Updated: Jul 21, 2018
Normal and natural are terms that are used to describe birth all the time. I think we have lost sight to what they actually mean and the connotations that they have.
I'd like to unpick these terms and explain why you should consider adjusting your aims for birth and changing the language that you use.
One definition of 'normal' is: "conforming to a standard; usual, typical or expected."
Conforming to a standard? We live in a day and age that any mode of birth is quite usual. I feel that there is no longer the assumption that everyone will have a vaginal birth. Caesarean sections are widely acceptable and I am sure that you know atleast one person who has had one. In 2016-17, almost 30% of births were via caesarean section, 15% instrumental births and 55% vaginal. I think this allows us to see that there is no one 'typical' mode of birth. There is always the question of, were ALL of these operative births clinically indicated? Were all these women informed? These are things we will never know, but can only assume that the medical professionals used their professional judgement to make clinically informed decisions about the safest way to birth for both mother and baby.
The World Health Organisation define 'normal birth' as:
"Spontaneous in onset, low-risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously (without help) in the vertex position (head down) between 37 and 42 completed weeks of pregnancy. After birth, the mother and baby are in good condition"
I find this quite astonishing. 'Normal' Birth is very clearly defined here, but what does this mean?
Spontaneous onset - the labour must begin without any medical intervention. So, in order to have a normal birth according to this definition, you must not be induced in any capacity. This includes membrane sweeps.
Low-risk at the start of labour - another one of my bugbears. This is hard to define. Medically, low risk would mean that you have no medical conditions, or other factors which may compromise the health of you and your baby. It is very difficult to find a woman who has absolutely NOTHING which could be defined as a 'risk factor'. Categorising women into levels of 'risk' is a skill in which healthcare professionals tend to struggle with, due to the wider practicalities to care which it brings. For example, deciding which methods of fetal monitoring are most suitable in labour, or which place of birth is the safest.
Remaining so throughout labour and delivery - one of the biggest issues which healthcare professionals face is monitoring the baby's heart rate effectively. If you are low risk, you should be intermittently monitored throughout labour, which is brilliant. It will allow you to stay mobile and not feel restricted by continuous monitoring. However, one change in the heartrate, which may or may not be an issue, and it may be recommended you switch to continuous monitoring. Based on the World Health Organisation's definition, this would mean you are no longer having a 'normal' birth.
The infant is born spontaneously - this is rather self explanatory. The baby is born vaginally, without assistance.
In the vertex position - so what about those having a vaginal breech birth? Can this not be 'normal'?
Between 37 and 42 completed weeks of pregnancy - this is an important point, as outside of this gestation there are likely to be other factors which influence the course of birth. However, you can still give birth vaginally without assistance before and after this gestation, so is that not 'normal'?
The mother and baby are in good condition - the majority of babies cry spontaneously and adapt to the outside world well. Most mothers also do not have any issues. However, what if the baby requires a bit of support? What if you as a mother bleed more than we expect? Is your whole 'normal' birth then not normal? What even is 'good condition'?
There aren't really many women who would fit this normal birth criteria, are there?
Birth is NOT tick box. This is why I feel we should change the goal-posts and aim for something else. A POSITIVE BIRTH.
People will have various ideas of what they would like their birth to be and not everyone's focus will be on having a vaginal birth - this is fine and totally great, because vaginal birth may not be the safest or ideal for you as an individual. This is why you should focus on having a positive birth, no matter what and not beating yourself up if things were not the stereotypical 'normal', because I don't think it exists. Sure, there are many things we can do, to optimise our chances of this, but birth is not textbook. Birth is different for everyone. Birth is a process in which women's bodies were created to fulfill, BUT it does not always happen in the same way for everyone.
Aiming for a positive birth means that you will be ready. You will be informed. You will understand that whatever the course your labour and birth take, the outcome is the same. Your baby has to come out some way and you should not judge yourself, or others, for how it happens. By all means, aim for a vaginal birth, if you are wanting to birth physiologically, but normal is not the way to define this. Normal is not a thing in such a diverse culture. You are not normal. You are individual and unique and your birth will too be this way.
What do you think? How are you preparing for a positive birth experience?
Hypnobirthing is the perfect way to reframe your thoughts and alter your mindset and perception of birth. If you want to book yourself a course, or just meet for a tea and natter about how it could help you, please get in touch!
Hope you are having a wonderful sunday.