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Basic Competency: To understand some pregnancy and childbirth choices concept and

midwifery terminologies through intensive reading activity
Learning Material: Basic concept of childbirth choices: natural childbirth, caesarian section
and water birth
MATERIAL
Basic concept of childbirth choices:
A. Natural Childbirth
Natural childbirth is a philosophy of childbirth that is based on the belief that women who
are adequately prepared are innately able to give birth without routine medical interventions.
Natural childbirth arose in opposition to the techno-medical model of childbirth that has
recently gained popularity in industrialized societies, and is a childbirth philosophy that
attempts to minimize medical intervention, particularly the use of anesthetic medications and
surgical interventions such as episiotomies, forceps and ventouse deliveries and caesarean
sections. A woman’s definition of ‘natural’ may range from no intervention at all to birth
which includes any intervention deemed appropriate. The application of this philosophy may
occur during a physician or midwife attended hospital birth, a midwife attended homebirth, or
an unassisted birth. The term “natural childbirth” was coined by obstetrician Grantly DickRead upon publication of his book Natural Childbirth in the 1930s, which was followed by
the 1942 Childbirth Without Fear.
These are 3 stages of labor in the process of childbirth:
Stage One: Contractions
This is the stage where labor contractions happen. The time duration for this stage
may vary from individual to individual. The long muscles of the uterus contract from the top
to the bottom and then they relax. This process helps draw the cervix over the baby’s head.
This is called ‘dilation of the cervix’.
The cervix initially dilates up to 3 cms. At this point the contractions are 30 to 45
seconds long and repeat every 20 to 5 minutes.
Then the cervix dilates from 4 to 7 cms. At this point the contractions last for 45 to 60
seconds and repeat every 5 to 2 minutes. There may also be some backache and some
membranes might rupture.
Now, the cervix dilates from 8 to 10 cms. The contractions last for 60 to 120 seconds
and repeat every 30 to 90 seconds.
Stage Two: Labor and Delivery
In this stage of labor, the baby is pushed out of the uterus into the birth canal. The
urge to push is quite uncontrollable at this stage and the doctor will usually advise the mother
when to begin pushing. The contractions in this stage last for 50 to 90 seconds and repeat
every 2 to 5 minutes. There may also be extreme rectal and back pressure. When the head of

If someone else is pulling the placenta out. cesarean childbirth is not a procedure to be undertaken lightly by the doctor or the expectant mother. or the placenta can be pulled out of the body as well. There are benefits of natural childbirth: 1 – Natural childbirth is faster 2 – Natural childbirth shuns the damage of drugs or forceps to the baby’s brain 3 – Natural childbirth heightens the baby’s alertness 4 – Natural childbirth empowers the mother B. Caesarean section Cesarean delivery. the baby has come out completely. Sometimes. While at times absolutely necessary. is a major abdominal surgery involving two incisions (cuts): One is an incision through the abdominal wall. The baby is often born head-first. the woman may be awake but numb from the chest to the legs. During the surgical delivery. it may tear and come out incompletely. it adjusts to breathing air. It is therefore very essential to understand the position of the baby during this stage. Stage Three: Placenta Delivery In this stage. Sometimes. and the second is an incision involving the uterus to deliver the baby. The contractions may continue for a while. Thus. the opening of the vagina may also be needed to be cut in order to facilitate this movement. especially in emergencies or for the safety of the mother or the baby. As soon as the baby comes out of the birth canal completely. The first . This can often be a natural process. This can lead to post partum bleeding or even an infection. If the placenta is pulled too hard or incorrectly.the baby is seen at the beginning of the vagina. it is absolutely necessary to examine the placenta once it is removed. The placenta then detaches from the uterus and is pushed out of the body. also known as c-section. This can also be a stage accompanied by several complications. The umbilical cord is usually cut at this stage and the baby is often bathed with lukewarm water. a caesarian procedure may become necessary if complications occur. then that person has to be extremely careful while doing so. it is often accompanied by a burning sensation. This may also be accompanied by loss of blood. the baby is ‘breech’ where the buttocks come out first. if not an emergency. But there are cases where the baby moves feet-first or sideways. Midwives are often able to help with complicated birth procedures if one is opting for a natural childbirth process. However. Often breastfeeding the baby immediately after it has been born can also induce the delivery of the placenta.

but is done lower on the uterus where the uterine wall is thinner. Water birth should always occur under the supervision of a qualified health care provider.  In the later stages of labor. heals well and has a lesser danger of rupture during subsequent labours o Classical Incisions – also called the “High Vertical Incision” or the “Granny Cut”. Water Birth Water birth is the process of giving birth in a tub of warm water. . Some women choose to labor in the water and get out for delivery. birthing centers and a growing number of obstetricians believe that reducing the stress of labor and delivery will reduce fetal complications. Benefits for Mother:  Warm water is soothing. birthing into a similar environment is gentler for the baby and less stressful for the mother. this incision is associated with the highest risk of bleeding and subsequent rupture of the uterus.  Your abdomen will be washed and shaved before surgery A catheter (tube) will be placed in your bladder to empty it  You will be put on intravenous (IV) fluids and medication during surgery  Your Doctor will cut through the layers of your abdomen and uterus to deliver the baby  There are three basic types of incision and your Doctor may choose one of these:   o Low Transverse Incision – also called the “Bikini Cut”. this horizontal cut across the lower portion of the uterus is commonly used as it bleeds less. Midwives. the water has been shown to increase the woman’s energy.modern Caesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. During a C-section. comforting. The theory behind water birth is that since the baby has already been in the amniotic fluid sac for 9 months. relaxing. It may be done to deliver a baby in an awkward position or when an incision may have to be extended into a classical incision The uterus will then be closed with stitches that later dissolve on their own C. and is now used only in emergency situations o Low Vertical Incision – similar to classical incisions. Other women decide to stay in the water for the delivery as well.

 Immersion in water often helps lower high blood pressure caused by anxiety. Into the Tub When the birth tub is filled. Mechanics of Water Birth When an expectant mother goes into labor and has opted for a water birth. allowing free movement and new positioning. .       Before the Baby Arrives Once labor is confirmed. This temperature allows the mother to be comfortable and the child can maintain a normal heartbeat (water greater than 100 degrees can increase the heartbeat of an unborn child). If the mother has selected to give birth in a hospital or birth center. the laboring mother will be monitored to check the status of her child as well as her own health.  Buoyancy promotes more efficient uterine contractions and improved blood circulation resulting in better oxygenation of the uterine muscles. fetal monitoring and dilation checks are often preformed on a schedule to ensure the well-being of the mother and child. it can reduce inhibitions. and more oxygen for the baby. she will travel to that facility.  Water causes the perineum to become more elastic and relaxed.  Eases the stress of the birth thus increasing reassurance and sense of security. the laboring mother is assisted to the tub. the support staff will begin to set up the birth tub. she is able to relax mentally with greater ability to focus on the birth process. and fears. which is either by checking for dilation or contraction monitors. The effect of buoyancy lessens a mother’s body weight. reducing the incidence and severity of tearing and the need for an episiotomy and stitches. She is free to position herself in a way that is comfortable to her.  Since the water provides a greater sense of privacy. Blood pressure. she will immediately contact her physician or midwife and any other support personnel such as a doula. less pain for the mother. Benefits for Baby:  Provides an environment similar to the amniotic sac. anxiety.  As the laboring women relaxes physically. When the mother is moving toward active labor. allowing the mother’s body to produce endorphins which serve as pain-inhibitors.  The water seems to reduce stress-related hormones. And begin preparing the room for the impending birth. Water between 96 and 100 degrees Fahrenheit is introduced to the birth tub.

TASK 1. The tub is then drained. the newborn’s head is raised out of the water C. C. Giving birth in a tub of warm water E. placenta delivery G. Water birth KEY ANSWER: 1. Contractions. . It is known as c-section F. the new mother will often be allowed to hold her child as well as nurse. The nose and mouth is suctioned while the rest of the body remains under water. the newborn is evaluated and measured. Once the child is delivered. It involves two incisions (cuts): One is an incision through the abdominal wall. H. Natural Childbirth: A. Labor and delivery. Natural Childbirth 2. TOPIC : BASIC CONCEPT OF CHILDBIRTH CHOICES Type : Quizz Pick some options on the right side and match with each basic concecpt of childbirth choice on left side! 1. This allows the child to stay warm. F A. the newborn’s head is raised out of the water. It can empower the mother D. and the second is an incision involving the uterus to deliver the baby. the pregnant woman can remain in the tub. During this time. After the cord is cut. Caesarean section 3. Eventually the mother will be removed from the tub and evaluated for hemorrhaging. tears or retained placenta. A philosophy that is based on the belief that women who are adequately prepared are innately able to give birth without routine medical interventions.     When it is time to deliver the child. cleaned. B. Eases the stress of the birth thus increasing reassurance and sense of security. Once the child is delivered. sterilized and packed. The abdomen will be washed and shaved before surgery I.

This temperature allows the mother to be comfortable and the child can maintain a normal heartbeat (water greater than 100 degrees can increase the heartbeat of an unborn child). Water Birth: B. cleaned. TOPIC: WATER BIRTH Type : Quizz (Procedure text) Arrange these sentences into correct order! 1. After the cord is cut. Once the child is delivered. the newborn's head is raised out of the water. the new mother will often be allowed to hold her child as Well as nurse. If the mother has selected to give birth in a hospital or birth center. 7. H. D. the laboring mother is assisted to the tub. The laboring mother will be monitored to check the status of her child as well as her own health. The uterus will then be closed with stitches that later dissolve on their own .2. 8. The tub is then drained. She is free to position herself in a way that is comfortable to her. When an expectant mother goes into labor and has opted for a water birth. 2. During this time. I 3. Eventually the mother will be removed from the tub and evaluated for hemorrhaging. The nose and mouth is suctioned while the rest of the body remains under water. Begin preparing the room for the impending birth. TOPIC: CAESAR BIRTH Type : Quizz (Procedure text) Arrange these sentences into correct order! 1. the support staff will begin to set up the birth tub. 5. she will immediately contact her physician or midwife and any other support personnel such as a doula. 10. 4. she will travel to that facility. This allows the child to stay warm. Your abdomen will be washed and shaved before surgery 2. When the birth tub is filled. the newborn is evaluated and measured. 3. tears or retained placenta. Blood pressure. fetal monitoring and dilation checks are often preformed on a schedule to ensure the well-being of the mother and child. G 2. 6. 9. sterilized and packed. KEY ANSWER 2 – 3 – 1 – 5 – 7 – 9 – 8 – 10 – 6 – 4 3. Water between 96 and 100 degrees Fahrenheit is introduced to the birth tub. Caesarean section: E. When the mother is moving toward active labor.

It may be done to deliver a baby in an awkward position or when an incision may have to be extended into a classical incision KEY ANSWER: 1-5-4-3-6-2 . this incision is associated with the highest risk of bleeding and subsequent rupture of the uterus. heals well and has a lesser danger of rupture during subsequent labours o Classical Incisions . Your Doctor will cut through the layers of your abdomen and uterus to deliver the baby 4.also called the "High Vertical Incision" or the "Granny Cut". There are three basic types of incision and your Doctor may choose one of these: o Low Transverse Incision . and is now used only in emergency situations o Low Vertical Incision .also called the "Bikini Cut".similar to classical incisions. this horizontal cut across the lower portion of the uterus is commonly used as it bleeds less.3. but is done lower on the uterus where the uterine wall is thinner. You will be put on intravenous (IV) fluids and medication during surgery 5. A catheter (tube) will be placed in your bladder to empty it 6.