Giving Birth
Preparing to give birth can be a stressful time, and there are many things you might want to consider. It is important to remember your rights and know how to have control over your choices when navigating the maternity system.
The BRAIN acronym can help you make an informed decision about your birth (and all aspects of your reproductive health!):
- BENEFITS – what are the benefits of making this decision?
- RISKS – what are the risks involved?
- ALTERNATIVES – are there any alternatives?
- INTIUTION or INFORMATION. What does my gut tell me? or Do I need more information?
- NOTHING – What if I do nothing (or wait it out)?
Whether you are being offered, or choose to have a natural birth, a c-section, epidural, or an induced birth, using the BRAIN tool and asking your midwife or health provider these questions can help with your decision.
If you have made a birth plan it is your right to stick to your decision, if it is safe to do so. It is your right to receive safe, quality maternity care, and to make your own choices about the care or treatment you are offered when you are pregnant and giving birth.
In Australia, there are different options for care and support during pregnancy and birth. Deciding where you would like to give birth may depend on:
- what you can afford,
- if you want to see the same doctor or midwife each visit,
- if you would like your GP to look after you throughout your pregnancy,
- what kind of medical intervention or pain relief you would like during your birth.
Some of the options include giving birth in a public hospital, a private hospital, a birth centre, or at home. Your doctor can discuss your options and help you choose what’s best for you. You can also talk to your family and friends about their experiences, but remember that pregnancy and birth experiences are different for everyone. Some of the pros and cons are outlined below:
Public Hospital | · You may be able to choose your model of antenatal care. · You can have minimal intervention during birth if you choose, while still having access to medical intervention if you need. · Medicare covers most of the cost of care during the pregnancy and birth. · Most major public hospitals can care for you and your baby if there are complications. · You may be able to see allied health professionals if needed. | · You might not be able to see the same midwife or doctor throughout your pregnancy. · The midwives or doctors you see during pregnancy might not be at the birth. · You won’t be able to choose which midwife or doctor you see. · After the birth, you’re more likely to be in a shared hospital room. |
Private Hospital | · You can choose the doctor who will care for you throughout pregnancy, labour and after birth. · You might be able to choose a more convenient location for your care. · You will have the option to stay in hospital for a few days after birth. | · It’s expensive if you don’t have private health insurance. |
Birth Centre | · Birth centres provide a more home-like environment to give birth than a hospital. · You’ll probably go home within 24 hours after birth, with care from midwives at home afterwards. · Birth centres are an option if your pregnancy is low-risk and your birth is expected to be uncomplicated | · Birth centres usually don’t offer epidurals. |
Homebirth | · You will be in familiar surroundings, where you may feel more relaxed and better able to cope · You will have more privacy than in hospital · having your family with you and as many support people as you choose · You will be looked after by a midwife or doctor you have grown to know during your pregnancy · You may have a better chance of success with breastfeeding | · Depends on the availability in your area, if you and your baby are healthy, and if your pregnancy is low risk · You may need to be transferred to a hospital if there are complications during the labour, birth or afterward. · Some pain relief options such as nitrous oxide gas and epidurals are not available at home. · Homebirth with a private midwife is expensive, as the birth is not covered by Medicare. |
Labour
Most pregnancies will go into labour between 37 and 41 weeks[1]. If you are worried you might be in labour but you’re not due to have your baby yet, call your midwife, doctor, or hospital as soon as possible. If you haven’t had your baby by 41 weeks, you’ll have more frequent checks to make sure your baby is healthy.
There are a few stages of labour, and some signs that will indicate if you are going into labour. Early labour signs might include a show (when bloody mucus comes out of the vagina – known as your mucus plug), your waters breaking and period-like pain. Call your midwife, doctor or hospital. In the first stage of labour, your contractions get more intense. In the second stage, you birth your baby. In the third stage, the placenta is delivered.
Vaginal Birth
For most pregnant people, a vaginal birth is safer than a caesarean section. There is a reduced risk of needing a blood transfusion, postpartum infection, and internal uterine scarring. Vaginal births may injure your pelvic floor muscles which can cause bladder and bowel control problems, however this is quite rare and depends on the size of your baby, how long you push, or some of the tools used by health professionals during your birth.
Speak with your midwife or health professional if you have any questions or concerns about a vaginal birth.
Caesarean Birth
A caesarean section (commonly known as a c-section) is a surgical procedure in which your baby is born through a cut made in your abdominal wall and uterus. C-sections can be elected before you go into labour, or in some cases may be considered necessary.
C-sections are relatively safe operations, however they are a major operation and possible complications include infection, damage to your internal organs, an increased risk of respiratory distress for your baby, and complications with future pregnancies. You can expect to remain in hospital for 3-5 days after a c-section, and recovery can take upwards of 10 weeks. After a c-section, it is important to not do anything strenuous, lift or move anything heavier than your baby for at least 6 weeks. C-sections generally have a much longer recovery time than a vaginal birth.
Speak with your midwife or health professional for more information about c-sections.
Induced Labour
For some pregnancies, your doctor or midwife might recommend an induced labour, which causes the process of labour to start artificially. Some of the common reasons induced labour might be recommended include:
- pregnancy has gone longer than 41 weeks,
- waters have broken but the contractions of labour have not started naturally,
- baby is not well or is not growing well,
- mother has specific health issues.
There are risks associated with induced labour, and some might choose to wait and see whether natural labour will start. There can also be risks with continuing your pregnancy if induced labour has been recommended.
What happens if I am told my baby is measuring big?
During routine check-ups throughout pregnancy, the size of your baby may be estimated via ultrasound or palpation. It is important to remember that this is an ‘estimation’ and studies show a strong tendency to overestimate, rather than underestimate, a babies weight. Your pelvis, cervix and vagina are all designed to stretch and many people give birth to bigger babies with no complications at all.
Being told by an doctor that you have a big baby can create fear and unnecessary anxiety. One of the risks often discussed when birthing bigger babies, is the risk of the babies shoulder dislocating as it comes through the birth canal. The Royal College of Obstetricians and Gynaecologists in the UK states “ultrasounds are not good at telling whether you are likely to have a large baby and therefore they are not recommended for predicting shoulder dystocia, if you have no other risk factors.”
Some of the reasons you may have a bigger baby:
- you simply have a big, healthy baby,
- your due date was calculated wrong,
- you are further along in your pregnancy
- you have gestational diabetes
- genetics
Sometimes your health professional may recommend an early delivery or planned caesarean section. Remember that it is okay to make whatever decision feels like the right decision for you and your baby. To read more about having a bigger baby, here is an Australian Government website, and here is the link to Midwife Thinking a website that discusses some of the birth research with a midwifery practice lens.
Epidural
An epidural is a procedure that injects a local anaesthetic into your lower back (around the spinal nerves) to block the pain from labour contractions during birth. It is an effective procedure, however there are some risks, and side effects, including:
- low blood pressure, which can slow your baby’s heart rate
- infection, bleeding, headache,
- prolonged labour and delivery process
One of the drawbacks of epidurals is that once you have one you can no longer move around, you are numb from the waist down, which can slow labour. One of the benefits is the effectiveness of the pain relief. If you have any questions about epidurals or other types of pain relief (such as inhaled nitrous oxide), speak with your health professionals.