Approaches to Childbirth

Prepared childbirth refers to being not only physically in good condition to help provide a healthy environment for the baby to develop, but also helping soon-to-be parents prepare to accept their new roles as parents and to get information and training that will assist them for delivery and life with the baby as much as possible. The more parents can learn about childbirth and the newborn, the better prepared they will be for the adjustment they must make to a new life. Nothing can prepare parents for this completely. Once parents find that they are to have a child, they begin to conjure up images of what they think the experience will involve. Once the child is born, they must reconcile those images with reality. Knowing more about what to expect does help them in forming more realistic images thus making the adjustment easier.

Preparation for Labor

There are many different approaches to childbirth that influence how expectant parents prepare. The two most common approaches to childbirth in the United States are the Lamaze method and the Bradley method.

While the Lamaze method and the Bradley method differ in their philosophy and focus, each prepares the mother for natural childbirth. The Lamaze method emphasizes teaching the woman to be in control of the process of delivery, and to view childbirth as a natural process. While Lamaze classes do not discourage or support the use of medical intervention during childbirth, expecting moms are taught to reduce the pain associated with labor by using techniques such as, muscle relaxation, breathing through contractions, and having a focal point (usually a picture to look at) of concentration to distract from the pain of labor. In addition, the Lamaze technique suggests that a support person go through the six to eight week training classes with the mom and be prepared to serve as a coach during delivery process.

The Bradley method, or husband-coached birth, focuses on preparing the mother to deliver without the use of medical interventions. Like the Lamaze method, the Bradley method focuses on reducing pain and staying relaxed. Fathers play a much more active role in the coaching process than in the Lamaze method, and dads are expected to practice breathing and massage techniques with their partner.

Nurse-Midwives

Historically in the United States, most babies were born under the care of lay midwives. In the 1920s, middle-class women were increasingly using doctors to assist with childbirth but rural women were still being assisted by lay midwives. Nurse-midwives continued to assist most rural women with delivery until the 1970s and 1980s, when their growth is thought to have posed a threat to the medical profession. Today, pregnant individuals who are at low risk for birth complications can successfully deliver under the care of nurse-midwives and report having positive birth experiences, particularly those who deliver with midwives who are integrated throughout the pregnancy and delivery process (Vedam et al., 2018).

Home Birth

Because one out of every 20 births involves a complication, most medical professionals recommend that delivery take place in a hospital. However, some parents choose to have their baby at home. About 1.5 percent of births occur at home, often assisted by midwives. In the United States, home birth were more likely for individuals who had low-risk pregnances (MacDorman & Declercq, 2016). Studies show positive outcomes including fewer interventions (e.g., fetal monitoring) and higher parental satisfaction, but the outcomes for newborns are more variable (Zielinski et al., 2015).

Birthing Centers

A birthing center presents a more home-like environment than a hospital labor ward, typically with more options during labor: food/drink, music, and the attendance of family and friends if desired. Other characteristics can also include non-institutional furniture such as queen-sized beds, large enough for both parents, and perhaps birthing tubs or showers for water births. The decor is meant to emphasize the normality of birth. In a birth center, parents are free to act more spontaneously during their birth, such as squatting, walking, or performing other postures that assist in labor. Active birth is encouraged. The length of stay after birth is shorter at a birth center, with some families being able to leave just 6 hours after birth. One-third of out-of-hospital births occur in freestanding clinics, birthing centers, or in physicians’ offices or other locations.

Water Birth

Laboring and/or giving birth in a warm tub of water can help an individual relax. The buoyancy of the water can help alleviate discomfort and pressure for the pregnant parent. Many hospitals have birthing tubs that allow individuals to labor in them. However, only some hospitals allow for birth to take place in the water. Some believe that water birth gives a more calm and tranquil transition for the baby from the womb. Water births are more common to occur at home or in birthing centers.

Hospital Birth

Most births in the U.S. occur in hospitals (Grünebaum et al., 2023). Parents have the choice to have a medicated or unmedicated delivery. Some do fine with “natural methods” of pain relief alone but many blend “natural methods” with medications and medical interventions that relieve pain. Building a positive outlook on childbirth and managing fear may also help cope with the pain. Labor pain is not like pain due to illness or injury. Instead, it is caused by contractions of the uterus that are pushing the baby down and out of the birth canal. In other words, labor pain has a purpose.

The most common pain relief method used during labor and delivery is an epidural. An epidural is a procedure that involves placing a tube into the lower back, into a small space outside the spinal cord. Small doses of medicine can be given through the tube as needed throughout labor. With an epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness felt can be adjusted. An epidural can prolong the first and second stages of labor. If given late in labor or if too much medicine is used, it might be hard to push when the time comes.

Another form of pharmacologic pain relief available for laboring parents is inhaled nitrous oxide. This is typically a 50/50 mixture of nitrous oxide with air that is an inhaled analgesic and anesthetic. Nitrous oxide has been used for pain management in childbirth since the late 1800s. The use of inhaled analgesia is commonly used in the UK, Finland, Australia, Singapore, and New Zealand, and is gaining in popularity in the United States.