Thursday, February 7, 2013

Natural childbirth

Our first baby was delivered without any serious complications (thank God!) but was assisted with forceps that left bruising marks on his face and a bout of jaundice that got to pretty high level at one point after that. (Google for 'forceps + jaundice' to see the coloration)

Curious to know if all that could have been avoided, I did quite a bit of research after that on the experience of other parents and realised that just like us, many had interventions that were not actually required and probably the cause of complications in the first place.

So when we found out that we were pregnant again, we aimed to avoid as much interventions as possible the next time round and hopefully experience a natural childbirth by getting the help of a doula.

Though we did not experience a total natural birth, it was close enough and looking at how it turned out, we would definitely would want the same should we get pregnant again in the future.

So I would like share our experience and knowledge and hopefully be useful to any expecting parents out who are clueless, just like us the first time round, about natural childbirth or aimed for a natural childbirth


First Childbirth

My wife was about a week plus before her due date when her water broke around sunrise. I did not waste much time getting her to the hospital even though she felt no contractions and was doing just fine. She even managed to pose for the camera during during registration process!

Once on the delivery bed, she was induced with Pitocin and sure enough the contractions came and she was in labor for the next 12 hours as she was slow to dilate. Due to the intense pain and prolonged labor, she opted for epidural. 

Even when fully dilated, she did not feel any urge to push and so was made to push. After failing to push our boy out, an episiotomy was performed. When that did not help, the doctor decided to try to assist with forceps first before sending her for a c-sect as a last resort. Our 3.1kg boy decided to work with the forceps thankfully but not without the side effects mentioned earlier.

Second Childbirth

About a week before her due date, our gynae did a sweep of the membrane during her last few routine checkup as she was already 4 cm dilated but without any real strong contractions. Her contractions before this came and went like a tease.

After we left the clinic for lunch, she had contractions that felt like the real thing. So we cut short our lunch to head home thinking that it will be better for her to labor at the comfort of our home.

As she was not able to even make two steps once out of the car, I decided to head to the hospital straight, after dropping our boy, who was with us at that time, with his grandparents.

Once on the delivery bed, the contractions got intense and she went crazy on the Entonox (laughing gas). At this point time, she is pretty much preoccupied with the pain and asked for pain relief. To be honest, most women do not even know what is going on at this point.

We tried to delay giving her pain relief by asking her to change positions and providing her with massages and encouragements. It worked because in certain position, she did not even need the Entonox.

As she was tensed up fighting the pain, she was not dilating any further therefore we decided to give her Pethidine to help her relax. I am not sure if it actually worked because she was still in pain after that and the baby was crowning a short while later.

The doctor was rushed in and she did not even have the time to put on her gown when our 3.6kg baby girl decided to say hi.

It all happened so fast. No pitocin, no epidural, no forceps and no episiotomy!

At Term / Full Term / Post term 

Your due date is based on 40 weeks of pregnancy. However, if your baby decides to say hi to the world anytime after 39 weeks, even before your due date, he will be just fine.

Sometimes your pregnancy may be overdue or post term, which is after 40 weeks. For some women, it may even stretch to 42 weeks. Your baby will still be fine even if they are overdue.

After 42 weeks, complications may arise and your doctor may decide to induce you.

However, these are just calculations and it can be wrong since it is based your last menstrual cycle which varies from women to women, where some have regular cycle and some do not.

Human body have their own way on deciding what is the best time for the baby to be delivered. Many gave birth as early as 37 weeks or as late as 43 weeks yet their baby is just fine.

We were told that every pregnancy is different yet when it comes to due date, we were told otherwise.


Contractions are signs that you are in labor. Contractions do not go away and it gets stronger and closer. Normally, once it is gets to 5 mins apart and 1 min long for at least 1 hour, that is the signal that you should head to the hospital. You should not head to the hospital too soon as you might be induced with pitocin. Why you should try to avoid that is covered later on.

Other than that, you should stay home and relax as much as you can. Home is the best place to be when you start to labor. You can have anyone and anything you choose to have around to make it all easier, unlike the hospitals and all their restrictions.

However, this is just a guide. Sometimes labor can be really fast, especially when it is not your first  pregnancy, like my wife's. The time between her first contraction and the delivery itself was around 3 hours. So if the pain is no longer bearable and you feel like pushing, or for some, feel like having a bowel movement, you should head to the hospital.

Water breaks / rupture of the membrane

If your water breaks before the onset contractions, or what they call premature rupture of membranes (PROM), it is not necessary that you need to rush to the hospital immediately because you might also be induced with pitocin. This is what happened during our first pregnancy.

You should not worry that you may run out of amniotic fluid as your body will keep producing it. The majority of the hind water remain inside the womb until the baby is born as the baby's head will act like a plug to prevent the water from emptying.

However, take extra care to prevent any possibility of infection. This means, keep your groin area as clean as possible.

Again, wait for the contractions before heading to the hospital.

Inducing Labour

Inducement can be recommended or be a put up an option by your doctor even if it is medically not necessary. There are many types of inducement.

Natural way of inducement is by eating spicy food, long walks and even sex.

Sweeping of the membrane, which is a process to separate the water bag from your cervix, is another form of inducement. Although it is still an intervention, it is considered by many as a natural way of inducement as it do not involve any synthetic chemicals.

The next stage of inducement is drip you with pitocin, a synthetically made oxytocin. This is to kick start your labor just like what natural oxytocin will do when produced by the body during labor.

The reason why you should avoid being induced with pitocin is that contractions after that can be more painful because

- your body is not yet fully prepared, hence the reason why you are not producing oxytocin naturally.
- the dosage might not be right for you. Nothing beats your own body when determining how much to produce since everyone is different.

For some, since their body is not prepared, the labor process may even take longer, which defeats the purpose of being induced in the first place. It is better to not start laboring rather than experiencing prolonged labor.

Sometimes because your body is not ready to push but the baby is ready to get out, your doctor might decide on a c-section to prevent the baby from being stressed.

So what is the point of inducing yourself when in the end, your body is not ready and you suffer the labor pains for longer than necessary and then end up with a c-sect?

The reasons given by gynaes to induce you are usually for safety reasons, but what they don't tell you is that it is also easier for them to plan and schedule the delivery of all their patients as labor is unpredictable and can be a snooze fest if the mother decides to be warded when they are not actually fully ready.

Hospital also prefer that you are induced because they want you out of the delivery room as soon as possible so that someone else can make use of it.

On the other hand, some expecting mothers chose to be induced because they get to choose the date of birth of their child. It is also more of a convenience, just like how doctors prefer to stick to a schedule.

Being induced is so common nowadays that it is considered normal and you may be burden with guilt for not wanting to be induced for fear of the safety of your unborn baby.

Pain reliefs

The best pain reliefs are those that are natural. Walking, swaying, changing position or sipping water are some of the things you can do to help in relieve the pain. For us, we got a doula to help out with massages and calming oils as well as emotional and psychological support.

As mentioned, when you are induced, the pain can be even more than if you are not induced and your labor can be longer hence may cause you to surrender to the pain and opt for synthetic pain relief. If you are not induced, you might not need them as the pain you will experience is well calibrated by your own body with Endorphin produced by the body when in pain.

As with any modern medication, pain relief options available during labor has it side effects. Below are just some of it.

Entonox - even though this is considered safe as it does not pass over to the baby, it may make you feel light-headed, drowsy or nauseous. This will cause you to lose focus and end up with decisions that you may not actually agree with if you are thinking straight.

Pethidine - it crosses the placenta to the baby and make him or her drowsy, causing respiratory depression after birth where an "antidote" medication can be given to your baby to reverse these side effects.

Epidural - involves placing a plastic tube into your epidural space by passing it through a needle which is inserted in your back at about waist level. It may take more than once to get the placement right. My wife had it done twice. Others only got it right after the 5th time! It also has the tendency to numb your legs and affect your ability to push during the 2nd stage of labour, which is what happened to my wife too, which almost cause her to have a c-sect.

However, choosing to get an epidural or any pain relieving options is totally a personal choice. Everyone has a different pain tolerance level so do not be ashamed or feel pressurised to go without it.


My wife was not allowed to move around on during our first birth. She was made to lay on her back on the delivery bed throughout the whole period. The reason given was that it can dangerous as she may hurt herself should she fall off the bed etc.

Lying on your back is not the only birth position. Any position that helps is the right position, like getting on all fours, squatting etc and that was what we did for our second birth and it helped.

Lying on your back only provide convenience to your doctor and nothing else. The one who should be receiving all the convenience is you, not your doctors. Therefore any position is ok, as long as the all necessary measures are taken to ensure that the baby will be safe when delivered and the mother is safe from falling off the bed etc.

My wife was also not allowed to eat during her first delivery to prevent her from having bowel movement during labor. That do make sense in a way, but if your labor stretches for hours just like my wife's, where are you going to have the energy later to push when you need to when you have nothing to eat for 12 hours?

The other reason that they do not tell you is that you are actually being prepared for c-section, just in case you need it, as they need your stomach to be empty during the procedure.


You can push only when you are fully dilated, which is about 10 cm, and because of this, many are fixated on knowing how far long they are as they want to get it over and done with. The thing is, you still cannot deliver your baby if you are not fully dilated, so would it make any difference at all if you know or not?

Sometimes it can be emotionally draining and demoralising knowing that you are still not fully dilated. It is made worse when you are already in hospital hoping to get it over and done with as compared to being in the comfort your home.

It can also be inaccurate as it depends on who does the checks. Not to mention the discomfort too.

And dilation may not happen in a regular sequence. It may take a while to get to 4 cm but from then on, it could be faster than you think and you could be popping sooner than you expect.


We have seen this many times before - in movies, in reality shows etc, where the women were asked to push even when they do not feel the need to push yet.

Pushing will come naturally. The baby will come out when it wants to get out.

The reason why some women, like my wife, was not able to push during her first delivery was because she was induced and her body is not ready yet. She did not feel any urge to push. The epidural also numb her of the need to push.

Another reason why pushing should not be imposed because it can cause tearing more than it should and may require an episiotomy to be performed.

Tearing / Episiotomy

Inducement, premature pushing, uncomfortable positions can cause unnecessary tearing.

Episiotomy, an incision to enlarge vaginal opening, is another intervention that is actually not required. Your body should be able to accommodate accordingly.

When your body is ready, it should not tear or tear that much and do not need an intervention.


1. Do not be obsessed with the due date. Make preparations but don't expect it to be sure date as it is just a gauge. Do not stress yourself over it.

2. If you have past the due date and are getting uncomfortable, have long walks to kick start things up.

3. Do not head to the hospital too soon. Unless you have real contractions and feel like pushing or bleeding, it is best to labor at home as much as possible.

4. If you decided to head to the hospital, eat something before that if possible. You will need the energy although you should not gorge.

5. Request not to be induced with pitocin.

6. Little or no cervical check, unless necessary. It does not help. Checking will not help speed up anything.

7. Be in any position during labor where it is comfortable for you. Get on your back or side only when the baby is crowning and when it is time to push.

8. Find other ways to manage the pain instead of getting a shot of Pethidine or an epidural. Changing positions help. Essential oils helps. Anything that makes you happy helps.

9. Do not push when it is not time. You will know when it is time to push.

10. Trust your own body.


Humans have been through labor even before modern medicine. So why do modern medicine have to be so intrusive on this otherwise natural process?

It reminds me of a medical reality show that I watched before where it follows the movements of the ER staff. There was one scene where a woman who is about to give birth came in and as there was no gynae to attend to her, a general doctor on duty had to step up. After she had given birth safely, he came back on screen and said of how he practically did nothing. He said something along the following line:

"No offence to gynecologists out there but birth requires little or not help at all from doctors"

I could not agree more. A woman's body knows best. Birth should be as natural, with no intervention of any kind, as possible. It is not that natural childbirth is superior but a normal pregnancy with interventions during childbirth could actually be the cause of complications you are trying to avoid in the first place.

Having said that, I am also a firm believer that medical intervention is required when necessary and called for.

What I wrote here is based on my understanding. It only applies to pregnancies that are normal and are not preterm. Else any labour like symptoms experienced should be consulted with a medical practitioner.

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