“Bringing a child into the world is a natural act. This event does not happen so often in a lifetime and we want to experience it according to our tastes, in a relaxed atmosphere.This is what parents say and today it is what more and more professionals are listening to and respecting. Natural childbirth is a concept that is gaining ground in France. Women want to be able to count on their own resources, to feel free to move around during labor and to welcome their babies at their own pace. Giving birth in a maternity hospital is not necessarily synonymous with medicalization or anonymity, as some parents fear.
The birth plan drafted during pregnancy allows professionals to best adapt to the wishes expressed by future mothers. Obstetric teams are organized to help women who express their desire to approach the birth experience differently: by letting the contractions open the cervix and lowering their baby, by finding the positions that will favor this process, while feeling reassured.
These future mothers are supported by their spouses who are by their side. They say that giving birth like this gave them great confidence in caring for their baby. Some maternity hospitals have as a priority to respect the normal course of childbirth, for example without intervening to break the water bag or to put an infusion which would accelerate the contractions. The epidural rate is not very high and the midwives are there to help the mother find positions that suit her; as long as everything is going well, the monitoring is discontinuous to leave the woman the possibility of moving around, and for the same reason the infusion is only put on at the time of expulsion.
Birth rooms or natural rooms
Maternities have created physiological birthing rooms, or natural rooms, which can be equipped with: a bathtub to relax during labor and reduce pressure on the cervix through immersion in water; traction lianas, balloons, to adopt positions that reduce pain and promote the descent of the baby; a delivery table allowing a mechanically more suitable position to be chosen. The decoration is warmer than in the usual rooms.
These places have the same medical supervision as the other delivery rooms, with the same security and administrative rules. If necessary, an epidural is possible without changing the room.
Technical platforms
Some maternities allow liberal midwives to access their “technical platform”. This allows women to give birth with the midwife who monitored the pregnancy and prepared for the birth. The monitoring of labor and delivery take place in a hospital environment, but the midwife is fully available for the expectant mother and her companion, which reassures them. The mother returns home two hours after the birth, unless of course there has been a complication. If the pain is more intense than expected, the labor longer and less well supported by the mother than she imagined, an epidural is possible. In this case, the maternity team takes over. If the condition of the mother or baby requires it, there may be hospitalization. Here are the contact details of (ANSFL): contact@ansfl.org
Birth houses
These are structures managed by midwives. They welcome future parents for consultations, preparation and offer comprehensive follow-up from pregnancy to post-partum. Only women without specific pathologies are admitted.
These birth centers are linked to a maternity hospital which must be close enough to allow access to them within a reasonable time in the event of an emergency. They respond to the principle of “one woman – one midwife” and respect for the physiology of childbirth. Thus, for example, an epidural cannot be performed there. But if the need arises, whether for medical reasons or because the pain would be too difficult to bear, a transfer to the maternity unit with which the birth center is linked will be made. Likewise in the event of a complication. The operating rules specify that a midwife must be able to intervene at any time. In addition, during childbirth, two midwives must be present on the premises.
The birth centers do not have accommodation and the return home is early (a few hours after childbirth). The organization of this return is set up with the midwife who followed the pregnancy and gave birth. She will make a first visit to the mother and newborn within 24 hours of discharge, then at least two more in the first week, with daily contact. The examination of the baby’s 8th day should be done by a doctor.
Birth centers have existed with our neighbors in Switzerland, England, Germany, Italy, Spain (also in Australia) for many years. In France, the law authorizes their opening since 2014. Five are currently operating (2018), three will open soon. A first evaluation of the experiment must be carried out by the regional health agency (ARS) after two years of operation. To be continued…
In the context of a technical platform or a birth center, parents appreciate the continuity of the link established with the midwife. They have prepared with her for birth and parenthood and it is she who will accompany them during childbirth. Home childbirth can sometimes tempt some couples who wish to experience the birth in the warm atmosphere of their home, in continuity with family life. Today it is not recommended by health professionals who fear complications because of the distance from the hospital. Moreover, very few midwives practice it.
Note: It is recommended to register in a birth center as early as possible and must be before 28 weeks (6 months of pregnancy).
To report
There are establishments where medicalization is reduced to situations which require it. Find out and talk about it around you, during consultations, during parenthood preparation sessions. The security of a maternity hospital does not prevent you from respecting your privacy, from meeting your expectations while taking your fears into account.
The (Interassociative collective around birth) brings together associations of parents and users. He is at the origin of many initiatives in the field of birth (birth plan, physiological rooms, continuous presence of the father in the maternity ward, etc.).
This article is taken from Laurence Pernoud’s reference book: 2018)
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