Why NVD is best for baby… (Part 1)

“There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong.” ~ Laura Stavoe Harm

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At about 28weeks gestation our gynecologist completed a slip of paper for us to register at the hospital. What seems like an inconsequential tick on paper can actually be a nightmare-type-decision to make. We had to specify whether I would like to deliver my baby via Normal Vaginal Delivery (NVD) or Caesarian Section (C-section).

I have lived through many very traumatic births during my student and intern-years. I treated multiple babies that barely survived (or did not) the complications of NVD during my pediatric residency years, so this decision was not as easy as I had initially thought.  I knew that a NVD is the best for baby.  I had to make a mind-shift about what the birth of a baby could be like, should be like, and keep my fears trampled underneath the grace and love of God.

“Nothing in life is to be feared; it is only to be understood. Now is the time to understand more so that we may fear less.” – Marie Curie

In South Africa we have one of the highest C-section rates in the world! Nearly 70% of babies are born via C-section. In comparison about 30% of women in the UK and the US have C-sections. I find it so sad! Have we started to make decisions only based on our own comfort?

Before and during my pregnancy journey I had the privilege of talking to multiple strong, passionate women about childbirth. My decision was made: I was so excited to birth this baby the “natural” way. When faced with any mountain in my life I have always stayed positive and motivated by thinking “if others could do this, so can I”. And with childbirth, literally millions of women have done it before me! During my pregnancy I attended ante-natal classes, read books and prayed, and I was SO excited to see how strong my body could be. To live through the pain and be the WOMAN God made me. I had confidence in my body and was ready to embrace this experience.

While studying the physiology of the baby changing from a totally dependent fetus into a self-sufficient baby I realised once again that NVD is the best for baby. I would like to share a few facts with you, get ready to be amazed at how perfect every detail was created to be!

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  • As your pregnancy approaches term, there are many changes in the baby to prepare for survival outside the uterus. This is why it is so traumatic for a baby to be born prematurely. Their brain, heart, lungs, gut and skin are just not ready. It does not mean they cannot survive (I have seen many very tiny preemies who are warriors and who live against all the odds), it is just a much more bumpy road for them and their parents. It is thus vital that you are very certain about your gestation (you do not want to get an induction or c/section too early).
  • A few days before you go into labour a beautiful dance of hormones start that is vital for you and your baby both during labour and in the first few days of baby’s life.  One specific hormone (prostaglandin) prepares the cervix for opening, but will also ensure that the main “shortcut” that the blood was taking between the heart and lungs in-utero will close once baby is born. (Your baby does not use his lungs in-utero as he gets all his oxygen from you, and the blood thus bypasses the lungs through the “Ductus Arteriosus”. It is important that it closes after birth so that more blood will flow through the lungs to collect oxygen).
  • A few hours before labour starts, the Cortisol (stress hormone) levels of the baby increases. In-utero your baby’s lungs are full of fluid (this is important for the stretching and development of the lungs) that is produced and secreted by the lining of the alveoli (the small balloons in the lungs). When Cortisol increases, this production decreases, and the lining actually starts to re-absorb some of the fluid. The baby will also start to exhale some of the fluid. As the baby moves through the birth canal, even more fluid is expelled out of the airways due to the pressure on the chest. The lungs are thus already much drier, which makes it easier for baby to take his first breath! 1
  • Cortisol also helps the liver to produce Glycogen which helps to mobilize glucose during the first days when baby does not feed well yet. The thyroid hormones are activated by Cortisol, which in turn helps to keep your baby warm outside of the womb.2
  • One of the latest buzz words is the “microbiome”, the organisms that live on your skin and in your gut that has recently been found to play a big part in allergies, immunological diseases, obesity, diabetes and cardiac diseases. Your microbiome is formed from birth and how you are born plays a big role. The first organisms to inhabit you can either be the good flora from mom’s birth canal, or the hospital bugs from the theatre surroundings.  The infant’s microbiome is also influenced by antibiotics and formula feeding, all of which your baby has a higher risk for after a C-Section. 3 (I will tell you more about the microbiome in a future post.)
  • Once baby is born via NVD he can be put directly on your chest where he feels safe, stays warm and can look you directly in the eyes. The bonding / breastfeeding can start without any interruptions, and this makes the rest of the journey so much easier.

 

How amazingly did God design us? We really are fearfully and wonderfully made! However, with all of that said, we live in an imperfect world where things go wrong and many moms and babies have died over the centuries during childbirth. So yes, there is definitely a place for Caesarean Sections. It could be planned due to mommy- or baby-issues, or it could be an emergency surgery if things go wrong during labour. If you have to have a C-Section you can still give many of the benefits to your baby by waiting until you go into labour spontaneously.

I hope I could help you with the big decision… it is so important to make a fully informed decision, and not to be pressured into an option because of the comfort of the doctor, or the opinions of your friends, or because of ungrounded fears. You are a woman, your body was built to do this! And if things go wrong, thank goodness for the evolution of medicine to help us!

In my next post I will tell you all about my own birth experience, because we do not always get exactly what we want!

“The birth of a child is the ultimate perfection of human love.” ~Dr. Grantly Dick-Read, 1953

 

* Photo by Desi McCarthy Photographic art

References

  1. Wyllie,J; Applied physiology of newborn resuscitation; Current Paediatrics Volume 16, Issue 6; Nov 2006; 379-385
  2. Liggins GC; The role of cortisol in preparing the fetus for birth. Reprod Fertil Dev.1994;6(2):141-50.
  3. Noel T et al; The infant microbiome development: mom matters; Trends in Molecular Medicine; Volume 21; Issue 2; Febr 2015; 109-117

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