Ep. 20: Let's Learn About Physiologic Birth

Natural birth, unmedicated birth, physiologic birth....what does it all even mean? And more specifically, what does it mean for me? 

I believe physiologic birth is the closest thing we have to God's design for childbirth, so join me as we dive in to this topic and learn what it could look like to give birth in this way, as well as why you would even want to! 

Thanks for listening!

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Want to learn more or take my in-person course? Reach out at allisonsroose@gmail.com

Let’s build a foundation that lasts - for you, your future babies, and generations to come.

Transcript

SPEAKER_01 0:01

Welcome to Foundations for the Childbearing Years with Alison Roos, the podcast equipping married couples with empowering biblical and practical guidance for preconception, pregnancy, childbirth, and postpartum. I believe this is a transformative season of life, and the best time to prepare for it is long before you ever see those two pink lines. Think of this like premarital counseling, but for your childbearing journey. If you want to step into parenthood with wisdom, clarity, and Christ at the center, you're in the right place. Let's jump in.

SPEAKER_00 0:33

Okay, hey everybody. Today I am going to be talking about physiologic birth. Um, maybe you've heard of that before, maybe you haven't. Uh so I'm gonna start off just with some definitions and then get into why I want to talk about this and what it is. Okay, so just the word physiologic, I looked that up just by itself, not just not the birth part, but physiologic relates to the normal healthy functions of a living organism and its bodily parts. It describes how the body works in a state of health, contrasting directly with pathologic, which pertains to disease. So I thought that was helpful. Um, because you're not gonna hear that in like the definition of physiologic birth, but that even that alone, I'm like, that's so helpful for me. I'm like physiologic birth is when birth happens from our body being in a state of health, not it being treated as a disease, which is the exact opposite of how the system, the maternity care system in America and in lots of other countries approach birth. Um and before I get into this even more, I just want to give my classic caveat and just say that I'm not talking about physiologic birth because I think it is the gold standard, and that if you don't have a physiologic birth, then you are a failure. Uh, that you have not done it correctly. That is just absolutely untrue, and uh all birth is beautiful. I just think that if you're going to give birth, you ought to know what was the original design of God, or the closest thing we can get to on this side of the fall of man. And I think that physiologic birth is that. It is um, you know, we don't know what birth would have looked like in the Garden of Eden. Nobody gave birth before sin came into the world. So, but now this is what we this is what we have as like this is how God designed birth. And um I think that if you're gonna give birth, yeah, you should you should know this is like the baseline. This is and the the sad part about this is that when you go to school to become an OBGYN, uh unless you intentionally seek it out, or you come across a unicorn mom who, you know, has this type of a birth or something close to it in a hospital, you have very, very likely never seen a physiologic birth. Um, and you're supposed to be the experts on birth that women are going to to say, help me have this baby, help me bring this baby into the world. Um, and I think that is just honestly criminal. I'm like, how can we be entrusting our care to these people that have never seen birth as it was intended? Like they've only seen it treated as pathology, as disease, as something to manage. And honestly, I am going off on a tangent right now, so let me just rein it back in. I could I would get real fired up about this. Um so that's why I'm talking about this because I think it's important um that we know what it is. I think we we should we should know how birth can work. Of course, again, it doesn't always work, even if you leave it alone. So I get that. Um, but I just think that many people don't even know that this is a possibility of the type of birth that you could experience. Um, so if I had to define physiologic birth in my own words, and then I'll give you like an internet definition, but what I would say is a birth that is left entirely alone to unfold as it was designed to by God, all the way from late pregnancy when you're waiting to go into labor through early postpartum and initiating breastfeeding and all of that. It's not a very succinct definition, sorry. But then the definition you'll find on the interwebs is this. I kind of like took this from a few different places, but and put it all together. A birth where the baby is birthed vaginally following a labor which has not been modified by medical interventions. And then some definitions go on to include like keeping baby's cord attached in the early postpartum window as well. That's like part of physiologic birth. I also wanted to point out that physiologic birth is different from the term natural birth or even an unmedicated birth. Um and I don't I think people I think when people say natural birth, it's all semantics, honestly. But I think when people use that online, typically they're meaning like an unmedicated vaginal birth. Um, but that doesn't mean that it's necessarily physiologic, because if you intervene in any way with the process, you're kind of veering off of physiologic birth. Because really, if you intervene in any way, you actually have no idea what could or would have happened if you would have left it alone. For example, um, even if you're you know not in the hospital, but you are past your due date, you're 41 weeks, and you are just done, you're over it, and so you decide to take castor oil um to you know basically naturally induce labor. Um, you have now intervened in the process of physiologic birth because you have not left your body alone and your baby alone to do what they would do without being like hurried along, basically. Um, so again, I'm not judging any of these choices, I'm just trying to explain like how um even something like that is like an inter a medical intervention, even though it's not like you know, you had an epidural or you um, you know, had a C-section or something. Those are there's like a there's a spectrum of interventions. And I've actually heard it said that the first intervention in physiologic, a physiologic birthing process is simply leaving your home. Um, because it it's just the first step in interfering with your body's natural rhythm. So you if you go into labor on your own, of course, there could be things before that that you've already interfered with. But let's just say you've you've just waited, you've gone until your water broke in the night, and then you started having contractions the next day, and so you're in labor at home. Then you decide, okay, it's time to get in my car and drive to the birth center, the hospital, the Airbnb where I'm giving birth, whatever. Um, you have now intervened in the process because our bodies and our babies and our hormones, the design um is that we need a safe um private uh space to allow all of the hormones and pieces of labor to unfold naturally when we go into a place with really bright lights and people that we don't know, or um honestly, even just getting in a car, like it's just so unnatural to the process. I've never heard a woman who was like, Man, I really just had an amazing time, an amazing time riding in my car. The contractions were no problem in those positions. You just don't hear that. And I like to think about animals, like even like a deer or even like a cat, you know, like a cat when they're having their kittens, they like want to be in the back of the coat closet, like or in the laundry room alone. Like if and if you if if uh or going back to the deer example, if a deer is disturbed, like if they feel danger, if they sense that there is a predator around, their body will stop the labor process, like their hormones will shut it down because it's like this is not a good space, this is not a good time, we're gonna do this later. Um, and that obviously we're not animals. I I'm not equ you know, equating us to animal animals, but I think it's just interesting to observe birth in nature because that is where we can see it most obviously left alone. Um so I guess cats aren't even the best example unless it's a stray. But yeah, like a deer in in the woods is like looking for a dark, cozy, safe place to give birth without anybody there. She doesn't need help, she doesn't need anyone to help get her placenta out. She does in, you know, of course, and sometimes it goes badly. And I'm sure that mama deers die in childbirth, you know. So it's again, it's not that physiologic birth is if you do that, then you will have the most amazing outcomes. Um, because it's just birth is uh uh unpredictable in nature as well as you know with us um as humans, and so uh yeah, just thinking about that. Thinking about okay, what are all the ways that I could put out potentially intervene in my labor and birth, and how can we like minimize those as much as possible if physiologic birth is something that you are interested in. Obviously, achieving something like this, a physiologic birth, a totally left alone labor and birth, is very difficult, if if not honestly impossible, I would say, to achieve in today's modern world. I think even at a home birth, it's difficult. Um because you're still going to have like one of the things that feels really difficult for me with all of my home births is knowing when to call my midwife to come. And to me, that feels a little bit like an intervention because I'm having to use my logical brain. I have to like, because when you're in labor, your brain is is going out of the logical side. You're like that part is like shutting down, you're trying to get into this very primal state where um I forget what it's called, honestly. Someone who knows more about like your nervous system and brain science could explain this a lot better. But you kind of go into this other world almost, it feels like, when you're really in the thick of labor, where you you shouldn't you shouldn't need to be like making decisions or you know, thinking about uh any kind of logistics, you know. And so this is a logistical thing that sometimes can like really get mess with me. And I remember this last birth specifically. I like had my midwife come before I was like really, really ready because I knew like I don't want to be thinking about that when I get deep into active labor. Like I don't want to have to be stressed about should she come? Is it time? I don't know. Um, and the same thing goes for I know people feel that way about just like when should I leave to go to the hospital? You know, it's like kind of the same, it's it's the same like interruption that you experience. It's just one is different, it's for a home birth, so you're saying, when should I invite my birth team to come? And one is like, when should I go to my birthplace? Um, and so honestly, I think that the most ideal setting for truly a physical physi, excuse me, physiologic birth, uh, where it's totally left alone is a free birth, which if you don't know what that is, it's just giving birth by yourself with your family in your home, like no one else is there, you don't invite any help or whatever, or maybe you just have a, you know, your sister who you love and who has had 10 babies or something. Um I am not promoting free birth. I'm just observing that I think that would be the setting where you could like get as close to this as possible because there's no um medical intervention. Because honestly, yeah, I mean, having having midwives at your birth is technically medical intervention. And I'm not saying that medical intervention is bad. It's just something to think about that it's like, okay, there you have to. I guess when I'm thinking about my own births, like I am trying to like mitigate that as much as possible. I tell my midwife, I'm like, hey, I really want to be left alone. I don't want people coming in and out of my room until it's absolutely necessary. I don't want anyone watching me while I'm in labor. I don't want the assistant around until she has to be, you know, like that's what I tell them. And they're great with it. They're like, great, yeah, we would respect your decision, you know, respect your choices. And it's great. And so nobody she comes in every once in a while to like listen to the baby's heartbeat, and then she leaves and goes and sits in another room of my house, and then the other people, I don't even know that they're there until basically after I have the baby, because once they come in, I'm like pushing the baby out and I'm not paying attention to anything else at that point. Um, so anyway, that's just like an example of how I am thinking about um how can I help my body and baby work together the way that God designed, and I think one of the ways is just avoiding any kind of intervention. Um let's see. Even though this is really difficult to achieve, I still it doesn't mean that we can't like strive for something close to it and still receive a lot of the benefits of birthing in this way. And so I want to get into that now, just like why is physiologic birth ideal? What are some of the benefits? Um, and I'm gonna quote a couple of different papers that I read just to obviously I have my own thoughts on why it's beneficial, but people have actually done some different studies on this and different midwife uh and nursing groups have like written, you know, position papers on this and things. So um the obvious one is just that of why is physiologic birth ideal is that it allows the mom's body and the baby and the hormones involved in childbirth to work together without interruption, which if you just think about that logically, it's like, yep, that would be the best thing. That would be the best thing for everyone, is if this just works the way that it was meant to work. Um okay, so from the International Childbirth Education Association has a paper on this from 2012. Um, I'm gonna go through uh their like what is it characterized by, the benefits, and then also what disrupts it. So they say normal physiologic childbirth is characterized by the spontaneous onset and progression of labor. It includes biological and psychological conditions that promote effective labor. Okay, you could get into what are those, but that's what they say. Results in the vaginal birth of the infant and placenta, results in physiological blood loss, facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period. And they have a little sub-note there that's like even if the infant needs help with breathing, you still do that. You still keep them skin to skin as much as possible and keep the cord intact while you're doing that. And then also physiologic birth is characterized by supporting early initiation of breastfeeding. Okay, so some of the benefits that they list are less postpartum pain, quicker physical recovery from the birth, increase in self-esteem as a result of the birth, enhanced bonding with the baby, reduced likelihood of postnatal depression, a calmer, more settled baby, an easier breastfeeding experience, effective respiratory transition for the baby, and more effective gut colonization that prevents allergies in the baby. Okay, so those are some of the benefits that they list. And then the following factors disrupt normal physiologic childbirth: induction or augmentation of labor, an unsupportive environment. And then they say, like examples, bright lights, cold room, lack of privacy, multiple providers, lack of supportive companions, etc. Another one is time constraints, including those driven by institutional policy and or staffing. So that's like your provider saying, you know, hurry up because I gotta go sooner, or like your water break, so you only have 24 hours to have this baby, or else you're getting a C-section. Nutritional deprivation disrupts physiologic childbirth, like not being allowed to eat or drink in labor. Opiates, regional analgesia or general anesthesia, so any kind of drugs to numb the pain, epesiotomies, operative uh vaginal birth, which is like using a vacuum or forceps, or a C-section, immediate cord clamping, separ any separation of the mother and the infant, um, and then they wrap it up with just any situation in which the mother feels threatened or unsupported. I love that. I think that's uh such a good uh kind of overarching idea that I I just completely agree with that. Okay, so those are just like some of the benefits, and I'll actually share a few more at the end. But amazing, like why wouldn't we want that? You know, all of those things. I would like to have, you know, uh increase in self-esteem. I've heard people talk about like you hear people talk about how they um received so much confidence in themselves as a mother, like after giving birth, and I think a lot of the times it is following a birth that is in this vein, but um easier breastfeeding experience. I'm like, yeah, I I didn't really quite get that one, but I was able to breastfeed, so praise God. Um even though but the issues had nothing to do with my birth, it was just other things. But so of course, these aren't guarantees, it's just like in general, these are potential benefits that you could experience. Um I wanted to add here that like in an ideal world, pregnancy would also be treated similarly, like you would also be thinking about your pregnancy in such a way that you're not just like intervening constantly, whether that's like getting a bunch of ultrasounds or getting all these cervical exams or doing all kinds of testing and poking and prodding and looking and um like stressing about everything, but more so just like leaving it alone, you know, letting it be, letting your baby just stay as long as they need to, all of that. Um, that will like feed so well into the birthing process, um, if you also kind of leave leave things alone leading up to that. Um and I also wanted to say that if you are trying to get close to a physiologic birth in the hospital, you are going to need to very intentionally choose your provider. We've talked about this ad nauseum, I feel like, on this podcast. Just go back to some other episodes where I talk about that. And you're gonna need to start talking to them about all of this very early on. Um, like showing up with a birth plan and hoping that they're gonna leave you alone uh is just not the route that you want to go, unless you happen to have, you know, an hour-long labor in birth, and then it probab they'll probably mostly leave you or I mean they won't leave you alone, but just you'll you'll barely be there, so not not much time for interventions to happen. But uh you have no idea how long your birth will be. So would really encourage you to do some of these like prep things up front. Adula is also really helpful to help like protect your birth space, birth space, um, along with obviously your partner just being on the same page about that kind of thing and help having them act as kind of like a guard or a protector. I know that's what dolphins do. I actually read this in one of my kids' books, but uh I think or maybe it's about birth actually, but it talks about how dolphins always have I can't remember if it's a friend or who it is, but like someone like stay like basically swims around the dolphin giving birth to like what keep watch. And I'm like, I just love that. I love that there's like a guard uh looking out for that mama. It's so so sweet and so important. Um so we obviously have incredible amounts of technology and medical. Medical interventions to help with childbirth if that is needed. And of course, there's always a time and place for anything. I I have said that and I will continue to say that. Um, everything from hospitals to epidurals to forceps to IVs and then everything in between. Um, so we have all of this stuff, and I just think it's really interesting to to look. If you just do a quick Google shog search on like morbidity and mortality rates for moms and babies in the United States, not none of these have improved with all these additions of technology, all of the monitoring, all of the helps that we have, um, all of these interventions. Like it, we haven't had seen an improvement in outcomes. We are the worst ranked of all the high-income countries in the world, actually, as far as maternal and infant morbidity and mortality goes. Um, so just what do we even do with that? Like, I I could go off about that for a long time, but that's just you really just food for thought, you know? Like, what is it? Like, could it be that even if we just had a shift to prioritizing like certain aspects of physiologic birth, like could that be beneficial? You know, could it be beneficial to actually remove some of these things that we've you know, we've accepted as the norm for childbirth in our country? Like, could could it be that we are interfering too much in this process? I I just really I feel like there's a strong case to say that we are interfering way too much. Um so in conclusion, when birth is left alone, it goes better. That's my whole argument. Just when you leave things alone, it tends to go better. Um I loved this paragraph from another paper that I read. It was written collaboratively by three different midwife associations, including the American College of Nurse Midwives, which are the ones who tend uh typically work in hospitals. And so this kind of summed it up. It's a it's a little bit wordy, so try to try to follow me here. For most women, the short-term benefits of normal physiologic birth include emerging from childbirth feeling physically and emotionally healthy and powerful as mothers. Their infants will benefit from the ability of their mothers to respond to their needs and from the lack of exposure to medications that can affect neurological behavior. Long-term outcomes include beneficial effects for the woman's physical and mental health and capacity to mother, enhanced infant growth and development, and potentially diminished incidence of chronic disease. Together, these outcomes are beneficial to the family and society through enhanced family functioning and cost-effective care. Importantly, a focus on these aspects of normal physiologic birth will help to change the current discourse on childbirth as an illness, state where authority resides external to the woman, to one of wellness, in which women and clinicians share decisions and accountability. So I love that. They're saying that if we can shift towards physiologic birth uh in our society, we it would enable the conversation and the reality of what childbirth ends up looking like to shift from being all about managing a a problem or an illness to one in which this is a state of wellness and women can actually be a part of the decision-making processes and work together with their providers, um, which is just better for everyone, you know? So that way, if there is an intervention that needs to be done, then the woman doesn't feel like this has been done to me, but I was a part of this process. So I just loved that. I thought it was really great, um, some other really great benefits that that are out there that are potentially available if you um give birth in this way, in the way that our bodies were designed to work. I think it's just a really I love thinking about when I am pregnant and when I'm not, but especially when I'm pregnant and I'm kind of getting close to birth and I'm getting a little anxious and I'm feeling very, you know, the anticipation is really high. I love thinking about over and over again that my body was made to do this. Like my body grew this baby all by itself. I did nothing, you know. I mean, I did, I supported it how I could, but like ultimately my body did this, and my body knows how to give birth. Um, and that is such an encouragement to me, and I'm so thankful that that's how God designed it. And so I just want to encourage everybody out there that you too, you, your body also knows how to give birth. And um yeah, this is just I would say this is like the floor, you know, this is this should be like the bare minimum of what we um of what we ask for and what we fight for for birth is that like it the first option is to leave it alone. The first option is to let it unfold and then to intervene if necessary, not to start with let's intervene and intervene and intervene and hope that things go well, because as we've seen, it's just not what's happening. And so just encourage you to think about that um as you prepare to either get pregnant one day or if you already are pregnant, just to think about that as you approach giving birth. All right, thanks for listening this week, and I hope you learned something new about physiologic birth.

SPEAKER_01 28:09

That's it for today on foundations for the childbearing years. If you found this helpful, be sure to follow the show and send it to a friend who's preparing for this season too. See you next time.