Alot of people will come into the hospital to be induced, but there are also a lot who will be coming into the hospital in spontaneous labor. We need to know how to support these people to move through the stages of the normal physiologic birth process!
We need to have tools in our box other than just offering a bunch of medical interventions.
Normal Physiologic Birth
This is defined by the midwife organizations in the United States as “labor and birth powered by the innate human capacity of the woman and baby”. No interventions are introduced to disrupt the labor/birth process.
This type of birth process is a way to have best outcomes in birth because there is no disruption to the natural process. There are some who will still develop complications that will need interventions, but for the most part the normal physiologic birth process is the way to have the best outcomes for mom and baby
Characteristics of NPB
Spontaneous onset and progression of labor
Results in the vaginal birth of the infant and placenta
Physiological blood loss
Skin-to-skin contact and keeping the mother and infant together during the postpartum period helps to facilitate bonding
Early initiation of breastfeeding
Some Benefits of NPB
Reduced maternal morbidity
Improved likelihood of breastfeeding
Quicker recovery in the postpartum
Less pain in the postpartum
Decreased risk of c-section
Improved bonding between parent and baby
Tips to support Physiologic Birth in a Hospital
The first intervention we introduce when someone is in labor and delivering at a hospital if their drive to the hospital plus the admission process at the hospital.
This process could cause stress or could cause contractions to possibly slow down due to moving them from a place that is comfortable and safe to them, to a place that is bright, weird smelling, and may make them feel uncomfortable.
Knowing ways to support those in normal physiologic labor in a hospital can help our patients/clients have a better and smoother birth experience!
Approach supporting pregnancy and birth with anatomy, physiology, and evidence-based information. Support your patients and clients by understanding what is happening during labor; the anatomy of the pelvis and baby’s movements; and more!
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1. Create a birth cave in their room
Creating an environment that is familiar and feels safe to them can help with the stimulation of oxytocin. Melatonin makes our bodies more sensitive to oxytocin, and we have the highest amount of melatonin at night.
Some Things that I like to do:
- Turn off/Dim the lights: If you can’t dim them having some way to make the room not pitch black with battery powered candles, fairy lights, or night lights can be useful. This can help with the oxytocin and melatonin release!
- Playing music that is calming for them, music that they like to drown out any sounds of a hospital
- Diffusing a smell that is familiar to them, this can also cover the sterile smell of a hospital
2. Minimize Interruptions/Distractions
Minimizing people going in and out of the room, you (or anyone else) going in and out of the room can cause a distraction for them. Hospital Staff are an intervention every time they go in the room because they are not someone who is “safe” to them.
Hospital Staff: Limit how many times you go in
Doulas: Try to encourage staff to not come in every 5 mins.
3. Keep noise/sound level down
Loud noises could cause them to release stress hormones, which could cause a stall in labor
Loud noises can also bring them out of the labor land that they are in and distract them…also leading to a stall
By minimizing sounds by lowering our voices, opening any packaging outside of the room so we aren’t making loud crinkle noises, and have conversations necessary with other staff members outside.
The music playing in the room should hopefully drown out any sounds from outside, but also limiting being too loud outside of the rooms can be helpful.
4. Create a relationship of support
If we can create a relationship of trust with the client/patient, this can help with them feeling safe and supported during labor. They are more likely to confide with you during labor if they feel unsafe or like something is off, to help with labor progress. It also can help prevent labor stalls. If they feel unsafe or tense by your presence, that could cause labor to slow down or stop!
Hospital Staff: talking to them at admission to help create a relationship of trust. Some things I like to do if time allows:
- Sit down to ask them the labor admission questions
- Asking their birth preferences
- Explaining all procedures and why we are doing them
- Ensuring they understand all risks and benefits of any interventions that may be offered to them
- Smile
- Validate their feelings, any feeling they are having during labor is valid and allowed!
- No means No! Don’t multiple times when they say NO
Doula: Prenatal visits and communication throughout pregnancy to create that bond before labor. The better the bond, usually the better you are able to support them during labor and birth!
5. Honoring their Birth Preferences
Hospital Staff: If they come in with a birth plan, whether written or verbal, honor that as much as you can. If you cannot honor something, explain why in depth, not just ” We can’t do that” or refuse with judgement.
Doula: Advocate for their birth preferences, with as least about of aggression as possible. If you help them come up with a birth plan, you can explain what your experience is in those hospitals with what they are wanting. If that hospital cannot accommodate what they want, maybe recommend a different hospital.
6. Understanding labor biomechanics
By understanding labor pelvic biomechanics you can help recommend positions or intensify the positions they are intuitively choosing to help labor progress!
It can also help you be able to identify labor progress externally without any cervical exams! By knowing where baby is within the pelvis based on what they are choosing to do.
There are so many ways we can support our patients/clients in physiologic labor that are so easy to implement in our practice!
What new tips will you implement?
Learn more about Supporting Birth in our Birth Workers online self-paced course!
We are hosting a FREE 30 min webinar on Supporting Physiologic Birth on Oct 4th at 7pm EST