Integrative Medicine and Natural Birth: A Comprehensive Approach to Labor and Delivery

Bringing a new baby into this world can be one of the most exciting times in a mother’s life. If this is your first time experiencing pregnancy, or you are trying to become pregnant, you may be looking into your options for pregnancy care and childbirth. While a majority of women choose to do a conventional hospital birth with their medical doctor, there are alternative options. Considering a natural birth can offer a holistic approach to your journey through pregnancy, labor, and delivery. With recent statistics revealing that home births have increased to the highest level we’ve seen in the past 30 years, it’s important to know your options for safe and effective methods to implement.

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What is Natural Birth?

Natural childbirth is the omission of conventional medical intervention to assist in the process of labor and delivery. Many women that choose this path believe that their body has an innate ability to have a vaginal birth without the use of pharmaceuticals or medical interventions such as episiotomies or fetal monitoring. Natural births are mother-led, often with the support of a midwife, doula, or both. During a natural birth experience, mothers choose what is right for them and the birth of their child. This can be in a hospital setting, in a birthing center, or at home. Natural births can occur in a variety of environments and positions such as water births, with the mother squatting, on all fours, kneeling, or lying on their back. Mothers incorporate a variety of methods and calming techniques to get through the pain and discomfort of labor and delivery.

What is a Doula?

Doulas are part of a pregnancy care team that assists the mother during pregnancy, labor, or postpartum. For this article, the focus is going to be on labor doulas. A mother-birth doula relationship usually begins in the second or third trimester. During labor and delivery, the doula is a trained birthing companion to assist the mom through her experience. Doulas provide emotional, physical, and educational support for the mother. They can provide insight into techniques such as perineal massage, breathwork, and imagery, assist in creating and executing your birth plan, and help you stay centered during birth. Doulas are not trained to provide medical care or give medical advice; their purpose is to solely be a companion and birthing support personnel during the birthing process.

What is a Midwife?

A midwife is a trained medical professional that provides pregnancy care throughout the pregnancy, labor, delivery, and postpartum. A general consensus is that midwives lean towards facilitating a natural birthing process as much as possible and under appropriate circumstances. There are three levels of midwifery training: Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), or Certified Professional Midwives (CPMs). CNMs have the largest scope of practice and are licensable in all 50 states. You can be under the care of a midwife in a hospital setting, birthing center, or at home. Women who choose this route rather than working with a Western medical-trained obstetrician (OB) should have no prior pregnancy complications and be medically approved to receive this type of care. Much like an OB, your midwife can perform necessary prenatal exams, order tests, provide medical education throughout your childbearing process, give nutrition, provide exercise and health recommendations, assist in formulating your birth plan, and assist in the delivery of your baby safely. Midwives are also trained to recognize situations in which an OB or traditional hospital birth is necessary. If a situation escalates during a home birth or at a birthing center, well-trained midwives have the tools needed to assess and make clinical decisions for the well-being of the mother and baby. While hospital births under the care of an OB are still the most sought birthing care, midwifery is an option to consider. One retrospective study on the topic revealed that among low-risk pregnancies, the care of a midwife is significantly associated with fewer interventions during labor and fewer preterm births.

When to Choose a Doula vs. Midwife?

Since these professionals provide different services, both of which are valuable to the mother, you can choose to go with one or both. Doulas provide excellent advocacy and emotional and physical support to the mother during labor. Midwives can also provide this support, but their primary role is to deliver your child safely. Hiring both to work as a team in your care can be an excellent option. If you choose to just go with a doula, it’s advised to have a hospital or birthing center delivery with an OB. Doulas can be part of this conventional birthing process and assist you in executing your birth plan in that setting.

What Integrative Medicine Treatments Are Commonly Used in Natural Birth Labor and Delivery?

While the primary focus of natural birth labor and delivery is on maintaining a safe and healthy process, several integrative medicine treatments can be used to support women during this transformative time. Here are some commonly used integrative medicine treatments in natural birth:

Mind-Body Techniques

Techniques like relaxation exercises, breathing techniques, guided imagery, and mindfulness meditation can help manage pain, reduce anxiety, and promote a sense of calm during labor. Hypnobirthing is also a method that some women utilize to help manage pain and bring them into a peaceful state.

Nitrous Oxide

While some natural births would not include this method, many midwives utilize nitrous oxide to assist mothers through labor pains. Nitrous oxide, also known as laughing gas, does not act as a traditional pain reliever; instead, it helps decrease anxiety, which can help a birthing mother self-manage and tolerate pain more effectively. This can be used during any stage of labor, and administration can be stopped and started by taking the breathing mask off and only utilizing it when needed.

Acupuncture and Acupressure

Acupuncture is a practice that involves placing thin needles into specific points of the body. This technique can be used during labor to help manage pain, promote relaxation, and facilitate the progress of labor. One study found the combined intervention of acupressure (pressure applied to specific points of the body) and massage brought significant relief by reducing anxiety, relieving tension, and reducing pain.

Massage Therapy

Massage has be used to relieve muscle tension, reduce pain, and promote relaxation during labor. Techniques such as effleurage (gentle stroking), counter pressure, and sacral pressure can provide comfort and support. This technique is an open opportunity for the partner to be involved in the birthing process, or if a doula is a part of the team they can assist the mother in this.

Hydrotherapy

Water therapy, such as soaking in a birthing pool or taking a warm shower, can help relieve pain, promote relaxation, and facilitate labor progression. Immersion in water is believed to increase comfort and provide a soothing environment. Women choose a water birth because of the pressure relief and relaxation they feel while their lower body is submerged in the water. Birthing a child into water is also a familiar transition, as they have been used to a water-like sac for the past 9-months.

Herbal Remedies

Certain herbal remedies, such as red raspberry leaf tea, may be used during pregnancy to tone the uterus and support the overall health of the mother. There is potential use for herbal medications like black cohosh to induce labor. However, it's imperative you consult with a qualified healthcare provider before using any herbal remedies during pregnancy and labor.

Homeopathy

Homeopathic remedies, which are highly diluted substances derived from natural sources, are sometimes used during labor to manage pain, promote relaxation, and support the natural birthing process. It is important to consult a qualified homeopath or healthcare provider experienced in homeopathy for appropriate remedy selection and dosages. This form of natural medicine is very individualized and a particular remedy is selected based on the patient's unique presentation.

Aromatherapy

The use of essential oils can help create a calming and soothing environment during labor. Oils like lavender, chamomile, sweet orange, geranium, jasmine, and frankincense may be used in diffusers or applied topically (with proper dilution) to promote relaxation, relieve anxiety and manage discomfort.

Functional Medicine Labs to Run During Pregnancy for Those Wanting a Natural Birth?

Depending on the type of professional natural birthing care you are receiving, there are a few tests that may be required. Determination on whether or not home birth is feasible is typically based on medical history, family history, and arising complications. Some parents do decide to do genetic testing to rule out unsuspecting fetal disorders. Optimizing health and taking preventative action can also be beneficial for birth outcomes and the well-being of the mother and baby. Considering labs that will assess gut health and micronutrient status are great for this.  

Routine Labs

Running an Obstetric Panel by Access Medical Laboratories is a great way to screen for health concerns. Common complications of pregnancy include iron deficiency anemia (IDA), gestational diabetes, and preeclampsia. Obtaining a comprehensive blood panel to evaluate these areas of health can catch complications early on while also assisting your medical team with an appropriate birth course. If midwifery care is desired when diagnosed with gestational diabetes or preeclampsia, hospital care with a midwife (rather than a homebirth) where additional supportive staff is available is the medically recommended option.

Genetic Testing

Certain genes code for biological pathways that impact maternal and fetal health. If you are looking to optimize your pregnancy and birthing process, you could gain beneficial data from doing a GrowBaby genetic analysis by dnalife. Information from this test can help your holistic doctor customize a nutrition plan, lifestyle recommendations, and personalized supplements to utilize throughout your pregnancy.

Microbiome Evaluation

Evidence suggests that the microbiome of a baby begins developing in utero. They then pick up microflora as they exit the vaginal birth canal. The mother's microbiome is directly correlated to the development of their baby’s microbiome. Starting life with optimal gut health can set your child up for a thriving immune system, digestive capability, and less colic (to name a few). Diagnostic Solutions has a gold standard stool analysis test called GI-MAP that can assess your gut microbial diversity. Getting this test done before pregnancy is ideal, but it can still be valuable during pregnancy, allowing you to support gut health through nutrition and supplementation that is appropriate for pregnancy.

Micronutrient Testing

Fetal development is greatly influenced by the health and well-being of the mother. To optimize your pregnancy and plan for a successful birthing experience, it would benefit you to make sure all your vitamins and minerals are in tip-top shape. Micronutrient levels can be tested with the Micronutrient Test offered by SpectraCell Laboratories. Commonly assessed vitamins are D, A, K, C, and folate, along with minerals such as potassium, iron, zinc, and calcium.

Functional Medicine Labs to Run Post Labor and Delivery for Those Wanting a Natural Birth?

There are a few labs that can be utilized postpartum if that patient is experiencing abnormal symptoms or is having difficulty adjusting mentally and emotionally.

Thyroid Panel

A Thyroid Panel can test for postpartum thyroiditis, which is an autoimmune-like thyroid condition, could be helpful. Symptoms can vary depending on if there is a hypothyroid or hyperthyroid situation occurring, but a very common indicator is that you are not feeling yourself past the 4th trimester period. Running a comprehensive Thyroid Panel will detect if there is thyroid dysfunction that is negatively impacting your health.

Iron Panel

If you have persistent bleeding past the normal range of vaginal birth, investigation is warranted with an Anemia Panel. Determining if your iron levels and iron storage (ferritin) are in a healthy range is a great assessment. Low iron can also be a culprit of persistent fatigue.

When to Follow Up With Your Practitioners After Birth?

A postpartum follow-up visit should typically happen at 6 weeks postpartum. During this visit, there will be a pelvic exam, you will have time to discuss your mental and emotional well-being, express any concerns regarding breastfeeding or bottle feeding, be screened for postpartum depression, and receive education for family planning. During this visit is when practitioners will draw any labs they deem necessary. If you have concerns please express them with your doctor, assuming a discomfort or new symptom is normal can sometimes lead to. It’s best to address issues head-on and get guidance and support from your healthcare provider.

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Summary

Choosing a natural birth can be a liberating experience for you as a mother. Tuning into your body and honoring the process of childbirth can help you achieve this goal you may have. Leaning on the support of a trained doula and/or midwife is a great holistic option for a successful natural birth. Setting yourself up by getting key blood tests and functional medicine labs can also help your practitioner determine a targeted plan for you and your baby. Thankfully there are a handful of integrative treatment options from mind-body techniques to aromatherapy and you don’t need to feel like you don’t have any tools you can reach for. Remember that a safe birth and a healthy baby is the ultimate goal, and redirecting your course is okay if the journey changes.