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Psicología prenatal y perinatal

The right to a natural birth

By Elisabeth Schaupp

 The birth of a new life should be the culmination of a process, already begun during pregnancy, of intimate and intense communication between mother and child, where the physical, emotional and energetic dialogue between the two allows the birth to develop in a natural way, without biochemical or mechanical interventions hindering and debilitating this singular contact.
 
All of the emotions, experiences and events surrounding birth, the quality of the welcoming of the baby, the first contact with the skin, smell and gaze of the mother and also of the father, the beginning of breastfeeding… are experiences that leave a deep imprint on the newborn and determine, to a great extent, the child’s perception of him/herself and his/her way of interacting with the world. If the birth occurs in a natural way, in an environment sensitive to the emotional and physical needs of the baby and his/her mother, it is quite probable that the newborn will feel welcome, loved and cared for and that his/her first perception of the world will be that of a warm and friendly place. A traumatic birth, on the contrary, will result in the child feeling endangered, attacked, and that his/her needs had not been taken into account. In this case, it may be that his/her first impression of the world is that of a hostile and threatening place.

The birth experience also has consequences for the parents, in that when a birth is a distressing and frustrating experience, parents may have difficulties in establishing strong and deep bonds of affection with their child. This may translate into maternal lactation failure or difficulty in accepting the child’s crying, which is the way in which a baby expresses him/herself emotionally.
 
The natural process of childbirth is interrupted and problems emerge when the contact and dialogue between mother and child breaks down or weakens. The principal factors that can provoke this situation are a cold, depersonalized hospital environment, not at all empathetic with the needs of the mother, an inadequate use of obstetric technology and, what is for us the most important factor, the unresolved emotional conflicts of the mother, which impede her from confidently surrendering herself to this experience and from using all of her natural and instinctive capacities to collaborate with her son/daughter during his/her birth.

Given that this natural process can be obstructed with relative ease, because of the vulnerable situation in which the mother and child find themselves, it is necessary to take into account and attend to all those aspects that may be a hindrance to its correct evolution.

We defend the parents’ need to receive all necessary information about the progress of the birth, which in turn will allow them to manifest their disagreement with certain procedures and make specific demands as to the way in which they desire their child be born. For this, it is fundamental that health-care infrastructures begin to adapt themselves to the needs of the parturient and not the opposite and allow her, among other things, freedom of movement and the ability to choose the most adequate position for her during dilation and when giving birth.

We are in total disagreement with the generalized and indiscriminate use of anesthetics such as epidural anesthesia or the application of oxytocin, because they impede or hamper the mother’s ability to collaborate actively in the birth of her child. In this situation, the mother needs to remain fully conscious of her body, of what she is feeling, and be receptive to the manifestations and responses of her baby. Her physiological rhythms must be respected at all times, as well as her particular rate of evolution within the birth process. In the same way, we consider that the use of traumatic techniques such as the rupturing of membranes, cesarean sections, forceps, and suction pads should only be applied when absolutely necessary. The objective should be for technology to always be at the service of the child and his/her mother, of their well-being and somatic-emotional balance, and not of the medical institutions, which, all too often, give priority to the interests of health professionals or make decisions based more on economic considerations. We consider it necessary to continue to define, with ever-greater clarity, in which cases it is essential to make use of obstetric technology and when to let the mother go through the process in a natural way, but with all of the support that is necessary.

We all know that our emotional conflicts such as fear, rage, and anguish, and our insecurities cause us great difficulties in our relationships with friends, family, and co-workers, or in the enjoyment of our sexuality. However, we must be conscious that they also cause us problems in maintaining a good relationship with the child we gestated and who we have to help to be born. We consider that, during childbirth, when the baby passes through the vaginal canal, a very intense and intimate contact is produced, in which the bodies of mother and baby have to adapt to each other and synchronize their rhythms, the body of  the child literally penetrating his/her mother and both of them able to experience great pleasure. Clinical experience has confirmed that, on many occasions, when the mother has problems accepting and surrendering to this type of contact, complications occur during the dilation phase and/or during birth.

Starting during pregnancy, the mother should receive the necessary psychological attention that enables her to become conscious of those feelings and emotions that may hinder the establishment of the affective bond with the child growing inside of her. To the greatest possible degree, all of the circumstances that provoke high levels of stress or anxiety in the mother should be processed: the possible rejection, albeit unconscious, of becoming pregnant; the possible disappointment when the sex of the baby is not the desired one; the anguish of having lost a baby in a previous pregnancy; economic problems; the fear of not being able to endure labor pains; possible problems with her partner or difficulties in combining the pregnancy and birth of the child with her professional plans, etc...
 
If we want to help the mother to maintain contact with her baby during birth, in spite of the difficulties that may arise, we have to insure that the space where the birth is going to occur is a comfortable place that allows for privacy, intimacy, peacefulness and protection. During the entire process of childbirth, the mother should be accompanied by people she trusts, with whom she can share everything she is going through and feeling and with whom she can lean on emotionally in the most complicated moments. The mother should establish, starting during pregnancy, a relation built on trust and confidence with the health professionals who will be assisting her during the birth. Otherwise, she will quite probably block her expression of emotions. The mother should be able to express fear and pain, or other emotions, freely, without fear of feeling judged or reproached. This can help her to open herself, physically and mentally, to this experience, helping to make the birth of her son/daughter a positive experience.

Childbirth is a situation in which both the mother and her child find themselves extremely vulnerable and sensitive to everything that is occurring and to any lack of the contact, support and empathy that they need both physically and emotionally. Given the transcendence of all of the experiences that comprise childbirth for our later view of life, we consider it essential and obligatory, to provide optimum conditions to facilitate and ensure that the contact between mother and baby continues without interruption during the whole birth process, in an attitude of profound respect for the beginning of life.