by Janet Balaskas Here is an important voice in childbirth. Janet Balaskas is speaking to those women who want to grow in self-awareness and to use their bodies actively in labour. In her childbirth classes Janet Balaskas stands for activity rather than passivity, for movement rather than immobilization, and for a woman's right to choose whatever position she finds comfortable throughout labour and delivery.
All over the world and throughout recorded history women have chosen upright positions to give birth, and it is only we in the West who have had the extraordinary notion that a woman should lie on her back with her legs in the air to deliver a baby. But to get women upright is to do much more than help them find a comfortable posture. It is to turn them from passive patients into active birth-givers. It is to challenge the whole obstetric view of birth in Western society. This is based an the assumption that childbirth is a medical event that should be conducted in an intensive-care setting. The whole pregnancy is seen as a pathological condition terminated only by delivery. The modern high-tech obstetrician actively manages labour with all the technology of ultrasound, continuous electronic monitoring, and intravenous oxytocin drip. Many obstetricians have never had the opportunity to see a truly natural birth.
To turn the process of bringing new life into the world into one in which a woman becomes simply the body on the delivery table rather than an active birth-giver is a degradation of the mother's role in childbirth.We are now beginning to discover the sometimes long-term destructive effects on the relationship between a mother and her baby, and on the family, of treating women as if they were merely containers to be relieved of their contents, and of concentrating attention on a bag of muscle and a birth canal, instead of relating to and caring for the person of whom the uterus and the vagina are a part.
Bonding is a fashionable term today. In many hospitals special time is devoted for bonding, and there must be few midwives and obstetricians who would not claim that they consider bonding important. But everything that happens after delivery is the outcome of what has gone before. Bonding is either spontaneous and easy, or made virtually impossible by the atmosphere at delivery and by the care a woman is given as a person, not merely a "para I," an elderly primigravida, a maternal pelvis, a contracting uterus, or a dilating cervix.
The way we give birth is important to all of us because it has a great deal to do with the kind of society we want to live in, the significance of the coming to birth of a new person and a new family.When we hand over responsibility for choosing between alternatives on the basis of what we believe to be right, we hand over responsibility for the quality of the society we, and our children, must live in.
During the rapid development of modern obstretics in the past three hundred years, women have lost touch with their power as birth-givers. We have almost forgotten how a natural physiological birth unfolds.An active birth is nothing new. It is simply a convenient way of describing normal labour and birth and the way that a woman behaves when she is following her own instincts and the physiological logic of her body. It is a way of saying that she herself controls her body while giving birth, rather than being the passive recipient of a birth that is managed by her attendants.
By deciding to have an active birth you will be reclaiming your fundamental power as a birth-giver, a mother, and a woman. You will also be giving your baby the best possible start in life and a safe transition from the womb to the world. Should an unusual difficulty or complication arise, you will be free to make use of the safety net of modern obstetric care, knowing that you have done your very best and also knowing that this is your choice and that the intervention was really necessary. In this way, even the most difficult birth can be a positive experience.
Preparing for an active birth during pregnancy will lessen the likelihood of complications arising. It will also ensure that you approach the birth of your baby in optimal health, which will enhance and hasten your recovery, whatever happens. If you give birth actively you will want to move around freely during the early part, or first stage, of labour, choosing comfortable upright positions such as standing, walking, sitting, kneeling, or squatting. In between contractions you can find ways to rest in these positions, comfortably supported by pillows. As you approach the expulsive or second stage, during which your child can be born, you will continue to use the upright positions that are most comfortable or practical. At the end, for the actual birth, you can use a natural expulsive position (probably Supported) like squatting or kneeling.
An active birth is instinctive. It involves your giving birth quite naturally and spontaneously through your own will and determination, having the complete freedom to use your body as you choose and to follow its urges. Active birth is an attitude of mind. It involves acceptance and trust in the natural function and involuntary nature of the birth process, as well as an attitude or appropriate positioning of your body. It is not merely a vaginal extraction in which the attendants are in control and you are a passive patient. It is more comfortable, safer, and more efficient than a passive "confinement. " This is supported by the many scientific studies comparing women who are active in labour with those in a passive, recumbent position.
Some women, left to themselves, will instinctively know what to do in labour, but most of us, having no example to follow, need to be made aware of the possibilities of using various upright positions in order to discover our instincts. This can easily be done by practicing during your pregnancy the birth positions and movements that are most appropriate and comfortable. (Yoga-based exercises will help lead you towards your own instincts for labour and birth, while cultivating the right and natural body habits for a healthy pregnancy.)
