Take birth back

Empower yourself for a positive birth.

As soon as you announce you are pregnant, the stories and discussions will start rolling in. Stories about the gynaecologists who schedule caesarean sections according to golf tee-off times, who coerce women into c-sections, epidurals and episiotomies; hospitals that tell you to labour faster to fit into their procedures and timetables; and midwives who push so hard for you to birth naturally that they refuse to call the gynae and cause long-term damage to you and baby: whatever the truth behind each story, the mother is always painted as a hapless victim forced into a birth she does not want, and is then judged for it by friends and family, and by herself. According to Dr Peter Koll, a specialist obstetrician, “Recent research shows that postnatal issues such as breastfeeding difficulties, bonding and relationship problems, and depression are related more to the birthing experience than the method of birth. In other words, if a woman considers herself an involved part of the birthing experience – whether vaginal or c-section – she is less likely to develop postnatal problems.” So the best way to make sure that these stories do not become a reflection of your own birth story is to empower yourself, stop blaming the system or your caregiver, make the choices that are right for your child and you – and be involved in your birth. Here is how.

CHOOSE YOUR CAREGIVER WITH CARE

One of the key elements to a positive birth is trust, not just trusting yourself, but also trusting your caregiver. In order to trust your caregiver, you need to believe that they not only have the medical expertise to carry you and your baby safely through pregnancy and birth but also that you both share the same vision or philosophy of birth. Remember, just because your gynae has been your doctor since you were 16, does not mean they are the right person to see you through pregnancy and birth. Do your research, ask friends and family about their caregivers, and interview your own caregiver. You can ask questions such as the following ones:

■ Why did you become a gynae?

■ If you are not on call or are delivering another baby, who will deliver my baby?

■ If I call with routine questions between visits, how will you handle them?

■ What is your policy on informed decision-making by parents?

■ How much time do you normally spend with mothers in labour?

■ What views do you hold about professional labour assistants such as doulas?

■ Which procedures (epidural, episiotomy) do you routinely employ during labour?

■ For which situations do you most commonly perform a c-section?

Ask your doctor about any aspect of pregnancy and birth that is important to you: from the use of candles, water birthing to epidurals and elective c-sections. This will give you a good sense of where your caregiver stands on the issues that are important to you. If during the course of your pregnancy you realise that your relationship with your caregiver is more stressful than supportive, you should look for another one. You are also perfectly entitled to a second, or even third and fourth opinion. A word of caution though: at some point you need to listen to the advice given. If two or more doctors say, for example, that you are not a candidate for a VBAC, then start to consider other birthing options.

READ, LEARN, EDUCATE YOURSELF

Know your stuff: you cannot be involved in your birth unless you understand what being involved means. Go to birth education classes: again, like caregivers, not all classes are the same, so shop around. Find a class with a childbirth educator who is experienced, who will answer your questions and whose birthing philosophy matches your own – if you and your partner are city slickers, sitting in a room listening to whale music and burning incense is going to put you off well before your first twinge of labour. Read up about pain relief options, and understand the risks involved with any procedures or interventions, so that you can make an informed choice yourself, and so that you can understand why an intervention is necessary, if it is. Read as many birth stories as you can, but steer clear of birth horror stories (those that people will tell you as soon as they find out you are pregnant).

‘DO’ULA IT, YOUR WAY

Your gynae and midwife’s role in labour and birth are to provide the medical care you and your baby need, and that will be their focus. A doula or professional birth partner is someone who will care for you, the mother, during labour and birth. This is also a person who knows your wishes for birth and will ”fight your corner” for you while you are focussed on labour. A doula also acts as a ”translator” between the medical staff and you, explaining any medical terms or procedures that are necessary, and will involve you in any decisions that need to be made, so that you can make the best choices in the moment.

WRITE A BIRTH PLAN

Write it all down. A birth plan is your wish list of what you would like to happen at your birth. It includes whom you would like to be your birth partner, whether you want pain relief and what interventions, if any, you are happy with. It also shows your caregivers that you have done your research and understand the risks and benefits of certain procedures. Most births do not go according to the plan, so your birth plan should also include your wishes should any interventions become necessary and which interventions you are happy to try. For example, you may be aiming for a natural birth, when a c-section becomes necessary, so include any steps you would like to include at a c-section too, like skin-to-skin or partner cutting the cord.

OWN IT, LET IT GO, AND DON’T JUDGE

Labour and birth are unpredictable.

You may have done everything to ensure a smooth birth, but it might not turn out like you hope.

These suggestions, like your birth plan, are not prescriptions; they are tools to help you so that no matter how your baby is born, you experience the birth as a positive and healthy one and one where you feel in control and informed of the choices made. If your baby’s birth was traumatic and leaves you feeling empty or scared, then speak to someone about it: While friends are a good option, it may be better to talk the birth through with a professional – some midwives and doulas even offer ”birth trauma workshops”. Then, let it go. This may be easier said than done, but try to remember that the birth of your child is not the end of a journey, it is the very start. We are our own worst critics, so try not to judge your birth. See it for what it is: your child’s birth, a rite of passage. “Each woman should own her decision,” says mom Chantel Heron. ”As hard as it is, try to ignore the judgement, criticism and self-righteousness. I can’t believe that women do this to each other instead of saying ‘you’re a superstar’, whichever choice is made.” ●