Informed Choices

Informed Choices for Childbirth

It’s very easy for me to simply say: when you are in labour relax, try to breathe, your body knows what to do. Yes, I have been there in your shoes, with aching feet and ankles, possible a size bigger than they were pre-pregnancy. I have experienced pregnancy, been through labour twice. But I haven’t experienced YOUR pregnancy, YOUR labour, haven't had to make your decisions based on your available choices.  I certainly didn't have the opportunity to make an informed choice, which is so important to ensuring a woman feels trusted and confident while she brings her baby into the world.

It is true though: your body will know what to do, and the baby will come out one way or another. Women have been giving birth forever, and  your body will usually give you all the signs you need to know that labour is imminent. But perhaps we do need some help interpreting those signals. We have plenty of options surrounding everything connected to childbirth. But what are they, and where to begin with researching your choices so that you feel fully informed?

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Watching and Waiting

Because we exist when we do, birth has moved away somewhat from the more primitive, natural experience that our cavewomen ancestors would have perhaps had. They may have clearly known what labour signs to watch for, waiting to see how they felt, ultimately finding a safe space and pushing without being told by an onlooker. Which in many ways is great, because I for one don’t fancy having to skin and cook something my cave-husband just speared, or run away from another invading tribe whilst trying to give birth. 

There is a balance we need to find between becoming the cavewoman again that lurks under our decades, or being the modern millennial we are currently as our busy self.

Somewhere along the way women’s primal instincts have been trained to ‘be quiet’ and we are expected to put our trust in medical professionals, sometimes without knowing them or having the chance to ask questions. Would you go into hospital for surgery without feeling 100% informed about the possible risks, or why you were having the operation? No! The medical staff of course are fully trained professionals, and we might assume they know women’s bodies and birthing inside out… but they don’t know YOU inside out. Or your body or your baby. You do. You are the only one who feels exactly what your baby’s movements feel like. Nobody else touching your bump from outside will experience that exactly as you do from within. A woman’s instincts are a powerful tool, and we should embrace them, not hush them. That mysterious ‘within’ that nobody can pin down or get empirical data from… that’s your birth power and you can harness all your strength when you need to.

This is why MummyNatal classes and understanding more about mindfulness are so beneficial during pregnancy. We can help to guide you through ways of tuning in to your body and connecting with baby.

We have Birth Talk education sections each class to fully inform you about what is happening to your body as your pregnancy progresses, and as labour approaches and begins. We can discuss all elements of birth plans with you, with no bias or agenda so that you can make clear and informed decisions.

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Attending antenatal classes can not only relax you and give you a brief window of time that is just for you and baby, but it can help you to feel more in control as you learn about your choices. Understanding what is happening can feel very empowering, and that feeling of empowerment could give parents the confidence and strength to find out yet more about their choices and preferences, so you build layer upon layer of information and unpick the multiple options open to you.

When you try our mindful breathing practice, birth ball movements, or transition into relaxing positions on the floor, you are learning about your body and what feels comfortable for you, and creating new pathways in your brain that you can easily recall when your birthing experience begins. You are retraining your brain and telling yourself that, ‘Hey it’s ok just to stop and listen to yourself for a moment.’ It’s giving you chance to figure out, ‘Nope, this doesn’t feel right, let me move here instead,’ without the feeling you have done something ‘wrong’ or you aren’t ‘allowed’ to try that. When you lean over the ball, not only do you give yourself permission to fully relax, you are also naturally in a position that can help baby settle in the optimum position for birth (head down, spine along the left side.) When you sit to breathe and tilt on your ball, not only are you looking after yourself and baby physically by aligning your pelvis and releasing tension, you are using your own body’s power to create space for baby to grow, and to create mental and emotional toolkits for yourself.

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Options Laid Bare

There are so many options open to you about your birthing experience. They range from what type of birth you want (such as at home, pool, hospital birth, Caesarian section, vaginal delivery); to the finer details such as:

  • do you want a managed third stage, or wait to push out your placenta?
  • do want as few a vaginal examinations as possible, or regular checks and updates?
  • do you want checks on baby to wait until after 'The Golden Hour'?

Above are just an example of some of the choices you can make around your baby's birth. You can find a more complete list of options here. In our MummyNatal classes we will talk you through the main options, as well as some of the smaller choices that might not even have occurred to you, but could actually make a big impact upon you when the time comes. The midwife, consultants and GPs are there to help you with your choices too. Never feel afraid of asking what you need to know. Write them down, type them up, save them somewhere and add to them each time a new query pops into your mind. If you’re my client you also have access to me and my confidential Facebook group 24/7, and there are absolutely no stupid questions!

informed choices means you can say NO at any point

Making an informed choice about your birth means knowing what your options are so that you can make the best decision for you. The best thing might be to say 'No' at some point if you are feeling under pressure, and you should not feel wrong or bad about saying that. During my classes we have a social time section where we can all chat, air our experiences or our concerns, there’s no bias and everything is up for discussion. You can do some of your own research around your birthing options too, but make sure you look at reputable sites such as www.nhschoices.co.uk or www.babycentre.co.uk. As well as these sites there are numerous Instagram accounts, Twitter feeds and Facebook pages you can access focusing on choices and rights for pregnant women. The Positive Birth Movement also have regular free meet-ups if you are feeling anxious and want to hear some beautiful birth experiences, or have one of your own to share.

How Your Maternity Unit can Help

Maternity units want to help you prepare for birth, and lots offer tours of their wards and delivery suites. You may need to contact them to find out the dates and times, or you may be able to simply turn up when you choose. Quite often you’ll see an online tour offered where hospitals can’t allow physical tours. If you can’t access any tour at all, it’s a good to at least find out about the car park situation, and ask which entrances are open in the middle of the night; the last thing you need is to be in labour and standing outside a locked maternity unit!

If you can take a tour, you could ask what a ventouse or forceps looks like; you can also ask about ways of foetal monitoring, and find out if there are mobile epidural units or scanners available at the hospital.  The more informed you feel about the equipment potentially used during delivery or intervention, the less fear or panic you will experience if you should see these items in your delivery suite or ward. And if you’ve been to MummyNatal classes, you’ll know how important it is to reduce the adrenaline caused by fear!

Homebirth Options

You might be planning a homebirth and hiring a pool for example, and you still have plenty of choices around this. You can chat to your midwife about what the midwives on call will be bringing with them when the time comes, and you can go to meetings arranged by your local home birthing support group where they can show you a pool, the gas and air and other equipment. There are important things to consider with home birth, such as how long the pool will take to fill, what point you call the midwife team, where the pool will fit in your house. If you are planning a home birth you might think you do not need to know about C-sections or labour wards, but sometimes birth doesn’t go down the route you hope for. You may end up having to go into hospital and having a Caesarean if complications arise.  If you haven’t considered this, and don’t know what may happen or what options and rights you have in this situation, it could be even harder for you to accept the change in your plans. So it’s a good idea to inform yourself about ALL of the options connected to birth, and not just the options you most hope for.

Caesarean Sections

You might be thinking “Well if I’m going to have a section, I don’t have any choices as the hospital will just do it as a routine procedure.’ Actually there are many options for you here. If it’s a planned C-section you have more options than if it is an EMCS (Emergency Cesarean Section.) So if it is planned, you can choose if you want to see the birth by having the screen lowered for example, or choose to walk to the operating theatre yourself instead of being wheeled down. If you aren’t having a general anaesthetic you can choose to be talked through the operation.  See my blog post all about informed choices during a C-section.

Whatever birth you decide you would like to have, just bear in mind that babies have plans of their own! Keep an open mind, because things can change, and remember that whatever sad or scary thing happened during a previous birth, or your friend’s birth, or that one time on One Born Every Minute, it does not mean this birth will be like that: That is their story and this is yours. Use ‘BRAIN’ where needed. Take your time if you can. Go with what feels right for you and for baby, feeling at ease and empowered with your informed choices.

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