With research to support its advantages, trends suggest that modern women are drifting back towards a more natural, drug-free approach to bringing their babies into the world. With higher success rates for breastfeeding, better bonding experiences and a reduced need for medical intervention, some moms are choosing home births and birthing centers instead of hospitals.
Natural and instinctive, most women move through the process with a minimum of intervention and for these moms, having a say in how and where they give birth can positively influence their confidence as a parent. "Research has shown us that the way a woman births and her feelings around her birth impact her for the rest of her life, and also impacts the way she parents her child," says Tracy Hanson, midwife and head of the doula program with Providence Medford's BirthPlace.
• Does your health care provider consider your situation low risk and appropriate for a non-hospital setting?
• Tour the facility. Talk to staff, interview potential midwife and ask about credentials.
• Does the facility support your choice of birthing methods? What is the policy on pain medication? This could mean that you will not have the option to have an epidural or other type of pain management at the birth center.
• Explore the range of services offered. Do they offer classes/workshops, pre-and-post birth support?
• Check with your insurance provider as coverage varies widely. Payment options should be discussed in advance.
• Ask what the emergency backup plan is, what hospital the center is affiliated with, and how long it takes to get there. Under what circumstances would you be transferred?
Natural Methods for Pain Control
Water births are highly rated by mothers who use a bathtub, birthing tub, temperature-reduced hot tub or other pool of water while in labor. The effect of buoyancy allows easier position changes for the mother. Water relieves gravity's pull on her body which inhibits the growth of stress-related hormones and encourages the production of pain inhibitors-endorphins that complement labor. Many midwives and doctors acknowledge the analgesic effect of water.
This is a natural technique for inducing labor and/or pain management during labor. It is based on the fundamentals of acupuncture, but uses only fingertips and thumbs on pressure points that are either compressed or rubbed in order to help with specific issues.
Women who choose to have a doula present during labor and birth are less likely to have pain medication, less likely to have a cesarean and have a more positive birth experience overall. A doula's sole focus is to provide guidance, comfort and support, and to create an environment of relaxation during labor.
Prenatal massage helps to relax tense muscles, ease sore spots and improve circulation and mobility. Therapists are specially trained in prenatal massage techniques and sessions are tailored to meet the needs of pregnant women and their changing bodies.
Learning hypnosis techniques enables your mind and body to relax, and practicing during pregnancy helps relieve pregnancy-associated stress and discomfort. Achieving a deep state of relaxation can diminish the perception of pain at the time of the birth.
Although some use "alternative" to describe non-hospital births, Augustine Colebrook, state-certified midwife and director of Trillium Waterbirth Center in Medford, feels that in the more natural scheme of things, a hospital setting is really the alternative choice. "According to the World Health Organization and many other experts, most women do not need to give birth in a high-tech environment," she says. "What they really need is a more individualized approach. We call it high-touch, low-tech and we have found that when they get that, they birth more normally. Of course, some babies need the technology for various reasons, but we have had great success with our approach."
The use of water, acupuncture, acupressure, hypnosis and a variety of birthing positions are some of the ways expectant moms are coping with pain and taking charge of their labor and delivery. "We have found that when a mom gives birth under her own power, she is more confident in her choices and feels more in control of making decisions," Colebrook says.
Low risk means more choice
Experts agree that because unexpected complications during birth can require immediate medical intervention, choosing a non-hospital birth is only appropriate for low-risk pregnancies. Trillium Waterbirth Center is one of the few licensed birthing centers in Oregon and the only one in Southern Oregon. "One of the main jobs of our midwives here is risk assessment," says Colebrook. "From the moment we meet them, all the way through labor and delivery, we are assessing any risk factors and determining whether or not this woman needs to be in a hospital environment."
Some women feel they receive more attention, more education and more personalized support from midwives and birthing centers as opposed to more traditional obstetrical care where actual time with the doctor can be limited. That doesn't mean they must sacrifice the benefits of modern prenatal technology. "We are a full service maternity center," Colebrook says, "which means that we offer the same tests, lab work, genetic screening and ultrasound that any other obstetrician's office provides. Our moms can have their babies in any position, any place they feel most comfortable, including their own homes. The only things we do not offer are pain medication and surgery."
Naturopathic doctor Wendy Green specializes in obstetrical care at Kalista Birth Sanctuary and Wellness Center in Medford. "I get a lot of people who have had babies at the hospital and they want more attention and better care. They want to spend more time with their doctor, and I feel like that's very important. Our frequency of care is similar, but we have one-hour visits, whereas most obstetricians schedule 15 minutes or less, so with me, patients can get all of their questions answered. We also provide a lot of education about diet and nutrition."
Unlike other birthing centers with a staff of midwives, Green handles the prenatal care and the births herself. "It's my sole practice so when a woman is under my care and it's time for her to have her baby, she knows it's me who's going to be there for the birth, whether it's at home or at our center. I have a doula that attends also and she helps with coaching and she knows all the little things that provide comfort during labor. What I like about my practice is that as a naturopathic doctor, I get to deliver the baby and then continue the family care as they grow up."
Doulas have become an important part of the birthing process, says Hanson, who implemented the program at the Providence Medford's BirthPlace. A doula works in conjunction with the midwife or doctor and the nursing staff. Her sole focus is the mom's emotional and physical wellbeing. "Giving birth can really be emotionally overwhelming and the doula knows different techniques that comfort and soothe a momma in labor like warm baths or ice chips or whatever can make the labor easier," Hanson says.
Best of both worlds
Not every woman is considered low-risk enough to choose a birthing center, so some hospitals have made an effort to accommodate higher risk moms with some of the same choices they have elsewhere. At Providence Medford's BirthPlace, moms-to-be can still enjoy the comforts of a personalized suite with the use of a midwife and doula, but with high-tech medical intervention, if needed, just a heartbeat away.
"We are the only accredited Baby-Friendly facility in Jackson County," Hanson says, "which means we have met some stringent criteria that pertain to breastfeeding policies. We also have an amazing nursing staff that is highly professional and very responsive to moms during the labor and birth."
Providence Medford offers a variety of childbirth and parenting classes. "We encourage our mommies to speak up and ask for what they want," Hanson says. "We want them to make informed decisions and that's where the classes and the information we share allow them to do that. The more they learn, the more they know about what their choices are."
No matter their level of risk, some moms-to-be just prefer the security of a hospital birth, says Grant Walker, public relations representative with Asante. "Women often choose a hospital because they want the high level of care and safety they find with their doctor or midwife and working with a team of nurses specially trained for labor and delivery in a medical setting," Walker says.
Asante provides a choice of birthing options at all three of its locations, Asante Rogue Regional Medical Center in Medford, Asante Three Rivers Medical Center in Grants Pass (also designated as Baby-Friendly) and Asante Ashland Community Hospital. "At Asante Ashland Community Hospital, there are many options for moms who might prefer an alternative birthing experience," Walker says. "For example, the hospital provides doulas and the option for water births. This hospital is well known for its patient-centered model of care."
For women who have high risk pregnancies or complicated deliveries, Rogue Regional Medical Center provides genetic counseling and a state-of-the-art neonatal intensive care unit with highly trained neonatologists and nurses. "Many of our nurses are board-certified in labor and delivery," Walker says, "which is a higher level of training than a registered nurse. If there is a complication, it is comforting for moms to know that all the resources of a hospital, including the only neonatal intensive care unit in the region, are available for them and their baby. Our hospitals also provide extensive prenatal and birthing classes, which many moms find very helpful in preparing for childbirth."
In Grants Pass, Asante Three Rivers Family Birth Center offers private birthing suites and has also earned a Baby-Friendly designation, which places an emphasis on breastfeeding and natural nutrition.
You have friends in the baby business
Expectant mothers must make many decisions when it comes to bringing their babies into the world. Ashland-based Southern Oregon Birth Connections is a group of practitioners, businesses, and community members who meet together to provide resources and education to women and their families throughout the childbearing years. "We're an organization that looks at how we can support them as they go through this process, no matter what their choices are," says founding member, Glennie Feinsmith.
Members of this group, who include local practitioners, business owners and community members have made it their goal to provide education and resources. "We host monthly educational talks on topics related to pre-conception, fertility, pregnancy, childbirth, newborns, postpartum, children, and parenting. In addition, we sponsor special events including fairs, film screenings, and other family-friendly events," Feinsmith says.
Their network is comprised of midwives, doulas, birth therapists, lactation specialists, birth hypnotherapists, naturopaths and massage therapists. The organization has over 40 members, Feinsmith says, and their events have become increasingly well attended. "We have two or three large events a year, including one on Mother's Day." They also publish a resource guide two or three times a year, and they hope to become known as the referral and resource agency in the valley for women in their child-bearing years.
"The whole birth experience is really profound," says Colebrook. "A lot of people think of birth as just another hospital procedure, but it's actually a rite of passage in our life cycle. The way we do it here is informed both by the art and by the science."