NATURAL BIRTH: "If a baby is born naturally, there is a feeling of success. It's a good way to start to be a mother," according to the renowned American midwife Ina May Gaskin.
Ms Gaskin was the guest speaker at a conference last Friday, hosted by the Home Birth Association of Ireland in Dublin.
Her powerful message was that childbirth doesn't have to be the fearful, painful and terrifying experience it is often portrayed as being. "Lots of women are getting a fixed idea about a vaginal birth because they are are watching too much TV, where it appears terrifying.
"I see women having valuable birth experiences. You discover things about yourself that you didn't know before and it's empowering," she told The Irish Times.
Ms Gaskin believes the lack of privacy in hospital disrupts the whole natural process of labour, and that women's bodies work better when they are not in hospital. This is largely because they are more comfortable in their own surroundings.
Ina May's Guide to Childbirth, has had an impressive impact on the resurgence of natural birthing methods and direct-entry midwifery in the US since the early 1970s. She set up a natural out-of-hospital birth centre, The Farm Midwifery Centre, in Tennessee, in 1971, which operates on the principles that women should be allowed to deliver babies naturally.
There, with the aid of a midwife and her assistant, natural and simple methods are used to ease the woman's discomfort and to ensure a smooth delivery. Women are encouraged to laugh as much as possible in labour because it is a natural relaxer and to move around as much as possible because it often takes hours off labour. Some have massages, while others pull from a rope, strongly anchored above them, during contractions, or use a birthing ball.
An important innovative measure, introduced by her is the aptly named, Gaskin Manoeuvre. It is an important birthing technique, which allows for a safe, non-invasive solution to shoulder dystocia, one of the most perplexing and feared complications facing obstetricians.
There is an absence of drug-induced pain relief at The Farm Midwifery Centre. While for many, this appears unnecessary torture, according to Ms Gaskin, the use of drugs is simply a bad social habit and a lot of the desire to be in a drug induced state when giving birth stems from what the general population is programmed to think.
"Most people don't need pain relief if they're not scared out of their wits and it's also safer for babies not to use pharmaceutical drugs," she says.
Natural births also allow the woman all the time she needs to deliver the child. All too frequently in Irish maternity hospitals, if births take too long medical interventions are undertaken to speed them up, according to Ms Krysia Rybaczuk of the Home Birth Association of Ireland. This can often lead to tearing and the unnecessary surgery.
Ms Gaskin believes this trend is partly because the US has had too much influence worldwide in the area of obstetrics. She also says women are dying in childbirth because of too many unnecessary inductions and Caesarean sections.
In the US in 1996, there were 12 maternal deaths per 100,000 live births - the US ranks behind 20 other countries in maternal mortality rates. Ms Gaskin has campaigned to highlight the issue of maternal mortality, through her Safe Motherhood Quilt Project. She herself, avoids the problem of litigation by not having any malpractice insurance.
The Farm Midwifery Centre in Tennessee has a very low rate of Caesarean sections, 1.4 per cent, as well as low rates of anaesthetic use, forceps deliveries and episiotomies. The US national average for Caesarean sections is 24.4 per cent in comparison to 4.5 per cent in 1965 - Ms Rybaczuk estimates that in Ireland the national average is 20 to 22 per cent, depending on the hospital.
Meanwhile Ms Gaskin does not doubt that hospitals have their role to play because a small percentage of women need to give birth in that setting. However, she emphasises the fact that hospitals, by their nature are for sick people.
Home births in Ireland
• In 2002, only 0.6 per cent of women opted to have a homebirth.
• Some 85 per cent of women are suitable to have a home birth.
• There are approximately 20 independent midwifes in Ireland.
• Some health boards give grants to cover the cost of home births. It depends on where you live.
• Some health boards give women the option of having a midwife only assisted birth as part of a domino scheme in hospital, and/or of having a mid-wife assisted home birth.
• Since 2001: Waterford Regional Hospital, has an integrated hospital community midwifery team which gives women the option of having a midwife assisted delivery (known as a domino scheme), or of having a mid-wife assisted home birth.
• Since 1999: Holles Street Maternity Hospital, Dublin, have operated a domino scheme.
• Since 2001: The Southern Health Board have a contract with eight independent midwifes.
• Since 2000: Cavan General Hospital provides the services of one independent midwife to assist with home births.