who are aiming for a drug-free birth, the doctor can perform membrane sweeping at term to promote labour, so as to avoid formal induction of labour.
• Augmentation of labour Sometimes, uterine contractions aren’t successful enough to open the neck of the womb for a vaginal delivery. Interventions, such as breaking the waters (artificial rupture of membrane) and an oxytocin infusion may be employed to increase the frequency and intensity of the contractions.
• Pain relief Labouring women who eschew drugs can try a birth companion and adopt an upright position or walk around in the first stage of labour. She can also do controlled breathing exercises, use a birthing ball, as well as try transcutaneous electrical nerve stimulation (TENS) and hydrotherapy. Some women overcome labour pain with hypnotherapy and meditation.
• Antibiotics Women who are screened and found to be carriers of Group B Streptococcus (GBS) infection in the lower genital tract will be offered penicillin or equivalent antibiotics during labour to reduce the risk of their babies getting GBS sepsis. So, if they decline preventive antibiotics, they will be advised to get a paediatrician to screen their newborn, and treat it, if needed.
Increasing your success at having a medication-free birth
Going through labour and birth is like taking a driving test. Some 80 per cent of the preparation is “pre-test” or prenatally, Phang notes. On the day of the test, you cannot control the weather conditions and the kind of drivers you meet on the road, you can only choose how you respond.
Massaging your perineal area in pregnancy stretches the area around the vagina, and may help to ease labour pain and shorten delivery time.
“In the same way, it is important for a mother and her partner to work together towards a common goal and outcome of what they would like their birth experience to be,” she adds.
Adequate preparation is the key to increasing your chances of a drug-free birth by making pregnancy and labour easier. Here are tips to increases your chances of having one.
1. Increase your knowledge
Information is power — by learning as much as you can about the labour process, you will have a better idea of what to expect and be able to have more trust in your body’s ability to handle the natural birth. So, read positive books and attend childbirth education classes.
2. Train, train, train
A healthy and fit body will weather labour more easily. Stay fit during your pregnancy, so that your body will be able to adapt to changes that labour will bring about. You will also be able to recover faster postpartum.
3. Practise relaxation and pain-management techniques
Prenatal yoga relaxes and focuses on movements that open the hips and tilt the pelvis to help a mum-to-be prepare for childbirth. Practise deep-breathing techniques to cope with pain. Massaging your perineal area in pregnancy stretches the area around the vagina, and may help to ease labour pain and shorten delivery time.
4. Get the right support
It’s vital to get your doctor and husband’s early support of your drug-free birth plan. You don’t want to be challenged or questioned on every decision you make. This includes declining an epidural or internal foetal monitor, using essential oils, playing relaxing music and accepting the doula in the operating theatre.
5. Get professional help
Hiring an experienced doula increases your chances of sticking with your no-medical-intervention plan. She’ll provide emotional and physical support and encouragement before and during labour, and knows exactly how to help you manage your pain and comfort level.
6. Make a birth plan, with alternatives
Write a birth plan and ensure that your doctor, doula and husband know what you have in mind. Include contingencies or alternatives as your drug-free birth plan may go out the window. Plan and list your preferences, especially if the labour is prolonged/stalled or foetal distress occurs.
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