SW and I registered for the Natural Birthing Class with EMMa Care. It was going to take the whole of a Saturday sitting in a workshop but we were quite keen to hear what they would advise and to meet the other participants.
The opening and initial presentation was delivered by Deborah, the Australian midwife who was the original promoter of natural delivery at NUH. She related her own experience as a mother and as a professional midwife and introduced all of us to each other. There were seven couples altogether, two of whom were mothers already while the rest of us were first time think we know-it-alls. Out of the first timers, two mothers were local and the rest were from everywhere else in the world. We enjoyed meeting a German couple who had 2 kids and were expecting their third. All their children were born naturally and their second was a water birth at NUH. It was really interesting that despite this being her third baby, she had decided to attend the class with her husband again (note to self, it’s a continuous education process and birth techniques may change so it’s good to attend refresher classes).
We found the session very useful because it was conducted in a friendly “let’s sit around and chat” style, where we were all free to speak a little bit about ourselves and pose questions during the class. The midwives covered the process of natural delivery in a detailed and authentic manner. This was very very important and I’ve never seen doctors describe birthing through the birth canal with physical props (mostly just a powerpoint slide of photos, which gives you an idea but it’s still very far from the real deal).
The midwives demonstrated the angle and approach of the baby, how it has to twist and turn in order for the head and shoulders to be able to fit through the pelvis before exiting the birth canal. It seems to casual, too easily accepted that this is the journey of a newborn. Grab a doll, flip it upside down and slip it through the calcified scaffolding in your hands. Hey, I think, birth is easy.
But wait. Layer on top of that all the structures that you don’t see. Stomach, muscles, fat, liver, kidneys, appendix, meters and meters of intestines. Add the body’s safety valves – the sphincters – cervix and vagina, and narrow them down to width of a whiteboard marker. Now imagine squeezing everything together (include a baby the size of a watermelon) with the force equivalent of you trying to get our the last bit of toothpaste from the heat sealed side of the tube…. for seventeen hours. OK STOP, let’s not jump ahead of ourselves.
The important point h
ere is that there is a structure that’s like a little lever – that vestigial anatomical structure- the tail bone. Deobrah pointed out that in a natural
birthing position where the hip is unhindered by anything pressing against it, the tail bone has a certain degree of flexibility. (It was, after all, a tail before) Normally the tail bone is angled inwards from the spine into the body. When the baby emerges through th
e pelvis, the tail bone structure moves outwards to allow more room for the baby’s head to pass. It would be equivalent of lifting the tail in other mammals. As Deborah enlightened us, this tail lifting would not happen if delivery of the baby were to be in a sitting position or lying down position. In those positions, the tail bone would be pressing against the bed.
What is the significance of this? Well, if the tail bone is pressing inwards towards the birth canal, it can prevent the baby’s head from having a smooth passage into the birth canal. It’s already complicated with the whole turning of the head and shoulders, and to have the tail in the way would just increase the odds of having to have an episiotomy.
Did I want an episiotomy? NOOOOOOOooooo……… this was going down in CAPS in my birthing notes. I decided then that I was not going to give birth lying down.
In the rest of the class, we learned about the positions for natural birth, the ways of getting comfortable in labour (for husband and wife positions) and also some tips on writing a birth plan. We all had to write a brief one to submit to the midwives, but we could refine and send in a more detailed version later. I was grateful that they shared some examples because I would never have been able to think of some of those details as important. Finally, there was a company that came in to give massages to the pregnant ladies and teach the fathers how to massage the mothers’ aching backs, arms and feet. My husband did an OK job, he’s definitely capable of giving good massages but was somewhat distracted on that day and focussing instead on trying to obtain one himself.
What we loved about the class was that Deborah encouraged us to discuss what we knew about hospital procedure and our obstetrician’s expectations about how women should deliver babies. How it convenienced the doctors and not the patients and how we should challenge the SOPs. We were private paying patients in a certified mother-baby friendly hospital and we could dictate how we wanted to deliver our baby. They showed us how to navigate the system and when to expect what. This would be considered downright rebellious in most hospitals… can you imagine that the most natural way of delivery would be the one that most outrageous for doctors and hospitals? it seems almost ridiculous but this information was so precious to us as it showed us how clueless couples have no control.
Mothership 
great post 🙂