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Natural birth: it’s a spiritual affair

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It’s a question that crosses the minds of almost all mothers – to – be: natural birth or cesarean section? And it’s a question with no definite answer. All mothers – to -be have the authority to make the choice between natural birth and a planned cesarean, unless, of course, some complication arises that makes a C-section a necessity. But for those who are in control of making this choice, Yaowaluk Rapeepattana, obstetrician and gynecologist at Samitivej Hospital Women’s Center, shares some ideas as to why she thinks a natural birth should be the answer.

Why would you recommend natural birth over planned cesarean?

Because nature is better. There is a lot published data that shows if a woman can succeed with natural birth we should not perform an unnecessary cesarean. 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 because of abnormal positioning or the baby was in danger, such as when the umbilical cord was wrapped around its neck — or an abnormal placenta location or a 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. Though you believe in a woman’s right to choose, you believe natural birth is the best course of action. Is that correct?

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

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

We cannot compare the pain. I always tell my patients, you cannot just expect that a cesarean section to be less painful than a natural birth pain. Of course, if you doubt it and decide to have a cesarean section, then you skip labor pain. You will have no labor pain, it’s true. But after the cesarean section you will have a painful abdomen. Nobody can skip some pain. We have to accept that there are many pains in this world. We have to go 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?

For the baby there are thousands of publications with accepted data that show a cesarean can decrease neo-natal mortality. Neo-natal mortality is mostly caused by hypoxia (oxygen deficiency) among new born babies. It is still about 5 per 1,000 new born deliveries for natural birth. For cesarean sections it is less than 0.1 per cent.

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 start breast feeding it will be the same, because 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 had a cesarean section previously?

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 is birthed in water. The mother needs to sit. She cannot lie on her back or stand up either.

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 birth — or vaginal birth — you need to do special exercise to keep your muscle strong and healthy as it used to be.

And the Woman’s Centre here 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 don’t have the strength to finish the delivery – that it’s too hard physically?

No, not really – if you prepare yourself well such as with exercise, which is very important before delivery. And get rest and have healthy food and support. You need to believe in yourself 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 happiness too. We want the parents to be happy and the baby 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 advise 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 they love to be there supporting them. I think that it is very important to have someone you love [with you] to prepare you, support you and to 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 on the birth plan paper, so we will know what you want – as long as it’s safe, we will follow it.


Samitivej Pregnancy Care

Photo Credit: jmayer1129 via Compfight cc

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Yaowaluk Rapeepattana, M.D. Summary: Obstetrics And Gynaecology Obstetrics And Gynaecology