As you can imagine Jo, I often find myself reflecting on the issue of choice. I am often appalled by the birth stories I hear from parents attending my classes. Increasingly it appears to me that their experience more often than not pivots on who attends them during labour.
This was highlighted to me very recently when a local midwife observed one of my courses. Within minutes of meeting her she was telling me how much she enjoyed her job as a midwife unlike (and I quote) “ most of the miserable lot who don’t give a hoot about it”. I asked if she thought these midwives were unkind to the women in their care, she replied “oh yes, definitely, that can be the case, yes.”
I encouraged her to talk to the group about what they could expect whilst they are in hospital. At one point she discreetly took me to one side to say she didn’t think that I ought to tell parents that they have a choice about being monitored ( we were talking about women who have had a straightforward pregnancy, and spontaneous labour being intermittently monitored rather than EFM ). She said that as midwives they hated EFM for this kind of labour and “fight” not to use it but if told to by a Dr they would have to use it. She said this was more likely to happen with a junior Dr (!) She said there would be no choice; the woman would not be allowed a choice. I asked her if she thought this was right for the woman, she said no she did not. I asked her if the woman would be treated differently (as in poorly) if she asked to be monitored intermittently, she said yes she would be treated a as trouble maker. This is a midwife who loves her job!
I acknowledged what she was telling me and said I understood why she thought it was inappropriate for me to be talking about choice, when in reality those choices may not exist. But it just feels so wrong! I can’t not discuss choice when being part of the decision making process has such a long term positive influence on a woman’s mental and physical wellbeing.
Since then I have been pondering whether women who know they should have a choice but when in labour are given no choice or made to feel like a trouble maker are actually more disempowered and have a less positive birth experience than women who were unaware they had a choice. I feel heavy of heart to know that women are treated so unkindly.
Another woman I encouraged to believe in her own body’s ability to give birth, arrived in hospital to be told at a glance from a midwife that her bump is huge and she will most likely need a caesarean. She goes on to have an assisted vaginal birth. She wonders why no one else picked up on the fact her baby was so big (8lbs!) and I am left wondering if a midwife like you Jo, would have treated her differently, with respect and with the belief that she was the best person in the world to birth her baby, and if she was upright and not on her back for the later part she may have birthed her baby with ease, without instruments and may now think he was a perfect size. Would she now be confident that she has enough milk to feed him rather than giving him extra hungry formula because she believes he is a big baby and he needs more than she can provide. This woman said that next time she will have a planned caesarean because her baby will be too big to birth vaginally. She is left feeling that her body has failed, because of one midwives thoughtless comment.
I realise I have been ranting but I feel so little and powerless to make any difference.
Ask any women planning a home birth and they will tell you that there seems to a universal response “You must be Crazy!” Can I point out that if you plan to have your baby in Hospital you will have hours of labour at home alone without a midwife. You may even get to the point where you think “this is it I am nearly there” only to be sent home from the hospital as you are not deemed in need of midwife support yet! Having a planned Home birth the midwives come to you!
Here are reasons why you may want to consider a home birth.
Oxytocin is the hormone that women release in labour and for birth to progress normally without intervention we need to create the right conditions for this hormone to flow. These Conditions are
• You feel uninhibited.
• You feel safe
• You know and trust those with you
• Relaxing music is playing.
• Dim lighting or in the dark
• A lot of caressing
• You are being encouraged
You feel safe in your own surroundings so staying put and having your baby at home actually improves the flow of Oxytocin so keeping birth normal. Now add the support of a midwife who is solely concentrating on you and your baby’s wellbeing, a Midwife who won’t leave you and you have already got to know then you are going to have the very best chance of a normal birth!
I want to tell you just how critical the period from Conception to birth is in the emotional and physical development of your baby. It is for this reason that you must be happy to accept that a hospital birth will increase the chances of interventions such as “Augmentation “(speeding your labour up) separation of you and your baby and early cord clamping . All of which will have implications for your baby.
On line forums are often quick to criticise those of you who choose to have a homebirth as putting your wishes before the safety of your baby and label one as selfish for choosing a homebirth.
What is selfish about choosing?
• A natural birth shielding your baby from Narcotics.
• Preventing your baby from being rushed or hurried by promoting a physiological birth.
• Delayed cord clamping a natural transition to life outside the womb for your baby.
• Undisturbed birth with skin to skin and dim lighting for your baby to bond with you
Another popular quote is that either the mum or the baby would have died if they hadn’t been in Hospital. In many of these cases there has been a cascade of interventions that have led to the emergency situation and had the women chosen homebirth the interventions may not have been needed!
On a personal note, I have been supporting women for 25 years and have observed that women have great outcomes when they choose to give birth at home with the support of a midwife who is comfortable with this setting.
I have spoken and blogged many times on the subject of Oxytocin and its importance at birth and in the early days of a babies life. Well here is a video that shows how it can even cause a predator to turn protector. Yes when 3 ducklings were found by a cat who had just had kittens thanks to the amazing power of Oxytocin creating over whelming feelings of love, bonding and protection in the cat, she takes on the ducklings as her own offspring!
Raw honey is an all-natural food that is delicious and packed with an enormous amount of nutrients. Here are five ways raw honey can improve your overall health and well-being:
1. Fights against allergies. While the research for this is lacking, many individuals say that using raw honey has helped lessen their allergy symptoms. It may be suggested that raw honey strengthens immunity, therefore building a defence system against allergic reactions.
2. Improves digestion. Raw, natural honey contains digestive enzymes that can help break down food more easily, which strengthens the digestive system and fights against digestive-related illnesses.
3. Helps relieve cough. Raw honey is potent with anti-bacterial properties and other anti-inflammatory compounds that may help soothe upper respiratory infections. Many parents use raw honey for their children with a persistent cough because of its sweet taste and massive bacteria-fighting potential.
4. Soothes skin. Using those anti-bacterial, anti-fungal, and antiseptic elements, lotions or skin creams that contain raw honey can help relieve skin irritations, as well as improve skin moisture, promote wound healing, and encourage a youthful glow.
5. Enhances brain functions. Eating honey before going to bed may help reduce stress hormones and produce more melatonin, which is known to aid with sleep as well as being an important hormone in learning improvement. Raw honey is a potent supplement that can enhance overall mental functions, as well as provide stress relief, better memory and sleep support.
Here the renound Obstetrician talks about the primitive archaic brain structures that result in birth being an involantary process. The birth process needs to be protected against stimulation of the neo cortex, the midwife needs to be able to protect women from being in their neo cortex. What sort of midwife would be perfect for protecting women so they can get into their birth mode… A mother figure ! The basis of our cultural conditioning today is that a women can not give birth by herself she needs someone with her , they can not give birth by themselves. Many socities have beliefs that make it necessary to have another person at the birth eg. female genital mutilation. A women needs help she can not do it by herself. This is cultural conditioning. I emplore you listen to Michel Odent and his message about natural childbirth.
You are unique, and fantastic, and a perfect human being, as is your baby, your pregnancy and birth matter so much. I became an Independent midwife to ensure I could continue to support women through this amazing journey in the best way possible. Please take time to consider your choices in who attends you during this time. It is one of the most important times of your life.
As an Independent Midwife I work intensively during your pregnancy to maximize the chances of your wishes coming true. I am available for you between visits to answer any questions and help allay your anxieties. I offer you massage let you borrow books and DVDs, however most importantly I get to know you and your family and your unique qualities and needs. You will have the opportunity to discuss the things that trouble you and cause you anxiety and together we can formulate a birth plan.
A lot of people carry fear about birth, both men and women alike. Each of you will have a lot of preconceived ideas about birth long before you have your first baby .How you feel about the forth coming birth will depend on what you have watched on “You tube” or TV documentaries. May be reading birth guides listening to Women’s hour discussions or simply seeing babies being born in a Soap Opera these will have influenced your levels of anxiety.
Gaining control in a fearful situation means trusting those around you. The feeling that you have choices and that you hope you will be supported with your choices is at the heart of trust and once you feel you can trust your care givers then your fear will subside. Having a midwife that you get to know and trust who’s going to attend you during one of the most intimate acts of your life will help you build confidence about birth. This is the different from the NHS as you never know who will be at your birth. I on the other hand will get out of bed in the middle of the night to come to your birth whenever it happens and it won’t depend on if I am on duty or not as I am on call for you 24/7! I’ll hold your hand, or sit quietly offering words of encouragement to you and your partner because I will already know you. I will have taken your resting vital signs on many previous occasions and know your full medical history I will be familiar with your baby’s position and gestation. I am with you throughout you need not fear that my shift will end and someone else will take over.
If the birth journey encounters an obstruction I will arrange for your transfer to Hospital and accompany you to the Hospital I do not hand you over to the Hospital staff and then leave you. I will work hard in Hospital to be your “gate-keeper” to help protect your choices. In the case of a Hospital Transfer you will always know it was necessary due to my years of home birth experience.
Following the arrival of the baby I am on hand to help you welcome and feed your baby helping you to assimilate the birth outcome. I spend an intense amount of time visiting you at home in the early days and in this way breast feeding will have the best chance of success and you as a new Mum will be nurtured in the way you deserve.
I have been so privileged to have been invited on the birth journey of so many women and seen them transition into amazing new Mums!
Only 2% of births happen at home and this means that 98% of births are taking place in Hospital. Why are you all convinced that the Medical model of birth is best? This picture is of Agnes Gareb who is under house arrest for supporting Home birth in Hungary.What does it mean in Britain to give birth in Hospital? Once you go to the Consultant Unit to have your baby then you are exposing your selves to the following philosophy…..
The Medical model views pregnancy as high risk and only normal in retrospect.
Your labour needs constant measuring and vigilance which in turn disturbs the normal physiological progress of labour.
The medical model separates mind from body and yet it is the state of your emotions that lies at the very heart of labour progressing.
This philosophy believes that your body is a baby making machine which can’t “fix” itself but rather requires a “Mechanic” in the form of an Obstetrician.
You will become an object, yes really instead of being “Tina Smith” you will be referred to as “The trial in room 4”! Roughly translated to “Tina who wasn’t supported well with her 1st birth and ended up with an emergency caesarean and is optimistically hoping that she can survive this trial of labour and give birth naturally in room 4!”
You will be exposed to a hierarchical standardisation of care where the Consultant will sweep into your room and talk in terms of “allow you “ “We will give you “ “This is the plan”
The medical model has amazing faith in technology and despite 20 plus studies discrediting the use of CTG monitors it is still the technology that reigns supreme.
Finally the medical model is intolerant of other models of care. There is a brick wall! That intolerance leads to bullying and coercion and stamps out choice for women.
I however believe in a holistic model of care that sees that we are all individual and because of this deserve an individual approach to the way we are cared for .I believe whole heartedly that women should have the continued support of a midwife so that she gets to know her and trust her and as a result it builds confidence in women.
I had to leave the NHS and become an Independent midwife in order to work this way and that was 8 years ago. I have never once regretted making the change and I have now joined forces with UK Birth Centres Ltd to achieve full insurance and can continue to offer individualised birth support for women.
I have had a lot of experience looking after women who wish to have a normal delivery following a Cesarean. This is known as VBAC or HBAC for home birth after Cesarean. Some women choose to have the Hospital Consultation arranged at 20 weeks and they ask me to attend this meeting. The opinion of the Obstetrician is sort in an attempt that the women can make a fully informed choice about place of birth.
In one instance the meeting was going well , the Consultant could see the benefits to the client of receiving one to one care in labour from myself as he understood that I am an experienced midwife with positive outcomes working with VBAC clients.
He then said
‘With you being of abnormal stature you are more likely to need intervention on your delivery!’
She said it felt oppressive because he was a consultant who was accompanied by a medical student and the hospital midwife as well. He was saying that as she was both short and fat it would be a problem. When she challenged him to explain the studies and statistics on which his opinion was based he couldn’t…!
She was overweight but otherwise active fit and healthy. Normal blood pressure throughout, no signs of diabetes, able to run up and down the stairs not exactly the classic couch potato. But he offended her in his approach and words!
In one sense she didn’t care about his opinion at this point as she had already emotionally stepped out of that system and had chosen me as her lead midwife. They didn’t believe in her ability to give birth but I did!What if she had no option but to accept his negative sumary of her abilities to give birth!
She had suffered when the midwife at 16 weeks had failed to find the baby’s heartbeat and wouldn’t listen to her about where she thought he was positioned and sent her crying to the hospital for an emergency scan. Nobody ever phones up to see if she was ok, if the baby was ok. She had felt at that moment that she was merely a number and that nobody actually cared.
The next week she was booked into my care and says she certainly never looked back. The journey it took her on has affected her in many positive ways.She went on to have a fabulous water birth .Following her home birth she was overwhelmed by the thought that the Consultant was so negative about her ability to achieve a normal delivery based on her shape! Having given birth to her baby at home in the pool with her husband holding her hand she was empowered with a feeling that she can do anything that she puts her mind to.
She had sought the Consultants opinion about her options and then made her own informed choice. If she had listened to all the negative reactions to wanting a home birth and agreed to give birth in Hospital being hooked up to a CTG machine restricted from movement she may have had a different birth out come. How many women have been prevented from achieving their full birthing potential because no one had faith in them!
Taking part in your birth choices including where and with whom you give birth are the fundamental rights of all women.It is part of womens right to be listened to and have your choices up held and if you feel you are not being listened to contact me directly or UK Birth Centres Ltd . If women loose the right to say where and how they birth their children, then they will have lost something that is as dear to life as breathing. (Amy McKay The Birth House.)
Why you should not be tempted by induction of labour unless absolutely necessary!
There is a great web site www.GoTheFull40.com
This site is aimed at informing women about the implications of, social induction. A social induction is one where your Doctor may say
“You have done well and reached 37 weeks, you’re not sleeping and your hips are aching let’s call it a day I will induce tomorrow!”
Visit the web site to read “40 reasons to go the full 40”. I would even suggest it should say “40 reasons to go the full distance” Especially for 1st babies it is very common for you to be at least 41 weeks.
Here I have reproduced the first 10 reasons to consider turning down social induction.
1. End right by starting right—keeping all of your prenatal appointments helps ensure a healthier ending
2. Savour the journey—soon you will meet your baby
3. Let nature take over—there are fewer complications and risks for both you and baby through natural birth
4. Recover faster from a natural birth than caesarean, which is major abdominal surgery that causes more pain, requires a longer hospital stay and a longer recovery
5. Birth a brainier baby—at 35 weeks your baby’s brain is only 2/3rds the size it will be at term
6. Set her thermostat—baby will better regulate her temperature when born at term
7. Boost breastfeeding—term babies more effectively suck and swallow than babies born earlier
8. Delight in those kicks and flips—marvel at the miracle of the life inside
9. Enjoy your convenient excuse for every mood swing and crazy craving
10. Nourish your body—a healthy diet and breastfeeding will help you lose the baby weight
I urge you to be patient and go the distance .
If you are truely feeling that you are term and ready to meet your baby there are several natural remedies you my wish to consider.Having sex ,eating fresh pineapple,spicy food such as curry, having a membrane sweep, taking a soak in a clary sage bath , visiting an acupuncturist, a reflexologist, positive birth affirmations, rebozzo massage and consulting a homeopath .
Or my favourite is relax and wait !
I have been an Independent Midwife for 8 years and have had the priviledge of looking after women who have had a previous C-Section and wish to remain at home for the next birth. These photos were taken at a VBAC birth and they show the way birth is relaxed and includes the family.Enjoy.