Natural Childbirth Options

Last Editorial Review: 1/30/2005

WebMD Feature

Natural childbirth, which women have experienced for centuries, is undergoing a renaissance of sorts as a growing number of women are electing to have a midwife shepherd them through the delivery at home or in a birthing center.

Although the numbers are small -- only a tiny percentage of births in this country occur at home or at birthing centers -- more and more women are choosing a self-directed approach to birth. Combining safety with the comfort of home or a birthing center allows for the natural process of birth to unfold in an unhurried manner.

Birthing Centers

Birthing rooms at birthing centers resemble homes with a large bed, a living area, and bathroom and kitchen facilities. Centers are usually equipped with hot tubs or whirlpool baths. Lighting is low, the mood intimate, and the environment soothing. Mothers are encouraged to walk, eat, drink, and get into positions that are comfortable for them throughout labor and birth -- such as on their hands and knees, in a birthing chair, or in a tub. As soon as the baby is born, he or she is placed into the hands of the mother to promote bonding.

Home Births

The mother and caregiver create the home-birth setting as they see fit, usually in a spare room made as comfortable and as clean as possible. If a woman opts for a water birth, a portable tub is set up in a designated room. A midwife brings the necessary medical accoutrements, which may include a birthing chair to take advantage of gravity during labor.

Water Births

Water births, which occur at home or at birthing centers, grant infants a peaceful transition from the womb to the world. Tubs are heated to temperatures of 90 to 101 degrees. Hotter water can overheat the mother and baby and cause dehydration. "The warm water relaxes the mother's back and pelvic muscles and takes the weight of the baby off the back and hips," explains Suzanne Saunders, a certified nurse-midwife based in Atlanta, Georgia. "Relaxation combined with the buoyancy of water helps the baby come down. I've seen it work as well as drugs in some women."

Midwives and Medication

Midwives working outside hospitals often eschew pain-relieving medication, a standard option for hospital births. "Drugs used in childbirth come with inherent risks that are often not explained thoroughly to women," points out Patricia Downing, Portland, Oregon-based midwife and director of Sage Femme Midwifery School. "For example, epidurals -- commonly given to laboring women in hospitals -- can provide relief from labor pains. However, there is a very slight risk of permanent spinal injury to the mother."

Natural Can Be Safe

For women with normal, uncomplicated, low-risk pregnancies, giving birth outside the hospital can be as safe as a hospital birth. In a 1991 study comparing physician-assisted births with midwife-assisted births, midwives had a 19 percent lower infant mortality rate.

Midwives subscribe to the philosophy that the body's system generally works if you give it what it needs, Saunders says. Birth is viewed as a natural, common occurrence that requires time, patience, strength and endurance -- all well within a woman's capabilities. "If a woman is in good shape and has followed a sound nutritional plan throughout her pregnancy, when labor begins, nine times out of ten her body will follow nature's plan and do the job it was meant to do."

Statistics about Natural Childbirth

  • Midwives attend 6 percent of all births in the United States.
  • Of midwife-attended births, 95 percent occur in hospitals, 3 percent occur in birth centers, and 1 percent occur in private homes.
  • According to the World Health Organization, 90 to 95 percent of the entire world's births are normal.
  • According to the Public Citizen Health Research Group, certified nurse-midwives have a cesarean section rate of 11.6 percent compared with a national average of 23.3 percent.

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