French women increasingly attracted by natural childbirth without epidural
Anna was 27 when she learned that she was expecting her first child. The young woman fears the distressing atmosphere of the hospital, its neon lights and the incessant passage of doctors in the corridors. She therefore chose to give birth without an epidural, at home, in the middle of the Breton countryside.
The environment is calming and she wants to feel the baby’s movements in her body. “My child’s dad was very present, during the preparation sessions, then on the day of the birth,” she says. The midwife also accompanied me throughout the labor. I remember a phase of intense pain, during which I regretted my choice. Then I gave birth to my baby and an incredible feeling of power came over me. I felt capable of anything! »
According to surveys and some professionals, natural childbirth – meaning without an epidural – is popular. In 2021, an Ifop study indicated that six out of ten women would like to give birth in a birthing center – less medicalized structures than in hospitals, where people give birth without an epidural. There are around ten in France.
More surprisingly, 17% of women would “totally” like to give birth at home if they had the opportunity. In fact, only 1% succeed. The epidural, which became popular in the 1990s and until then appeared to be undeniable progress for women by considerably reducing the pain of childbirth – barring complications – concerned 82% of deliveries in 2021, according to INSEE. We can therefore deduce that a certain number of future mothers going to the hospital are now also refusing the infusion.
“No peri” raises the hackles of obstetricians, but in public opinion, it is demonized thanks to the rise of podcasts or YouTube channels featuring mothers testifying. Desire for calm, rejection of technicality… The #MeToo feminist wave has also been there, leading in particular to the denunciation of obstetric violence. Giving birth to your baby without an epidural would be a way of regaining your autonomy from the medical profession.
In 2015, an Inserm study – the latest available – indicated that women under 25, those who had already had children and those from working-class backgrounds were more attracted to this type of childbirth.
In the water, standing, on your knees…
When the big day arrives, the candidates, who must neither suffer from diabetes nor be expecting twins, enter the hospital in a “nature” room, where a midwife accompanies them. They can choose to give birth in a bathtub, in a standing position or even on their knees.
Future mothers also have the option of going to a birthing center or giving birth at home, with the assistance of a midwife who will have to transfer the patient to the hospital in the event of complications.
Vocalizations against pain
When, at the age of 27, Marine wanted to give birth naturally to her first child, she had to fight to obtain a special room at the hospital, where no one was there to accompany her. “I was so stressed that I ended up asking for an epidural,” she regrets. For the birth of her second daughter, she turned to a trained midwife, with whom she practiced vocalization sessions to manage the pain.
“We don’t have a miracle method, but we explain to mothers what will happen so that they are ready,” explains Henny Jonkers, midwife at a birth center in Castres (Tarn). The follow-up is adapted to each person. We teach them to relax, to let go. » Marine gave birth at home, on her knees. Her partner and the midwife who followed her for nine months were near her. “I wouldn’t say I felt extreme pain,” she said. Rather, I experienced an act of great intensity. »
Outside the hospital, around a hundred liberal midwives are campaigning in favor of home birth – a risky adventure for them, because no insurance agrees to cover them in the event of complications. Isabelle Koenig co-founded the Professional Association for Accompanied Home Birth (Apaad) in 2019.
“I left the hospital environment ten years ago to practice global support and physiological deliveries,” she says. Women should have the choice of their birth, while we are in the overmedicalization of births. Giving birth on your back, immobilized by an epidural, as in 80% of cases, is not adapted to this physiological process, and the hospital environment is too stressful. The midwives who work there must accompany up to six patients at the same time. »
According to Isabelle Koenig, this anxiety-provoking environment would encourage future mothers to request an epidural, a technique which slows down labor and leads to a cascade of interventions. Are the contractions decreasing? An injection of artificial hormones is given. The patient no longer feels the baby and does not know which way to push? Forceps or caesarean section are required.
Yves Ville, head of the maternity department at Necker hospital in Paris, however, sounds the alarm about births outside the hospital: “A woman takes many more risks because there is no ambulance near her. Emergencies like placental abruption or serious hemorrhage are difficult to predict. »
In addition, this system is expensive for the hospital system, which has a notorious shortage of staff. The midwife must accompany the mother throughout the delivery, whereas in the hospital, she can follow several mothers under epidurals.
Without resources, how can we train more professionals in this method of delivery? The generalization of “natural” birth is not for tomorrow.