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No induction in Baby Jesus' birth

Mary didn't have to plan how she would give birth.

Mary didn't have to plan how she would give birth.

Baby Jesus was lucky, you could say. Yes, he had to endure a long bumpy journey on a donkey while in his mother's womb and, yes, there was the teeny-weeny problem of not knowing where the birth would happen, but at least his mother did not spend an agonising nine months deciding on how she was going to give birth.

This is a recent phenomenon. It's now on the 'to decide' list once you discover that you're preggers. There is the choice of pain relief provided by medicinal science: epidural, gas and air, TENS machine, pethidine, the whole lot.

Plus there is a selection of alternative therapy activities: music, controlled breathing, acupuncture, reflexology, antenatal swimming, yoga classes, squatting and birth pools.

Admittedly, I was such a scaredy-cat when it came to childbirth - I had heard so many horror stories of labour and hysterical pain - that the first thing I did was practically beg my gynaecologist to plan (eight months before birth) a C-section. But I was lucky in that I had a good mentor in my gynaecologist. And in a kind, gentle manner, I was told to go home, forget about it, and just follow the signs of life.

But this is not what usually happens. A friend of mine, who was due on New Year's Day, was 'encouraged' by her gynaecologist to fix an earlier birth date by induction, 'so as not to clash with the festivities'. Another one was told in no uncertain terms that unless it's an induced birth, in a private hospital, he wouldn't be present.

Figures released last week as part of the comprehensive European Perinatal Health Report (EPHR), which compares data on maternal and infant health across Europe, reflect this birth-by-appointment attitude. The EPHR report shows that in 2004, Malta had the highest rate of labour inductions, at 37.9 per cent. This country also has the third highest rate of elective Caesarean deliveries carried out before labour starts.

The statistics suggest a light attitude on the part of the medical profession to this sort of surgery, and to the birth induction. Nobody, for example, tells you that induced births have a tendency to lead to furious, powerfully-lingering contractions - the howls of my next door neighbour at hospital still haunt me to this very day.

Sure, giving birth hurts like hell, but so does recovering from having your belly sliced open. Most pregnant women in Malta don't seem to inform themselves of the risks of both vaginal and Caesarean delivery. A C-section may ultimately be medically necessary, but no expectant mother should be encouraged to go for it breezily, as the risks are not slight.

Unfortunately, over the years it seems to me that several obstetricians seem to find it easier to fit an induced birth or a Caesarean section into their busy diaries than to be present at a long labour. And this means that clueless parents have to become more assertive. They have to forgo 'the doc knows best' approach when planning a birth and question everything beforehand to ensure that the gynaecologist is aware of their wishes. If he or she does not inspire trust, then pack up and look elsewhere.

Malta is small, and it's easy to find out by word of mouth which gynaecologists and midwives tend to be very qualified yet holistically soulful in their approach to the profession. It's important that this rapport is built before the mother goes into labour, otherwise it will feel too late to question your doc's or midwife's advice.

I do not exactly subscribe to the idea of giving birth in a field and then embracing everyone by the campfire. The thought of a rugby ball passing through the eye of a needle still gives me sweat beads to this day - despite the fact that I've been through it. But I do not think that a planned, induced birth, which smacks of a lifestyle choice (to preserve your figure, because you're too posh to push, to time the birth to fit in with other plans) is to be lauded.

Each birth is different. Natural deliveries tend to be painful, but if you suffer from terrible period pains, not exceptionally so. The moment is so dramatic, the emotions so extreme, that a woman should be encouraged to go for it if it is possible.

But, of course, everything has to go according to plan, and we know that doesn't always happen.

It's pointless chasing an ideal if it means putting a woman through hours of unnecessary pain and misery.

What's important is that the mother is not bullied into any decision. For the professional medical people, the interests of the mother and child have to be first and foremost. Their personal interests should never feature in the story. They must follow the lead of good old St Joseph.

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