Informed Choices on childbirth
Virginia Oosthuizen / Certified Doula
Good care is based on procedures and interventions that have been justified by scientific research.
As health professionals we must be aware of the most up to date research and changes. Ideally only using the interventions that are of a benefit to the women should be used.
Mobility during labour – the benefits are greater intensity of contractions, less painful labour & medication less likely.
Different positions for labour – women like to be upright which can be less labour pain, possible reduction in labour duration, improved apgar score for the baby and less discomfort in bearing down.
Fluids and food during labour – women are able to monitor their own intake, and will avoid heavy meals. This helps with energy levels, dehydrations and complications due to a lack of food (ketosis).
Companionship during labour - doula (birth assistant) can help labour to be shorter, women who have support throughout their labour feel better about themselves, their labour and their baby. A doula will guide the husbands/partners on what to do and how to help their partners.
Magnesium sulphate should be used routinely to treat all women with eclampsia – it is cheap and easy to use. It could reduce risk of maternal mortality.
Postpartum haemorrhage is a significant cause of maternal deaths. Evidence shows that the bleeding after birth can be reduced by the active management of the third stage of labour. This includes administering oxytocic drug . Syntocinon 10 units intravenously or intramuscularly is almost as effective as syntometrine, and has the advantage of fewer side effects, and being safe in women with hypertension. Benefits are it can reduce blood loss after the birth.
Delayed cord cutting - this can increase the iron in the baby for up to six months. It only takes 2 minutes to wait until the cord stops pulsating.
Enemas are not always necessary but can be the women’s choice.
Stop Public shaving – if shaving is done routinely with a non sterile blade, the risk of HIV infection may be increased. This should also be the women’s choice.
Stop routine episiotomy - this can cause a number of risks eg . HIV and irritations of the skin.
Principles of the Better Birth Initiative :
Humanity - women treated with respect
Benefit - Care that is based on the best available evidence
Commitment - health professionals committed to improving care
Action - effective strategies to change current practice.
3 top tips –
Choose the right care providers for the birth you want. If you want to give birth vaginally and without medication, ask your doula to recommend care providers who will support you in this.
Find out as much as you can about the pros and cons of medical interventions ie epidural procedures.
Breast feeding is not best feeding but natural feeding.
Look up delayed cord cutting. It can increase your baby’s iron up to six months.
Skin on skin contact for the first hour after birth.