The importance of choice.
A major part of the success of hypnobirthing is the creation of confidence and therefore the removal of fear. A large component of this is removing yourself from tales of negativity and instead making sure you are surrounded with positive birth stories and people who actively support your wishes. This can come across to some as a bit ridiculous, the idea that simply thinking everything will be ok means that it will be. In itself, that’s true, it is an odd concept. But in fact no one is suggesting this. Far from it.
A huge amount of fear relating to childbirth can come from the unknown. That’s not to suggest for a second that anyone is ignorant, but rather that nobody can possibly be expected to know absolutely everything. For a lot of first time parents there are often many things that we just don’t know. Sometimes, second (or more) time parents can also be unaware of their choices, particularly if there has been a big gap between babies as medically things change all the time. On occasions, parents can almost resign themselves to the fact that if the circumstances of their last birth arise again then this birth will automatically take the same path. This is absolutely not necessarily so. There are always choices. From area to area what is available can differ, as can ideas and suggestions between care providers. The passage of even the smallest amount of time can also bring with it many new discoveries, facilities, options and possibilities. We just need to find out what they are.
Well informed article or horror story? – Where to look…
This can be a very difficult and fine line to tread when teaching hypnobirthing. There is a constant dilemma between staying completely away from negativity and scare stories whilst still making sure that worries and concerns are talked about and properly addressed. I’m not ever advocating immersing oneself in negativity as far as birth is concerned and going down the path of “what if’s?” but we absolutely do need to ask questions and discuss our concerns in order to explore the options available to us in whatever circumstances we may find ourselves in.
So, what are all these choices about? Well, with each individual birth there are many! So many that they can’t all be covered in one post. The important thing is that you know that you have them. Basically, whatever your concern, there are options and the final decision is always yours. I’ll illustrate this point with some common scenarios, but the whole idea of the informed choice being very much yours is actually the key point here.
For instance, one concern of some women is that for whatever reason they do not wish to have an internal examination during labour – It is irrelevant what those reasons are (unless you feel that discussing them would be of benefit to you). The simple fact of the matter is that if you do not wish to be examined in this way then you will not be. You do of course need to accept that should you decline this offer (for an OFFER is exactly what it is) then it just means that your caregivers will not be able to tell you exactly how dilated your cervix is at that precise moment. Many people are happy with this and labour perfectly well this way.
Another example of where informed choice is so important is women who do not wish to be induced. They are often anxious that they will be “made” to do this – this is again your choice. There are still alternatives to an induction when it is suggested to you. For instance, Mum and baby can be frequently monitored and decide to wait for labour to occur naturally. More natural induction methods can be tried first too. Some alternative therapists have good success rates. You can ask for more information as to why induction is recommended in your particular case and should you decide that you think accepting the offer would be best for you and baby you can still discuss to a fairly generous extent how you would like it to take place.
Place of birth is another common situation where Mum may not feel supported in her wishes – some women voice the concern that they are “not allowed” a home birth. Ultimately, nobody can stop you giving birth in your own home. If you have been advised that home birth is not best for you it is always worth asking why. It could be based on something as simple as advanced maternal age (as I have once heard of) or a previous c-section or anything else for that matter. Questions can be asked and more detailed information sought about your own personal situation/risk. It may be discovered that your risk is not significant and that a home/water/wherever else- birth is more than possible. Or adjustments can be made and your “risk” can be managed in your preferred place of birth.
Respect for your decisions
All of the above are real biggies when faced with them and there are many more besides. They can cause nights of sleeplessness and worry when in reality asking questions, requesting more information or even to speak to a supervisor of midwives* may be all that is needed to achieve what you need. (* – in a “please could you check with someone more senior so we could work with them to facilitate something?” kind of a way rather than a “RIGHT ! – Let me speak to your supervisor NOW” kind of a way). I do like to stress that whilst we all come across rude people every once in a while or people who may be having a bad day, or are so busy they don’t give you the attention you deserve, the NHS and its overstretched staff are actually generally rather fabulous. They have their procedures to follow which I think can often be the unintentional cause of distress. A person who has seen their 20th pregnant woman that day, may just slip out “so we’ll book you in for induction if baby isn’t here by the 7th”. Erm, no. They are of course not going to force it upon you, it’s just procedure which they have to follow. But it’s an offer, not a must. They do generally want to work with us to give us the birth we would like. It is always worth researching for yourself.
Informed decision making
Being told there is a “risk” if you do or don’t do something in pregnancy can be a pretty daunting thing to hear. It is always worth asking for the risk or statistics to be explained to you. A situation which makes a 0.0001% risk increase to a 0.0002% risk can of course be truthfully described as an increased risk. However, both are still very small. Asking questions at your medical appointments and getting opinion on (well-respected and balanced) hypnobirthing/positive birthing forums can throw up options which you may have never even heard or thought of which make your wishes totally and utterly possible. AIMS (Association for Improvements in the Maternity Services), NICE (the National Institute for Health and Care Excellence) and the recommendations published by NICE are all full of balanced information and recommendations which support the wishes of the majority of birthing women. There are links to all three at the bottom of this article.
I’m not anti or pro internal exam/home or hospital birth/induction. I never want a woman to look back and think “if only I’d have had these facts, I would have done it differently”. The most important thing is that every woman is given as many facts and options as she possibly can be so that she can make the choice, based on the fullest amount of information available, which she feels is best for her and her baby. Every birth is different.
The impact on your birth
Having sufficient information to confidently make good choices has an enormous impact on birth outcome. If you are well informed you have more options to choose from than someone who is not. This makes the likelihood of you finding one which you are happy with much higher. If you are happy, confident and relaxed with the way you are birthing, your body releases the perfect combination of hormones resulting in birth being more efficient and comfortable. This is in contrast to being consumed with anxiety when you are birthing which makes your body release fight or flight hormones which in turn makes labour generally more time-consuming and uncomfortable. So this is not simply about immersing yourself in positivity and hoping for the best. You are able to be positive because you are well informed. This positive confidence affects how you feel about birth which affects your body physically, which in turn makes birth a more positive experience.
The final decision is yours…
The ability to question needs to stay with you throughout the whole of pregnancy and very importantly, during labour itself. There is no right or wrong. You don’t “have” to do anything and you always do the “allowing”. What works brilliantly for some doesn’t work for others and vice versa. With each pregnancy, explore all the options. The decisions are all yours. It’s always ok to ask….
Recommendations –
https://www.nice.org.uk/guidance/cg190/chapter/1-recommendations
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