In countries such as Germany or the United Kingdom it is common. In fact, the social security of some states (Great Britain, Holland or Finland) contemplates and covers this possibility. Their hospitals are designed so that the woman in labor has a pleasant environment with background music, dim lights, relaxation and birthing tubs, armchairs adapted to give birth in an upright position or high support bars to facilitate expulsion.
In Lanzarote there is the possibility of giving birth at home, squatting, in the bathtub or however you want, under the supervision of a midwife who works in the private sector. The pregnant woman can also experience the contractions with her family and go to the hospital at the end of the process. Angelika Buchholz is a qualified midwife, attends at home and accompanies in the hospital. Her wish is to have a closer contact and expand collaboration with hospital professionals to 'humanize' the service together.
Collaboration with the hospital
In Buchholz's opinion, in Lanzarote adequate attention is given taking into account the material and human resources available to the Island in Gynecology and Obstetrics. Her work, she clarifies, does not imply a contrast to the work of the hospital but, on the contrary, a complementary service that gives the pregnant woman the option of giving birth in company and in a harmonious environment.
Before childbirth, the midwife offers a series of services to the pregnant woman ranging from swimming courses to gymnastics and exercises related to the breathing technique, through preparatory acupuncture for childbirth or learning to carry the baby in a sling, for example. Accompaniment from the first contraction until entering the delivery room, in the event that you wish to give birth in the hospital, is also possible.
Contractions in the water
Debbie Ibrahim resides in Lanzarote and explains her experience of giving birth in warm water in a public hospital in England ten years ago. "It is the best day of your life and it is great that the conditions are put in place to enjoy this process. It was all very natural, I spent a lot of time in the water and it was wonderful, I loved that experience, with soft music and dim light, something different from the first birth, which had not been with water."
To the testimony of Debbie Ibrahim, who had had a first induced and more complicated birth than the second, we add the experience of Bettina Cieslinski, 26 weeks pregnant and with a previous birth on the Island with a scheduled cesarean section due to a breech presentation. In this case, she is being cared for, in addition to Social Security, by the Angelika Buchholz service.
Close relationship
According to Cieslinski, "unfortunately, in Social Security they do what they can and there is not much time to chat and ask questions. With Angelika there is a closer relationship, I consult all the doubts and clarify things that I do not understand. I want her to be in the process of contractions, it is perfect, to prepare everything with someone expert and then be there, in childbirth."
The confidence and tranquility, in addition to the security provided by having exhaustive information on the process of pregnancy, childbirth and postpartum, comfort women like Bettina Cieslinski, who points out that massages, breathing techniques and acupuncture sessions have helped her a lot to carry a pregnancy with several months of vomiting and nausea.
The sessions she receives from the midwife begin in an environment of carpets and cushions, with soft colors and pleasant lights that facilitate tactile exploration to see the placement of the baby. The smoothness of movements and the comments in a low voice relax Bettina and prepare her to listen to the baby's heart in a totally clear way. An oil of cypress, geranium, calendula and grapefruit, among other ingredients, helps at the beginning of the massage of the growing belly.
The massage gives way to a small visualization and meditation "so that the mother can feel closer to the child and can also feel like the baby itself", explains the midwife.
In some sessions, postural exercises are also performed with a large ball that is also used for indications on the most appropriate breathing in order to "reduce the pain of contractions, relax the muscles and receive pleasant energy", adds Angelika Buchholz.
Pregnancy care
The services offered by Buchholz consist of preparing for childbirth with "relaxation and balance with body awareness practices, gymnastics and exercises related to the appropriate breathing technique to be able to arrange childbirth autonomously." In addition, swimming courses are taught "suitable and individualized for the needs of the pregnant woman and sling courses to carry the baby with lightening and relief for parents in a practice that provides safety and well-being for the baby."
From week 34 of pregnancy until delivery, acupuncture sessions can be developed once or twice a week. "These sessions help shorten labor by two to three hours, thanks to the relaxation of the birth canal, and have a positive influence with recommendations against discomfort such as acid, insomnia, edema or pain," explains the midwife.
She also carries out follow-up after the hospital stay, outpatient delivery or home delivery, with help and guidance in baby care and control of the uterine regression process. She also provides advice on breastfeeding and nutrition in general, as well as monitoring possible bleeding, cures and control of the general condition with subsequent gymnastics for the pelvic floor.
When the baby arrives in the family there is the possibility of accessing contact courses and exchange of impressions with other mothers, as well as the Prague PEKip Program so that parents have guidelines to play with their babies from six weeks of birth with more than one hundred activities and games aimed at body exploration, expression, touch and the development of their autonomy. To this is added the massage for babies according to the techniques developed by Dr. Frederik Leboyer, one of the key figures in the contemporary history of childbirth.
"Massages give well-being to the baby from eight weeks. They need to be pampered and caressed. It is a good exercise," says Angelika Buchholz, who recalls that infant swimming is also recommended "to enjoy together the contact with the water at a pleasant temperature or the development of the perception of one's own body, balance and motor skills."
87% OF BIRTHS WITHOUT COMPLICATIONS
The medical journal Bristish Journal recently published a study conducted in 2000 on 5,418 women who gave birth at home and the more than 400 midwives who cared for them in Canada and the United States. Of this amount, 87% of births had no complications and proceeded completely normally.
Cesarean sections:
According to the study, at home, the transfer to hospital and the recourse to cesarean sections was 3.7%. In low-risk births in the hospital, 19% of them ended in cesarean section.
Satisfaction:
97% of the mothers who gave birth at home were "very satisfied or extremely satisfied" with the care received from the professional who cared for them. As an added fact, six weeks after delivery 95.8% of the women who had given birth at home were still breastfeeding and 89.7% of them exclusively.
Episiotomies:
According to the British Journal study, at home episiotomies were reduced to 2.1%, compared to 33% in the hospital.
(Information extracted from the association El Parto Es Nuestro: www.elpartoesnuestro.es)
SEGO RECOMMENDATIONS
The Spanish Society of Gynecology and Obstetrics (SEGO), which updated its recommendations in 2007, points out - among other aspects - that "the most physiological management of the expulsive should be to wait for the woman to feel like pushing. If the pushes are effective, she will be allowed to do them in the way she wants for her comfort, facilitating at the time of the expulsive, the visualization of the perineum to protect it adequately."
It adds that "depending on the availability of each center, assess the possibility of giving birth in the delivery room or, if the woman wishes, in the birthing chair or in bed. Give the woman the option of adopting the position she wants during the expulsive, as long as the principles of quality care and control of the fetal state are respected."
SEGO clarifies that during recent times "a conceptual change is taking place in our country, both in obstetric care in general and in assistance to the childbirth process in particular. This change has as its fundamental axis that the pregnant woman is the center of the care received."
NATURAL BIRTH OPTION IN GALICIA
All Galician hospitals will offer natural or humanized childbirth in 2009 to all women who wish it, once they have adequate information and training, according to the forecasts of the Consellería de Sanidade. This was highlighted by the coordinator of the humanized childbirth program and the Guide to normal childbirth care, puerperium and breastfeeding, Iñigo Montesino, last April, who stressed that currently the Hospital Virxe da Xunqueira, in Cee, and O Salnés (Pontevedra) are the ones that offer this service in Galicia.
According to information published by the newspaper La Opinión de La Coruña on April 27, in hospitals where this option exists, pregnant women are provided with relaxation bathtubs and a bed that makes it possible to give birth vertically or in the "most comfortable" position for the woman. It is, according to Montesino, to approach childbirth as "a physiological process", compared to the custom of doing it "as a disease." Montesino explained that a technical guide is expected to be approved in these months that includes "quality criteria or minimums" of childbirth care, support for breastfeeding and puerperium, for its subsequent implementation in the hospitals of the Servizo Galego de Saúde network with the aim that "there is equity in care."
