The Language of Birth

The language of birth – does it really matter?

In recent years many birth workers have started to look carefully at the language used around pregnancy and birth. Why? Does it really matter? It is after all just words.

Well actually, yes it matters quite a lot! Whoever said that ‘words can never hurt me’ had obviously never been told any of the following :

– that they were ‘failing to progress’

– that their cervix is ‘incompetent’

– that they will have a ‘trial of forceps’

– that they are ‘not allowed’ to choose/decline (whatever) at their own birth

The above are just a few examples of the unintentional yet totally scary, discouraging and dis-empowering words and phrases which a woman does NOT need to hear as part of her birth.

So, with regards to the previous four points above –

‘Failing to progress’ = not birthing at the expected speed based on whoever decides at what speed the average uterus should operate this week, however if mum and baby are both well then being supported to relax and continue should be offered to mum.

‘Incompetent cervix’ = When the cervix shortens and opens in the second trimester (16 to 24 weeks) or early in the third trimester without any other symptoms of labour. Nobody is incompetent! This is not your fault and options are available.

‘Trial of forceps’ = When a caregiver offers to assist baby to be born using forceps as opposed to the word ‘trial’ immediately suggesting that failure is expected!

‘You are not allowed/have to do something’ = Mum does the allowing. Your baby, your body, your birth, your informed choice. Things can be ‘recommended’ to you or ‘not recommended’ but use of the word ‘allow’ is simply inaccurate and unacceptable.

The language use during labour and birth can have a profound impact in the birth room. Even when it refers to the same thing! For instance, ‘we don’t allow you go past 42 weeks here’. Scary huh? What will happen I wonder? Do they send the maternity police round with a warrant to bring you in? Will they tell social services? (No on both counts).

Had the correct language been used ‘we don’t recommend you past 42 weeks here’ would have been a much better way of explaining while taking into account some important points…

-it’s actually the birthing mother who does the ‘allowing’ nobody else

-the word ‘recommend’ is the appropriate one as it opens up a conversation about the recommendation and then enables mum to make a decision based on the information she is then given. A decision made when in full possession of all the facts makes it more likely to be one mum is comfortable with and subsequently create a more positive experience

When a mother hears negative words and phrases at her birth it makes her feel tense and insecure. This in turn stops her birth hormones functioning optimally and labour can be longer. This can cause adrenaline which blocks mums naturally occurring pain killers (endorphins) being released thus making birth more uncomfortable too.

Each birth experience is different even between different births for the same woman. Birth preparation is key as there is so much that a woman can do to influence their birth experience (a whole other blog topic in itself there!)

There are of course many things which affect how a woman experiences her birth, the way a woman is made to feel during her experience is as important as the physical aspect with regards to how positive she perceives her birth to have been.

Sometimes I hear a birth story where on paper it sounds far from the perfect birth as it deviated a fair way from mum’s original plan yet despite all this she reports a very positive experience. Well, here’s why…if she was listened to, she is able to feel supported, if all options are explained to her she feels confident in her decision making, if the ‘words’ offer and ‘recommend’ are used she feels as if she has choice, if her wishes are respected she feels empowered. It makes such a difference.

To my absolute delight there has been a change in emphasis in the (NICE) Clinical Guidelines over recent years. While previous guidelines focused almost exclusively on clinical actions, the latest version emphasises the importance of good communication and respect for a birthing mums’ choices. A direction is also made to senior staff to “demonstrate, through their own words and behaviour, appropriate ways of relating to and talking about women and their birth companion, and of talking about birth and the choices to be made when giving birth.”

Of course, some birth language comes down to personal preference. Some people prefer to use the word surge or wave instead of contraction, others prefer to avoid use of the word pain. If that is your preference let your caregiver know! Nobody can be expected to second guess whether every single word they say may or may not offend someone. All we can do is our best but a small amount of forethought about our words could be all that is needed to make a world of difference to one of the most significant events in a woman’s life.

Becky X

P.S. I would like to sign off by saying I’m not bashing our amazing NHS. Where would we be without them?!

Thank you to Lou at With You in Mind Therapies for asking me to write this guest blog.

Sleep (or lack thereof…)

And relax…

So today marks the end of Sleep Awareness Week. I’ve checked and can confirm that I am not aware of much sleep taking place since my first child was born 15 years ago.

How ironic for me that my most prolific sleep thief (child three) actually shares her birthday with the beginning of the aforementioned week!

This post is a timely reminder to look after yourself and prioritise your own rest wherever you can. It is often surprising just how much better things look/feel after a refreshing sleep (and conversely how much more challenging everything can be without adequate sleep).

Towards the end of pregnancy if tiredness comes, accept it and rest where you can, however you can. Once baby is here try where possible to do the same. I used to be annoyed by people telling me to ‘sleep when baby sleeps’ thinking to myself ‘so I’ll just wash up and do laundry when baby washes up and does her laundry shall I?’ Not quite…

Bearing in mind that babies seem to have a disproportionate amount of naps to my own tiredness levels I’m sure that while some domestic tasks are necessary, that during at least one of baby’s naps a snooze next to them would actually be quite possible.

But what if I can’t get to sleep just like that in the day though?

I hear you on this one as that’s me too. No matter how tired I am, I don’t find sleep comes easily during the day. However, having the time to lie still with your eyes closed, quietly and in a comfortable position brings more benefits than you might think. Don’t fall victim to the pressure to fall asleep right away. Just take that time to yourself, if you do fall asleep, even better.

If you are lucky enough to have a partner, family or supportive friends around then make the most of it! Baby will be fine snuggled into Dad, Granny or that special family friend while you rest for an hour.

But some people put on Facebook etc that their newborn slept through the night from two weeks old, why doesn’t my baby do that?

They’re lying and deserve to be blocked and reported to Facebook.

Now if you’ll excuse me I’m off to bed (at 810pm).

Happy Sleeping!

Becky x

Hypnobirthing – removing the weird

“Ugh, so we’ve got this bloomin woman coming round for the hypnobirthing thing tonight”

…a phrase perhaps occasionally uttered by the odd sceptical birth partner at work.

But – there are many many myths about taking a hypnobirthing class. Let’s bust a few shall we?

So, for some if there’s one thing worse than the prospect of attending a hypnobirthing course it’s having one in your own home so you can’t even leave. (Though I suppose technically you could if you wanted to?!) Someone is coming round to teach a course and as much as you try to force your brain to think polite thoughts sometimes natural wonderings about your teacher/course do occur…

Is she going to be weird?

Ha, some would say so but erm nope – just a normal woman with kids, a husband and a dog. I one day wondered about birth just like you. I found a great way to birth and love teaching and talking about it.

Sorry to ask but is she a hippie type who is going to make us all sit on bean bags and do weird stuff that makes us feel REALLY REALLY awkward?

Nope – nothing against bean bags but we can’t have them in our house anyway because of the dog. Unless you yourself choose to use one for birth I won’t be mentioning them. Same goes for wind chimes. I’m not a hippie though am vegetarian (non preachy variety) so potentially halfway there in the eyes of some people.

The techniques taught are a toolkit of options, there isn’t going to be a test. All I will do is explain them and they will be your choice to choose from when I am not there.

Is she herself going to do stuff that makes us feel really awkward?

Nope, it’s all about teaching various techniques and coping methods for you to decide which ones you would love for birth. I explain all methods and choices and the scientific reasoning behind them. No more awkward than a work training day (but hopefully less boring)

Is she going to be a natural birth police type who will ban all pain relief?

Certainly not! Informed choice is one of the most important messages of hypnobirthing. Lots of information and a balanced view on the pros and cons of ALL options. And by balanced I mean BALANCED. Not all the pros to my view and then a list of negatives to the opposing view. Being perfectly honest I couldn’t tell people what to do if I wanted to, every birth is so different that the “right” thing to do for one would almost certainly not be best for another. All choices will be absolutely yours and fully supported whatever they may be.

What if I don’t agree, want to question things or think something’s rubbish?

That’s fine! There are many techniques taught over the classes and it is human nature that some people think one thing is fantastic whilst someone else thinks it’s really not for them and decides to focus on another. This is actually all about you so whatever you choose is correct, what works best for you is the right thing for you. The idea is you feel comfortable and happy with your choices. I’ve birthed three children of my own, all very different births. Ask anything you like, no discomfort here.

Are we going to have to participate in role play, presentations and group work etc?

Oh the horrors – definitely not. When I explain certain things I may ask your opinion but that’s all, I love my couples to talk to me, the many different views I have heard in different classes have brought a lot to the table ideas wise and otherwise. But that’s it. Different birthing Mums and Dads want different things and I like to know what their preferences are so I can facilitate them.

Is she going to show graphic pictures etc that have squeamish people running for the hills?

No. I do show a baby being born but it’s not the sort of hideous thing often seen in GCSE biology or some of the more sensationalist TV shows. It’s more an image of how gentle birth can be and focuses on the calm demeanour of mum rather than any gynaecological shots. I always ask before showing anything anyway so people do still have a choice.

So let’s get one thing clear – I still hate how the name is misleading, but hypnobirthing is what it’s called so hypnobirthing it shall be, as off putting as it sometimes is there’s a lot more to it than just the ‘weird’…

Private Hypnobirthing classes – a surprisingly normal experience…

*disclaimer – of course I have absolutely nothing against wind chimes (or bean bags for that matter) to facilitate a peaceful birth environment. But nor would I stereotypically force them on anyone either!

calminthebirthroom.weebly.com

We are not at war with the NHS…

Informed choice and informed consent are two huge parts of hypnobirthing. Both topics run prominently through most hypnobirthing courses, websites, books and Facebook pages. They’re both big and important topics.

Maybe because of this, frequent discussions come up in such forums regarding a birthing Mum wanting something in particular with regards to her labour (birth pool/not being induced/no needles) and she is either ‘not allowed’ to have whatever it is or has been told that she ‘has to’ do/have whatever it is. This is obviously unacceptable.

I can’t stress strongly enough that scaring expectant parents into procedures instead of giving genuinely balanced information is simply not on, as is ‘routine procedures’ carried out without discussion and “we’ll just internally examine you now/we’ll book you for induction at 41 weeks” statements – also out of order.

But…caregivers quite rightly have a duty of care to everyone. As such they have to comply with certain protocols which are there for our protection and theirs. However, this is not an excuse for rudeness or lack of thought.

Having worked on the employee side of the emergency services (thank fully never in the NHS – quite frankly, anyone who works in A and E on a Saturday night deserves a medal) as well as being a service user too, I can absolutely see both sides of the fence and the balance is a tricky one.

An overstretched service, full of knowledge but physically not enough time to impart every single last drop of it to every individual they meet whilst running around putting out metaphorical fires all over the place. As well as having to contend with the sort of understandable defensive medicine which many staff feel forced to practise when they may not wish to. Whilst initially these protocols may come across as catastrophic insurmountable birth hurdles, this is not necessarily so.

Despite restrictions of protocol most caregivers really do want to grant your wishes. This means that it’s actually pretty likely they will do their upmost to work around things where they can, in order to make sure you have what you need/want. Whilst frustrating when protocol is an issue, discussion with caring staff can be the main facilitator in compromise and accommodation.

But, on the other side of this are people expecting a baby. The most important thing to them in their whole world. Their baby, their pregnancy, their birth. As all hypnobirthing information frequently stresses – nobody should EVER have their consent for anything assumed. Equally though, to assume that your consent will be assumed is maybe a slightly negative thing to do? Yes, there are absolutely bad apples in every group of people be it caregivers/teachers/police/retail workers/whatever and I don’t doubt that there are also one or two in the NHS within maternity services but I really believe that going into NHS care assuming that you won’t be respected and listened to probably goes right against the positivity we try to so strongly immerse ourselves in during hypnobirthing.

What can of course make this worse is if you yourself have had a negative experience with a caregiver in the past. That’s really tough and I speak from experience (albeit from a looong time ago) that it can put you in a slightly more negative mindset towards all future caregivers, making it feel as if every single one including the medical receptionist (ahem) is against you. The good news is – I can assure you that they are not.

Also, people often post in forums and on Facebook pages when they do run into a specific problem or caregiver who is perhaps not being as helpful as they should be. These forums are fantastic sources of information when such things arise and certainly people should be absolutely able to ask for advice in these places when they need it. Understandably, in these forums we never see “I was offered induction but said no thanks and they agreed and all was well”. Of course we don’t, it’s not what such pages are generally for (although some do have wonderfully fabulous positive birth stories and articles).

There is a big difference between spouting negative birth drivel all over Facebook and sensibly asking for informed advice. Part of hypnobirthing is about being prepared so of course it’s vital to consider what we would do if we were to come across someone who is rude/unthinking or presumptuous, but armed with the fact that you know how to request more information etc, you can confidently put that thought to one side. By all means use the (good) advice from such places to store in the back of your mind for what you could do should you find yourself in a similar situation but then bring yourself back to the positive mindset that the situation in question probably won’t happen anyway. And in any case, the final say is ALWAYS yours.

But no – we are not at war with the NHS. Sure, there will be the odd rude person just like in every other walk of life, I’m certain our caregivers have come across their fair share of rude birthing mums too but generally, we are one team, with one common aim. A happy and healthy birth experience for all. Presuming our caregivers are against is us not a great principle with which to begin a birthing journey.

The general hypnobirthing stance is that everything is positive, because let’s face it there’s no reason why it shouldn’t be! Statistically, it is much more likely that everything will go to plan and if that doesn’t happen you know that you are well informed enough to make a good decision.

It needs to be shouted from the rooftops that the chances are, despite the challenges faced; the staff will more than likely be wonderful. So frequently, people go in armed for battle and are very stressed about a situation for weeks or even months beforehand only to be told “yes no problem you can have whatever”.

The likelihood is your caregivers will bend over backwards to get you the birth you want. During my own last birth I was very close to the end of labour when I was suddenly stricken with the most intense heartburn. My solution to this throughout pregnancy had been milk which for me gave immediate total relief. So I wailed to my husband “I’ve got heartburn, it really hurts, I need some milk”. I could see him immediately contemplating the not wanting to leave me versus getting the milk I was desperate for. Before I’d had chance to think any further my midwife appeared with a glass of milk and put it to my mouth. How did she do that? How did she do it so fast? Where did she get it from? At a guess I’d say from the staff fridge, where they put the milk they have bought for themselves with their own money. They do stuff like this all the time. If often goes unnoticed. Please remember this sort of thing. Whether you birth at home, in theatre or in a midwife led unit we are in this together, you and your caregivers are a team. They care rather a lot and their default position is facilitating the birth you want.

Visualise your birth as a team effort, the majority of caregivers could not be more on your side if they tried. In the first instance at least let’s approach our caregivers the way we do the rest of hypnobirthing, with positivity and a can do attitude.

We are not at war with the NHS…

…and it would be terrible for all concerned if it came across that way.

Hypnobirthing – getting it right…

An inflammatory title if ever there was one! But thankfully tongue in cheek.

Most people who decide that hypnobirthing is for them throw themselves into the whole process with great gusto and enthusiasm. This is of course with good reason. People have often invested hard earned money in their pursuit of a hypnobirth and are keen to invest an equal amount of time and effort in the process in order to make it a success. After all, hypnobirthing does take practice throughout pregnancy. Unsurprisingly, just buying the book and sticking it in a drawer without reading it does not mean you are hypnobirthing and is probably slightly less likely to be effective. Along with the reading and classes there are lots of other things for parents to be to consider. This is of course, a good thing.

 So many choices! (lets name a few)

So, what is ‘right’? Many people have a specific perception of hypnobirthing and how it’s ‘supposed’ to be done. This often consists of birth balls/candles/little or no anaesthesia/essential oils/birth pool/music to name but a few. To an extent this is actually a reasonably accurate impression of how a hypnobirth may go. This could be because of the reasons people often come to hypnobirthing in the first place; a peaceful and calm birth being important to many hypnobirthers means that the birth environment is very likely to be one containing the aforementioned things.

Labour and birth are easier for the majority of people in an upright position. Good positioning (choice of) is discussed at length in hypnobirthing classes so to many a birth ball then seems a good option.

Positivity is a big component of a hypnobirth too. Because of this, a hypnobirthing mother is likely to surround herself with positive things. And of course informed choice is a very big topic indeed in class. This leads to more pool births because more mothers realise this is a safe option and one which for many brings great relief. It can often lead to the decision to home birth for the same reason.

Um, but no pain relief…?

Often – no. But not because it’s banned! There are no hypno-police guarding the door to the birth room, fending off passing anaesthetists. As the statistics show, many hypnobirthing mothers just don’t want/need it. For a variety of reasons, some women decide that they would like to birth without anaesthesia as the advantages for them of not having it, outweigh the disadvantages. The relaxation methods learned in a hypnobirthing class lead your body to finding birth more comfortable in the first place meaning that the desire for anaesthesia is often less/not there. This does not mean you ‘can’t’ have it if it is your preferred informed choice.

 So you don’t frown upon induction, c-sections and anaesthesia?

Absolutely not! For the majority of women these things would probably not initially be their first choice for birth. But… hypnobirthing is about being fully prepared to meet whatever circumstances your birthing brings. It’s not about avoiding the above things like the plague or considering them taboo. It’s about being empowered to make sure that they are something you only do when YOU consider them necessary and beneficial. And on the occasions they do become necessary we are very very thankful for them indeed. Making a decision that one of these things is for you is by no means catastrophic, it is NOT the end of your hypnobirth as you know it. You can absolutely still hypnobirth in such circumstances, in fact under any circumstances. Every single tool you have learned can be used no matter what path your birth goes down.

There are no birth circumstances where using the techniques you have learned and practised to relax yourself could not still be beneficial and I’m absolutely certain that there are definitely no birth circumstances in which you would not be required to breathe!

But – the pressure to hypnobirth “properly”…

-Don’t put it on yourself! During classes a person often (understandably) thinks that home birth/music/pool etc all sound rather pleasant and they decide to make it part of their plan. Because these things tend to be the most regular/popular, it can lead to a perception that if your birth or birth plan develops into something other than this then it’s not a hypnobirth anymore. This is simply not true!

If for whatever reason, birth takes a turn which means certain elements are no longer possible, it is vital to remember that these are preferences from a range of options, not an actual set in stone plan. What is set in stone are the skills learned and your ability to question and make good decisions which can be used in all birth scenarios. Sometimes I hear things like “I can’t use the pool because (insert very good reason here), so that’s the hypnobirth gone out the window”. It’s really actually not… hypnobirthing is about informed choice, before birth and on the day. It’s about YOU making the right choice for YOU and baby which will of course always be different from the next person and the next.

By all means decide on the things that you would like, but remind yourself that you can deal with a change. If birth circumstances change, then you can re-chose. Would an evening out be ruined just because the dish you had decided to order was suddenly not an option? Of course not*, you’d go with something else which was equally as acceptable to you. Birth is the same.

*unless I’d been expecting chocolate brownie – then the evening would actually be ruined…

You are already doing it right…

In fact, there is no right or wrong.

It’s about learning to work with your body to make the experience as comfortable and enjoyable as it is absolutely possible to be. It’s knowing you are prepared for whatever path your birth goes down.

It’s being well-informed about all your practical options so that you feel empowered enough to ask questions and make whatever decision is right for you and baby at the time (and this can change, which is fine).

It’s about making use of the tools you have gained in whatever circumstances you find yourself in, in order to give yourself a positive birth experience on the day.

It’s YOU choosing the right birth for you, appropriate for your personal circumstances.  There is no right or wrong. Whatever you decide is right, it just has to be your choice.

Hypnobirthing – a load of old rubbish?

The first time it was suggested to me, I thought exactly that. Now I teach it…

Many years ago when I was pregnant with my first child I voiced my fears about birth to a colleague and they suggested I try hypnobirthing. I instantly rolled my eyes and dismissed it, thinking ‘um sorry, but I don’t really think that someone just telling me that birth won’t hurt means that it suddenly will not! Next ridiculous statement…’ So off I trotted and awaited the big day. When it finally happened it was not a particularly positive experience.

A good few years/pregnancies later, I happened across hypnobirthing again. I was older and I’d like to think wiser (though probably not…) and so researched and read up a bit more about how it all works. It became crystal clear to me what it was really all about and made perfect sense.

Scoffing at such perceived nonsense is still often the thing which goes through many people’s minds when they first hear the word ‘hypnobirthing’. Some are also equally happy to voice this opinion quite openly to a woman who has expressed this as her preferred birth choice! To an extent, I do understand why that would be. Particularly if someone has already had a negative birth experience themselves. But no, it isn’t nonsense at all. Unfortunately, the word ‘hypnobirthing’ doesn’t describe particularly well what the whole concept actually is. It implies rather heavily, that in a scene reminiscent of a tacky holiday camp style show; a person is hypnotised with regards to their birth and then quite remarkably on the big day, birth doesn’t hurt. This is indeed ridiculous.

So is it just thinking positive, burying your head in the sand and hoping for the best?

No, it’s not. A major topic in hypnobirthing classes is how the mind affects the body in a very big way. So yes, in that respect positivity really is an essential part of hypnobirthing . Some of the hypnobirthing scripts/tracks which reinforce positivity have more of an effect when a woman gets to birth than she ever realised they would. It’s one important part of the whole package. Immersing yourself in negativity will not promote a relaxed confident birth in the same way that surrounding yourself with positivity will. So yes, positivity is of course very important but hypnobirthing is about way more than just that alone.

O.K. then, so if all these women are proclaiming it works – tell me how?

As I’ve mentioned before there is a cycle in the human body when birthing, where Mum being happy, confident and relaxed makes her body release the perfect cocktail of hormones for birth. These hormones make labour more comfortable and efficient/quicker and with this she also releases the body’s own natural painkiller. On the flip side of this, should mum be terrified, she becomes tense and her body is working against itself. She then releases the fight or flight hormones which make labour more uncomfortable and generally slower.

The whole idea of hypnobirthing is to teach yourself, with practice, how to relax during labour. In hypnobirthing classes there are quite a few different methods of relaxation taught. Some people love them all, some prefer certain ones over others and some people have some of their own too. If you look at a relaxation method and think ‘that’s not for me’ then that’s ok. I’d consider giving it a go as you never know, but if something else works better for you then use that. The actual point is the relaxation and confidence. Whichever way you achieve that is great. It doesn’t matter.

With all this talk of relaxation methods it’s important to remember that hypnobirthing classes still cover the more practical things as well. Being well informed about how birth works and what  your options are enables you to feel confident about any decision-making during pregnancy and the birth itself. This in turn leads to confidence in your body’s ability to birth your baby.

Getting your own way always helps…

O.K. so maybe not quite as spoiled brattish as that sounds but in a nutshell, that’s sort of what it is. Which incidentally, is perfectly acceptable under the circumstances! It is your birth after all.  A major topic in most hypnobirthing classes is informed choice.Whilst learning to put yourself into relaxation is obviously a very major part of every hypnobirthing course, there is also a big focus on getting the birth you want on a more practical level too. This is with regards to finding ways round things that you would like to avoid and how to facilitate the things which you would like to happen. By these important issues being dealt with and Mum being satisfied with them also contributes hugely to the relaxed and confident feeling needed to promote the correct hormones for a good birth.

While it sometimes feels like the world is full of people brandishing their negative birth stories in your direction, every now and again you do come across someone who says it wasn’t that bad. I remember speaking to one mother (of five) in the street, about her most recent birth, who said ‘yeah it was fine, it’s not a big deal really is it? You just get on with it’. Now maybe describing birth as ‘not a big deal’ is not technically the way to go, as of course bringing a baby into the world is a huge deal! But, I think what actually happened in this lady’s case was that without realising it, she hypnobirthed. (Now that IS awesome) She wasn’t worried about birth, she hadn’t even considered that fact that things may not go to plan, she knew that she/her body knew how to do it and that was that. No questions asked. Confidence brought relaxation, which brought the perfect combination of hormones, which brought the easy comfortable birth she was expecting. This does not mean that just saying everything will be easy means that it will, but it does brilliantly illustrate just how much the mind affects the body and what a huge impact confidence and relaxation has on the hormones which affect the smooth running of a birth.

If only we could change the name! I can really see why people are dubious, but I guess whilst potentially misleading, ‘hypnobirthing’ has a slightly better ring to it than ‘having the confidence in your own body and learning to relax and be comfortable-birthing’.

So no, it’s not a load of old nonsense. Perhaps just badly named.

Informed Choice…removing the fear

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….

 

http://www.aims.org.uk/

https://www.nice.org.uk/

Recommendations –

https://www.nice.org.uk/guidance/cg190/chapter/1-recommendations

If you would like to find out more about us and what we do, check us out at –

http://calminthebirthroom.weebly.com/