Alice Charlwood, Active Birth teacher, Wiltshire.


ACTIVE BIRTH - MORE THAN A MATTER OF POSITION

Sound scientific evidence from trials confirms what common sense has long suggested - that having the freedom to be mobile and adopt physiological positions tends to shorten and facilitate normal labour and birth, and reduces the need for pain-relieving drugs and operative delivery.

Yet not many midwives are putting these findings into practice, and this is a crucial matter for the women in their care, who are themselves quite often unaware of the benefits of active birth because the modern medicalised media vision of birth is so deeply engrained in our culture.

Technology continues to dominate our birth practices in this country, but in spite of this (or perhaps because of it) Lye notice an increasing demand from mothers who want to understand better and develop the skills to cope with a natural, physiological birth. It is dawning on them that there is a world of difference between what they would consider a normal birth, and what passes for "normal" birth in many UK hospitals.

I will describe a number of the benefits and the relevance of our yoga for pregnancy classes, and how the ante-natal work of Active Birth teachers can

· promote good health and a greater sense of well-being during pregnancy
· improve women's strength and flexibility
· help them become familiar with a range of movements and positions for their greater ease and comfort in labour
· teach them how to relax and breathe so that it becomes second nature to do so whenever they are under stress
· encourage them to have more confidence in their bodies, and in their potential to give birth normally.

Week by week in our classes expectant mothers enjoy immersing themselves in a form of whole body "learning by doing" which is particularly relevant to the impending birth of a baby. All this is very empowering, in stark contrast to the loss of control that is inevitable in the mechanistic, active management model of intrapartum care. We want mothers to keep an open mind and be aware that medical interventions are sometimes necessary for some women and babies, but it is not acceptable that so many women find their wishes to avoid routine medical interventions "rapidly invalidated as soon as they enter the terrain of obstetric power" as researcher John Mason put it recently.

For the Active Birth approach really to work consistently involves more than constructive childbirth education and merely getting women off their backs. Not nearly enough attention is paid to the quality of the birth environment, although it is crucial for the unhindered release of oxytocin and endorphin; and because so much depends on how the midwives fulfil their role we are urgently in need of more "Active Midwifery". The change from passive patient to active birth-giver has proved to be profoundly empowering for more and more women over the past twenty years, but their professional support lags far behind. It seems clear that midwives will soon have lost the right to regard themselves as the guardians of normal birth unless they undergo a similarly significant change in what they do as practitioners, and in the way they do it.