Midwife says women need many labour choices

Press, 23 July 1987, Page 16

Midwife says women need many labour choices

Last week MAVIS AIREY looked at childbirth choices in Christchurch, in her Parents’ Survival Guide. Today she offers midwife Adele Birkbeck’s view that bed should be only one of many options during labour.

Bed is usually the last place a woman should be during labour. Birth is safer and easier when the mother is upright or semiupright, and free to change positions whenever she feels the need, says midwife Adele Birkbeck. “Almost as soon as they enter the maternity hospital most mothers in active labour expect to be put to bed, and some of the staff in these hospitals expect it as well. “Bed should be only one of many options during labour,” she maintains.

Although she trained as a nurse and midwife in Auckland, it was the birth of her first child in the United States that convinced her that there had to be a more suitable position for labour than the back- or side-lying position that was then de-

manded by most hospitals.

She became an advocate of the mother’s right to choose suitable positions, and followed with interest the research of Dr Roberto Caldeyro-Bar-cia of Uruguay into the significance of a woman’s position during labour. Suitable positioning enhances the natural labour process, she believes.

“When a woman is upright the cervix dilates more efficiently, thus shortening the labour. This position also reduces

pain and is safer because there is less risk of inerference with blood circulation, which carries life-sustaining oxygen to the baby.” She acknowledges that attitudes to childbirth positions vary, depending on the training, knowledge, and philosophy of the midwives and doctors in any particular area. “Fortunately, the advantages of remaining more upright during labour and birth are becoming widely recognised."

Adele Birkbeck started teaching childbirth education more than 20 years ago while she was living in Canada, where her three other children were born. There she coauthored a book on childbirth in 1969. Returning to New Zealand in 1974 when her husband, John Birkbeck, became head of the Department of Human Nutrition at the University of Otago, she practised as a domiciliary midwife in Dunedin.

This led her, she says, “to a full realisation of how birth should, and could be.”

Now living in Auckland, she continues to attend women giving birth in their own homes, and she has written her second book, an illustrated handbook called “Reminders for Childbirth.”

Although she agrees

Adele Birkbeck ... “Increasingly mothers, midwives, and doctors are realising that lying either flat on your back or on your side are unnatural and uncomfortable positions for labour and birth.” there are already many excellent books on childbirth, she says she saw a need for something that

could be used as a quick reference guide during labour.

The 20-page book covers questions and answers about labour, with clear explanations of how a mother may feel, exactly what is happening to her body, and how she can best work in harmony with the labour process. Step by step, it shows mothers practicising positions which help to relieve pain, aid relaxation, and speed progress during the hours leading up to birth. It also illustrates actual births in three different environments, with black and white photographs of mothers from the author’s own classes.

The emphasis, is strongly on a couple sharing the birth experience. Photographs demonstrate ways the mother’s birth partner can assist her,

and the text is directed at both mother and partner. Adele Birkbeck also encourages the presence of a female companion who can offer a different type of support from that of the father.

A reassuring list of “reminders” has been prepared specially for the partner and companion.

“The birth of a child should be one of life’s most rewarding experiences,” Adele Birkbeck says. “A thorough understanding of the birth process and the support of a partner help create confidence and emotional security."

“Reminders for Childbirth" is available through most ante-natal classes and Parents’ Centres at $5.00 per copy, or from Professional Publishers, Ltd, P.O. Box 37-116, Parnell, Auckland.