Women want familiar faces at childbirth

Women would feel more comfortable having their baby delivered by a person who has followed them throughout pregnancy, a conference organised by midwives heard yesterday.

A first-time mother who is expected to give birth in three weeks' time said although she went to her gynaecologist throughout pregnancy, she had no guarantee that the doctor would be there when she went into labour.

"I would have paid double to have the person who followed me throughout pregnancy be with me when I am giving birth," she said.

Another expectant mother, Maria Mifsud, who is seven months pregnant with her first child, also highlighted the importance of forging a relationship with the person who would be helping her during labour.

"I would love to have someone following me throughout pregnancy and who would come with me in the delivery room," she said, adding that there was not enough one-to-one contact with midwives.

According to midwife Ċensina Deschrijver, mothers felt much more comfortable when somebody they had met before was with them when they gave birth. She has seen the difference even when she had spoken to the expectant mother just once beforehand.

Ms Deschrijver said women who gave birth at home were more cooperative, highlighting the importance that mothers-to-be were made as comfortable as possible during labour.

"When they are calm, their body releases more endorphins and they can tackle contractions better," she said.

Speaking during the conference for mothers, Welsh consultant midwife Grace Thomas said it was imperative to allow nature to take its course and keep labour as normal as possible.

"This means not introducing any medical interventions unless they are absolutely necessary," she said.

She compared interventions to a line of dominos - when one falls, it brings all the others tumbling down.

"If you induce labour, which is very common in Malta and happens in one-third of births, it leads to further interventions. Normally, the mothers will need to have their water broken, a drip in the arm and oxytocin to help labour progress. This means that they will need to be monitored to ensure that the baby is ok, which will in turn mean that they have to lie in bed," she said.

Ms Thomas said being immobile makes pain management more difficult, many times leading to a woman needing an epidural, which in turn could stress the baby and make a forceps delivery or a Caesarean section necessary.

"Some women do need interventions and it is very important that they are available. But it is imperative to minimise interventions so that women have the chance to give birth normally," she said, adding that although birth was a normal process, Western countries had made it very medicalised, a concern that has long been raised by local midwives.

Sina Bugeja, the chief executive of the Foundation for Social Welfare Services, stressed that women had the right to information which could allow them to make an informed choice. They should also be able to have an active participation in decision-taking during labour.

Health Parliamentary Secretary Joe Cassar, who opened yesterday's conference, said there was nothing better than natural birth, even because women tended to recover quicker.

A midwife's tips for a better birth

Midwife Ċensina Deschrijver highlighted the importance of preparing for labour.

• Squatting during the last weeks of pregnancy and tilting forward when sitting down will help the baby's head move to the pelvic passage in preparation for birth. Daily exercises on all fours will help the heaviest part of the baby, his spine, move to the front, which is also very beneficial during childbirth.

• Between 80 and 90 per cent of women can have a natural birth but they need to prepare for it. Regular intercourse after the 37th week of pregnancy will lead to the production of two important chemicals - oxytocin and prostaglandin - that help a woman go into labour.

• In the final weeks of pregnancy it is important to walk every day and practise birthing positions.

• Drinking red raspberry tea and eating spicy foods could also help labour. There is debate about the use of castor oil, which might be beneficial but could also lead to diarrhoea.

• From 35 weeks onwards it is good to monitor the baby's kicks every day and go to hospital if the baby is not kicking as much as usual.

• Moving during labour also helps to reduce discomfort and will also help the baby's head move down the birth canal.

A mother's story

When Marika Pace Gauci was being wheeled into the delivery room to give birth to her first baby, she felt as if she was being taken to her death.

But immediately after she held Lukas Nicolo in her arms, she started looking forward to having another baby.

"I think it was a good experience because I was well prepared for the birth," she said.

But like every other expectant mother, Ms Pace Gauci had fears during her pregnancy. "My first thought was whether I would be a good mother. Then I started fearing that something would go wrong or that I would not cope," she said.

At one point the gynaecologist told her that she would need a Caesarean section since the baby was not in the right position. But with exercise, the baby turned and she had a natural birth.

She said while it was good to have a birth plan, mothers needed to be flexible and prepared for the unexpected. "You need to be determined but not hard-headed and always ask for an explanation on what is being done," she said.

She compared labour to a long flight of stairs, which gets more painful and more difficult the further it goes. "But in the end I met my son," she said.