What is normal birth?

[carolinaw]

I’ve just read an article in the latest issue of ‘British Journal of Midwifery’ discussing women’s ideas about what is a ‘normal birth’ and whether these are the same as health professionals.

The WHO defines normal birth as “Spontaneous in onset, low risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position [i.e., head first, not breech], between 37 and 42 completed weeks of pregnancy. After birth, mother and infant are in good condition.”

The study only included 4 women, so I don’t really think any meaningful conclusions can be drawn about what they said, but what I found interesting was that it made me think about MY opinions about what is normal and what isn’t. What I think a ‘normal delivery’ means that the baby was born vaginally, without forceps or ventouse.
Any different ideas?

[Ca Plane Pour Moi]

One a hospital doesn't want you to have. (Says the cynical and jaded freebirther-to-be.)

[PumpkinZulu]

*MY* idea of a normal, natural birth is spontaneous labour, zero interventions during the labour (no drugs, no strapped on monitors, no internals), no forceps or assisted delivery, no episiotomy, delayed cord clamping and physiological third stage. That's *MY* standard and I get everyone has a different idea on what they consider normal or natural. By my views, I did not have a natural birth; I had a penthrox stick in the ambulance, one internal upon arrival at the hospital and dd's cord was clamped soon after her birth due to mec in her lungs, all with my permission/at my request.

[Cherished]

My idea of natural birth is no internals, no intervention need to turn baby, no intervention to induce labour, no equipment used to get bub out, no c-section, mother able to birth freely/move as she pleases so no monitering that would get in the way of that. Also delayed cord clamping (yet Lotus birth practices are way more natural again) . No drugs for mum to birth the palcenta, and absolutely no drugs/vaccination for bub even vit K. In my mind bub should go straight into mums arms for skin on skin and breastfeeding. And I'm very happy to say that I had all of the above and in the water to boot Oh and home birth is also way up there on the 'natural' list too. I was in a beautiful private hospital with amazing midwives and ob's who respected all of our decisions including letting us go to nearly 42 weeks (and beyond if I had of chosen that). Funny that you started this thread as just yesterday I commented on the 'natural' birth of that lady who gave birth to a very large baby. I wanted to know what their idea of natural was, I have a suspicion it was a vaginal birth not a natural birth.

[Novella]

I really like the idea of an 'optimal' birth!

I dont't know if I consider my DD's births as 'normal' becuase they were early but they were unassisted vaginal births. DD1 I had IV antibiotics and scalp monitoring due to prematurity and I had synto injection for delivering the placenta but no drugs, I dont know if this would be considered natural though. I enjoyed her birth but don't think it wasn't optimal but close to it

With DD2 she was earlier but I made an informed decision not to have antibiotics, I did have wireless CTG no pain relief and synto injection post as I tend to bleed. Hers was an optimal birth for me in our situation.

I think normal tends to reflect on how the majority of births are 'managed' and currently that is very different to what I would consider a 'natural' birth. I think the two most importnat things are the health of mother and baby and the families feelings towards their childs birth and that is different for everyone.

[Tegam]

Hmmm will need to ponder this for awhile first me thinks. ....

[Lenny]

carolinaw - if you are wishing to conduct research, there is a forum especially for this.

[Cherished]

carolinaw - if you are wishing to conduct research, there is a forum especially for this.

Yep and as you will see most bb members will be happy to give you their opinion while you are here you may also find that bb is a great community and if you have an interest in birthing etc you may find some great friends here along the way if you join in.

[HotI]

there are differences between normal and natural birth. what has become normal in our society is not natural.

[Ilithyia]

there are differences between normal and natural birth. what has become normal in our society is not natural.

Thats just about it.

A normal birth to me is a vaginal birth without the intervention of any kind - as the OP has asked about "normal birth" and not natural birth.

The normal births that I see are those that progress normally with decent and dilation progressing as it should.

Everything else is a variation of normal.

I think as time goes on and women become more educated and more active in their own health care, variations to normal become normal. Things like posterior labours, VBAC's, epidurals etc.

So I guess its hard to pinpoint normal birth. It really all depends on your HCP, your own beliefs, your place of birth and the beliefs of those supporting you.

As for the article, I'm suprised it was even published given the lack of participants.

[LuluHB]

I consider the births of both my girls as normal, but only DD2 was natural.

I was however completely in control the entire way through. No one did anything to me I didn't want or approve of, so despite the less than natural progress of DD1's birth, I was still happy. The only thing I still wonder on occasion is what would her birth be like if she hadn't been induced, but given my health circumstances that resulted in the induction I can live with the wonder.

I like the idea of optimal too. If I have a third "optimal" birth I'll be a very happy mummy.

[Jennifer13]

I think a normal birth is one where a mother is empowered and able to make decisions about what she would/wouldn't like to occur during her birth with the full knowledge of what each decision might bring about. A normal birth is one where the mother and baby's physical and emotional wellbeing take precedence. Only very, very few births if approached in a normal way would end up with an emergency outcome.

An abnormal birth is one where she is coerced, has information withheld from her (during pg and birth), is bullied, pressured to experience something that makes her uncomfortable, scared, or whatever situation she may find herself in that does not allow her to come to an informed and empowered choice. I also take this to mean information is not generally available in her culture (be it developed or developing!), so it may be superstition or medical in nature.

I do not think a normal birth needs to exclude medical assistance, just like helping someone who is sick doesn't mean the automatic inclusion or exclusion of medication, as well as natural remedies and helping your own body. But I think it's highly unlikely that most birth interventions are offered with the full knowledge of the mother as to all possible implications of those interventions. I don't think our culture is always conducive to having a birth that is not medical in any way.

[forshelby]

Yes! Optimal should be the way to describe it. I also had no grand plans for birth. I just wanted to be left alone. Due to the synto though, I had the monitors etc and was stuck on the bed. And we all know constant monitoring means the constant presence of a stranger. The MW on duty. There were many obstacles thrown in my path from the onset of labour. I don't feel I failed, but I do know in a moment of weakness., I dropped my guard and succumbed to their 'timeline'. I do remember feeling disheartened being told I was 'only' 5-6cm dialated after 12 hours of vicious contractions.

I would have been ok with the c/s without all the complications which arose as a result of the surgery. I'm still paying for it now.

I think I'm getting lost in my ramblings. My point is, we should have our own standards. What's ideal for one woman might be my worst nightmare. I don't understand all the judgement and smugness I see in conversations about birth. (not here, just in general) Maybe because of my particular experience, I'm more sensitive to that kind of thing. I think the fact that none of what happened to me was neccesary really is my issue. Neither of us were in danger. Until they intervened. How ironic. Even if I end up with another C/S, I think I can make peace with that, as long as my emotional wellbeing is protected, and I'm spared the agony of being mistreated by those I'm supposed to trust.

Rambling again. I hope I'm making sense.

[Floweryfields]

I like the word optimal too.

[HotI]

What is a normal birth?

What is a natural birth?

What is an optimal birth?

All 3 questions are asking different things, and the answers will be different to each question.

'Normal' is largely defined by culture and time. C sections or assisted vaginal birth are certainly 'normal' in Australia at this time.
e.g. it used to be accepted (i think in the 60s) that a birth lasting 48 hours was 'normal'. In the 70s, normal was redefined as a birth lasting up to 24 hours. Now, a labour over 12 hours is considered long and not 'normal'. (this last step was due to a Scottish dr at a very busy overcrowded hospital describing the 1cm dilation every hour rule to define normal).

And then there is 'normal physiological birth'...

I think 'natural birth' can be defined more concretely, but others may not agree. Not every woman wants a natural birth, even given the best circumstance not every woman will be able to safely achieve a natural birth.

Optimal birth is probably the most subjective term, what is optimal for me may not be optimal for you. What is optimal for the woman may not be optimal for society. What is optimal for me for this birth, may not be optimal for me next time.

[HotI]

Here is Abstract to the Article

Do women's ideas of 'normal' birth match those held by professionals? (439kb)
Alison Edwards, Jacky Conduit
British Journal of Midwifery 19(11): 720 - 728 (Nov 2011)

Aim: To explore the definitions of normal birth held by women who have not given birth, what influences that perspective, and compare it with those of health professionals. Background: Available evidence provides conflicting definitions of normal childbirth. The majority of available evidence encapsulates the views of the health professionals themselves or women who have experienced childbirth. Little evidence exists that reflects the views of women yet to experience childbirth.

Method: Six participants were identified via purposive sampling to undertake a small exploratory qualitative study utilizing semi-structured interviews and thematic analysis. Ethical approval was obtained.

Results: The definition of normal birth is individual and complex. The absence of complications and use of interventions influenced this definition, which in part agrees with health professionals' current definitions. Birth was perceived as a scary prospect; a view largely constructed from negative stories from friends and family.

Conclusions: The findings suggest that working within the confines of a definition of 'normal' childbirth is far from straightforward. It highlights a need to encourage women to view birth more positively. Expanding this research further would explore these issues in more detail, providing more conclusive evidence to support practice.

[PumpkinZulu]

there are differences between normal and natural birth. what has become normal in our society is not natural.

So very true!

[Cherished]

oh to true! my brain must have gone straight to natural as that is what should be normal to me normal is actually the very opposite. The birth of ds was actually abnormal! Normal today is monitoring, internals, induction and loads of intervention to 'get bub to do what they want' even induction to fit into time schedules. c-sections are normal, breach etc is normal, pumping newborn babies full of drugs and mothers for that matter for unnecessary things like birthing the placenta and vit K and Hep B, wtf?? Normal is everything that mainstream medicine does in their hospital system! Yeah.... Goodluck with that research carolinaw