As you may have read in our previous article, “FWH Maternity Support - More Than A Medical Service”, birth with us means birth with options. But how do those options line up with international recommendations?
According to The American College of Obstetricians and Gynecologists, a labor support team should“help women meet their goals for labor and birth”. They also suggest that this is achieved “by using techniques that are associated with minimal interventions”.
So what does this mean? And how does FWH support this? Here are a few FAQs from Dr. Michelle Lu-Ferguson:
FWH encourages laboring out of bed.
During normal labors, we suggest intermittent fetal monitoring over continuous fetal monitoring, and encourage this monitoring to be performed in the position most comfortable for you. We recommend moving, walking, and the use of birth balls, only staying on the bed when necessary.
FWH encourages a range of medical and non-medical pain relief options.
We support hypnotherapy, TENS, water submersion, massage, heat packs, etc., as well as more ‘medicalized’ methods of pain relief (e.g. epidural). However, heavy epidural use during delivery may reduce the urge to push and extend pushing times, possibly putting further stress on your baby and pelvic floor. The FWH Labor Team strive to find the better pain relief option that suits you and your situation well. This will constantly be reassessed during your baby’s birth.
FWH encourages drinking and eating light foods during labor.
We recognize that childbirth is a normal process, and that you should not be denied the sustenance you body needs during this process. IV hydration is not routinely given to the women in our care: You may drink to stay hydrated without an IV restricting your movements.
FWH encourages pushing in any position.
We have assisted women to deliver their babies on the bed, in the water, on a squatting stool, and on all fours. If you are comfortable and your baby is ok, we are happy to support you in whatever feels best to you. Surprisingly, many women find that it is not just one position or pushing technique that works best, but rather a range of positions are needed as the baby works its way through the pelvis. Our Labor Team (doctors, midwives and doulas) are thinking about this constantly as they suggest the best positions to guide you, and ultimately listening to what feels best for you, even if it’s not what you originally envisioned.
FWH is supportive of a range of breathing techniques during the pushing stage.
We encourage you to stay oxygenated, and if holding your breath, only to hold for as long as you feel comfortable. We are also supportive of non-breath-holding pushing techniques (‘breathing the baby down’), although we recognize that this may be harder to achieve effectively if you have had an epidural. We’re happy to help you find the method that works best in your own unique circumstances.
FWH advocates for intact perineum.
We strongly disagree with the use of routine episiotomy, and in fact our episiotomy rate is 2.3% of all vaginal deliveries (In 2016 and 2017, it was less than 1%). In addition to this, we strive for little (if any) perineal tear and actively employ techniques to achieve this outcome. Not one woman in our care has experienced a major (3rd or 4th degree) tear.
FWH advocates against frequent use of vacuum or forceps deliveries.
These procedures are useful to achieve delivery under complicated circumstances, but they also carry risks to your baby and your pelvic floor recovery time. We try all other options first, and aim to continue to keep our vacuum delivery rate within the recommended limit (less than 3.3% of all deliveries), and ensure a smoother delivery and faster recovery for you.
FWH avoids stringent time frames as much as possible.
We recognize that every woman progresses at her own pace in the early phase of labor, and in the absence of any complications, we will not push you to progress at a certain rate during this phase. This is reflected in the fact that we have not had a single c-section due to “failure to progress” (2017).
FWH Labor Team’s opinion is that most women just need time and support to deliver their babies in the way that they feel best. We are equally concerned with your safety and that of your baby, and so, while you may not be aware of it, our decisions can be influenced by many factors. There are cases when we need to speed things up, intervene or perform c-section and are considered to be a last resort (See our statistics below). As always, our team is happy to discuss this with you, at each and every step of the way, and the point of ‘informed choice’ is that you have the final say in your treatment.