Birth Information
This page covers:
- MAKING DECISIONS ABOUT BIRTH
- NATURAL BIRTH
- CULTURALLY SAFE BIRTH FOR INDIGENOUS AUSTRALIANS
- WATERBIRTH
- CAESAREAN BIRTH AND VBAC
- HOMEBIRTH
- UNASSISTED BIRTH
Birth Matters seeks to provide up-to-date evidence-based information from medical research and official statistics which people can use to make choices about their care. This includes information on the range of care providers and birth places in South Australia (intervention rates associated with various birth places, types of care provider available, etc), and people's experiences in relation to pregnancy, birth, postnatal care and early parenting. We know from our experience and the feedback we receive that people who have such information to consider in advance feel greater control and involvement over their birth experience and more satisfaction, regardless of the type of birth that they eventually have.
Birth Matters makes available information that is relevant to South Australia, including the Birth Choices Guide for South Australia, information on Midwives and Midwifery services in SA and a list of Private Health Insurers reimbursing for Midwifery and Homebirth across Australia. At our meetings and via email contact we also provide information on alternative ways to deal with problems that may occur during pregnancy and birth, information on issues surrounding pre-natal testing and birth interventions, how to minimise interventions in pregnancy and birth, how to maximise your levels of confidence and support, and contacts for other groups or associations which you might find useful. Below we have listed information and links in relation to the main areas of interest:
MAKING DECISIONS ABOUT BIRTH Childbirth Connection, an organisation founded in 1918, is a US national not-for-profit organization dedicated to improving the quality of maternity care. They promote safe, effective and satisfying evidence-based maternity care for all women and families and provide information, including the "Listening to Mothers" survey. The website also includes the contents and full text of the current edition of the well-known Guide to Effective Care in Pregnancy and Childbirth (Oxford University Press, 2000 - courtesy of the authors: Murray Enkin, Marc J.N.C. Keirse, James Neilson, Caroline Crowther, Lelia Duley, Ellen Hodnett and Justus Hofmeyr).
NATURAL BIRTH
For information on 'natural' birth (ie birth without medical intervention), see the following:
Fish Can't See Water: The Need to Humanize Birth excellent overview of how birth has become dehumanized and what can be done to return birth to women, by Dr Marsden Wagner, Director of Women's and Children's Health for 15 years for the World Health Organization.
Birth guru Sheila Kitzinger's website (UK) for information on natural birth, waterbirth, caesarean birth, birth in other countries...
Henci Goer (USA) the site of the award-winning medical writer and internationally known speaker who is the author of "The Thinking Woman's Guide to a Better Birth" and "Obstetric Myths Versus Research Realities"
Maternity Coalition AUSTRALIA'S national consumer advocacy organisation - provides information leaflets online on many aspects of birth in Australia. Subscription to this organisation helps the campaign to Federal politicians to get Medicare numbers and indemnity insurance for all midwives so that more women can have care from a known midwife and Medicare reimbursement for private midwifery services.
"Better Birth: The Definitive Guide to Childbirth" written by Birth Matters members to help raise satisfaction and reduce fear about birth, available online from Capers Bookstore and most good bookstores
Ina May Gaskin's website (USA) for inspirational information about birth from this well known author, activist and innovator
Midwifery Today (USA) for a wealth of information for consumers and midwives
CULTURALLY SAFE BIRTHING FOR INDIGENOUS AUSTRALIANS
Maningrida (Qld) .- a great resource for birthing women, as well as anyone involved in providing maternity services.
WATERBIRTH
(From Wikipedia 2008) During the 1960s, Russian researcher Igor Charkovsky undertook considerable research into the safety and possible benefits of water birth in the Soviet Union. In the late 1960s, French obstetrician Frederick Leboyer developed the practice of immersing newly-born infants in warm water to help ease the transition from the womb to the outside world, and to mitigate the effects of any possible birth trauma. Another French obstetrician, Michel Odent, took Leboyer's work further, using the warm-water birth pool for pain relief for the mother, and as a way to normalize the birth process. When some women refused to get out of the water to finish giving birth, Odent started researching the possible benefits for the baby of being born under water, as well as the potential problems in such births. By the late 1990s, thousands of women had given birth at Odent's birthing center at Pithiviers, and the notion of water birth had spread to many other Western countries. Water birth first came to the United States through couples giving birth at home, but soon was introduced into the medical environment of hospitals and free-standing birth centers by midwives and obstetricians. In 1991, Monadnock Community Hospital[1] in Peterborough, New Hampshire became the first USA hospital to create a protocol for giving birth in water. By 2005, there were over 9000 hospitals in the US that had adopted such protocols. More than three-quarters of all National Health Service hospitals in the UK provide this option for laboring women.
(From King and Camacho Carr 2005) http://pediatrics.aappublications.org/cgi/content/full/115/4/1116) An accurate assessment of the risks and benefits of immersion in water during labor is the subject of a Cochrane meta-analysis3 published in February 2004 [Cluett et al) that included 8 randomized, controlled trials. The meta-analysis found no difference in Apgar scores, neonatal unit admissions, or neonatal infection rates in women who used water immersion during labor when compared with women who were offered "usual care." The water-immersion group had statistically significant improvements in pain and no significant difference in vaginal operative delivery or cesarean-section rates. Case reports of some adverse neonatal effects after water birth are being reported in the literature and should serve as a caution and a call for thorough investigation. This is the current state of the science that should be shared with women who are considering these options.
A Masters degree student at the Auckland University of Technology (Ashcroft 2007) has analysed media representations of waterbirth using a power and subject approach (Foucauldian analysis). She found three different ways that waterbirth is talked about. The scientific medical discourse contests waterbirth as an unsafe, unproven practice that puts babies' lives at risk. This discourse categorises women who choose waterbirth as unsafe, irrational, alternative, tree-hugging hippies who favour perceived benefits of waterbirth for themselves above the safety of their baby.The natural birth discourse contests that waterbirth is a safe practice that has encountered few problems since its emergence as a validated birthing practice in the late 1980s. It promotes waterbirth as having multiple benefits for both mother and baby and as a way of enhancing the physiological process of birth through non-intervention.The dive reflex discourse underpins the issue of babies drowning when born into water. This discourse details a reflex that suppresses the normal breathing mechanisms in neonates at birth. Literature debates its existence and troubles the overall trustworthiness of such a reflex to prevent a baby drowning when born into water. It is this discourse that sways people's views and positioning on the overall discourse of waterbirth.
No statistics are currently available for the number of births occurring in water in Australia or South Australia. The SA Government's policies on labour and birth in water have only been operational for a few years and not all midwives and obstetricians are yet experienced with facilitating waterbirth.Note however that the SA Govt policies are not restricting on independent midwives. All independent midwives in SA are experienced with waterbirth and most women birthing with them at home will use a birth pool for labour and/or birth. Our Birth Choices Guide for South Australia indicates where you may or may not be able to have a waterbirth in South Australia. For further information about waterbirth you will find the following useful.
Waterbirth Policies, SA GOVERNMENT DEPT OF HEALTH webpage gives the SA policies on "First Stage Labour in Water" and "Birth in Water". Note that women must leave the birth pool/bath in SA hospitals for the 3rd stage (birth of the placenta), but this does NOT apply to homebirths with an independent midwife. These policies are being currently under review (2008); the review committee has 2 consumer representatives from Birth Matters and the Homebirth Network SA.
Waterbirth International (USA) for everything you want to know about waterbirth!
CAESAREAN BIRTH AND VBAC (VAGINAL BIRTH AFTER C-S)
Deciding about VBAC info from Childbirth Connection to help you make the decision about whether VBAC is right for you.
CANA - Caesarean Awareness Network Australia for information on caesarean and VBAC in Australia
Best Evidence on C-Section from Childbirth Connection.
Avoiding Unnecessary Caesarean 5 minute YouTube Video
CARES-SA caesarean support group in South Australia.
HOMEBIRTH
The latest statistics from the Australian Institute of Health and Welfare show that around 740 women a year plan a homebirth in Australia. The balance of the research evidence worldwide is reflected in the South Australian Government's new Policy for Planned Homebirth (2007), showing that planned homebirth is as safe as (if not safer than) hospital birth for women who are attended by a suitably qualified and experienced midwife and who are at low-risk of complications. Find out more about Homebirth here.
A summary of many homebirth research studies is available at this website.
Planned Birth At Home Policy and "patient" information brochure, SOUTH AUSTRALIAN GOVERNMENT DEPT OF HEALTH (note: applies to SA public hospitals and health units, not to independent midwives).
SA Homebirth Information from a homebirth midwife's perspective.
UNASSISTED HOMEBIRTH: A small number of people in Australia choose to have an unassisted birth at home (otherwise known as freebirth, solo birth, pure birth, or do-it-yourself homebirth). This is a birth which is planned to be at home but which, for a range of reasons, the parent(s) intentionally arrange to be unattended by a maternity care provider. At present the only data available about the safety of birth unattended by a care provider in Australia is for unplanned homebirth, which is associated with higher death and injury rates for mother and baby. Since no data is published in Australia for births which are planned to be at home but which are intentionally unassisted, this choice is at present experimental in terms of safety. However, the World Health Organisation states that safe birth (lower death and injury rates) occurs when skilled midwifery care is available, and that midwives play a central role in making pregnancy and birth safe (WHO 2005). On the other hand, advocates of unassisted birth point to other issues which they feel should be weighed alongside medical safety, such as the woman's feelings of empowerment, her religious and cultural views etc. Further information and links are available on Wikipedia.
GENERAL INFORMATION
Australian Breastfeeding Association for breastfeeding information, online helpline, and classes held in South Australia
Australian College of Midwives for information about "What Midwives Do", research on midwifery care, and ACMI/Maternity Coalition publications "Men At Birth" and "Having a Great Birth in Australia"