Suzi Hume, Andrea Vincent & Aunouska Myers, 2011 Home Birth Conference

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The document discusses skills that women can use to reduce interventions during birth such as directed breathing, finding effective positions, and internal work like massaging. It suggests that using these skills can help women have more positive birth experiences with fewer interventions and complications. Statistics from 2000-2002 also show decreasing rates of epidurals and other pain medications as more women learn and apply these natural skills during labor and delivery.

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What did your mothers tell you about birth?

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New Zealand put in place a Midwifery Model of Care in 1990. Everything birth and midwifery advocates wanted has been the maternity system in New Zealand. What was hoped for: more natural births (or physiological births), more choice, informed consent, respect for pregnant women, continuity of care, a partnership model with primary care midwives, primary care midwives who continue care when secondary care is necessary ... great system. What could possible not work out? Simple ... the partnership model is weak and ineffective. The result ... a rise from 12.9% to 30% of caesareans since, more complaints against midwives and the unexpected ... women 'choosing' elective cesarean births and epidurals for pain relief. We can have a strong partnership in maternity care only if we grow a skilled birthing population. It's a wonderful idea to believe a woman should choose what she wants at her birth. It's a great idea to know what a woman wants from her birth provider. However, there is absolutely NO societal expectation that families bring a good set of skills to their birth. Why is this important? Birth choices are not always available. Choices often change. Choices have to be for 'saying no' to medical care and 'saying yes' to more medical care than necessary. Choices are varied and many so which ones are really important to a woman? It's great if women are informed and respected. Sometimes a woman is being respected but doesn't appreciate it. Some women are informed, make decisions that they regret months later. Very, very few women have the birth they 'want' or 'plan' but instead have the birth they have. We use terms like 'having a baby' or 'giving birth'. Instead we need to say 'you are going to 'do' your birth'. Doing your birth occurs over time. Skills are what you use to fill your time of doing your birth. Skills are what you do to cope with both the internal and external sensations or situation. Andrea talks about how she strengthened her partnership with her general population clients. Clients know they will create a Birth Plan about what they 'want' and what they 'expect' of her as a birth provider. Clients are expected to learn birth and coaching skills and use them.

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Every expectant mother or father-to-be wants a POSITIVE BIRTH. Unfortunately there has become such a division in the childbirth conversation that only one type of birth is considered to be positive ... natural home birth. Yeeks ... a hospital birth can't been seen of as a positive much less an elective surgical birth. Good heavens what are we doing to our society when so many families are left out of truly feeling their baby's birth is honored, respected and valued? This has to stop. The hundreds of Birthing Better Pink Kit families who developed The Pink Kit skills in the early 1970s all wanted a positive birth and they all achieved that. This is not rocket science. How did all these families and tens of thousands afterwards do the same thing? Simple. They learned skills to prepare their pregnant body to become a birthing body. This is fun to do, enjoyable, part of becoming a mother and father, a commitment to our baby and a good idea. Then these families learned, practiced and USED their birth and coaching skills to work through their baby's birth no matter how that birth unfolded. That's right. To achieve a positive birth all it takes is to use skills to work through your baby's birth journey. Who knows what will happen to or around you during the birth but with skills you can always achieve a positive birth because you are a skilled birthing mother and coaching dad.

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Pain relief in labor is complex and often challenging. Effective management of labor pain plays a relatively major role in a woman's satisfaction with childbirth. Labor contractions usually cause discomfort or a dull ache in the back and lower abdomen, along with pressure in the pelvis. Contractions move in a wave-like motion from the top of the uterus to the bottom. Some women describe contractions as strong menstrual cramps. support measure during childbirth Reduction of fear and anxiety by providing information and support. Facilitation of appropriate rest, sleep and for ambulation. Provision of a labor companion. If you are an expectant mother, you should talk with your obstetrician and your anesthesiologist to develop a plan on Pain management during labor and delivery that ensures the safest possible pregnancy, childbirth, and recovery.

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INTRODUCTION Even though delivery is a natural phenomenon, it has been demonstrated that the accompanying pain is considered severe or extreme in more than half of cases. Besides conventional approaches, such as epidural analgesia, many complementary or alternative methods have been reported to reduce pain during labor and delivery. (1).These methods are popular because they emphasize the individual personality, and the interaction between mind, body and environment (2). They are attractive to people who want to be more involved in their own care and feel that such therapies are more in harmony with their personal philosophies. The conventional medical community usually offers traditional choices of analgesia, such as epidural and intravenous drugs. Patients may have access to alternative methods, but will generally be obliged to do the relevant research themselves beforehand. Those seeking alternatives are not necessarily dissatisfied with conventional medicine, but attempt to supplement rather than replace traditional care. Quite often, users of complementary medicine do not inform the practitioners in charge of their pregnancy and delivery. There are also different expectations for the management of pain during labor according to the category of professionals. Physicians are expected to provide pharmacological therapy, whereas midwives, nurses and other auxiliaries are required to assist patients with psychological methods, and in fact use alternative approaches more often. The theoretical bases for many alternative methods derive from Eastern tradition or philosophy. ALTERNATIVE THERAPIES Alternative therapies are used instead of conventional or mainstream therapies for examples, the use of acupuncture/acupressure rather than analgesics to relieve pain. COMPLEMENTARY THERAPIES Complementary therapies are those used in conjunction with conventional therapies for example meditation used as an adjunct to analgesics drugs. Nature of Pain During Labor and Delivery A scientific definition of pain is ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage . Acute pain such as labor pain has two dimensions: a sensory or physical dimension, with the transmission of information, the pain stimuli, to the brain, and an affective dimension due to interpretation of these stimuli through the interaction of a wide variety of emotional, social, cultural and cognitive variables unique to the individual. Components of pain For the management of pain, conventional medicine focuses more on the physical side, while alternative methods deal mainly with emotional considerations. In the laboring patient, the two stages of labor correspond to different types of pain and routes of transmission. During dilatation (first stage), visceral pain predominates, due to mechanical distention of the ce

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