One week to go to my due date now…! As I said before in my post about packing my hospital bag, I’m not sure yet if I will stay home or go to the hospital for the birth. But in any case, I am preparing to give birth naturally for the fifth time! Following the un-ignorable nesting instinct, I’ve made sure my house is in order and our bedroom looks the way I like it. Cosy and tidy with a nice candle next to my bed and the nursery corner sweet and inviting.
I’ve listened to TED talks and read blogs about giving birth naturally and coping with stress and pain. Of course I’ve read the bible of giving birth naturally — Ina May Gaskin’s Guide to Childbirth. I make sure to walk daily and eat healthily, try to sleep well, stay relaxed and positive. I feel ready!

Breastfeeding Ava just after she was born.

In the hospital, walking though contractions. And sending messages to my girlfriends! Check the clock: Casper was born at 18:35.

In case you’re curious — here are some thoughts and notes that I have gathered about giving birth naturally. It’s really all quite simple — most important is to feel safe and relaxed, and to actually believe that YOU CAN DO THIS.

Giving birth naturally

Last year, at our local manage (where Sara, Pim, Ava and I ride), a foal was about to be born. I remember how big the mother mare was, and how everyone was waiting anxiously for the birth. The owners of the manage knew what they were dealing with. As prey animals, mares instinctively look for a quiet, safe place to deliver their foals. So they zoned off the part of the stables where the mare’s stable was, to give her privacy, peace and quiet and to make her feel secure. They also knew, that even though they could do their utmost best to shield the mare and give her as much privacy as possible, she would probably give birth the moment everyone was least expecting it. (Mares are known to hide signs that foaling is near, even pretend to be asleep — only to give birth the moment the caretaker runs to the house for a quick cup of coffee!)

Even though humans partly are predators themselves, they are also very much prey. We still have strong instinctual responses to predators. Just like a mare, we need a safe and secure place where we can give birth. It really is MOST important to feel safe, cared for and positive while giving birth! If your body and mind do not feel safe and relaxed, birth will be stagnated…

Here are my tips for giving birth naturally:

1. Take charge of the birth with a positive mindset. Trust in your body and in nature. You have to believe that you can do it! Women were made to do this, and have been doing so since the beginning of time. You’re surrounded by all of the women of the world, your mothers, your daughters, your sisters… they have done this before, and they will do this after you.
2. Make sure your environment is calm and relaxed, so your mind can calm down and relax as well. Dim the lights, maybe light a candle… Play music if you like! Don’t have anyone in the room with you who you don’t feel 100% comfortable with. Be free of fear (fear will make your body tense which will stagnate the birth and can make it more painful). Remember: this is natural, and you can do it!
3. Be active. Walk for as long as you can! The pressure of your baby on your pelvis will stimulate it to open up faster. I personally also feel that walking around, and chatting to my husband, works distracting and relaxing. In the beginning of my labours I walked outside, after that I tried to keep walking up and down the delivery room. If you eventually feel the need to be inactive or lay down, try to change positions regularly. Remember that gravity is your friend — you may try squatting. (I never liked squatting myself, but I know it works for lots of women!) Drink sips of water regularly, have something to eat if you can. Try to keep smiling (remember the positive mindset!)! A warm bath or shower can help to keep you relaxed and cope with contractions as well.
4. Breathe! Try deep belly breathing in the first stages. Focus on long exhalations. Later in labour, during the difficult stage of transition, there are techniques like the so-called horse lips (deep belly breath in — long breathe out while flapping your lips like a horse). Here in the Netherlands, we are told to ‘puff’ breathe — breath in through the nose, then exhale through the mouth, with loose lips ‘pffffff’. In the last stage, just before pushing, you can try ‘hahaha’ breathing — a short breath in, breathe out in three times: ‘ha-ha-ha’. Whichever technique works best for you — don’t hold your breath! Keep breathing as rhythmically as possible.
5. Open up. Literally! Make sure to keep your mouth and throat relaxed and open. Keep your jaw loose and your hands relaxed. And focus your energy! An open and relaxed mouth, throat and jaw will help directly to open your cervix. So open your mouth and relax your throat during a contraction and when birthing your baby! When it’s time to push, try to relax and open up your vagina. A good way to practise this in advance is when you do your Kegel exercises: lift up in three times, let go in three times, but then go one extra level ‘down’ (to the ‘basement’). Focus on the feeling of relaxing and opening up your vagina. This techniques has worked well for me after my first birth, where I was told at my first urge to push, to hold back (to prevent tearing). Thus, when it was time to start pushing with full force, I unconsciously had trouble surrendering and it took over two hours to push Sara out! (And I still tore.) With later births, this ‘lift to the basement’ technique has worked really well for me (Pim, Ava and Casper were pushed out quickly in two to three contractions! And without tearing…).
6. Surrender to your contractions. Don’t fight them! Go with the flow of the wave of energy. Visualise your baby going down, see yourself opening up like a flower. Remember that every contraction will bring you closer to meeting your baby! Try to make low moaning or humming sounds, putting your energy in riding the ‘wave’ instead of fighting it with yelling or screaming.
7. Instruct your birthing partners to affirm your awesomeness with loving and positive words. They can massage or push down on your lower back and upper legs, tightly hold your left ankle. Tell them to remind you to keep breathing and to relax your hands, jaw and mouth. Tell them to keep telling you that you are a wonderful and strong woman and that you can do this!

Of course, giving birth the natural way is just one way. If you prefer (or are scheduled in) for a medical birth, that is perfect as well. Or, if you were aiming to give birth naturally and end up having a medicated birth — just remember that the most important thing is to deliver a healthy baby to a healthy mother! We all make our own choices, and we all sometimes have to follow a different direction in life than we first envisioned. Remember: stay calm and relaxed, give in to the flow of giving birth — you can do this! Whatever way : ).

xxx Esther

PS My first two children were born in London. Home birthing at that time and place was basically impossible (especially since I was following the NHS system), so instead I chose to go to a birthing centre — a midwife led unit within the hospital. Both Sara and Pim were born naturally this way.

Back in the Netherlands, Ava and Casper were also born naturally in a hospital here in Amsterdam. Not specifically in a midwife led unit, but because in the Netherlands birthing is not regarded as a medical ‘problem’, there was just one or two midwives present in the birthing room. (Although a team of doctors was obviously standing by in case a medical intervention would be needed.) The birthing rooms are nice and spacious here in Amsterdam and have their own lovely bathroom. All good!

After-birth care is provided for at home in the Netherlands. A home maternity nurse will come to your house for at least 8 days after the birth, to take care of the usual tasks of the household, help care for baby, and to make sure the new mother can rest and recover. So most women who choose to birthe at the hospital and have gone through an uncomplicated delivery, leave the hospital within a few hours after giving birth.

Our ‘kraamverzorgster’ (Dutch home maternity nurse) with baby Ava

But there is still a large percentage of women who choose for a home birth. A few months before the due date, all women receive the ‘(home) birth box‘ from their insurance, with all the necessities needed for a home birth or for the after-birth care at home. This keeps the options open to choose at the last moment — stay home, or go to the hospital!

When contractions start and have been regular for a while, your midwife will come over to your house and assist with the birth. (The home maternity nurse will also come over and she will assist as well.) The midwife coaches the mother through the birth. She makes sure the environment is safe and relaxed, and helps with coping with pain or anxiety.

Of course the wellbeing of the mother and baby is closely monitored during the process and if there are any signs of trouble or distress, an ambulance will be standing standby. The midwife also brings oxygen and other first-aid care just in case, so she can administer the same immediate care as in the birthing room in the hospital. All in all, it feels safe and normal to give birth at home in the Netherlands. (But it is totally normal and accepted as well to choose to give birth at the hospital). I feel lucky to be in this country where birthing is considered a natural, uncomplicated process with free choices!