Thanks to the brilliant initiative of Millie Hill, positive birth is quickly becoming the new gold standard of achievement for pregnant mamas. For me, a positive birth means an empowered one. Here are my 6 savvy steps to achieving a birth that’ll leave you rocking out like a victorious Birth Warrior!
1 – Start in pregnancy
It’s never too early (or too late) to start creating a detailed birthing preference list. I call it that (as opposed to a birth plan) because childbirth is kinda tricky in that things can be unpredictable when labour gets going. Preference List, conversely, eludes more favourably towards the exercising of your rights to choose what your specific care plan would like in a range of possible birthing scenarios.
A good Birth Preferences List will be well considered, easy to read and quick to refer too. I’ve seen some Birth Plans that are 4-5 pages long prose. Whilst clearly a well-thought through and detailed document, it was difficult for the midwives to refer to efficiently and therefore difficult to consult (and implement). Birthing Preference Lists can include simple images and you can download free, easily identifiable symbols that will immediately communicate to your care providers your wishes.
When I work with pregnant clients to create Birthing Preferences Lists, we consider 3 main scenarios that include an ideal labour (Scenario A), a potential deviation with increased medical intervention (scenario B) and finally a scenario that involves delivery via caesarean section (Scenario C). Within those scenarios, we find the transferable preferences for example, it might be possible to include low-level lighting, soft music and delayed cord clamping from Scenario A into Scenario C.
2 – Use your BRAINS
Decisions you make in pregnancy may impact upon your birthing outcomes. Choosing to stay as active as possible, in pregnancy, for example, may support you in having an active labour. Choices you make around place of birth may impact your birthing outcomes (See point 4 below) so be sure that the decisions you make are congruent with your ideal labour scenario.
There is a lot to consider when making chooses about your labour care plan. Again, start early and give yourself enough time to research and discuss fully (with your partner or midwife) what your preferences are. Using the acronym BRAIN can be a really useful tool to help you fully consider all aspects of your care plan and making a truly informed-decision!
B – What are the BENEFITS with this course of action…
R – What are the RISKS…
A – Are there any alternatives…
I – What are the IMPLICATIONS of this? Will it lead to further INTERVENTIONS? What is my/ your INSTINCT/ INTUTION saying?
N – What would happen if NOTHING was done for an hour or two?
3 – Nurture your inner Warrior
A Birth Warrior is a brazen-faced mamma-to-be who yells “Yes, I can!” in the face of childbirth; who takes courageous, decisive action to manifest a powerful, shame-free birth. To do that, you have to get to work on your mindset. So much of what we achieve is a direct reflection of what we believe we are capable of (or not!). Be bold, be brave, have courage and believe in yourself. No doubt labour will be the hardest physical test your body will ever undergo but I know you are more than capable of rising to that challenge and conquering it, like the heroine-birthing-goddess you truly are. Do you know that yet? If there is any doubt, get to work! Training your mind is like training your body; a little work each day pays dividends. Create some birthing affirmations, display them where you’ll see them daily, build on your self-belief by reminding yourself regularly of all the challenges in life you’ve overcome so far, steel yourself with knowledge, research your birthing preferences. Stop at nothing!
4 – Consider your place of birth wisely
In 2011 the Birthplace study reviewed and evaluated the birthing outcomes of 75,000 women delivering at home, in birthing centres and labour wards across the UK. The study concluded that for women who had previously given birth, with a low risk of developing complications in her current pregnancy, her own home or a free-standing Midwifery Unit (FMU) were associated with lower rates of medical intervention and better outcomes for mum and baby. It also demonstrated that low-risk women birthing in obstetric-led units experienced higher rates of medical intervention, with poorer outcomes for Mum and Baby, with a higher Caesarean rate in comparison to those delivering in Midwifery-led units.
I always say to my clients that it’s important that they choose to give birth wherever they feel the safest. However, it’s still important to do the research because afterwards a persons sense of safety may have shifted. Its also important to choose a place of birth that is congruent with your desired birthing outcomes. A recent postnatal client of mine had elected to deliver under obstetric care; Even though she was ‘low-risk’, she perceived the care she would receive from an Obstetrician as being superior to that of a Midwife and that made her feel safe. Despite wanting an unmedicated, vaginal delivery, my client was delivered by emergency caesarean section after being given drugs to speed-up her (augmentation) and having an adverse reaction to the medications used, which significantly compromised the wellbeing of her baby. At no point were the benefits, risks or alternatives to augmentation discussed with my client, and at no point during her pregnancy did she consider that a midwifery-led unit may have been a better option for her, because she simply wasn’t open to it and therefore didn’t do the research. She now thinks differently.
5 – Assemble your A-Team
Whether it be your lover, your mum, your sister or your friend, calling upon the support of your loved-ones during your labour is a wise move. Receiving care from someone around whom you do not feel inhibited, someone who will care for you unconditionally can help you to feel safe, reassured and calm. But the role of the birthing partner involves so much more than simply providing a hand to squeeze. Your birthing partner is your coach, your cheerleader, your champion. When birthing, your partner should encourage, nurture and nourish you. They can have a huge impact on the progress of labour by managing your environment and providing loving touch in such a way that they help the release of Oxytocin (or hinder it, if they’re not careful!). So, it might be worth your time (and theirs) to read-up on exactly what they can do to help and what they ought to avoid.
Midwife and NLP Practitioner, Mark Harris has written a wonderful book for men – Men, Love and Birth – that covers just about all one would need to know if entering a birthing room for the first time. I also enjoy Penny Simpkin’s The Birth Companion for lay-wo/men providing labour support.
Most first time parents I meet tell me with hindsight that they wish they’d had a Doula to support them in labour. This is absolutely no reflection on the quality of care their partners were able to give but the facts are that when a labouring women receives continual care from a someone other than a relative (i.e. someone who is perhaps more able to retain some emotional distance) and not a medical professional from the hospital (e.g. Midwife, doctor etc), she is less likely to report feelings of mistreatment, has better outcomes for her and her baby, is less likely to want an epidural and less likely to have caesarean section.
The reality is, if your partner has never seen a baby being born – or you being tested to your physical limits – no one really knows how s/he will respond. A good Doula will support your partner to support you, enabling your partner to feel absolutely integral to your care which in tern will allow you to really lean-in to your labour. A good Doula will take care of you both, enabling your partner to take much-needed refreshment breaks without you feeling abandoned or vulnerable. If events take an unexpected turn or elevate to an emergency, having a Doula around that is well used to such events, can help to keep you and your partner calm and reassured and may even be able to continue to promote some of the ‘normality’ you had hoped for with a natural labour, despite events becoming medicalised.
Doula’s normally charge for their services and despite being worth their weight in gold, most offer sliding-scale fees, payment plans and Pro Bono work (usually based on household income). Some lesser experienced Doula’s may offer services for a reduced rate whilst they remain under mentorship. So, whatever your financial situation, hiring a Doula might be worth a second thought if you and your partner are keen to have an empowered birthing experience.
6 – Shield yourself the BS advice
“Just go with the flow…”
Arrrrrrrrrrrgh! If it were possible to ban phrases, I’d campaign for the outlawing of this phrase today, tomorrow and every freakin day hence forth until it was struck from the mouths of every well-intended, wanna-be do-gooder alive. This tiny and seemingly innocuous phrase insidiously places labouring women into a passive position where the experience of labour is something that happens to her, rather than with her. YUK! (Read more about why I hate this phrase here). That is NOT what we need for an empowered birthing experience.
“You’re not allowed”
Sorry, what?! Since when was anyone – other than you – granted power of attorney over your birth, your body or your baby?
There is no such thing as not being allowed in childbirth. There is “That’s not what I would recommend” or “That wouldn’t be in alignment with our usual hospital policy”, but healthcare providers in the UK have a duty of care to ensure that a pregnant women’s right to choose what is best for her and her baby is upheld, unless there is a serious concern regarding a pregnant woman’s decision-making capacity. And that is all there is to say about that. Rebecca Schiller says a lot more in her rousing book, Why Human Rights in Childbirth Matter. Go check it out, if you fancy.
And finally, one we hear ALL THE BLOODY TIME…
“My labour was HORRIFIC! If I were you, I’d…”
Well, she’s not you so STOP RIGHT THERE, thank you very much!