Effective non-pharmacological birth interventions.

Midwifery expertise is in 'normal' birth. What constitutes 'normal' is debatable, but well embedded within 'normal' are the birth plans of women who aspire to give birth without using drugs. To give birth without drugs for many may seem undesirable or intolerable, especially to those whose cultural references to birth have been overwhelmingly negative, fearful or risk-obsessed. However, significant numbers of women have confidence in their innate ability to birth their babies and are rightfully concerned about the undesirable side effects of pharmacological interventions. As well as providing wider choice for women, looking for alternative ways of addressing pain and progress in labour enhances birth attendants' knowledge and becomes a delightful journey of discovering the ancient and modern arts of midwifery. Shared here are a collection of ideas to contribute to the toolkit of knowledge about non-pharmacological interventions.

To push ... or not to push?

I was formally asked by my supervisor of midwives to reflect upon two episodes of care. Both of these involved women who would be termed as 'low risk' primigravida and in both instances the women had considered whether, had they been advised against pushing when it was 'too soon', they might have avoided caesarean sections. To help this process I used my own reflection triangle: 'What happened ... Was it OK ... What about next time?' informed by the Gibbs model (1998). In this paper I present my reflections alongside my reflection triangle.