Birthspirit The Spirit of Birth Workshop: An Open Access Resource

SpiritOfBirthCroppedIn the last three decades, women in New Zealand, as in the rest of the Western world, have experienced escalating levels of intervention during childbirth and a declining ‘normal’ birth rate – the latter being recorded as 65.0% of all births in the Ministry of Health’s Maternity Tables 2013. As induction and/or augmentation of labour (51.1%), epidural anaesthesia (27.0%) and episiotomy (13.3%) are included in that rate, it is unknown how many women and babies actually experienced physiological labour and birth.

This Workshop embraces the facilitation of birth without unnecessary medical procedures. It actively promotes the restoration of physiological labour and birth as an ideal childbirth culture, and the time-honoured role of the midwife as a non-interventionist caregiver.

You will get most out of this workshop if you:

    1. Watch the Lecture movie below first as the context of the other components of the Worskhop are referred to in this. Please note, the ‘Leave a Reply’ at the bottom of this page replaces the Discussion Forums referred to in the Lectures.
    2. Take time to reflect on each of the resources and share your confusions and insights with others.

This Lecture movie runs for 25:42 minutes. Printouts of the Lecture slides and Bibliography may assist with the Lecture movie.

Movies applicable to this workshop

This 27 minute interview is with the late Marsden Wagner, perinatologist and perinatal epidemiologist who served as a Director of Maternal and Child Health for the California State Health Department, Director of the University of Copenhagen-UCLA Health Research Center, and Director of Women’s and Children’s Health for the World Health Organization. Filmed in 2010, it addresses many of the basic questions relating to the medicalisation of childbirth.

This 4 minute UNICEF movie featuring Shagufta Shahzadi, a community midwife in Pakistan, simply and effectively exemplifies many of the essential skills of the midwfe.

After watching this 6:45 minute move consider the challenges or opportunities to physiological birth in the environment in which you usually work. What changes, if any, are needed?

Podcasts applicable to this workshop

Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Declane Devane from the School of Nursing and Midwifery at the National University of Ireland compares the use of intermittent ausculataion and admission CTG in this 4:15 minute podcast.

Birth hormones. This hour long podcast is an interview with Dr Sarah Buckley on labour hormones. It is a resource aimed at women.

Lecture references and/or suggested readings

Alfirevic Z, Devane D, Gyte GML. (2013).Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD006066. DOI:10.1002/14651858.CD006066.pub2.

Banks M. (2009). The obstetric bed: resistance in action. Birthspirit Midwifery Journal, 4:43‐46.

Banks M. (2003.) Utilising the unborn baby’s in‐labour movements. New Zealand College of Midwives Journal, 29:6.

Begley CM, Gyte GML, Murphy DJ, et al. (2010). Active versus expectant management for women in the third stage of labour. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD007412. DOI:10.1002/14651858.CD007412.pub2.

Buckley S J. (2015). Hormonal physiology of childbearing: evidence and implications for women, babies, and maternity care. Washington, D.C.: Childbirth Connection Programs, National Partnership for Women & Families.

Chalmers I, Enkin M, Keirse MJNC. (1989). Effective Care in Pregnancy and Childbirth. Volume 2: Childbirth. Parts VI‐X & Index. New York: University Oxford Press, p. 839.

Cheng YW, Hopkins LM, Caughey AB. (2004). How long is too long: does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes? American Journal of Obstetrics and Gynecology, 191(3): 933‐938.

Cluett ER, Burns E. (2009). Immersion in water in labour and birth. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD000111. DOI: 10.1002/14651858.CD000111.pub3.

Cooke A. When will we change practice and stop directing pushing in labour? (2010). British Journal of Midwifery, 18(2):76‐81.

Davis D, Baddock S, Pairman S, et al. (2011). Planned place of birth in New Zealand: does it affect mode of birth and intervention rates among low‐risk women? Birth, 38:111‐119.

Dixon L. (2003). Birth in a caul: a discussion on the role of amniotomy in physiological labour. New Zealand College of Midwives Journal, 29:7‐10.

Downe S, Gyte GML, Dahlen HG, et al. (2013). Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD010088. DOI:10.1002/14651858.CD010088.pub2.

Duff M. (1998). A journey in assessing labour progress. Book of Proceedings, New Zealand College of Midwives National Conference, Auckland, pp. 1‐13.

Gherman RB, Tramont J, Muffley P, Goodwin T. (2000). Analysis of McRoberts’ maneuver by x‐ray pelvimetry. Obstetrics & Gynecology, 95(1): 43‐47.

Gherman RB, Goodwin TM, Souter I, Neumann K, Ouzounian JO, Paul RH. (1997). The McRoberts’ maneuver for the alleviation of shoulder dystocia: how successful is it? American Journal of Obstetrics & Gynecology, 176(3): 656‐651.

Hiersch L, Melamed N, Rosen H, et al. (2014). New onset of meconium during labor versus primary meconium‐stained amniotic fluid – is there a difference in pregnancy outcome? The Journal of Maternal‐Fetal & Neonatal Medicine, 27:13:1361‐1367.

Hodnett ED, Downe S, Walsh D. (2012). Alternative versus conventional institutional settings for birth. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD000012. DOI: 10.1002/14651858.CD000012.pub4.

Hodnett ED, Gates S, Hofmeyr GJ, et al. (2011). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. Feb 16;(2):CD003766. doi: 10.1002/14651858.CD003766.pub3.

Katz VL, Bowes WA. (1992). Meconium aspiration syndrome: reflections on a murky subject. American Journal of Obstetrics & Gynecology, 166(l:1): 171‐183.

Kroeger M, Smith LJ. (2004). Impact of birthing practices on breastfeeding: protecting the mother and baby continuum. Jones & Bartlett: London.

Lauzon L, Hodnett E. (2003). Labour assessment programs to delay admission to labour wards (Cochrane Methodology Review). In: The Cochrane Library, 4. Chichester, UK: John Wiley & Sons, Ltd.

Leap N, Anderson T. (2004). The role of pain in normal birth and the empowerment of women. In: Soo Downe (Ed). Normal childbirth: evidence and debate. Churchill Livingstone: London, pp. 25‐39.

Letić M. (2003). Inaccuracy in cervical dilatation assessment and the progress of labour monitoring. Medical Hypotheses, 60(2): 199‐201.

Madi BC & Crow R (2003) A qualitative study of information about available options for childbirth venue and pregnant women’s preference for a place of delivery. Midwifery, 19(4): 328‐336.

Mercer JS, Erickson‐Owens DA, Graves B, Mumford, Haley M. (2007). Evidence‐based practices for the fetal to newborn transition. Journal of Midwifery & Women’s Health, 52(3): 262‐72.

Mercer JS, Skovgaard RL. (2002). Neonatal transitional physiology: a new paradigm. Journal of Perinatal and Neonatal Nursing, 15(4): 56‐75.

Mercer J. (2001). Current best evidence: a review of the literature on umbilical cord clamping. Journal of Midwifery & Women’s Health, 46(6): 402‐414.

Miller S. (2009). Are midwives more ‘at home’ at home? Birthspirit Midwifery Journal, 1, 7‐11.

Miller S. (2008). First birth at home or in hospital in Aotearoa/New Zealand: intrapartum care midwifery care and related outcomes. Unpublished Masters thesis, Victoria University of Wellington: Wellington.

Ministry of Health. (2015a). Report on maternity, 2014. Ministry of Health: Wellington. Available at:

Ministry of Health. (2015b). Report on maternity 2014: accompanying tables. Ministry of Health: Wellington.

Monen L, Hasaart TH, Kuppens S. (2014). The aetiology of meconium‐stained amniotic fluid: pathologic hypoxia or physiologic foetal ripening? (Review). Early Human Development, 90(7): 325‐328.

Muza S. (2012). The Wax home birth meta‐analysis: an outsider’s critique. Last accessed 23 February 2017.

Naaktgeboren C. (1989). The biology of childbirth. In: I Chalmers, M Enkin, MJNC Keirse. (1989). Effective care in pregnancy and childbirth. Volume 2: Childbirth. Parts VI‐X & Index. New York: University Oxford Press, pp. 795‐804.

Olsen O, Clausen JA. (2012). Planned hospital birth versus planned home birth. Cochrane Database of Systematic Reviews, Issue 9. Art. No.: CD000352. DOI: 10.1002/14651858.CD000352.pub2.

Phelps JY, Higby H, Smyth MH, et al. (1995). Accuracy and intraobserver variability of simulated cervical dilatation measurements. American Journal of Obstetrics and Gynecology, 173(3:1): 942‐945.

Roberts JE. (2002). The “push” for evidence: management of the second stage. Journal of Midwifery & Women’s Health, 47(1): 2‐15.

Smyth RMD, Markham C, Dowswell T. (2013). Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD006167. DOI: 10.1002/14651858.CD006167.pub4.

Vain NE, Szyld EG, Prudent LM, et al. (2004). Oropharyngeal and nasopharyngeal suctioning of meconium‐stained neonates before delivery of their shoulders: multicentre, randomised controlled trial. The Lancet, 364(9434): 597‐602.

Wiegers TA, van der Zee J, Kerssens JJ, et al. (2000). Variation in home‐birth rates between midwifery practices in the Netherlands. Midwifery, 16(2): 96‐104.

Zhang J, Troendle JF, Yancey MK. (2002). Reassessing the labor curve in nulliparous women. American Journal of Obstetrics and Gynecology, 187(4): 824‐828.

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