Why are Natural Births Still Popular in 2021?

As your pregnancy progresses, you will need to start thinking about your birth plan and labour delivery options. Women have a choice of two types of births: natural and operative. To ensure you're informed of your options, here is what you need to know about the natural birthing options available.

What is Natural Birth?

Essentially, natural birth (or vaginal birth) is the idea that the baby comes down the birth canal as the result of uterine contractions (labour) and out of the vagina without assistance from an instrument such as forceps or a vacuum or the use of pain-relief medication.

However, a whole spectrum of definitions of what "natural" is exists. Technically, induction of labour is not a natural birth even if it results in a vaginal delivery, but many people define natural birth as any time the baby comes out of the vagina. The modern definition of natural birth means no medical interventions as in not taking pain medications or getting an epidural.

In contrast, operative births occur when the baby is assisted out of the vagina with an instrument or via cesarean section which is an operation performed through an abdominal incision whereby the baby is extracted directly from the uterus.

Natural Birth vs C Section (Cesarean Section)

In the past 2- 3 decades, elective cesarean section has also grown in popularity.

As modern medicine has improved, the risks associated with cesarean sections have decreased, which is why some women would rather schedule their birth and avoid the uncertainty of spontaneous labour. However, risks with cesarean sections persist:

• You are more likely to have a repeat cesarean section, which may be more challenging to perform due to scarring. In fact, mothers with a caesarean scar were 24 times more likely to develop a rare condition known as morbidly adherent placenta than those with an unscarred uterus
• Three times the risk of death compared to a natural birth
• Risk of uterine rupture in a subsequent pregnancy if labour ensues before a repeat cesarean can be performed

Risks and Precaution

There are times when a cesarean section is essential for either maternal or baby's well-being.

Situations such as multiple births, malpositions such as breech (feet first), transverse position (horizontal), placenta previa (placenta overlying the cervical opening), placenta accrete (placenta burrowing into the uterine muscle layer) all require medical intervention to ensure the delivery of the baby is safe.

Advice

The decision to birth naturally can be a personal one. Whether you opt for a natural birth or not, your delivery and labour should be what's most comfortable for you. Pregnancy is not black-and-white; sometimes, things don't go to plan. The best way to prepare is to be educated have your preferences for labour and birth in place.

To find the right choice, you should discuss all your options and concerns with your healthcare practitioner. At OT&P, we also provide hypnobirthing classes to educate mothers-to-be seeking a peaceful pregnancy, labour and delivery.

Natural Birth in Hong Kong

Natural birth in Hong Kong is relatively low but rising, the Matilda Hospital recorded a rate of 40.6% natural births in later 2019, compared to 32.19% natural births in 2017^[1]. The rising trend of natural births can be attributed to mothers becoming more aware and cautious with what happens to their bodies. The choice to have unmedicated birth is due to the concern about the complications where there is medication involved and they don't want to assume the risk.

Why is Natural Birth Popular?

Many women consider natural birth more empowering as they have greater control over their birthing process. As labour and delivery are different for every pregnancy, the benefits may differ too. Here are some of the most discussed benefits:

• Faster recovery
• Earlier walking (unless provided with epidural)
• Leaving the hospital sooner
• No major incision in the abdomen (which requires a longer recovery)
• Less pain, although some lacerations of the vagina can be uncomfortable
• Less risk of excessive bleeding
• Less chance of infection and scarring
• Less risk of blood clots
• Earlier bonding and breastfeeding for the baby
• Less baby breathing difficulties because the birth process squeezes out the lung fluid
• Exposure to the mother's microbiome improves immunity for baby
• Subsequent vaginal births are generally easier and faster

However, like with anything, natural births do come with some risks. Mainly tearing and episiotomies that can cause discomfort and take time to heal, though this usually happens within two or three weeks depending on the individual.

References

1. Berit Thorkelson, Renee Bacher, Carrie Murphy, and Jeanne Faulkner, R.N. (2020). '13 Tips for Having a Successful Non-Medicated, Low-Intervention 'Natural' Birth'. Parents Magazine. 17 August 2020. Available at: <https://www.parents.com/pregnancy/giving-birth/vaginal/dos-and-donts-of-natural-childbirth/> [Accessed 23 August 2021]
2. Emily Tsang. (2015). 'Hong Kong mothers who opt for caesarean section at risk if they get pregnant again'. South China Morning Post. 3 December 2015. Available at: <https://www.scmp.com/news/hong-kong/health-environment/article/1886283/hong-kong-mothers-who-opt-caesarean-section-risk> [Accessed 23 August 2021]