Whose birth is it anyway?

No-one forgets their experiences of giving birth, so it makes sense to do all you can to make sure it’s the most positive experience you can have – and no, that doesn’t necessarily mean a whale-song homebirth.

How many times do you think you’re going to give birth in your life? Once? Twice? And that makes it very special for you. Contrast that with the midwife’s experience of birth. In some busy hospitals, there will be an average of 50 births per midwife per year. Your ‘once-in-a-lifetime’ is her ‘everyday’.

Ask most pregnant woman what their ideal birth experience would be, and they focus on the physical. Not too much pain; not too much intervention; no scary moments or sudden surprises. But psychological research suggests that the women who come through birth feeling good about it aren’t those who escape without stitches: in fact, the actual mode of birth seems to have very little to do with it. Instead, being included in the process – that you were part of the decision-making, that you felt well supported and had established a good, trusting relationship with those caring for you – is the big one.

That’s why I’ve taken five key points that’ll help you make sure your birth is special, however it actually turns out.

Use tried-and-tested decision-making techniques from the very beginning

If you were buying a new car, or choosing a holiday you’d be making subconscious decisions from the very start of the process. What do you want it for? What’s important to you about this experience and what isn’t? Having a baby can be viewed as no different. We often get swept along in a tide of health professionals who don’t always offer us a choice, and we go along with it, because we’re told that’s the way it is. However, the NHS is getting bigger and bigger on the concept of ‘informed choice’, and your brain is there to be used. That’s an acronym:

• What are the Benefits?
• What are the Risks?
• What are the Alternatives?
• What does my Intuition say?
• What if we do Nothing?

Get yourself a good birth partner

Dads are a common site on labour ward these days, but professional labour companions, known as doulas, are also becoming more popular. A doula has had some training but is not a midwife: ‘The key thing is that the doula is chosen by the woman and her partner, so she’s not part of The System, and that she’s there really 100% for the woman and her partner. Her support of the partner is important as well – then he can support the woman better too,’ says doula Adela Stockton. You will get to know your doula in pregnancy, she remains on call for your birth, and you’ll see her a couple more times postnatally as well.

Anecdotes that a doula improves your birth experience is backed up by research, which cites fewer caesareans, easier experiences of breastfeeding and lower incidences of postnatal depression among women who have chosen to have doulas. Kate’s story confirms this: ‘I knew when I went into hospital I wouldn’t be cared for by a midwife I’d ever met before,’ she says, ‘but I had had four hour-long get-togethers with my doula before the birth, and it was so lovely to have her there. She feels like a special friend now. The worst point in my labour was when she left the room to go for a wee, and I remember shouting out, “I want Alison!” several times! She really was magic.’

Make the birth environment your own

The health secretary has said she wants home births to be available to all; midwife-led units are all the rage, and there’s always a good old-fashioned hospital with all the emergency equipment available.

But wherever you chose to give birth, you can go a long way to keeping the experience unique by personalizing the environment. Easy peasy if you’re at home, but if you’re in a birth centre or hospital, it might need some forethought. Adela recommends, ‘Think carefully about how to make your environment feel familiar and comfortable, because it makes a huge difference to how your hormones work. Bring in your own pillows and cushions. Stick pictures up on the wall. And try to control as much as you can who is in the room.’ Elaine, mum to Tim, 3, and Katie, 6 weeks, says, ‘I practiced a lot of relaxation before the birth, and always lay on a special blanket while I did it. The blanket came to hospital with me and it really helped me feel relaxed!’

Make a flexible birth plan

How many times have you heard women – and midwives – rolling their eyes when you talk about birth plans? Midwife Sarah Montagu suggests you have a plan A – your ideal birth – and a plan B, which would consider which parts of your plan you could retain even if things don’t go smoothly. ‘It makes you feel like you haven’t lost control of all the proceedings,’ she explains. ‘Simple things can make all the difference to someone’s birth,’ she says, ‘like finding out the sex for yourself. You can have the most pearshaped birth in the world, but there’s no reason why the surgeons in a caesarean would have to announce that.’ Adela’s take on birth plans focuses on the ‘feeling’ of the birth ‘Think about the environment, whether you want a busy atmosphere, that sort of thing. And keep it short. By all means mention interventions, too, though.’

In my antenatal classes I do an exercise which focuses on the two aspects of birth that are closest to their hearts. For some couples that might something physical like avoiding forceps, for example – for others more emotional, like the levels of support. It varies enormously. So I would encourage people to establish those points first, then to think through how best to achieve those aims.

Do your homework – books and classes

There is a huge amount of books and classes on the market, yet obstetrician (and author!) Michel Odent believes that pregnant women should keep their reading to a minimum, as it encourages intellectual activity, and birth is a primal, animal experience, not an intellectual one!

The little research that has been carried out into effectiveness of antenatal education always connects it with birth outcome, and the conclusions tend to be that it doesn’t make any difference. However, it may improve your level of satisfaction, particularly if you have learned decision-making techniques such as BRAINS. Anecdotally, women report that making a close group of friends – such as offered within traditional antenatal formats – makes an enormous difference to their experience of the postnatal period.

Ask around for the right book for you – there are huge numbers of books out there, and what gets one mum-to-be excited will send another screaming for the first epidural she can! Many local NCT branches hold a library of books relating to pregnancy and birth, so save your cash and ask them first, or visit your local library.

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~ by Kedi Simpson on April 5, 2011.