Preparing for Birth…

At some point in your pregnancy you will start to think about your baby’s birth. You may have a firm idea of what you’d like it to look like, things you know you DO want to happen and things you know you DON’T want. Your midwife may have started speaking to you about making a birth plan and I would emphasise that this is a good idea!

Remember most women have some element of choice as to where and how they give birth, especially if their pregnancy is healthy and ‘normal’. And whilst it’s a really good idea to make a birth plan, it’s also important to consider a plan B, or even to let go of any rigidity you might have around your idea of a ‘perfect birth’.

It is likely to be in moments of real relaxation that you discover your wishes around labour and birth, so give yourself opportunities to listen and be in touch with what feels right for you.

The most important thing is that you feel able to discuss your wishes with your midwife/doctor to see what would be in the best interests of you and your baby/ies, and also if you do have a choice, go with wherever you think you will feel most relaxed and safe.

Is there anything you can do to prepare your mind and body for pregnancy, labour and birth? Eg., pregnancy yoga classes, relaxation/mindfulness/hypnobirthing? It’s a good idea to check with your midwife/doctor before you start to exercise in pregnancy.

“Female bodies are well-designed for giving birth; the soft tissues of the birth passage open so that a baby is gently squeezed out. Breathing and relaxation techniques can make birth even easier to manage, and most women now have plenty of chances to learn these techniques.” (Stoppard, 2008)

Some prompts for you to think about when starting to write your birth plan:

• You could ask your midwife/obstetrician the following questions to gauge their approach to childbirth:

- What do you think about inducing labour and birth?
- When would you think it necessary to break my waters?
- Do you think electronic fetal monitoring is a valuable aid in every birth?
- Would you mind if the lights were dimmed during labour?
- When would you think it necessary to do a Caesarean section?
- Will the baby be placed on my chest immediately after birth, and can we delay the cutting of the cord/putting on a nappy/weighing etc until after the first 30-60 minutes?
- And then ask yourself if you agree with their viewpoints, and if not, whether there is another hospital that has a different approach, or whether you might prefer to give birth at home.1

• What birth facilities are there in your area? Eg. Home from home birthing centre attached to a hospital.

• Dr. Grantley Dick-Read was the first obstetrician to realise that fear of giving birth was a main cause of pain in labour. His watchword for mothers was ‘preparation’ – not only with information, but also by seeking help, reassurance and sympathy. His teaching was basically about breathing control and complete relaxation and formed the basis of most ‘methods’ today.

• How do you want to feed your baby? And if that’s breastfeeding, what things do you need to consider during labour and birth to make that journey start as smoothly as possible?

 Home birth:

• A planned home birth can be one of the safest ways to have your baby1

• Remember if you plan to give birth at home, you can transfer to hospital if you change your mind, or if you need to for medical/safety reasons, but you can’t do it the other way round, ie start in hospital and then transfer to home!

• When you give birth at home, you’ll probably hardly notice the shift from pre-labour to full labour, allowing you to stay fully ‘in the zone’.

• Your waters will usually be left to break naturally

• You’ll be encouraged to find ways of easing any pain without drugs, but gas and air will be availble from your midwife if you want it.

• It can eliminate the need to find last minute care of older children.

• You will already be in your own environment once baby arrives which may be more restful.

Factors that might rule out a home birth:

• If you have pregnancy diabetes, or some other medical conditions

• Breech babies

• Multiple pregnancy

 Hospital birth:

• Medical intervention is more likely if you give birth in hospital.

• Do you feel safe in a hospital?

• You may have access to a birthing pool/bath – you’ll need to check but most hospitals have them

• Ask if your partner will be asked to leave at any time

• Find out what kind of pain relief is available and whether there are times when some forms aren’t available

• Medical help is on-hand should you or your baby need it.

Planned Casaerean: find out what basic labouring needs it is still possible for you to meet:

• Can you have your choice of music playing?

• Or can you ask for quiet?

• Can the lighting be dimmed at any point?

• Is it possible to still have skin to skin with your baby after the birth?

• Will you be able to breastfeed straight away?

• What possible effects will not having a spontaneous labour and birth have on your breastfeeding journey and what can you do to counteract them?

• How many people will be present in the room when your baby is born?

Notes:

1.       Stoppard, Dr. Miriam (2008) ‘Conception, Pregnancy and Birth’:
“A British all-party report concluded that although 94 percent of all births take place in hospitals, they’re no safer, and may be less safe, than home births.

In Australia, study of 3,400 home births reported a lower perinatal mortality rate, and less need for caesareans, forceps, and suturing for an episiotomy or a tear, than in women delivering in hospitals. The mothers taking part in the study were not all ‘low risk’: the figures included 15 multiple births, breech deliveries, women who had previous caesareans, and women with previous stillbirths. The group was older than the national average. Fewer than 10% had to transfer to hospital.”