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Gentle birth in Taiwan

National Taipei University of Nursing


and Health Science
Chien-Huei Kao
The Gentle Birth World

This is a global initiative that


promotes humane and evidence
based care for women during
childbirth using the principles and
practices of Gentle Birth.
The Gentle Birth Philosophy
Humanity: Treat women and families
with love, honor and respect

Benefit: Care that is based on the


best available evidence
yields the best outcomes

Commitment: Unite health professionals


dedicated to improving care

Action: Utilize effective strategies


to change current practice
Gentle Birth Principles
• Childbirth has great significance on all parties and the
current and future society

• Nature, Mothers, and Babies have the inherent


wisdom to bring about birth

• Birth is safest when it is not disturbed unless


absolutely necessary

• Mothers and Babies are interdependent

• Babies are conscious participants

• Birth is a Sacred Affair


Gentle Birth Principles
Provide expectant parents with education and
support through the childbearing year to:
• Achieve vibrant health and live healthy lifestyles

• Be fully prepared for pregnancy, birth, and parenting

• Identify their priorities and individual needs

• Be empowered with communication and assertiveness


skills

• Build a support network in the community to provide


postpartum and parenting support
Gentle Birth Principles

• Provide holistic and culturally competent care

• Collaborate with other community resources

• Honor the mother and her family as the center of


the childbirth experience

• Practice evidence-based maternity care


Gentle Birth Principles
• Use care practices that are proven effective
and beneficial for the best outcomes:
Allow labor to start on its own
Continuous companionship
A quiet, softly lit, distraction-free environment
Mobility during labor
Physiological based coping practices
Different positions for birth
Patience with the normal physiological processes
Immediate breastfeeding and uninterrupted contact
between mother and infant
Evidence-based Medicine (EBM)
is...

“...the conscientious, explicit, and judicious


use of current best evidence in making
decisions about the care of individual
patients.”

Sackett et al, 1996


Evidence-based Health Care
Without clinical expertise, evidence may
not be applicable to or appropriate for an
individual patient.

Without current best evidence, practice will


rapidly become out of date.
Principles of EBM

In healthcare, the overall objective is


to deliver interventions that:
‘Do more good than harm.’
Gentle Birth Practices
for Safe Maternity Care
The Challenge
Best evidence versus traditional
‘beliefs’

Are traditional obstetric practices based


on evidence of their effectiveness?
Mobility During Labor

Traditional Belief Best Evidence


Staying in bed Improved
is best progress of labor
if the woman is
mobile
Position for Birth
Traditional Belief Best Evidence
 Supine position best  Supine -progressive
access for attendant acidosis of baby, slower
progress
 Supine safest
position  Other positions (lateral
tilt, upright, squatting)
less pain, less vaginal
trauma, improved fetal
outcome
Enemas in Labor
Traditional Belief Best Evidence
 Necessary to avoid  No difference in soiling
soiling (more liquid)

 Use routinely  Irritates the bowel

 Use only if requested


Shaving for Labor
Shaving Problems:
advocated:  Painful, embarrassing

 Re-growth
 To facilitate suturing uncomfortable

 To reduce infection  Microabrasions cause


infection

 No benefits shown

 Risk of HIV transmission


Episiotomy

Traditional Belief Best Evidence


 Clean incision easier to  More perineal trauma
repair
 More suturing needed
 Heals better
 More complications
 Fewer 3° tears
 Use only when
 Used routinely absolutely necessary
Basic Needs
of Childbearing Women
Physical

• Safety for herself and baby


• Nourishment
• Warmth and comfort
• Calm, peaceful environment
• Support from others
Basic Needs
of Childbearing Women
Emotional

• Companionship • Autonomy
• Love and Trust • Power
• Compassion • Acceptance
• Privacy • Spontaneity
• Respect • Celebration
• provide informational, emotional, and
physical support to women through
pregnancy and childbirth.
• provides a new model of maternity care that
reduces the need for high-tech crisis
intervention and focuses instead on
preparation and health.
The two most important aspects of birth:
• 1) Women and babies should be treated with
respect and love, in other words, they should
be treated gently.
• 2) There are countless ways to bring a baby
into this world. Ultimately, it is a woman’s
choice how her birth should be.
• My goal in working with pregnant women and
their families is to help all women have a
positive birth experience.
• I believe that treating women and their
babies gently and allowing women to make
their own choices will help all women to have
positive birth experiences.
• I hope that as you learn more about
childbirth, you will be led to know what
choices are best for you to gently birth your
baby into this world!
• Thanks for your listening