Review of Janet Balaskas`s book : Active Birth, the new approach to giving birth naturally

Janet Balaskas`s book Active Birth is resourcesful manual for all pregnant ladies who want to labour and deliver naturally. The author urges mothers to learn about their bodies, being active during pregnancy and labour  and thus become active birth givers. She suggests that moving freely during labour, finding comfortable positions , following their instincts and taking control of the childbirth experience may result in seldom or no need of drugs and obstetrical interventions.

She also suggests that labour is natural body function and can happen spontaneously and naturally without need of any intervention and that labour can be empowering event resulting in improved self confidence and enjoyable motherhood, thus building stronger families. She views  Active Birth as natural and instinctive and aims to help women to get in touch with their own birth-giving instinct and also recommends yoga exercises - simple and 

instinctive movements – to improve flexibility and strength.

She stresses that active birth is instinctive and involves giving birth quite naturally and spontaneously through woman`s own will and determination , having the complete freedom to use her body as she chooses and also follow its urges. Active Birth is an attitude of mind, it involves acceptance and trust in the natural body function and involuntary nature of  the birth process, as well as an attitude or appropriate body positioning .  It is not merely a vaginal extraction in which the attendants are in control and woman is a passive confinement.

She explains reasons why Active Birth may be more efficient and safer during labour for mother and baby:

1.Upright position optimizes the pull of gravity - downward gravitational force- assists uterine contractions and bearing down efforts

2. Upright position optimizes the drive angle of uterus – the angle between the long axis of baby`s spinal column and that of mother`s spinal column- is greater when mother is upright, allowing uterus to tilt forward and  thereby assisting uterus to work without resistance, which is efficient way to reduce pain.

3. Upright position provides the best angle of baby`s descent into the birth canal

4. Upright position ensures direct application of the baby`s head against cervix and promotes more efficient and faster dilatation

5.Upright position ensures baby`s oxygen supply is adequate, lying down on the back may decrease oxygen supply to baby by compression of large arteries

6. Upright position does not apply pressure on sacrum and spinal cord, thus woman feels less pain

7. Upright position allows pelvic joints to expand freely and adjust to the shape of the baby`s descending head and widen pelvic outlet as much as 30 percent.

8. Upright position puts less pressure on the baby`s vertebrae

9. Upright position facilitate successful and spontaneous separation of placenta

10. Upright position facilitate easy drain of fluids from uterus and there is less likelihood of infection

11. When mother is in upright position, the perineal tissues can expand more evenly, thereby reducing need of tear and episiotomy

She also describes best positions for labour and birth:

-freedom to change positions is important

- Benefits of Squatting position:

there is no compression on large arteries and optimal blood supply for mother and baby , Pelvis is fully mobilized, optimal relaxation of the perineum, minimal muscular efforts, efficient angle of descent of baby`s head

Benefits of all-four position: the presenting part rotates inside pelvis more easily, mainly if baby is lying posterior or birth is very fast

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Active Birth book also includes:

Differences between Active Birth and Obstetrically managed birth

Woman`s body during pregnancy 

Fully illustrated yoga-based exercises for a comfortable and energetic pregnancy

Breathing technique

Massage for pregnancy and labour

Positions for labour and birth, for maximum comfort and efficient contractions

Labour complications and obstetric management

The latest information about water birth and how to plan one

Exercises and relaxation after the birth

Helpful tips for partners and birth attendants