Natural Birth: It’s a Spiritual Affair

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Make sure to read the entire series!

It’s a question that crosses the minds of almost all mothers-to-be, natural birth or cesarean section. And it’s a questions with no definite answer. All mothers-to-be have the authority to make their own choice between natural birth or planned cesarean, unless, of course, some complication arises that makes a C-section a necessity. But for those for whom the choice remains within their power, Yaowaluk Rapeepattana, obstetrician and gynaecologist at Samitivej Hospital Women’s Center, shares some ideas as to why she thinks a natural birth should be the answer.

Natural Childbirth a Spiritual Affair

Why would you recommend natural birth over planned cesarean?

Because nature is better. There is a lot of published data that shows if a woman can succeed with natural birth we should not do a cesarean unnecessarily. Cesareans pose more complications for the mother than natural birth.

What about mothers who say they prefer a cesarean?

Of course we accept that some women request cesarean sections. We respect what they choose. It is my personal opinion that everyone has a right to choose what, where or with whom they want to give birth – as long as they have the correct information. But let’s go back to the history of the cesarean section. Cesareans first happened when we needed to save the baby’s life – when a natural birth wasn’t possible (such as abnormal position), or the baby was in danger (such as when the umbilical cord was wrapped around its neck), or an abnormal placenta location or low lying placenta. In those cases a cesarean section would save the baby’s life, or even the mother’s life.

Since then it seems that planned cesarean has become more popular. It’s a cultural thing. You believe, ‘yes respect the rights,’ but now you want to promote natural birth. Is that correct?

Yes. We want to do the best for families because cesarean sections have complications for mothers more often than natural birth – for example, infection and bleeding.

Yes, but what about soreness or pain? Is one method more painful than the other?

We cannot compare the pain. I always tell my patients, you cannot expect a cesarean section to be less painful than a natural birth. Of course, if you doubt it and decide to have a cesarean section, then you skip labour pain. You will have no labour pain, it’s true. But after the cesarean section you will have abdominal pain. Nobody can skip pain entirely. We have to accept that there are many types of pain in this world. We have to live with that pain. But it won’t last long. Every pain can be healed.

Does it make any difference to the baby if it’s natural birth or cesarean section?

With respect to how it affects the baby, there are thousands of publications with accepted data that show that a cesarean can decrease neo-natal mortality. Neo-natal mortality is mostly caused by hypoxia (oxygen deficiency). It is still about 5 per 1,000 newborn deliveries for natural birth. For cesarean sections it is less than 1 per thousand.

Looking for a doctor for your birth option questions? We recommend:
Yaowaluk RapeepattanaYaowaluk Rapeepattana, M.D.
Obstetrics – Gynecology, Samitivej Hospital
Questions about your pregnancy, child birth or life with an infant? Ask the Doctor!
Is there any impact on breast feeding if the mother has a cesarean or natural birth?

No, because if we give the baby to the mother right away and she starts breast feeding it will be the same. Breast feeding, or lactation, depends on how early you feed the baby and how frequently.

Is it possible to have a natural birth, if you’ve previously had a cesarean section?

Of course, I cannot guarantee 100%, but if you try natural birth after a cesarean section . . . the success rate is about 80%.

Do you have any comments on the advantages or disadvantages of water birth and natural birth?

Natural birth is almost the same as water birth, except with the latter you need to sit in a pool and the baby comes in the water. The mother needs to sit. She can neither lie on her back nor stand up.

What about the mother and father’s sex life after natural birth? Does natural birth cause dilation of the vagina or vulva?

Yes. We have to accept that the baby needs some space to come out. After natural, or vaginal, birth you need to do special exercises to keep your muscle as strong and as healthy as it used to be.

And the Woman’s Centre at Samitivej Hospital can advise on what kind of exercise to do?

Yes, we always do that. We also provide an antenatal class at Samitivej Sukhumvit Hospital. We’re committed to helping expecting and new parents prepare for pregnancy, childbirth, and early parenthood. Our programs are led by experienced childbirth educators.

During natural birth, are some women scared that they won’t have the strength to finish the delivery – that it’s too hard physically?

No, not really – as long as you prepare yourself well before delivery such as with exercise and rest and have healthy food and support. You need to believe in yourself – believe that you can do it.

You recommend exercise, diet and plenty of sleep – exercise for nine months or for how long?

From after the first trimester until delivery, and after delivery as well. But we don’t push the patient. We just want the best for the delivery. It is one of the most important experiences in our lives. We want our patients to be safe – safety comes first. And happy too. We want the parents to be happy, the baby to be happy, everyone to be happy.

What about the differences in the recovery time for planned cesarean sections versus natural birth? How long does it take mom to get back to normal?

It depends on how long the delivery was. If it’s not the first delivery, it can be very quick. Especially if after the first baby the perineum does not tear. There will be no wound, no scar. So they’ll feel very little pain.

Some moms may want to bring their nanny or midwife along with them. Are they allowed to do that?

I don’t mind. Everyone is welcome to the delivery room, as long as the mother is happy. Even the whole family can come.

The hospital allows anyone to come into the delivery room?

Yes – with the permission of the mother.

What advice would you give to fathers who want to join their wives in the delivery room?

First of all, I think the husband is the most important person. The mom needs someone she loves to be with her. I think that it is very important to have someone you love [with you], and for them to stay with you at that moment. To prepare you, support you, and help you be strong physically and mentally. The husband shouldn’t panic if their beloved wife screams or cries or moans. Just try to support her. But everyone is different. Some women may like to be quiet. Some of them just want to have everybody stay quiet, just be calm. But some may need some support. Everyone is different. That’s why we write down the mother’s wishes on the “birth plan paper,” so we will know what she wants – as long as it’s safe, we will follow it.

Tell us more about the birth plan paper.

The concept is about what the mom wants when she is in labour, for example the environment. Does she want the room to be light or dark? What kind of music would she like? Does she want to bring her own music? Does she want everyone to be quiet or try to talk to her? Everyone is different. Does she want someone to massage her? Or she may not want anyone to touch her. Does she want us to lead her, to tell her when to push? Or Does she want to push on her own? And what position Does she want to be in when she gives birth – sitting, standing, lying down, or squatting.

A lot of young women giving birth for the first time would like the hospital to advise them what to do.

Yes. I always tell them that labour pain is nothing to be afraid of. You can be happy, because during labour your brain will produce hormones like oxytocin which will make you feel happy and help you bond with your newborn baby. There’s nothing to fear. You can enjoy the ride. Labour pain is like a cramp in your tummy. It will come and go, come and go. At last it may come every few minutes before you give birth. But you know that if the pain comes, it will go and then come again. The pain will dilate your cervix and then your lovely baby will soon come out. It means you’re going to see your baby. In our lifetime many events or situations happen like this. Sometimes after it rains you see a beautiful cloud or sky. You need to imagine something strong and beautiful like your new born baby.

I’m sensing that having a baby is as much a spiritual and mental challenge as a physical one?

Yes. You should be happy to be a mother. Labour pain is a privilege for women only. You should enjoy that. It’s nothing to be afraid of. Or at least you can try. I don’t mean that we push you. If you cannot cope with the pain – because people’s pain thresholds are different – if you ask for a pain killer, it’s also available. At least you can try without first and see how it goes.

In your experience, the most successful natural births happen to what kind of mothers? Are they mostly spiritually strong people, happy people first and foremost?

The first thing is the attitude. There is greater success among mothers who have a strong desire to succeed with natural birth. I don’t blame anyone who asks for epidural block or pain killer, because sometimes it depends on the baby’s position or the size of the baby. If the size of the baby is too big or the position is not right it can be more painful than a smaller baby, or a baby in the right position. I never blame my patients, because there are many factors.

With a planned cesarean you know that you will have your baby in at, say, 8 o’clock on a Saturday morning. But with a natural birth, it can be anytime within a few days, within a week, so that uncertainty might cause women to choose a planned cesarean?

As long as the baby is strong and the mother is strong, then there is no limit on the time. Some research shows that too long labour may have some effect on the baby. But we can monitor that. Nowadays we have instruments to measure if the baby is at risk or not.

Samitivej, We Care!

Yaowaluk Rapeepattana, M.D.
Samitivej Sukhumvit Hospital

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181

Photo Credit: Nina Matthews Photography via Compfight cc

Samitivej Hospital

Samitivej Hospitals are world class international health care facilities located in Bangkok, Thailand.

Fully equipped with the state-of-the-art technologies, our innovative Women's Health Center at Samitivej Sukhumvit Hospital provides comprehensive gynecological and obstetrical service for women of all ages.

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