Six Healthy Birth Practices
by Laura Maxson LM
Parents looking to develop a birth plan can often feel a little bit lost, wondering where to start, and what do I want? Lamaze International’s Six Healthy Birth Practices is a great place to start. Lamaze has a rich history of supporting parents in childbirth since the 1960’s. The Lamaze website provides parents with vital information including the Giving Birth with Confidence blog, videos, and many articles about pregnancy, childbirth, and parenting.
Lamaze Healthy Birth Practices
- Let labor begin on its own.
- Walk, move around, and change positions throughout labor.
- Bring a loved one, friend, or doula for continuous support.
- Avoid interventions that are not medically necessary.
- Avoid giving birth on your back and follow your body’s urges to push.
- Keep mother and baby together – It’s best for mother, baby, and breastfeeding.
When implemented, these six evidence-based practices mean less high-tech medical-model care and more low-tech midwifery-model care; fewer surgeries and more time allocated to laboring; more naturally starting labors, with fewer inductions; and more power to pregnant families, and less to care providers. Facilities and providers accepting and implementing these steps can help initiate the paradigm shift sorely needed in childbirth.
In the United States, technology and the medical model have long been the norm. Procedures and interventions adopted (often without adequate research) have proven difficult to change. Decades of medical tradition and cumbersome hospital protocols often wedge parents and care providers into power struggles and turf wars. Individual practitioners and parents together will be the ones to turn the tide. Change, however, often triggers roadblocks from a variety of directions. In other words – it’s political.
Parents can get a conversation started and figure out how to best incorporate these six ideas into their birth plan. Routine recommendations don’t necessarily meet everyone’s needs. Ask questions and make your birth plan individualized. Go to Lamaze.org for more in-depth exploration of each of these steps.
Let labor begin on its own.
Induction of labor more than doubled between 1990 and 2005 with no corresponding increase in medical need, resulting in poor outcomes for babies born between 37 and 39 weeks. This caused the March of Dimes and others to initiate programs to decrease the number of labors induced before 39 weeks with good results.
Walk, move around, and change positions throughout labor.
Tethered to the bed by IV lines, electronic fetal monitors and epidurals, many in labor are denied the ability to use one of their most powerful tools – movement. Not moving can increase labor pain, leading to other interventions.
Bring a loved one, friend, or doula for continuous support.
Although birth doulas are proven to shorten labors and diminish the need for interventions including cesarean surgery, they are routinely discouraged by some practitioners, outright banned at some hospitals, and rarely covered by insurance. John Kennell, MD, said, “If a doula were a drug, it would be unethical not to use it.”
Avoid interventions that are not medically necessary.
After routine episiotomy was found to cause more harm than good, it took 30 years to fully change protocols, and there are still some doctors who routinely perform episiotomies with no medical indication. Rupturing the bag of waters, IVs, routine electronic fetal monitors, and many more interventions that ought to be used based only on medical need are instead routinely performed in many hospitals and by many care providers.
Avoid giving birth on your back and follow your body’s urges to push.
Women are often asked to push in the position most convenient for the practitioner. Utilize the squat bar, birth stool, and other more upright positions, such as hands and knees or a birth stool, to help push effectively.
Keep mother and baby together – it’s best for mother, baby, and breastfeeding. Baby-Friendly practices in all three Santa Cruz County hospitals are helping families get breastfeeding off to a good start. Skin-to-skin is respected and encouraged for the first hours after birth.
Birthing people are better served when aware of the limitations and influences of current obstetric practices on low-risk pregnancies. Check out the many resources at Lamaze, March of Dimes, and Birth Network’s listing of local providers including: doulas, midwives, childbirth educators, and so many more.