Active Birth or Managed birth?

This article by Janet Balaskas, founder of the global Active Birth movement, clearly describes our approach to birth.

Active Birth is nothing new, and yet when Janet Balaskas founded the Active Birth Movement in the early 1980s, it began a revolution. A decade earlier, many hospitals around the world had adopted what was called ‘Active Management’ of labour—a highly technological approach, which favoured medical control over labour and birth.

Active Management was intended to standardise labour times to a maximum of 12 hours per woman. To achieve this, routine medical interventions were applied—induction of labour ; epidural; and the attachment of sensors to provide continuous electronic monitoring of the foetus.

As you might have guessed, ‘Active Birth’ was chosen as a deliberate play on words—to contrast with ‘Active Management’ – giving the power of birth back to the mother. But Active Management was only the latest example of the over-medicalisation of childbirth. For hundreds of years, advanced nations had been steadily transforming birth from a natural process into a medical procedure. To find women firmly in control of birth, you had to look back to the 17th Century.

In the early 1600s, European women were in control of how they gave birth. They delivered their babies in upright positions, attended by other women in the secluded and familiar environment of their homes, according to knowledge handed down the maternal line. Midwives carried birthing stools from house to house, with many families passing them down the generations.

This maternal tradition had many advantages. Giving birth upright (by standing, kneeling, sitting on a birth stool or squatting) opens the birth canal, makes contractions more effective, and allows the mother to work with her body in harmony with gravity. It has also been discovered that a darkened and private birth environment stimulates hormonal responses and involuntary reflexes that lead to a better experience for mother and baby.

But in the 17th Century, traditions began to change. Forceps were invented and not long after, European women began to labour lying back, under the instruction of male physicians. Some scholars claim the position became popular after the French King Louis XIV demanded that his mistress give birth on her back, so that he could get a good view.

From there, control over childbirth was gradually prised from women’s hands. The role of the midwife was diminished, and labour was manipulated to suit the birth attendants—but not necessarily the mother or baby.

When Queen Victoria’s child was delivered  in 1853, the social elite of London followed suit, and birth became almost completely passive - “not only lying down, but unconscious” as Janet Balaskas says.

When she founded the Active Birth Movement, Janet made it her life’s work to spread the message that “nature knows best”. She saw that routinely imposed medical interventions were often counterproductive for women having a normal labour—causing a cascade of avoidable complications. She recognised birth as a profoundly sophisticated physiological process, with its true beginning at love-making and conception, and its true end at the child’s growing independence from the mother. Finally, she realised that our scientific understanding of this process is incomplete—and that therefore, it should only be disturbed when truly necessary.

Birth can unfold spontaneously and magnificently—if only we let it! At Yogababy we are dedicated to helping women reclaim their right to an Active Birth.