Saturday, April 05, 2008
Childbirth and Parenting - 1
Planning for baby's arrival
In the first of a six-part series on childbirth and parenting, we explore the need for a 'birth plan'
Childbirth may be the most natural thing but every expectant couple has their own fears and anxieties about this life-changing event.
Enter the birth plan, a blueprint of sorts that a couple can draw up to decide how and where the birth should occur.
Dr Kenneth Lee, consultant gynaecologist at The Women's Clinic, said having a birth plan can give couples a better sense of what to expect. Options include water birth, natural vaginal birth without pain medication, natural vaginal birth with medication or Caesarean (C-section), and elective C-section.
In Singapore, the majority of women go to the hospital to have their babies delivered. According to recent reports, the rate of C-section births in Singapore is among the highest in the world at 30per cent. The World Health Organisation has advised that the rate should not exceed 15 per cent. Studies show that the risk of major complications with a C-section birth is three to five times higher than vaginal birth.
Dr Lee said that C-section births are generally safe and are necessary in a number of pregnancies. They are usually chosen by older mothers or those who might be facing other health issues.
However, many also choose to deliver by C-section for non-medical reasons, such as ease of scheduling or a desire to engineer the baby's birth on a particular day. Dr Lee warns that surgery is not risk-free and that recovery time will be longer than that of a normal vaginal birth.
Birthing options can be controversial, though every choice comes with its pros and cons. Natural birth enthusiasts cite research that says babies born by elective C-section might miss out on hormonal and physiological changes during labour which help mature the lungs. They also point out that 'episiotomy', a procedure where doctors cut the perineum (the area between the vagina and anus) to facilitate the baby's emerging head, is not as harmless as previously thought.
Research shows that natural tears heal faster than those in an episiotomy.
While some camps argue in favour of completely natural births, others feel surgery might be the safest way to go. Dr Lee believes it's a case of different strokes for different folks.
Many women feel comforted by the presence of a midwife or a doula, for instance. A doula is someone who acts as a labour supporter and offers the pregnant woman and her partner reassurance and practical assistance.
Given all these options, a birth plan lets women think them through: Natural or C-section? Epidural or bear the pain? Episiotomy or natural tear?
This is where a local outfit called ParentLink comes in. Run by trained doulas who are mothers themselves, it offers childbirthing classes and help with birth plans.
Ms Tania Grose-Hodge, a certified childbirth educator, doula trainer and mother of three girls, is an Australian who has made Singapore her home for the past 15 years.
At ParentLink, doulas spend a lot of time with mothers-to-be writing a birth plan, teaching them how to be direct without being aggressive.
However, birth plans are not rigid. They allow for changes in case labour does not go normally and can have contingencies written in.
'We don't promote any one approach as better. We are not against medical intervention. We are here to support the woman through the process that she chooses, which might work best for her,' MsGrose-Hodge said.
Mind Your Body
Shefali Srinivas
Labels: childbirth, parenting
