Active

Birth Workshop

Parents Notes

Morning Session

 Janet Balaskas 2001

The Comparative Benefits of an Active Birth

UPRIGHT POSITIONS Squatting, standing, kneeling Gravity Effective Weight of babys head and body puts even pressure from above on cervix and results in faster dilation. Uterus tilts forward during contractions With the mother leaning forward this can happen without resistance so contractions work more efficiently with less pain. No weight on major blood vessels Leaning forward allows better blood flow to baby and placenta, and better oxygenation so there is less risk of foetal distress. Sacrum mobile Pelvic canal can widen and adjust to the shape of the babys descending head. Pelvic joints can expand Less pressure on joints reduces pain (especially back ache). More space as internal pelvic proportions increase. RECLINING POSITIONS Supine, semi-reclining
Standing

Oppose gravity Less pressure on the cervix from babys weight. Uneven pressure on cervix results in slower dilation and more likelihood of an anterior lip. Uterus works against gravity These positions oppose gravity, and the resulting resistance make contractions less efficient and more painful. Weight of uterus compresses major blood vessels Can compromise blood flow to the uterus increasing the risk of foetal distress.
Squatting Hands and Knees

The lunge (standing)

Sacrum immobile With the mothers body weight resting on the sacrum, the pelvic outlet is narrowed. Pelvis less mobile More pressure on nerves increases perception of pain. Less space for baby as internal proportions of pelvis decrease.

Slow Dancing

Sitting Upright

Second stage - pelvis upright Babys angle of descent is easiest - down and out. Uterus can exert maximum force making bearing down more efficient and shortening the second stage. Perineum expands evenly Reduces the risk of tearing.

Second stage - pelvis horizontal Babys angle of descent is more difficult - up hill. Bearing down force made less efficient, prolonging second stage.
Sitting, leaning forward, with support

Kneeling over birth ball

Perineum cannot expand evenly Babys head presses directly on the perineum and risk of tearing increases.
Standing, leaning forward

Baby at birth in optimal condition when birth is active Less need for painkillers or interventions reduces risk of side effects. Mother feels proud, empowered and satisfied. Remaining upright for third stage Gravity assists separation and expulsion of the placenta and retraction of the uterus, reducing the need for Syntometrine. Fluids drain effectively from uterus, reducing risk of infection. Easy to position the baby well for first sucking. Latching on to breast stimulates uterus to contract and reduces blood loss.

Baby at birth may be compromised when birth is passive Greater need for painkillers or interventions with possible side effects.
Kneeling over chair seat

Lying down after birth Less efficient separation and expulsion of placenta. Slower retraction of the uterus may create need for Syntometrine to prevent excessive blood loss. Fluids tend to pool in the uterus, increasing risk of infection. More difficult to position baby well for breastfeeding.

The lunge (kneeling)

Kneeling, leaning on raised head of bed

Supported squat

Drawings by Shanna Dela Cruz, copyright Ruth Ancheta 1994 and 1999 from the Labor Progress Handbook, Blackwell Science, Oxford 2000. Recommended reading: New Active Birth by Janet Balaskas, Thorsons, London 1991.

A-Z of Natural Pain Relief

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

is for

Active Birth Breathing, Body awareness and Bath Cuddles and Cold Compress Dozing between contractions and Distraction Environment and Endorphins Freedom to do what you want Getting in tune with your body Honey and Hot water bottles Ice cubes and Imagery Judgement trusting your own and your midwifes Knowledge and Kisses Love and Laughter Massage, Movement and Music Noise and Natural sponges Opening and allowing baby to be born Positive thinking Quiet Relaxation and Rocking Support, Smiles and Shower Touch relaxation Understanding what is happening to you Variety of positions Water and Walking Xtra resources you have in labour Your own instinct ZZZZzzzzzz

Homeopathic Kit for Labour

Caroline Gaskin MCPH 020 7263 0767 carolinegaskin@blueyonder.co.uk One dose = one pillule. Where possible allow remedies to dissolve in a clean mouth. Try to familiarise yourself with the key features of the remedies. Labour is an intense experience, so respond to the physical and emotional changes as they happen and give the best indicated remedy immediately, rather than waiting to see if the state passes. If the remedy doesnt have any effect after 2 doses 5-10 minutes apart, try the next best indicated remedy. If a remedy works and then the symptoms return, just repeat the remedy for as long as needed. If two remedies are indicated then alternate them every 10 minutes Dont take two different remedies in the mouth at the same time.

Remedies for Early Labour

Arnica 200C Alternate hourly with Caulophyllum 200C to help establish labour.

Remedies for Labour

Arnica 200C Take regularly throughout labour to help the muscles function properly, and to reduce exhaustion and pain. Kali Phos 200C Alternate half hourly with Arnica during established labour to support the nervous system. Help to reduce exhaustion and keep your spirits up. Aconite 200C For fear, anxiety and restlessness. Chamomilla 200C For intense pain and irritability, feeling angry and doesnt want anyone to fuss. Demanding things and then rejecting them. Screaming with pain. Nux Vomica 200C Intense Pain, nausea, vomiting during labour. Gelsemium 200C Trembling, chilly (especially in her back). Nervous, feels better for peeing, voiding bowels. Use also if labour is slow and sluggish and she seems slow in her responses. Pulsatilla 200C - Weepy and Clingy. Contractions short, weak, stopping and starting. Can also be faint, nauseous, thirstless, backache, heated and wanting fresh air. Take one if third stage is slow to help speed delivery of placenta. Kali Carb 200C - Backache particularly if the baby is posterior. Nagging pain, irritable and chilly, especially after contractions. Headache during labour.

Caulophyllum 200C - Sharp, ineffective contractions in lower uterus, groin and thighs. Contractions that are slowing or stopping due to exhaustion. Cimicfuga 200C - Contractions in lower abdomen (like Caulophyllum) but pains moving from side to side. Feeling like she cant carry on. Cervix remains closed. Hypericum 200C - take for transferred pain during epidural, i.e. if shoulders hurt as lower back is numbed. Ipecac 200C - Nausea without relief from vomiting. Motherwort Tincture - 10 drops in a glass of water sipped whenever needed to distance from pain. I really recommend motherwort tincture in still or fizzy spring water to sip throughout labour totally underused these days but ab-fab. Labour Massage Oil Combine 6 drops each of Clary Sage, Geranium, Lavender and Marjoram in 30ml of organic oil and massage wherever it hurts or get Active Birth Organic Labour Massage Oil. Rescue Remedy 4 drops in water, sipped for calming the nerves and relieving panic. You can burn Lavender Essential Oil or add 4-6 drops to cold spring water in a plant mister to spray on if you are hot or put a few drops I hot water to use on a flannel to pat on where you want warmth (you can be both hot and cold in labour it can be a bit contrary!). Use warm flannels on the perineum to help encourage the skin to stretch in labour. Massage the perineum with cold pressed olive oil or wheat germ oil in the last 6-8 weeks of pregnancy (best after a warm bath). Massage inside and out.

Remedies for Third Stage

Secale 200C Take one at third stage to help deliver the placenta. Can be used alongside syntometrine. Dark, slow, fluid post-partum haemorrhage. Pulsatilla 200C Take one if third stage is slow to help speed delivery of placenta. Ipecac 200C Bright, red, gushing post-partum haemorrhage.

Remedies for Postnatal Healing

One Arnica 200C daily for 5 days and sitz baths in Active Birth Centre Healing Herbal Bath. Healing Herbal Bath is a blend of equal proportions of organic Calendula, St Johns Wort and Comfrey that you infuse with 2 crushed whole bulbs of garlic in 2 pints of boiling water (dont boil, just allow to steep for hour). Strain off herbs, etc, and use 1/8 of the brew in a clean washing up bowl of warm water. Sit in it for 20 minutes 3-4 ties daily for subsequent 2-3 days. Its superb, it just glues you back together. Or take one Arnica 200C daily, one Calendula 200C daily and one Hypericum 200C daily.