A Better Birth – 6 Top tips

As a woman being informed and prepared is the best way to make a decision on what kind of birthing experience you would like to get with your pregnancy.  To help you reach a decision we have complied some tips to guide you.  We have quite a few so rather than make this an epic blog post, we are going to break it up into 3 parts.  So this is part 1. Lisa Wilkinson is teaching the Birthing workshop Sunday 28th of October if you want more information soon

Physiological birth in hospital

Following the natural rhythms of labour, the vast majority of mothers with normal pregnancies are free to let their bodies’ normal physiological functions birth their babies. Many women birth in hospitals avoiding any medication and medical intervention unless medically necessary. We have used the term physiological birth to steer away from some of the different interpretations of ‘natural’ birth. By physiological birth, we mean a health mother with an uncomplicated pregnancy giving birth with no medical interventions. Of course some births will necessitate assistance from your caregivers but we mean to differentiate necessity from hospital procedure or managed birth.

1. Book with an independent midwife or a midwifery led unit (domino or community midwives).

Midwives are highly skilled and trained to look at birth as a physiologically normal and magical event in a woman’s life. The rate of women expressing birth as a satisfying experience, and success rates of physiological birth, is often far greater with midwives than with consultant led care (private or semi-private). There are great midwifery led units and independent midwives all over Ireland. Book early; they are popular and normally fill up.

Obstetric training comes from a different approach to midwives. Here skilled doctors look in great detail at the problems relating to pregnancy and birth. In their training they would be exposed to a whole plethora of conditions where their intervention may be crucial for the best outcome of the baby or mother.

Although important in modern maternity care for complications in pregnancy and birth, there general approach may have the worrying affect of these professionals looking upon birth as a potentially dangerous event with some or other disaster waiting to happen.

There is a saying that when you’ve got a hammer in your hand, everything looks like a nail.  Many obstetricians have lost touch with the possibility of physiological normal birth; sadly they just don’t get exposure to them.

There’s another saying that birth is as safe as life gets.  If birth does become dangerous for the baby or, very rarely, for the mother, this is when hospital-based maternity care really shines.  If a midwife feels that there is need for intervention, mothers can transfer into hospital or obstetricians are at hand and able to step in where medically necessary.

From the onset, midwives are best trained to support pregnancy and birth with the best outcomes as far as fewer interventions and most definitely mothers profess to have a far better birth experience in their care.

2. Attend independent antenatal education classes

Independent childbirth instructors focus on their clients needs, and will spend time discussing a variety of options in coping with the intensity of labour and birth. Since nearly all encourage physiological birth, they will equip and prepare you to manage your entire labour and delivery, not just try to “keep you comfortable until your epidural”.

They may inform you about both benefits and any associated risks with medical interventions and explain why they are sometimes not necessary but perhaps hospital procedure. They may also educate you on how to question interventions to see if they are medically necessary.

Classes offered at the hospital largely focus on helping “patients” understand what to expect at the hospital, and what the procedures are. They are often bound to teach according with the facilities current policies and procedures. Unfortunately these policies typically do not reflect the current evidence on pregnancy and birth related care, but are more in line with reducing litigation and keeping a steady throughput of women. They tend to focus more on medical pain relief by offer a menu of choices rather than encouraging and empowering women to with coping techniques.

Finding good independent antenatal birth classes and workshops, will really empower your self belief and give you multiple ways of dealing and coping with the rhythms of labour and birth. They will show you how to promote the good hormones that can make labour shorter and help women experience and copy with the intensity without having to resort to drugs.

3. Book a doula

Having a confident and positive woman with you from early on in labour will your labour to become very well established before you arrive into hospital. Furthermore she will normally have a bag of tricks to help you through any intensity experienced in labour, such as, practical measures, loving support and empathy, jokes, ways to distract anxious partners, effective pain coping techniques. She doesn’t have to be a doula, she could be a friend or relative who believes in natural birth and trusts your own abilities. Negative or fearful helpers should be avoided.

Some Irish hospitals have a strict one person per mother policy. We suggest your doula call herself a friend and have the father (if there is one) wait in the waiting room to be called when the head is emerging.

Even if you decide to not have doula in hospital, it is still worth having one at home and supporting parents there. Fathers may feel like a fish out of water at first births.  Women often arrive too early into hospital where fathers feel anxious being at home with a women displaying unfamiliar and sometimes distressed behaviour. Doula’s on the other hand will keep anxiety levels down and provide comforting support.

4. Stay at home as long as possible

At your independent antenatal classes, they should help you with recognising the rhythm of labour and when the uterus is pulling the cervix up away from the birth canal. Once this is well established, your labour is progressing nicely. Arriving in hospital whilst the cervix is dilating like this will assist in your physiological birth.

It’s quite common for things to slow down and stop during the journey to hospital and whilst being admitted and settling in. This is a natural effect of adrenalin that may be produced in anticipation of the new environment. Once you get settled and relaxed labour should establish itself again and start doing the work it needs to birth your baby.

Often women come in very early on in labour, especially with first babies as they are unsure of what stage they are at. Normally midwives would try and send mothers home that are not in an active dilation stage. Sometimes mothers do go home, others may feel too nervous and want to stay.

It is common in hospital to start a clock once some form of dilation is noted, and can lead to time constraints and extra anxiety for women to dilate within a set period of time. If labour does indeed slow down, options for speeding it up again may be offered. These can range from walking, change in position, water, relaxation but can sometimes be medical interventions such as breaking of the waters (ARM) or synthetic oxytocin (syntocin). These may lead to other side effects precipitating more interventions.

So do try and stay at home for as long as possible. Good antenatal preparation, yourself and partner watching realistic birthing films and having a doula or woman experienced in physiological birth at hand will all help you do this.

5. Visit the facility

It is very important to visit the rooms you may labour or give birth in. This way the familiarity of them will not cause you to be fearful or anxious of what it might be like. You can ask what can be done with the lighting or the arrangement of the room and what you will need to bring in terms of extra pillows, balls mats etc. Find out how you can warm heat packs, as hot water bottles are not normally permitted due to burns risks.

6. Have a birth plan

Your plan really doesn’t need to be the birthing Magna Carta! Keep it simple and one page long. Highlight the important points. Have a few copies with you and arrive with it in your hand. Have your partner refer any attendants to your plan whilst politely explaining that you are saving energy for labour and staying focused and would they be so kind to have a quick read of your plan.

You are likely to see several staff during your labour so make sure your partner keeps each of them aware of your plan before they start talking to you. Make a sign for the door or wear a T-shirt stating “Natural Birth in progress – please do not offer any pain relief. Mum is fully aware of its availability, and will ask for it if she needs it. There may be some noise (-: Thank you”

During labour it can be common for mothers to be frequently asked,  “what are you doing for pain relief”?  Probably because so many women are given it as part of the pain relief menu in antenatal classes, or all their exposure to birth is set around an epidural, thereby assuming it is a necessary part of birth, most automatically ask for it without understanding the negative side effects. Many midwives don’t get to practice their wonderful midwifery skills so it’s good to prepare them for your individual birth wishes, they will be delighted. Sometimes caregivers change or other staff may come in, and being asked during the throws of labour about relief only serves to disempower women who are coping.

Sometimes women ask for an epidural but really don’t want one! A midwife and well-educated partner can normally spot this and use something else to help a mother cope; reassurance, changing positions, using hot water and many more techniques really help. Distracting from one centimetre to the next is a great art.

The next installment…… coming soon

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