One of the advantages of home birth is that the mother chooses the most suitable place to give birth and that is where the whole process takes place, without affecting mobility. That is, dilation and expulsion occur in the same area. This would also be possible in hospitals that, however, usually have dilation rooms and delivery or expulsion rooms.
And although obviously the environment will not be as cozy as that of our own home, much could be done in this regard to improve it in the hospital. One of the issues would be to determine a unique place for delivery.
If the ideal is that the whole process of childbirth takes place in a single space so as not to deconcentrate the woman, and avoid her transfer at a delicate moment at the hormonal and emotional level such as the onset of the expulsive, this should be favored and implanted in the hospitals
According to the report “Integral architecture in Maternity”, prepared as a support material for the Normal Birth Care Strategy of the National Health System, it is not necessary to change the woman from the room because she does not have a “colt” or traditional obstetric bed where the dilation has occurred.
Some hospitals allow the woman to give birth in the same room. In any dilation room, the expulsion phase can be attended, either in the bed, in different positions according to the degree of mobility of the woman, or on the squatting floor, clutched to the bars of the bed. This is, favoring the posture that the mother spontaneously adopts, a premise that WHO indicates as necessary in normal delivery care.
If a complication occurs, the transfer for medical reasons (and here there would be a great advantage over home delivery) can always be done later and quickly to a conventional delivery room or operating room.
Delivery in different rooms, but better conditions
When organizational structures or needs make the change of space when the expulsive arrives, it is convenient to try to do it calmly, with the maximum possible privacy, avoiding that the woman crosses many people on her route, and if she does not carry epidural anesthesia, that she can do the route on foot if she wishes, since in this way Pelvic balancing and the descent of the baby through the birth canal are facilitated.
In this sense, it is also interesting to allow women in the first phase of labor, during active dilation and if the characteristics of the center allow it, to walk through other dependencies, through the aisles ..., accompanied by the chosen person, or even sometimes from the midwife. And of course, not forgetting the freedom of movement for women to choose naturally those positions that mitigate the pain of contractions.
As labor progresses, hormonal influences tend to make women seek “shelter” in a space where they feel sheltered and protected, safe, which Michel Odent exemplifies, reminding us that we are mammals, with animals that are isolated to giving birth.
We will see in what ways the physiology of childbirth can be favored and the needs of women in the hospital be met when labor occurs, as with the same room for dilation and expulsion, a solution that requires heavy investments in infrastructure, but that could gradually become widespread in our environment.
