Birth Environments and Labour Choices - Essay Example

Birth Environments and Labour Choices Introduction For majority of women along with their families, birth and labour is a time of anticipation and excitement combined with fear, anxiety and uncertainty. Giving birth constitutes most important transition in the life of a woman as she is not only turning into a mother but also be learning and growing throughout the process. The experiences and memories of birth and labour remain within the hearts and minds of women and their families across their lives. Obviously, the care and support received by women during the process is critical and of immense importance. The overall object of providing care to women experiencing labour and birth is to bring about a convincing experience for not only the woman but also to the entire family, while preserving their health, responding immediately to emergencies and preventing complications. Significance of Birth environment A pregnant woman has to make various decisions regarding the place and the way she wishes to deliver her baby. As there are various options for where she may decide to have the birth along with the options of how she may decide to deliver. Despite all these factors, the environment a woman chooses to labour can greatly impact the amount of anxiety and fear she may experience. The birth setting is greatly powerful and can be regarded as a differentiating factor between a traumatic or fulfilling experience of childbirth. Attention to detail as well as careful concern of the different birth environment dimensions constitutes most favourable circumstances for the progression of labour. Hospital is an estranging environment for majority women, in which privacy issues and institutionalised routines can lead to feelings of lack of control (Lock and Gibb, 2003). It has been reported that the interventions and technology that has become usual on various labour wards was concerned in women’s frustration with labour (Lumley and Brown, 1994). Enhanced anxiety induced through lack of control can intervene with the regular effective labour physiology (Steele, 1995). Since the control or lack of control are regarded as essential to the women’s labour experience and their consequential wellbeing (Simkin, 1992). Types of Birth Environments It has been found that there are three categories of birth places (an essential part of the birth environment) from which women may chose the one they suppose will be the most comfortable for them during the different phases of labour. These include home birth, birth centres and hospitals. Along with deciding the place of births, women may also choose the support persons they’ll feel comfortable with during the process. Since nearly all non-pharmacological techniques of pain relief necessitate a women experiencing labour to calm down in some way, therefore having an environment that encourages relaxation can enhance the likelihood of labouring without using any medication. Even if a woman chooses to make use of medication for pain relief during labour, the environment significantly sets the tone, and the way the supporting people treat the woman during her labour and in the institution of the baby’s birth memories. The correct birth environment is being more and more recognised for the crucial role it plays in the chances of a woman of undergoing a normal labour and birth. The birth setting and environment is immensely powerful and can be the difference between a fulfilling or traumatic childbirth experiences. Benefits of Home-like Birth Environments Home birth provides total control to the women of the environment. A birth environment similar to that of home puts beneficial impact on delivery and labour. For women having less risk for obstetrical complexities, delivering baby in a birth environment similar to home, is found to be linked with fewer analgesia use, foetal abnormalities, operative delivery, and increased contentment with care. Women having less risk are looked after usually in birth environments having home like settings such as birth centres where professional midwives provide assistance are found to render benefits like increased maternal satisfaction, decreased augmentation, operative deliveries, analgesic use and foetal anomalies. According to Hodnett et al., it has been concluded that the women are more probable to be mobile during the early labour stage and are more probable to deliver in semi recumbent or upright position in a birth environment similar to home. So these factors may lead to a significant decline in augmentation rates, unusual foetal heart beat tracings, analgesic use and operative deliveries. Operative delivery or analgesia (spinal and epidural) are a tremendous cost onus to health care providers, as it has been revealed that the costs of mean simple vaginal birth are 68 percent greater in a hospital than in a home birth environment. It is essential that healthcare providers caring to women in birth environments similar to home remain observing the women undergoing labour and birth to ensure that foetal compromise is acknowledged early and addressed with effectively. Therefore the employment of birth environments similar to home, for women with less risk has been found to have good consequences on parturient. In developing countries where financial shortages are a main issue the introduction of birth environments similar to home with good clinical care may provide a cost-effective alternative but needs guarantees additional attention, particularly to perinatal mortality. Labour and Birth Environment The essential constituents of a birth environment that may impact the labour experience include the supporting individuals, their communication (both verbal and nonverbal) with the woman, the excellence of support received by the woman, the care philosophy and the medical personnel practices, the comfort and familiarity of surroundings, including lighting, noise and temperature. The prior experience of labour decreases the feeling of being overwhelmed and increases the probability of the development of contending skills. These experiences can thus decline pain and fear. Factors Affecting Labour Pain Relief Choices The type of birth setting chosen by a woman limits the choice of labour pain relief alternatives. If hospitals are chosen for the birth then the women are more likely to have an access to the pain medications than at home or in a birth centre but a limited access to drug-free pain relieving methods. Majority of the women who prefer to give birth in hospitals use either one or more kinds of pain relieving medications. But in case if the environment chosen is home or a birth centre then a much greater variety of non-drug techniques and comfort measures will be available, instead of epidural analgesia and injected narcotics. In case a woman wants to get rid of labour pain through the use of medications (epidurals), she may prefer a hospital ward as the most suitable environment for the labour and birth. Similarly if there are complications in the delivery, the best suitable environment would be where the professional assistance can be provided i.e. in a hospital. Cases that are advised to have a caesarean section prior to the labour are also recommended to make use of an institutionalized birth environment provided by a hospital staff. Role of a Midwife in Building the Relationship between Newborn and Parents One of the issues that majority of midwives address on a routinely basis includes the health promotion for instance as they provide relevant information to the women regarding their smoking, diet, exercise and in postnatal care. Similarly the midwife also plays an essential role in encouraging normal childbirth and labour and it has been evidenced that care provided by midwives assists in preventing interventions and improving satisfaction during the childbirth ambit (Downe, 2006). Their significant role is evident in instituting a bonding between mother and the newborn where the aspects of mental health, public health and the encouragement of normality are united. The function of midwife goes beyond the context of a health service provider while caring for a woman during labour, child birth and neonatal development phases since an emotional factor arises that institutes the conception of nurturing. Nurturing has been defined in terms of promotion of development and that promotion is not merely restricted to child bearing women but also to the midwives too. The ways in which a midwife associates with a woman during labour and birth significantly impacts the parents’ exposure to this lifetime event (Hallgren, Kihlgren and Olsson, 2005). It has also been evidenced that the psychological care provided by midwives to child bearing results in declined morbidity. Midwives provide the chances of attachment between mother and child as soon as the child is born provides assistance in breastfeeding, diet and maternal health issues. The initial skin to skin contact of a baby brings in the natural attachment it may associate with its mother and father (Brazelton and Cramer, 1990). So the midwives are required to immediately let the mother hold her baby as soon as it is delivered and encourage the mother to breast feed her child within the first hour after birth. Therefore not only the role of midwife is significant while a woman experiences labour and birth but also in building a strong bondage between the new born and parents too. In other words, the role of midwife in enhancing attachment and bonding in the perinatal period can be regarded as being essentially important for the mental and psychological well being of baby and mother in the long term. Conclusion While reviewing the role of midwives in labour, childbirth and in the development of strong bondage of the newborn with parents, it has been seen that the decisions regarding the appropriate selection of a birth environment is quite essential for a woman. The role a midwife in these life changing events can’t be ignored. The functioning of midwives during these physical and emotionally stressful events facilitates in the long term well being of mother and child. So it can be concluded that the services rendered by midwives during these crucial moments of a woman’s life is of immense importance and midwives can be regarded as the professional support persons during these events. References Brazelton, T. B. and Cramer, B. (1990). The earliest relationship. Addison Wesley, New York. Downe, S. (2006). Engaging with the concept of unique normality in childbirth. British Journal of Midwifery 14(6):352-4,356. Hallgren, A. Kihlgren, M. and Olsson, P. (2005). Ways of relating during childbirth: an ethical responsibility and challenge for midwives. Nursing Ethics 12(6):606-1. Hodnett, E., Downe, S., Edwards, N. and Walsh, D. (2005). Home-like versus conventional institutional settings for birth (Cochrane Review). The Cochrane Library (1): John Wiley and Sons: Chichester, UK. Hundley, V., Cruikshank, F. Lang, G. Glazener, C. Milne, J. Turner, M. Blyth, D. Mollison, J. Donaldson, C. (1994). Midwife managed delivery unit: a randomised controlled comparison with consultant led care. British Medical Journal 309(6966): 1400-1404. Lock, L. & Gibb, H. (2003). The Power of Place. Midwifery 19(2): 132-139. Lumley, J. & Brown, S. (1994). Satisfaction with care in labour and birth: a survey of 790 Australian women. Birth 21(1): 4-13. Simkin, P. (1992). Just another day in a woman’s life? Part 2 Nature and consistency of women’s long-term memories of their first birth experiences. Birth 19(2):64-81. Steele, R. (1995). Midwifery Care in the First Stage of Labour: In: Alexander, J. Levy, V. and Roch, S. (Eds.). Aspects of Midwifery Practice: a research based approach. Macmillan: Basingstoke. Read More