Seven Catalan hospitals promote non-medicalised natural birth
Ana Pantaleoni and David Casals
El País 17/04/2007
An ever-growing number of pregnant women are in favour of having a natural birth without medical intervention, something that, until a few years ago was not possible in the majority of public maternity wards. Natural birth is currently offered by two public hospitals in Catalunya: Hospital Clinic (La Maternidad) in Barcelona and Santa Caterina in Girona, have special rooms for natural birth - larger than traditional labour rooms. Now, five other public hospitals will also offer natural birth. Until now, very few steps have been taken to introduce non-medicalised birth into public hospitals - the hospital of Huércal-Overa in Almeria is pioneer in this field. Little by little, however, the idea is becoming more accepted.
Giving birth in a natural and spontaneous way means respecting the physiological process of labour and the time it takes the pregnant woman to dilate. In practice, this translates into not inducing labour with oxytocin, a hormone that stimulates contractions. It also means treating the future mother with respect and not carrying out incisions to widen the vaginal opening (episiotomy). In natural birth, the hospital staff supports the pregnant woman when she needs it.
The demand for non-medicalised births rises each year, although there are no official statistics. In Catalunya there are 42 maternity wards, of which two have begun to adapt their installations, according to the Health Department. In the maternity section of Hospital Clinic, a reference point for natural birth, 4,000 births are carried out every year, an average of 11 per day. Of these, 22% are caesareans and 10% have no pain relief. Here they are carrying out a series of changes in the labour ward in order to create one general model: natural hospital birth agreed on by patients and professionals. "From now on all births with be natural, in the sense that the patient will be able to make decisions about her birth and in that medical intervention will be the minimal necessary to guarantee a healthy baby" indicates Eduard Gratacós, head of Maternalfeto Medicine. "When asked for, an epidural will be administered".
The programme for natural hospital birth simplifies the medical instrumentation involved in low risk births. The objective is to allow as much freedom as possible during labour without compromising perinatal safety. The Clinic (La Maternidad) will have five natural birth rooms - now it has just one, and two rooms that will still be for high risk births - they will also combine the dilation room and the delivery room so that the mother doesn't have to move, and a new type of bed will be introduced.
The problem is that birth is excessively medicalised in Southern European countries and what has happened in other countries, such as Scandinavia, hasn't happened here. There, clinical practice in the birth process has been simplified and made more respectful. "It's not just the responsibility of the health professionals, but also of social conscience and general concepts about maternity, labour, pain and also medical-legal pressure", says Gratacòs. The doctor underlines the importance of not bringing out surgical instruments until the delivery phase.
This model, also followed by the Hospital Santa Caterina in Girona, is to be exported to five more hospitals, explains Dolors Costa of the Health Department. The centres which, within the next two years will offer pregnant women non-medicalised births if they wish are the General in Vic´, and the hospitals of Puigcerdà, Mataró, Parc Tauli in Sabadell and Sant Pau in Barcelona.
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