Birth Options Series – What Are My Options?

Welcome and thank you for listening!

Many expectant couples have questions about what birth options they have and which will be the best for them. This will depend on your pregnancy, how labour unfolds, the health of Mom and Baby, where you live, and what birth facilities are available in your area.

I like to say there are three ‘types’ of birth:

  1. Normal birth – a vaginal delivery in the hospital or clinic.
  2. Caesarean birth – should only be used in case of emergency.
  3. Natural birth – as Mother Nature intended; calm, peaceful and with minimal intervention

Your main birth options include:

Normal Vaginal Delivery in a Maternity Facility

This is the most well-known option and generally includes:

  • Vaginal birth following labour in a private hospital or clinic, a state hospital, or a private or state midwifery-led unit
  • Possible intervention like induction, episiotomy, vacuum delivery, forceps, and medical pain relief
  • The delivery room often resembles an operating theatre
  • Moms can sometimes ask for individual needs to be respected, like freedom to move around in first stage, a more upright birthing position, and less automatic intervention like episiotomy


This is simply giving birth at home with the help of a private midwife!

  • It’s only recommended for uncomplicated pregnancies
  • Women often choose this because of wanting Baby to get a natural start, being anxious about hospitals, or having had a previous disappointing hospital birth
  • Family and friends can be involved
  • The relaxed atmosphere and familiarity of the environment often make labour progress more easily
  • An experienced midwife can take care of first stage and deliver Baby
  • Most midwives have an obstetrician who is called on if any complications or risks arise
  • Natural pain relief options are encouraged and you’ll have to move to the hospital for medical intervention and procedures

Water Birth

Water can either be used for pain relief during labour, or Baby can be delivered in water.

  • An experienced practitioner, usually a midwife, is needed to assist
  • The birth can take place at home in a hired birthing pool or in an Active Birth Unit
  • Generally pain is less and Mom feels more relaxed so labour is quicker and coping skills are better
  • The water needs to be kept warm
  • Water birth is safe if excellent hygiene precautions are adhered to and regular checks are done of both Mom and Baby’s condition
  • Baby can be gradually floated to the surface after birth, but shouldn’t be submerged again once the umbilical cord has stopped pulsating or Baby has started breathing

Active Birth in Hospital

An Active Birth Unit is a pleasant home-like suite where a private and occasionally hospital midwife will deliver your baby.

  • Being next to or in a hospital means that any emergencies can be treated promptly
  • Active birth is a form of vaginal birth with more natural options like giving birth in an upright position (kneeling or squatting), water birth, moving around during first stage of labour, and not having a routine episiotomy
  • The emphasis is on the fact that this is your birth and you are helped to make it as special as possible

Caesarean Birth

  • Baby is born either in an elective operation, or in response to an emergency towards the end of pregnancy or during labour.
  • South Africa is one of the only countries that allows Caesarean birth as an option; other countries view it only as a necessary intervention during an emergency
  • You can have spinal anaesthesia and be conscious throughout the procedure, or have a general anaesthetic
  • Caesarean section is major abdominal surgery, but is mostly a safe procedure for Mom and Baby

Choosing Your Best Birth

What the best birth for you is, depends quite a bit on what happens at the end of pregnancy and during labour. If, for example, you end up needing medical intervention or an emergency C-section then that is the best birth for you – regardless of what other plans you may have had.

Generally if there are no complications, then true natural birth is the best option for both Baby and Mom. If you’re very anxious about the birth it can help tremendously to take an appropriate homeopathic remedy and use the services of a dedicated private midwife. It’s important that you be as relaxed and comfortable as possible because anxiety raises your adrenaline and cortisol levels and suppresses the hormones which provide pain relief and make birth easier.

Many women find it very comforting to have a private midwife as she can help you through every step of labour without the disruption of shift changes. This is generally a safe option too because most private midwives work closely with an obstetrician who will be called in to help if medical intervention is required.