While most women are comforted by the thought of using the most up-to-date technologies, an increasing number of women are looking for other options. However, those numbers are still relatively low: 98.7% of women still give birth in hospitals, while just 1.1% go to a birthing center and only 0.2% do it at home.
No matter your preference, it’s important to gather enough information to make a decision that best fits your personal needs.
When preparing for birth, be sure to take note of the following:
- Are you giving birth at home, in a birthing center or in a hospital?
- How is your health and what is your medical history?
- Are you giving birth naturally or using anesthesia?
- Are you being assisted (doula, midwife) or not?
- Will you be using electronic fetal monitoring?
Vaginal delivery
This happens when the baby is delivered through the birth canal with both powerful abdominal and uterine contractions (pushing). In 2001:
- 56,500 women had a vaginal delivery in Quebec (81.5%)
- 52% had an epidural (that number exceeded 70% in certain parts of Quebec)
- 30% had local anesthesia
- Only 16% gave birth completely naturally
- Close to one-third (30%) of vaginal births resulted in an episiotomy
- 11% required vacuums
- 5% required forceps
Caesarean delivery
Caesarean section (also known as a “C-section”) happens when the child is extracted from the womb through an incision in the uterine wall. The word “Caesarean” comes from the Latin word “Caesar,” which means “child born through an incision.” In 2001:
- 12,800 women in Quebec delivered by Caesarean section (18.5%)
- 89% had an epidural
- 10% had general anesthesia
- 1% had local anesthesia
C-sections last about 25 minutes, of which it takes only 90 seconds to actually extract the child.
Disadvantages and risks of C-sections
- Complications of anesthesia
- Hemorrhage
- Risk of bladder, bowel, ureteral and vascular lacerations
- Higher risk of vein thrombosis and pulmonary embolisms
- Severe anemia
- Prolonged hospitalization and an increased risk of re-hospitalization due to infection
- Later first contact with the newborn
- Delay in initiation of breastfeeding and an increased risk of failure
- Prolonged postpartum pain and longer recovery
Advantages of C-sections
- Lower risk of urinary and fecal incontinence
- Sexual function less affected in the first three months
Vaginal birth after Caesarean (VBAC)
As its name suggests, VBAC happens when birth is given naturally following a C-section from a previous pregnancy.
- In 2001, 34% of women who previously had a C-section had a vaginal birth. That number, 25 ago, was only 1.5%.
- OBGYNs recommend VBAC rather than repeated C-sections because it’s considered safer.
- Eight women out of 10 who had a C-section could eventually give birth naturally.
Water birth
This happens when a woman gives birth in a correctly sized bath filled with water heated to 37°C. Water births rarely happen in hospitals, but are mostly available at birthing centres. This technique requires some preparation starting from the fifth month of a pregnancy. However, there are no available statistics for this type of delivery.
Advantages of water birth
- In water, the cervix dilates more easily and the pain is less severe
- Giving birth takes less time
- Lower risk of medical intervention
- Less risk of episiotomy
- No epidural
- Risk of tearing significantly reduced
- The father can be more involved in both pregnancy and childbirth
- Easier recovery for the mother
- Softer birth for the baby
However, in the event of illness (to kidneys, lungs, heart, blood, etc. or an STD) or problems with the baby (position, prematurity, etc.), this method isn’t recommended.
Home birth
Since April 4, 2005, midwives are covered by liability insurance, protecting them in the event of any complications, thereby allowing them to deliver babies at home.
In Quebec, the Centres de santé et des services sociaux (CSSS) offers midwife services free of charge to anyone with valid health insurance in Quebec. Birthing centres are responsible for reaching agreements that would allow home delivery. For more information, consult the Canadian Association of Midwives.
Close to 150 women in Quebec give birth at home every year. It allows them to stay in a familiar environment, close to loved ones, while experiencing less stress and a lower risk of infection than in a hospital.
Doulas* can also share their experience and support future parents. Though, unlike midwives, they are not authorized to perform any medical acts.
Checklist for a safe home birth
- Zero complications during pregnancy
- An active phone line
- Less than a 30-minute trip to the nearest hospital
- Access to an ambulance service
*Doulas usually work in private practices and bill anywhere from $250 to $800 for their services.
Birthing centre deliveries
Close to 600 childbirths take place in Quebec’s birthing centres, which offer a complete follow-up with the expectant mother. Contact your local CSSS for more information.
Advantages of birthing centre deliveries
- Pregnant women go in for their monthly visits, give birth there and return home with their baby
- Provides a quiet environment specifically designed for natural birth
- Family-first mentality is a major emphasis
- Less stress and lower risk of medical intervention
More options…
There are other approaches out there that are less common. If you’ve checked “none of the above” in your mind thus far, consider using a birth ball, the Bonapace method or even hypnosis.
