Janet Balaskas - New Active Birth - A Concise Guide to Natural Childbirth

When we hand over responsibility for choosing between alternatives on the basis of what we believe to be right, we hand over responsibility for the quality of the society we, and our children, must live in.

Sheila Kitzinger

The concept of ‘active birth’ is a milestone in the history of childbirth. Bringing together these two simple words is by itself a work of genius: ‘active birth’ covers a huge scale of meanings, at different complementary levels.

The first level might be described as muscular. When you just have a glimpse of some pictures of ‘active births’ you notice that at the end of the labour, when the baby is coming, many mothers are vertical, hanging on to someone or something, or leaning forward on something, or in a supported squatting position, or kneeling …

At the second level you penetrate more deeply into the physiological process of childbirth. Childbirth is first a brain process. When a woman is giving birth by herself, the active part of her brain is the primitive part. It is this part which we have in common with all the mammals, the part which secretes the necessary hormones. A woman gives birth actively when she can secrete her own hormones, or, in other words, when she does not need synthetic hormones from a drip, or any other kind of medical intervention. The activity of the primitive part of the brain implies a reduction of inhibitions coming from the ‘new’ brain, the neocortex. The factors which can disturb this brain process, this change of conscious level, are not easily eliminated in the context of modern obstetric units: privacy, semi-darkness, silence, and, at the same time, the proximity of an experienced person.

At the third level ‘active birth’ refers to the attitude that society as a whole has towards childbirth. In our society childbirth is completely under the control and under the responsibility of medical institutions. Pregnant and labouring women are called ‘patients’. Medical institutions include modern midwifery. Modern midwives, trained in obstetric units, are not any longer mothers helping other mothers. When a newborn baby is not healthy, the medical institution is considered as responsible. The concept of ‘active birth’ has been introduced by women who want to take back the control and the responsibility of childbirth. They consider the medical institution as a resource to use in precise circumstances. What a provocative challenge at a time when the negative side effects of obstetrics are better and better known!

The day when Janet introduced the phrase ‘active birth’ is possibly the most important one in the history of childbirth in Europe … since the day when the French doctor Mauriceau took control of this event and placed the labouring woman on her back.

Michel Odent

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