Active birth in a Hospital Setting
The knowledge of how to give birth without outside intervention lies deep within each woman. Successful childbirth depends on an acceptance of the process.” Suzanne Arms 
Active birth means being able to give birth to your baby without any interventions. You can stay mobile and you can choose the position you want to give birth in. It is your homebirth away from home.
Sadly in South Africa today, with our terribly high levels of intervention and unacceptable Caesar rates, you can’t just enter a maternity unit and hope for the best. Our private hospitals in South Africa have certain routines and protocols that they follow once a mother is admitted to the hospital.
You will have to be very assertive in making your wishes clear beforehand and ensure that you are consulted every time they want to intervene with your birthing progress. If you are attended by a private obstretician, you will have to ensure that he is “active birth friendly” before you embark on you journey. Ask for stats, listen to the words they use. Remember, it is never to late to change your care provider.
We do have active birth units in South Africa. Please see our page on Birth Units. These units are much more conducive to active labour and most use midwives to conduct the care.
Interventions in hospital can be any of the following:
- Ask to dress in a hospital gown
- Restricted to one room only
- Not allowed to eat and drink when you want to
- Having intra-venous therapy
- Augmentation of labour by given you drugs to speed up contractions
- Induction of labour by giving you drugs to start labour
- Continuous foetal monitoring
- Pubic shaves
- Enema
- Restricted to the bed in a semi-supine position
- Epidural
- Pain medication that restricts your ability to move around (Analgesics, e.g. Pethidine)
- Not allowed to shower or have a bath
- Artificial rupture of membranes
- Being moved from room to another to give birth
- Episiotomy
- Forceps delivery of baby
- Vantouse or vacuum delivery of baby
- Give birth in semi-supine or lithotomy position (legs in strirrups)
Steps to make an active birth possible in a hospital setting:
- Decide early that this is what you want and stick with it
- Prepare your birth plan and discuss this with your doctor and midwife
- Visit the hospital before and discuss your birth plan with them
- Believe in yourself and your body’s ability to birth your baby -Trust yourself
- Read, read and read about active births as much as possible
- Prepare your body by eating healthy and exercising regularly
- Stay at home as long as possible before going to the hospital when your contractions start
- Hire a doula – she will assist you in ensuring that your wishes are carried out within reason and support you
- See you contractions as bringing your birth of your baby closer every time
- Try out all kinds of positions for labour
- Ignore people who ask you why you want an active natural birth
- Get support from your partner – he needs to be comfortable with your decisions and must be your voice when you are active in labour
- Only surround yourself with positive people who believe you can do it
- Know that you are strong
- Choose a supportive doctor
- Choose a facility that will allow you to birth naturally
- Learn about natural pain reliving method
- Insist in giving birth in the position you want to
- Consider a home birth