Part 1 of 7, a series written by our team of Lamaze Childbirth Educators.
Supported by research studies that examine the benefits and risks of maternity care practices, these six birth practices are the foundation of Lamaze childbirth classes taught around the world. These healthy practices are designed to simplify the birth process in order to alleviate fear and manage discomfort. No matter what type of labor, the length of your labor, or your confidence level, these practices are key to keeping you and your baby as safe and healthy as possible.
Evidence-based care means using the best research about the effects of specific procedures, drugs, tests, and treatments, to help guide decision-making during labor and birth. This is the gold standard for maternity care worldwide. Yes, hospitals and medical care providers such as your OB or midwife, are often well aware of the latest research and recommendations based on these findings. That's all fine and wonderful until you consider the fact it takes - on average - 17 YEARS for medical professionals to change the way they practice!
Keep reading to learn how each of these six practices can help you optimize your birth outcome, then sign up to take our Intensive Study, the popular "ONE DAY" childbirth group class in Atlanta. You'll learn tested strategies for labor comfort and progress, gain insider tips from our time working at your birthing facility and alongside your OB or midwife, and to easily prepare for your transition to parenthood. Don't miss out!
What are the Six Lamaze Healthy Birth Practices?
1) Let Labor Begin On Its Own
A. In pregnancy, labor will start only when all the players - your baby, your uterus, your hormones, and your placenta - are ready. Every day of the last weeks of pregnancy is vital to your body's (and your baby's) preparation for birth. Should you choose for labor to be induced, it a medical event and proceeds quite differently from spontaneous labor.
B. Induction has a higher percent of cesarean rate associated with it. So while a cesarean is not definitive with an induction, ask yourself if the potential benefit truly outweighs the risks.
C. All the hormones that play a part in labor (oxytocin, endorphins, catecholamines, and prolactin) are important. However, there are studies that show now just how important those same hormones are to both mom and baby when spontaneous labor occurs. For example, the natural occurring oxytocin surge in the mother’s body that precedes labor is thought to have a neuroprotective effect on the baby, while higher levels of the synthetic version (pitocin) produced the opposite effect. Catecholamines are vital to readying the baby’s lungs for air breathing after birth, and fetal catecholamines increase a few days before spontaneous labor. Knowing that due dates are often off by at least a few days, even inducing at 40 weeks can lead to issues if the baby wasn’t ready.
If you wake up in the middle of the night feeling contractions, try to go back to sleep. Maintain the quietness of the night and don’t wake your partner right away. Let early labor play out – remember your partner needs rest as well so they can provide adequate support when labor really gets tough! Take a long, warm bath, then go back to bed and doze between contractions.
2) Walk, Move, Change Positions
A. Women who are moving around and use upright positions during labor have shorter labors, less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions.
B. Changing position frequently moves the bones of the pelvis, helping the baby find the best fit to come down.
C. Moving around can also help prevent c-section by reducing the chances of a stall of labor or shortening the amount of time a stall lasts; especially in early labor.
For back labor: hang your belly underneath you as much as possible; have your partner press on your sacrum or squeeze both your hips at the same time; sit backwards on a chair or the toilet; move your pelvis in a hula-hoop motion to help encourage the baby to rotate.
3) Continuous Labor Support
A. This is not a new concept. Ancient art depicts women giving birth surrounded by other women. This is how birth occurred in many civilizations for many years until about the 20th century when doctors moved birth to a hospital.
B. Having someone who is knowledgable and able to help you and/or your partner can greatly help the entire birth experience by reducing risk of cesarean, shortening the length of labor (by helping you with positioning and movement), and the ability to cope with labor by offering comfort measures.
Your partner is an essential support person for you to have by your side. However, your partner will need to eat and use the bathroom at times. Also, most partners have limited knowledge about birth, medical procedures, or what goes on in a hospital. Doulas and partners work together to make up a labor support team.
Having a baby is akin to running a marathon – laboring women need adequate nutrition and hydration to keep going. Some ideas: small amounts of cheese (1 oz), fruit, veggie pieces, rice cakes, honey sticks (can often be found at Farmer’s Markets). Stay away from heavy foods that may cause GI upset or nausea. Partners need to make sure they are eating and taking care of their needs as well so they can provide adequate support.
4) Avoid Routine Interventions
A. Interventions are like dominos. Often times, one intervention will lead to another and then another. Example: Using pitocin, means an IV, constant monitoring, and often times, an epidural...which adds frequent blood pressure checks, urinary catheters, etc.
B. Most U.S. births today are intervention-intensive. A majority of women surveyed for Listening to Mothers experienced one or more of the following interventions during labor:
- Continuous electronic fetal monitoring (EFM)(93%)
- Restrictions on eating (87%)
- IV fluids (86%)
- Restrictions on drinking (66%)
- Episiotomy (35%)
- Epidural anesthesia (63%)
- Artificially ruptured membranes (55%)
- Artificial oxytocin augmentation (53%)
Although research shows that routine and unnecessary interference in the natural process of labor and birth is not likely to be beneficial - and may indeed be harmful - many women give consent to routine procedures such as vaginal exams, INT/hep lock/IV ports, and continuous monitoring. While each of these routine interventions are sometimes necessary, you may wish to ask WHY you are being offered such interventions. We recommend you consider the benefits, risks, and available alternatives (acronym: BRA) to any proposed intervention.
5) Upright and Spontaneous Pushing
A. Spontaneous pushing allows baby to get more blood flow and oxygen than the typical coached pushing for 10 seconds. Pushing should not go for more than 6 seconds at a time to allow for optimal oxygenation of baby.
B. Use gravity! Giving birth on your back reduces the size of your pelvic outlet and fights gravity. When you feel the urge to push with a contraction, pay attention to what your body tells you. Do you want to stand up or get on your hands and knees to push? If so, go for it!
You may request a bar for support while squatting during the pushing stage. While in a squat position, there is maximum room for your baby to exit the pelvis and travel through a shorter birth canal.
6) Keep Mother and Baby Together
A. Ask that your baby is placed on your abdomen "fresh out of the oven" immediately following delivery. Your baby’s natural “crawling” movements as she makes her way to your breast can help expel the placenta naturally, as well as putting pressure on your belly to help minimize bleeding. Also, once the baby latches onto the breast, you begin naturally producing more and more oxytocin, which further helps your uterus to shrink down and prevent postpartum bleeding.
B. Any care that needs to be done immediately after birth can be done with your baby skin-to-skin on your chest.
Bruising may be seen on various places of the body such as the face, or sometimes on the back. Childbirth can be pretty rough on babies, too – not just mom!
The Most Comprehensive Pregnancy App Available for Expecting Parents: Lamaze International's Pregnancy to Parenting
In 2015, Lamaze launched its first-ever mobile application for parents, Pregnancy to Parenting. This unique app is complete with evidence-based weekly development updates, daily tips and helpful tools developed by Lamaze Certified Childbirth Educators. This resource is great for expecting parents and their partners to help them keep track of important events, questions to ask, and even has a contraction timer. The best part is that it is free to download - try it today.
We wish you a healthy and happy pregnancy, birth and postpartum adventure!
In Atlanta, we co-teach an intensive preparation for childbirth in a "ONE DAY" group class. If you cannot attend an in-person birthing class with us, we suggest you schedule a private prenatal lesson available in Atlanta, Columbus, Macon and Nashville. Registration for either the Intensive class or a private, in-home lesson includes access to our online Lamaze Learning Center where you may watch videos, read further research and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence based birth practices that can help you have the safest birth for you and your baby. Sign up today.