Modern Muslima.com :: Natural Pregnancy Q & A for Muslim Parents to Be ::

Natural Pregnancy and Childbirth Q & A
for Muslim Parents-to-Be
nb: this is intended for informational purposes only. for medical advice, please seek the expertise of a qualified health professional.
Q. Why "natural" pregnancy?
A. Pregnancy is a natural condition ordained by Allah subhannahu wa ta'ala. I personally feel that the "medical" view of pregnancy has lead many women to believe it is an abhorrent or unnatural condition, one that creates a deep sense of fear in many girls and women. The philosophy behind the "natural pregnancy and childbirth" movement is that trusting your body's instincts will allow you to proceed with minimal fear and pain, and will create the best situation for you and your unborn child. It is time for us to leave behind the view of some others that pregnancy and childbirth is a punishment for the sins of women, and to embrace the view that it is a gift and a blessing bestowed upon women by our Creator. Islam honors and cherishes the women who give birth, and it is time for Muslim women to reclaim this honor by approaching their pregnancies and childbirths with 'iman (faith), tawwakul (complete trust in Allah), education, and common sense.
Q. What about pre-natal tests in a natural pregnancy?
The American College of Obstetricians and Gynecologists recommends against ultrasound screening in low-risk pregnancies. Despite this, it is pretty common for almost all pregnant women to have at least one ultra sound during their pregnancy. (The American College of Radiology also discourages routine ultrasound screenings).
Amniocentesis, one of the most common pre-natal tests, is the withdrawal of a small amount of amniotic fluid to diagnose genetic disorders in the child. It is a common test for pregnant women over the age of thirty-five. However, there is a risk of miscarriage associated with amniocentesis. There are also ethical and moral issues raised for all parents, especially Muslim parents. No test can be 100% accurate or guarantee a "normal," healthy child. Women whose children are found to have genetic disorders are usually encouraged to abort a child which is believed to have a birth defect. Allah subhannahu wa ta'ala says in his Qur'an that "He creates what He wills." (42:49) He also reminds us that the believers will be tested. Therefore, the challenge for Muslims is to commit to raising a child with birth defects, not to wrestle with aborting him or her.
Q. What options do I have for pre-natal care?
Most women in the United States have three options when it comes to their pre-natal care: the Obstetrician, the Family Practitioner, and the Midwife.
The first, and most widely used, is the Obstetrician / Gynecologist (OB/GYN). These are medial doctors with four years of residency in the practice of obstetrics and gynecology. Some OBs can be very progressive and open minded, while others take a strictly medical view of pregnancy and may not be very supportive. Like all other MDs, OBs must carry malpractice insurance, and their risk of being sued when things don't go right (whether it was their fault or not) is very high. Therefore, OBs tend to be extremely cautious when it comes to things like "natural pregnancy," and "natural childbirth," and they are more likely to use medical interventions (pre-natal testing, induced labor, forceps delivery, C-Sections) than other birth practitioners.
It is also important to keep in mind that your OB practice may be a group practice. If you are on public aid, you will probably be steered towards a group practice in a public health clinic. One major disadvantage for the Muslim woman who is in a group practice is that you are often pressured and bullied into seeing more than one OB during your pregnancy, and you have no control over who will attend your actual birth. For the Muslim woman who is zealously modest or shy, having four, five, or even one male OB do vaginal and breast exams can be uncomfortable or traumatic. There are very few women-only group practices, and I can tell you that some practices do not take kindly to your insisting that you only see a female OB. Even if you do manage to see a female OB throughout your entire pre-natal period, there is no way of ensuring that she will be on-call or available to attend your delivery, and you may end up being delivered with a male doctor whom you who have never met. There is also no way of guaranteeing that a woman OB will be more sympathetic or empathetic to your experiences as a pregnant woman, and some women are very shocked to find their female OB to be very cold and uncaring.
You may also choose a "solo" or "partner" practitioner, meaning an OB who works alone or with one partner. Again, this arrangement has disadvantages. While you will have a lot more control over your pre-natal examinations, you do not have control over when you go into labor and when your OB has her vacation scheduled. If she is on vacation or sick when you go into labor, your birth will be attended by whoever is on call at your local hospital. Again, a stranger, and most likely a man.
For women with high risk pregnancies, using an OB is the safest way to go. Despite the privacy problems associated with using an OB, if your pregnancy is labeled "high risk," it is the best way to ensure that you and your unborn child come through the pregnancy and birth aided by technology and medical / surgical knowledge and expertise.
Q. What is a "Family Practitioner?"
A Family Practitioner is a doctor who took a three year residency in family practice, with at least three months in obstetrics and gynecology. Again, they can be very progressive and supportive of natural pregnancy and birth, or they can have a strictly medical / technology outlook. It is worth noting that family practitioners encourage a more "family wide" view of birth and pregnancy than OBs do. Another advantage to using a family practitioner is that he or she can provide care for your entire family, from babies to parents, and will therefore be more familiar with your family's needs.
Q. What is "midwifery?" Didn't midwives go out of style around the same time as covered wagons? Is midwifery a safe option in this day and age?
A. Midwifery is the practice of the midwife. Although it is often viewed with distaste as a relic of pioneer times, or a practice of the third world, the fact is that midwifery is growing in the United States, Canada, and the United Kingdom. In the United States, there are two types of midwives: Certified Nurse Midwives (CNM), and Direct Entry or Lay Midwives (DEM or CPM). CNM's are registered nurses (RNs) who have completed two additional years of training through an accredited program of the American College of Nurse Midwives. They may practice in hospitals, birthing centers, and attend homebirths. DEMs are lay women who have gained their training through practical experiences (on the job training) and workshops. They are not registered nurses. In some states, they are regulated and licensed; in other states, it is illegal for them to practice. DEMs usually attend birthing centers and, more commonly, home births. Both CNMs and DEMs do pre-natal and post-natal care. CNMs may also do well woman gynecology.
Insurers are now recognizing that midwifery is a cost-effective and safe alternative for women with normal pregnancies. Midwives have lower caesarian rates than OBs do. However, most midwives will refuse to treat a woman with high risk factors (gestational diabetes, multiple gestations, heart problems, etc.), and only an irresponsible midwife would continue to care for a pregnant woman with these conditions. Midwifery also costs much less (about $3,000 to $8,000 for pre-natal, birth, and post-natal care) than an OB (about $8,000 to $10,000 or more for pre-natal, birth, and post-natal care). Therefore, more and more insurance companies are accepting CNMs into their HMOs, giving you more choices when it comes to your pregnancy. If you do not have insurance, CNMs and DEMs may barter or use a sliding scale fee, or set up a payment plan. Also, Medicaid or PCAPs (pre-natal program for women without insurance who do not qualify for Medicaid) may cover midwifery care in your state. It is worth it for the Muslim woman to contact midwives in her area and find out if they accept Medicaid or PCAPs.
Q. Muslims are known for our strength in the American medical field. Why should I choose a midwife over a doctor?
A. If you have a normal, low-risk pregnancy, there is no reason that you can not have a midwife attend your birth instead of an OB/GYN. One of the biggest advantages for Muslim women in choosing a midwife is the fact that midwifery is woman centered. For the Muslim woman who has very real concerns about male doctors, nurses, or other hospital personnel examining and seeing her during pregnancy and childbirth, midwifery is a great alternative. Midwifery also tends to treat the pregnant woman as a whole woman, rather than a vessel carrying the uterus. This means that your emotional and spiritual needs and concerns will be taken into account along with your physical needs.  In my experiences, and the experiences of other sisters I have known, I have found that midwives are very open and empathetic towards Islam and the Muslim woman, and that they take a careful and supportive attitude towards hijab and our "women only, please" concerns.
Midwifery care also tends to be family oriented, meaning that your husband, other children, and even other family members are not excluded from the pregnancy and birth, but rather included and remembered as an integral part of the woman's support system. Since Islam itself places such a great deal of emphasis on the extended family, this can be very appealing to the pregnant Muslima who does not wish to have her husband and other children treated as peripheral personnel or unimportant in the birth process.
Midwifery also encourages that the mother take an active, not passive, role in her pregnancy. With some midwives, this can mean that you keep track of your own charts, do your own urine dips, and fill out some of your own records. Most midwives encourage, and some require, that their patients do a lot of reading on their own about pregnancy, birth, and childcare. You may be encouraged or required to take a childbirth class, a newborn class, a childhood CPR class, and / or a breastfeeding class. You may be encouraged to join a new mother's support class, and to engage in pre-natal yoga, massage, or exercise.
Q. What is a "doula?"
A. A "doula," also known as a labor assistant, childbirth assistant, or childbirth educator is a woman who gives support to the pregnant woman (and her husband) during pregnancy and childbirth. Many doulas also provide post-partum services, such as lactation consulting (breastfeeding education and help), house cleaning, shopping, doing laundry, and other things. Doulas can attend both midwife attended and OB attended births.
Doulas can provide a voice of advocacy to parents (especially first timers) who may feel shy or unsure about voicing their wants and needs to hospital staff. The presence of a doula also means that Dad or other birth attendants can take a break or a nap and not worry about Mom being left alone. Doulas can help Mom and Dad (especially first timers) understand aspects of birthing that they may not be familiar with, and explain the 'lingo' to them.
Sometimes, fathers to be (especially first time dads) may be too anxious and stressed out over the impending birth to give full support to the woman. Other times, he may not want to attend childbirth classes with her. Some new fathers to be prefer not to have to focus on childbirth techniques, at the expense of missing out on the experience of the birth itself.  For women who feel that their husbands may not be able to (or may not want to) give them the full support and attention they need during childbirth, a doula is a great option.
There are also many Muslims who come from cultures where men simply do not attend birth, as it is viewed as a "women's events." In cases such as this, the husband may be very uncomfortable attending the birth, and might refuse out of nervousness or shyness. With family far away, the women runs the risk of birthing her child without any family or friendly support. In cases such as this, a doula can be a valuable ally for the couple.
I would also like to point out that being a doula is a great career opportunity for Muslim women, and their services are sorely needed by Muslimas around the country. The cost of employing a doula varies from region to region, and depends on exactly what services they are offering you. If you can not afford to hire a doula, you may want to consider having your sister or best friend act as your labor assistant.
Q. What is a birth plan, and why should I have one?
A. A birth plan is a written statement from you and your husband outlining in detail exactly what you want (and don't want) during your labor, childbirth, and post-partum stay. You and your husband should write one, sign it, and give copies to your doctor or midwife and doula. If you are giving birth in a hospital or birthing center, you should make sure that a copy of your birth plan is in your file.
Birth plans are important because they enable you and your husband to control the situation (as much as you can control childbirth, anyway). For instance, many a laboring mother has been shocked to find out that once she is in the hospital, her wishes are not necessarily followed, and she may find herself strapped to a bed, with a fetal monitor, and being given an enema, even though this is not what she wanted. The husband and wife who desire utmost privacy may find male orderlies, phlebotomists, residents and interns, and other male personnel trooping in and out of their room during her labor, birth, and post partum stay. Families intending to breastfeed are often shocked and dismayed to find that they are not necessarily encouraged by the hospital staff to breastfeed, and that their newborn may receive supplemental feedings or bottles of sugar water while in the nursery.
It is important to note that just because you have a birth plan detailing what you specifically want and don't want, it doesn't mean that life will run according to your wishes. You may write in your plan that you do not want a C-Section, but circumstances may end up forcing you to have one (for your sake and / or the child's sake). Having a birth plan means that you can avoid having any interventions unnecessarily, as well as helping to ensure that your after-birth care follows your family's wishes.
Q. What are my options when it comes to giving birth?
A. In the United States, you have four options when it comes to giving birth: hospital birth, hospital birthing centers, free standing birthing centers, and home birth.
The first, and most common option, is a hospital birth. If you are using an OB or family practitioner, you will more than likely end up delivering in a hospital. (Some CNMs may also do hospital deliveries). Depending on where you live, your income level, and / or your insurance, you may give birth in a small, basic-care rural or semi-rural hospital, a large suburban hospital, a state or county operated urban hospital, or a high-tech University (teaching) or private (secular, or religious) hospital. Some hospitals, especially teaching and private hospitals, tend to be very cutting edge, and your labor and delivery room may have a "home like" environment with all the latest technology integrated in the design. You may have access to a shower or jacuzzi, rocking chairs, a double-sized labor bed, and other goodies. In other hospitals, especially older, public hospitals, you may labor in a semi-private or private room, and then be transferred to a delivery or operating room for the actual birth.
No matter the design or layout, a hospital is a hospital is a hospital, and the staff there has been trained to view birth as a medical, not necessarily natural, event. You are much more likely to be subject to medical interventions (such as IV drips, constant fetal monitoring) and non-medical restrictions (no food, no movement) in a hospital than in a birthing center or in your home. You are also subject to the work schedules of the labor and delivery staff, and depending on how long your labor goes, you may be attended by a rotating staff of nurses and other personnel. If you are in a teaching hospital, you will be interrupted by medical students and residents eager to examine "another case," and may be subject to repeated vaginal exams (not safe or necessary) and the same prying questions over and over. (A note: You CAN refuse to let a medical student or anyone else give you repeated vaginal exams during labor. You and your husband can insist that a labor and female delivery nurse check your cervix and report the findings to the doctor on call, if the doctor is a male whom you have not met before. Repeated vaginal exams during labor are unnecessary and can cause infection.) You may also not always have control over who comes in and out of your room. This means that male orderlies, phlebotomists, nurses, doctors, students, residents, interns, and dietary servers may enter your room.
If you will be giving birth in a hospital, it is imperative that you first take a tour of the center's labor and delivery area, the maternity ward, and the nursery. You should take notes and ask questions. Ask about the cesarean rate at the hospital, as well as the percentage of forceps deliveries and vacuum extractions. Ask when (what stage of labor) and how often epidurals and other drugs are given, and what percentage of women take them. Find out how long the normal post-partum stay is. Ask about newborn testing procedures, as well as issues such as rooming in (where your child stays with you, instead of going to the nursery), and supplemental feedings in the nursery. If you feel the slightest bit uncomfortable about the environment there, or if you feel that the staff is less than competant and caring, you must discuss this with your husband and your care provider. What may be a "small annoyance" or nagging feeling when you are seven months pregnant can become a huge issue when you are in labor or your post-partum stay.
Q. What is a birthing center?
A. A birthing center is a place exclusively designed for labor and childbirth. There are two types of birthing centers. The first type is in hospital, a birthing center run by a hospital that is usually housed on a separate floor from the medial labor and delivery floor. The second type is freestanding, an independent birthing center which is affiliated with a hospital, but not under their control or administration. (Freestanding birth centers are usually located within a few blocks of a hospital, if not directly across the street or next door). The average stay in a birthing center is four to twelve hours. (You do not stay overnight, but are required to go home the same day with your family, if there are no complications.)
More and more insurance companies are finding that childbirth in a birth center is as safe (or safer) than hospital birth, and that it is more cost-effective to boot. Therefore, it is worth it to find out whether or not your insurance plan benefits cover birthing centers. If you are on Medicaid or PCAPs, it is MORE THAN WORTH IT to call any and all birthing centers in your area and find out if they accept these programs. Many Medicaid and PCAPs patients report being treated very poorly or being discriminated against in hospitals, to the extent that in New York City, Medicaid patients (mostly Black and Latina) were placed in a separate, more public (noisy), less modern ward of a large University hospital than privately insured (mostly White) patients. If you do not have health insurance, and do not qualify for public health programs, you will find that birthing centers are much less expensive than hospitals, and that they are more likely to work out some sort of payment plan with you.
A note, when checking out an "in hospital" birthing center, it is important to take a tour, ask questions, and get as much literature as possible about the place. Some hospitals add a rocking chair and a bathtub to their labor and delivery rooms, and then call it a "birthing center." If you do not find out about the philosophies and procedures of these "birthing centers," you may find yourself in for a rude shock when you go into labor. A good sign that the in hospital birthing center holds a natural childbirth philosophy is if it is staffed by CNMs, encourages you to go home the same day, and allows for eating, drinking, and free movement during labor.
Birthing centers are attended by any combination of OBs, CNMs, RNs, and DEMs. The environment tends to be very "homey," with double or queen sized beds (regular beds, not hospital beds), large bathtubs, kitchens, couches, rocking chairs, and areas for your family to relax. The philosophy in a birthing center is that birth is a natural, woman / baby directed process, and that intervention is rarely necessary. You, the laboring woman, will be allowed to direct her labor, by being allowed to eat, drink, move around, bathe or shower (hot water can ease labor pains), dress as you please, and labor in the position you please (laboring on your back with your feet in the air actually slows down the labor process). Staffs of birthing centers are committed to drug free labors and births, and if you want to avoid an epidural or the use of drugs in your labor, it is worth it for you to check out a birthing center. Your husband, mother, sister, best friend, and whoever else will be allowed, even encouraged, to support you during your labor and birth, and be included as important members of your "childbirth team." In most (if not all) birthing centers, older children are also allowed to attend the birth, as long as they have a babysitter or someone else to take care of them when necessary.
For the Muslim couple, being given this much control over their environment can be comforting and empowering. In a birthing center, you, the laboring woman, decides who comes in and goes out (aside from your midwife or OB of course!) You and your husband will be allowed to stay with the baby at all times, and immediate breastfeeding will be encouraged and supported. For those Muslims used to having extended family support, knowing that the birthing center will welcome your family and traditions can be a big relief.
Most importantly, most free standing birth centers are located within walking distance or a short drive to a hospital. Should any complications arise during labor, birth, or the post-natal period, you will be assured that medical assistance is only a short distance away. Therefore, while you can avoid unnecessary medical interventions, you have the comfort of knowing that life-saving procedures are a short distance away.
Q. Isn't homebirth something they do out in the sticks, or in some third world country? Why on earth would anyone give birth at home in this day and age?
A. Homebirth was fairly common in the United States up until World War II. Before that time, hospital birthing was seen as the option for poor and destitute women, and hospitals were avoided by birthing couples because of the rampant diseases therein. While it is usually viewed as the domain of poor country people and left over hippies, homebirth is growing in popularity among middle class and upper class, suburban and urban families all over the United States, Canada, and the United Kingdom. In other places, especially Muslim countries, homebirth is something that never really went away. If you are a Muslim who immigrated to this country (or whose parents did), chances are that you, your older siblings, or your parents were born at home, attended by a midwife.  For a healthy woman who is undergoing a normal pregnancy, homebirth is just one of her three options.
For the Muslim woman who is having a normal, low-risk pregnancy, homebirth is attractive for several reasons. The first is that she has complete control over her birth environment, and over who enters it. For many Muslimas, this means relief from the spying eyes of nurses, orderlies, residents, interns, phlebotomists, and other personnel in a hospital. For other Muslimas, especially those with large families or restricted incomes, the relatively low cost of a homebirth is the main attraction. Homebirths can be attended by CNMs, DEMs, OBs or family practitioners (rarely, because of malpractice concerns), or even unattended (not highly recommended by Modern Muslima).
When considering homebirth, it is important to keep a few things in mind. One, how far do you live from a hospital? If there were a complication, how long would it take you to drive to the hospital? If there were an emergency, how long would it take the EMTs to respond? Two, is homebirth forbidden on your rental agreement or lease? If it is, you may be evicted if you give birth at home (of course, hardly any landlord actually includes homebirth on the list of verboten deeds, since it is thought by many to be non existent. If it is not specifically mentioned on your lease, then you are legally allowed to give birth at home, and you can't be evicted for this reason.) Three, do you have enough room? If you have a studio or one bedroom apartment, you may find that things get a little crowded during labor, and this can irritate you.
Four, consider who will be attending you, and whether or not your insurance covers this. If you are being attended by a DEM in a state where lay midwifery is illegal, your midwife can not accompany you to the hospital in an emergency, nor can she sign the birth certificate, or ever admit that she even attended your birth. If there is a complication with the child after birth, you may then be held responsible for this, and may even be prosecuted for child endangerment. You may also find that obtaining a birth certificate is a hassle. If you must be transferred to a hospital by ambulance, you may find that your insurer refuses to cover the cost because of this. Therefore, make sure that your birth attendant is licensed, and that she carries malpractice insurance. If you do not have insurance, and qualify for Medicaid or PCAPs, you may be required to see a clinic OB, and pay for the midwife out of pocket if you wish to have a homebirth.
However, it is important to keep in mind that women have safely delivered babies in their homes for hundreds of years, and that childbed fever and death in childbirth were more than likely the result of ignorance about germs rather than the danger of your own bedroom. Preparation required to get your home ready for birth is actually minimal. Your midwife will visit a week or so before the due date to make sure that the home is clean and clutter free, and she will give you instructions on how to sterilize the bathroom and the bedroom (or which ever room you are birthing in). Your midwife will also have a "home birth kit," or you may be required to buy it from a supplier, consisting of thick plastic sheets, and pads, in order to minimize the mess. The midwife, her assistant, and / or your doula will also take care of all the post-birth cleaning.
Q. What is natural childbirth?
A. Natural childbirth is labor and delivery without the use of invasive and potentially harmful techniques (such as fetal monitors) or drugs (such as Demerol, or epidurals). Oftentimes, in a normal childbirth, these techniques can actually slow down the labor, or create other difficulties for the laboring woman, which can lead to forceps delivery, vacuum delivery, or even cesarean section. The philosophy of the natural birth movement is that women and their birth partners (husband, mother, or doula) should prepare for childbirth through a childbirth education course. Natural childbirth encourages eating and drinking during labor, walking or changing positions during labor (as opposed to laboring in a bed on your back), and using baths and hot showers (hydrotherapy) to reduce the pain of contractions.
Without a doubt, the biggest obstacle for American women (Muslim or not) to overcome when it is time for birth is fear, especially the fear of pain. Fear and anxiety are known to contribute to problems in labor, because the adrenaline produced by fear actually causes the cervix to tighten. It is important to talk out these issues with your husband and care provider well ahead of time. You should also attend childbirth classes and learn relaxation techniques, so that you can better learn how to deal with fear and pain.
Q. I wouldn't get a root canal without drugs, so why should I give birth to a child without some sort of pain relieving drugs? Islam is not against the use of pain relieving drugs when it is necessary.
Natural childbirth proponents call labor pains "pain with a purpose." Some Bible-based religions view it as the necessary punishment for the "daughters of Eve," based on what they call her sin (Islam does not believe that Eve was alone in sinning, and our religion does not teach that menses, labor, and birth are punishments for women, but rather natural courses that are a sign of Allah's Creation and Majesty.) Islam is not against pain relieving drugs when they are necessary (vs. when they become an addiction), but Islam also teaches that childbirth is a natural process, and Islam is against the introduction of procedures or practices that can harm another or cause irreparable damage to the recipient and a third party (in this case, the third party is the child). Smoking is judged as haram or makruh because it harms both the smoker and those around him. Similarly, drugs and unnecessary procedures can harm both the mother and the unborn child. Introduction of interventionist techniques (such as an epidural, Pitocin, or narcotics), can cause a spiral of interventions, with more procedures being introduced in order to "fix" the effects of the previous one.
The guidelines of the World Health Organization call for the avoidance of pain relief (such as Demerol) and anesthetic drugs. However, in the United States, some 75 to 90 percent of women in labor receive an epidural. Many women are poorly informed or misinformed when it comes to the epidural and the risks of an epidural. Often, they are either committed to the epidural months beforehand (thereby enabling themselves to avoid facing their fears of labor and childbirth), or they are introduced to the idea by a nurse or doctor during labor, when judgment is impaired and their resistance is low. An epidural is injected into the woman's spine with a long needle. She must lay motionless on her side for twenty or thirty minutes while it is being injected by the anesthesiologist. The epidural causes her lower body to go numb, thereby allowing her to no longer feel the pain of the uterine contractions. However, it also increases the likelihood that she will be hooked up to an IV, thereby requiring her to remain in the supine (on the back) position during labor, which will make the pushing stage much more difficult.   The drugs used in an epidural are of the same family as Novocain and cocaine; in some epidurals, morphine (synthetic heroin) is also used. Side effects from epidurals can include severe headaches, backaches, fever, and numbness or weakness in the arms and legs. The type of headache that one gets from an epidural is a "spinal headache," and it makes your normal headache or migraine look like child's play. These headaches are extremely painful, and can last for days. When being given the consent forms for an epidural, many women find that the risks are either brushed aside or discussed hurriedly, as though they were small risks. Epidurals are associated with an increase in C-sections, forceps deliveries, and vacuum extractions.
It is known that any drugs taken by a pregnant woman cross her placenta and enter the unborn child. When the epidural or pain killer is given to the woman, the dosage is based on her weight, not the projected weight of the child. Therefore, a large dose of these opiates and anesthetics are entering the baby's body. Some of the effects of an epidural on a newborn include: jaundice, and lower muscle tone and strength, which cause a poor sucking reflex. They may also score lower on motor skills tests.
Q. How can I avoid pain without the use of drugs then?
A. You can't. Childbirth is painful. You can either avoid this pain, and increase your risk for a C-section and other interventions, or you can learn pain management techniques. Almost all care providers recommend that pregnant women and their husbands take a childbirth course. This is usually in the Lamaze method or the Bradley method. However, after taking one of these classes, it is important to remember that childbirth proceeds as childbirth does, and there is no guarantee that you will have a textbook birth. It is also imperative to remember that completing one of these courses and "mastering" the techniques taught there doesn't mean that you will be able to control your labor or proceed without pain. What you should learn from these courses is not just how to use these techniques, but how to face and manage fear and panic during labor.
Common natural childbirth pain technique managements include sitting, standing, squatting, or laboring on the hands and knees. There are special pillows and birthing chairs and stools to help you maintain your balance in these positions. You may also find that the positions of the salah (ritual prayer) help you to manage pain, especially the sajda (prostration) position. You may wish to talk to a scholar or sheikh about making salat in labor. Some shayukh hold that it is haram to pray once your waters have broken, and some say it is not. In any case, labor pains can start before the water breaks, and you may find some comfort for your pain in the emotional and intellectual absorption of salat.
Walking, rocking, and swaying your body may also help you to manage the pain of labor. Hydrotherapy, or the use of warm water in a shower or tub is extremely helpful for both your mood and your pain, and you can have your midwife, doula, or husband give you massages and provide pressure point support for your back during contractions in water. Most hospitals forbid a woman to eat or drink during her labor, but many laboring women find that they feel better (and have more energy) if they keep their blood sugar and hydration levels up by eating and drinking light and easily digestible foods and water. Midwives and some doctors may recommend homeopathic remedies, such as teas, aromatherapy, herbs, and massage oils to ease pain and encourage relaxation as well. Finally, you can exercise some control over your environment. If you are at home or in a birthing center, you will be able to control what you wear. This means a comfy t-shirt or night gown, as opposed to that hideously uncomfortable hospital gown. You can close the curtains and lower the lights if it makes you feel better, you can put on Qur'anic tapes or meditation tapes, use candles, etc. You and your husband, family, etc. may engage in prayer together, recite du'as, recite Qur'an, make dhikr, etc.
Forewarned is Fairwarned...
Some natural pregnancy and childbirth sites and books are extremely "anti-medicine" and "anti-OB." Do not let these people scare you away from the medical establishment. Muslims who are interested in natural childbirth should view obstetrical medicine as something available to them in the event of a high risk pregnancy or emergency. Obstetricians and obstetrical nurses are trained to give you the best possible treatment in the event of an emergency or unusual development. However, because much of their training involves unusual pregnancies, they are more likely to view the normal pregnancy as a pathological / medical condition rather than a natural one. The pregnant Muslima who has just been told that she has gestational diabetes should not shy away from using an OB, but rather she should devote her energy to finding an OB who can handle her condition while allowing her to control her diabetes, pregnancy, and childbirth.
It should also be noted that some of these books and sites will give you information regarding OBs and their preferred procedures which is patently false. Please research claims regarding medical interventions and other procedures carefully, and use more than one source when you are making your decision.
Finally....
The kind of birth you end up having does not necessarily determine the kind of parents you will be. If you end up using pain killers, getting an epidural, or having a C-section, you shouldn't feel as though you have failed yourself, your husband, your family, and your child. We, as humans, can plan, but Allah is the Best of Planners, and no one can divert Him from what He has written for us. What you, as someone who wishes to be a responsible, compassionate, and loving Muslim parent SHOULD do in preparation for your birth is become educated about risks and options, about choices and methods, and choose those which are in line with the teachings of the Qur'an and Sunnah. Modern Muslima advocates natural pregnancy because I believe that it is the best option for the mother and the unborn child, as well as her husband and extended family. I believe that treating birth as a natural physical process, instead of a scary medical event is more in keeping with the teachings of Islam, and I wish for other Muslimas to have this information so that they can make an educated choice about their pregnancies and births as well.
� 2000, Saraji Umm Zaid.