For many first time parents their only experience of birth and what happens during labour is either from movies, reality TV shows like “One Born Every Minute” or relayed stories from friends and family. These stories are often horror stories and, as I discovered after my own labour, who wants to hear the boring, no drama, birth stories anyway? So it's unsurprising that most have a view that having a baby is a ‘code red’ situation, one that calls for dad to run around in a state of panic and mum screaming and swearing at him for getting her into this state. The reality can be far from this and, as a hypnobirthing practitioner, I feel it is important for expecting parents to know what to expect and have a more realistic view of birth.
Below is a list of my 5 top movie birthing myths: 1- Myth- The start of labour is an embarrassing breaking of your waters
, cue gush of water all over the floor..Truth- Only 1 in 4 women’s waters break before labour starts
In most movies the rupture of membranes (waters breaking) happens in a comical fashion, usually outside in public causing embarrassment to mother and anyone else present. This is often a big concern for expectant mothers as they imagine their waters may break at the worst possible time but the reality is that only around 13% of labours start with the waters breaking and 75% break well into labour (most when around 9cm dilated).So the mother will know she is in labour as she is having surges (Hypnobirthing speak for contractions) and if
her waters break, chances are she will be at home or in hospital. That’s right, ‘IF’ her waters break as it is possible that they won’t break at all and the baby is born inside its sack with the waters intact which is perfectly normal and In some cultures it’s known to be very lucky. In my opinion, it must be one of the calmest entries into the world for baby as it’s still in its warm, cosy space. 2- Myth- Labour has started (panic!) I need to get to hospital as soon as possibleTruth- Labour can take hours, sometimes days; if you get there too soon you will be sent home again.
We see it all the time in movies; waters break, dad runs around in a total panic, getting everything together to take mum to the hospital and then driving like a lunatic to get her there in record time. The truth is, some labours can take a LONG time. The average length of established labour* for first babies in the UK is 8 hours and that’s not including pre labour** which, for some women, can be days.
In low risk normal births, a mother will be told to come into hospital when the surges are regular, lasting a minute, and 3-4 minutes apart. This is usually when the cervix has opened (dilated) to 4cm or more. If you go in before established labour you will probably be told to go home again. So rather than rushing to the hospital as soon as labour starts the best advice is to carry on with normal activities, sleep if you can, relax and for Hypnobirthing couples it’s the perfect time to start putting all the practise to good use.
*Established labour is when the mother's cervix is between 4cm-10cm dilated
** pre-labour is when the cervix softens and ripens, thins out and starts to open slightly (or dilate) up to about 1cm-3cm 3-Myth- Dad is a useless spare partTruth- A calm, well prepared birthing partner will be very helpful in labour
Although I do agree someone who is stressed and nervous can be detrimental to the birth as they produce stress hormones that can have an effect on the mother’s mood, I will say that in Hypnobirthing this is rarely the case. I very often hear, “I couldn't have done it without him” and tales of how wonderful the birthing partner was. This is because from doing the course, the birthing partner will have a better understanding of the birth process and have tools and techniques to keep mum calm and relaxed. During labour the birthing partner can be the mother’s eyes and ears, paying attention to the medical staff and making rational, informed decisions allowing the mother to remain focused on breathing and birthing. Birthing in this way makes it an experience which really brings the couple closer and promotes bonding for the whole family. 4-During the birth, mum will be on her back on the bed.Truth- This is not the optimal position to birth the baby
Unfortunately, as it’s a rather convenient position for medical professions, it is often used. The reason it is rather difficult to birth in this position is that the pelvis is up to 30% smaller, it forces the woman to put pressure on her tailbone, which flexes it upwards, forcing it into a curved position which makes the area smaller and can inhibit the baby’s descent through the pelvis. It’s also working against gravity so mum is pushing “upwards” rather than down.
There are many positions the mother could adopt in labour such as standing, squatting, or on all fours, all of which aid gravity. Changing position should be encouraged and in one recent study, mothers who changed positions frequently during labour and birth demonstrated a 50% reduction in time progressing from 3cm to 10cm dilatation.(1)
You can find some more suggested positions for birth here
:1-Mendez-Bauer C, & Newton M. 1986. Maternal position in labor. In Philip A, Barnes J, & Newton M (Eds.). Scientific foundations of obstetrics and gynaecology. London: Heinemann
5-Myth- You have to push until your purple in the faceTruth-Forced pushing could be detrimental to the birth, rather than helping.
I’m sure we have all seen the scenes where mum is red faced, jaw clenched and pushing with all her might more often than not being coached by medical staff shouting “PUUUUUUSH”. In reality of course every woman and her birth is different and some may benefit from some direction but for many this forced pushing can hinder the babies descent, slowing things down as it closes the vaginal sphincters
, causing exhaustion for the mother and in some cases distress to the baby.
The female body has a natural expulsive reflex that will gently nudge the baby down and out, women often describe this as having an “over whelming desire to push” or wanting to “bare down”.
New midwives are now trained to follow the mothers lead and encourage the natural expulsion rather than forcing the baby out. If the desire to push isn't there, the new guidelines suggest waiting until the mother is ready rather than putting time restraints on this stage and commencing forced pushing. You can read the new guide lines published by the Royal Collage of Midwives (RCM) here.
During Hypnobirthing classes we learn how to ‘breathe the baby down’, breathing techniques to work with the body’s natural urge rather than against it.
So with these points in mind I ask all parents-to-be to forget what you have seen on TV and become an educated expert in real birth. Go to antenatal classes, do your own research, learn about what an amazing body you have, what it’s capable of and learn to trust it. The more you know and understand the less there is to fear.
You can find out more about Hypnobirthing antenatal classes here
A great source for birthing research referencing can be found at site www.homebirth.org.uk
When my husband and I did our Hypnobirthing course almost 2 years ago, I remember the practitioner telling us that the Hypnobirthing skills we are learning can be used in many situations, not just during labour and birth but in everyday life. I didn’t really understand what she meant and I didn’t really give it much thought as like most first time mothers I was solely focused on my baby’s birth and couldn’t see beyond that moment.
Fast forward 2 years and I know exactly what she was talking about. I have used these skills many times and 3 examples I have revealed below... 1) Helping with an irrational fear.
After living in London for many years without the need for a car I suddenly needed one. Public transport wasn’t cutting it and a trip to Granny’s house 100 miles away was now a nightmare. As anyone travelling with a baby will know you have to take what seems like half the contents of your house with you and carrying these things along with the buggy and car seat on a train just isn’t an option. So we bought a car but what I hadn’t realised was that due to not driving for so long, I was really scared of driving on motorways. When I say scared I mean, palms sweating, heart beating fast, starting to hyperventilate scared. Completely irrational and I knew it was but as with any irrational fear you can’t rationally tell yourself you are being silly or override the initial panic you feel.
So it was during this journey to my mother’s, in this state of panic that I instinctively starting using the “Up Breathing” learnt during my Hypnobirthing class. After a few of these breaths I calmed down and realised I hadn’t been breathing properly and was holding my breath somewhat with the fear. So I carried on with the up breathing and felt a whole lot better. My shoulders relaxed and my palms stopped sweating.
Another part of Hypnobirthing is listening to positive affirmations about birth and during this car journey I started saying some positive affirmations out loud to myself “I am safe” “I can drive” “I am calm and relaxed” “I have confidence in myself and my driving” it may sound silly but it works, as long as what you are saying is positive and in the present tense it’s very hard to tell yourself you are doing one thing whilst doing another.
I carried on this way through that journey and made it to my mother’s safe and sound. The next few journeys were much better and if at any time I felt the familiar feeling of panic rising I went straight into the up breathing and that panic went away. That was almost 2 years ago and I can now say I love driving on the motorway and that the fear has completely gone. 2) Having a ‘Hypno-poo’
The breathing technique used when the baby is about to be born is called “down breathing”. Down breathing is a way of breathing that works with your body to move the baby down and out without forcefully pushing (or purple pushing as many midwives call it!) therefore avoiding unnecessary tearing and trauma. During the last few weeks of pregnancy Hypnobirthing mothers are encouraged to practice this whilst on the toilet when the body is 'realising' something else. It relates back to Ina May Gaskins ‘Spinkters law’ which you can find more information on here
So without going into too much personal detail, the down breathing is fantastic if you ever suffer from constipation. Funnily enough this one is very popular with some of the dads I teach, many telling me they practised the down breathing whilst on the toilet and were amazed at the result of having a 'hypno-poo' 3- Going to sleep/relaxing
Another tool used during Hypnobirthing practise is the Hypnotic script CD. Most mothers like to listen to the CD before falling asleep as it really helps to relax the body and mind and enables them to sleep peacefully, something that may become increasingly difficult as the pregnancy progresses. Some women have actually never heard the CD to the end because they fall asleep but everyone would have listened to the beginning which is where the soothing voice tells you to relax different parts of your body until the whole body is relaxed. This part here is usually enough to get me to sleep and when I’m feeling restless or cant switch off before sleep I go through this in my head and . I find I am asleep by the time I have got to my shoulders or so.
To find out more about hypnobirthing life skills or book a course you can contact me at info@hypnobirthUK.com
A question I have answered a lot recently is “what is a Doula?” especially when talking to pregnant women, many of whom asking if I attend births. Unfortunately as much as I would love to attend births this is not part of my job, where attending births is a large part of a doulas job description. So what exactly is a Doula?
Doula" (pronounced "doola") is a Greek word meaning "woman servant or caregiver”. According the Doula UK “Doula now refers to an experienced woman who offers emotional and practical support to a woman (or couple) before, during and after childbirth. A doula believes in “mothering the mother” - enabling a woman to have the most satisfying and empowered time that she can during pregnancy, birth and the early days as a new mum. This type of support also helps the whole family to relax and enjoy the experience”
To have a better understanding and find out more about hiring a doula I asked fellow hypnobirthing practitioner and doula Steph Grainger www.consciousbirth.co.uk
a few questions. Here she has shared what being a doula means to her and also some of her experiences working as one. In your opinion what are the benefits of hiring a doula?
A doula Recognises birth as a key life experience that the mother will remember all her life. She understands the physiology of birth and the emotional needs of a woman in labour.
A doula assists the woman and her partner in preparing for and carrying out their plans for the birth and then stays by the side of the labouring woman throughout the entire labour.
She also provides emotional support, physical comfort measures, an objective viewpoint and assistance to the woman in getting the information she needs to make good decisions and facilitates communication between the labouring woman, her partner and clinical care providers.
A doula perceives her role as one who nurtures and protects the woman’s memory of her birth experience.
Research has shown that a constant supportive presence throughout labour results in:
50% reduction in caesarean rates
25% shorter labour
60% reduction in epidural requests
40% reduction in Syntocinon use
30% reduction in analgesia use
40% reduction in forceps delivery
From Klaus & Klaus's The Doula Book (2002). Are you medically qualified?
NO! I am not medically trained at all and always ensure each client I work with understands that and they know that is the job of their Midwife/Health Professionals. I do not give advice or share my opinion on any matter. I help clients to make informed decisions based on up to date guidelines, resources and evidence Do midwives mind you being at the birth? Do you work together?
I have been in scenarios where midwives have not been best pleased with my presence, but I would like to think that changed once they got to work alongside me. Usually the main reason for hostility towards Doulas is because of a lack of awareness for what we do, or more importantly what we don’t do! A midwife can feel that we are there to take her role and that really is not the case. Having said that I have had the opportunity to work alongside some fabulous midwives, and it has been a really lovely experience for all concerned.
The best case scenario is being able to work with the midwife so that the birthing mother feels she can trust that everyone around her is there for her 100%.
As a member of Doula UK we do a lot of work regionally, raising awareness and part of this is going along to our local hospitals and talking to Midwives and Health Professionals about what we do. So this helps to iron out any issues or questions that may be out there about how a doula works. Can you tell me a bit about the births you have attended?
I have attended 11 births in the last 2 years. Some were natural homebirths in water pools, or on ‘dry land’ others were in hospital. I have also supported a couple through a C-Section too.
My role at each birth can be anything from making tea, pumping up birth pools, filling birth pools, taking photos, supporting the mother through surges, supporting dads through surges, protecting the space so Mum and Dad can have the experience together with no intrusion. I have also been there for siblings too when Mummy is birthing at home. As I said before each birth is completely unique! What seems like the ideal birth to one woman can be the very opposite to another!
The most enjoyable part of being a Doula is witnessing a birth where the client’s choices were respected and met wherever possible, and my client also knowing that if situations have to change due to reasons out of their control, they are fully informed so are able to make conscious decisions because of that. How long do you work with your couples/mothers?
That would all depend on when I was booked. I have been booked as early as 18 weeks to 39!
If we have time I like to get to know my clients as much as possible, so will try to meet with them at least two times before their birth, and I did manage this at 39 weeks!
We start out by chatting about what their expectations are for their birth and me as their doula and go from there. Many things are discussed during my meet ups with clients, birth preferences, feeding choices, coping with newborns etc. Again this varies from one client to another. I may be working with a first time mum that has very limited knowledge or experience of childbirth or I could be with another that has had a very traumatic birth experience and needs the space to de brief and let go of that. So each session I spend will be completely tailor made to each client.
My goal is to get to know my clients so that when the birth day comes, they are relieved when I walk in the room as they completely trust me and know I understand what they need and want. Who should hire a Doula?
Anyone! As childbirth has moved from home to hospital, a vital element of care has been lost from the whole process. Gone are the days where a woman would have continuous support from one carer throughout her labour unless she has an Independent Midwife.
It used to be the case that the womenfolk within the immediate and extended family (mothers/sisters/grandmother etc.) would be on hand to provide the nurturing role for the new mother, to guide by experience and help with the practicalities that need to be performed before, during and after a woman gives birth to a baby. Unfortunately this is not the case for a lot of people. Families are spread out and may not be close enough to help out when a new baby is coming.
There is also more pressure for men to be present in the birth scenario, when they may not feel 100% confident so having another person there to support both of them can help alleviate the pressure on Dad and he can enjoy the experience a lot more too. How do your clients find out about you?
The majority of my clients have found me through the Doula UK website, as there is a ‘Find A Doula’ section on there. But recently I am getting bookings through clients that have referred me to their friends, and this is the best scenario, because I know I have really done my job well if another client has recommended me. I also attend local baby shows, expectant parent evenings at hospitals and I have my own website too. Do you have any advice for parents looking to hire a Doula?
There are many women who have come to be doulas through a variety of journeys, all are passionate about their work. The most important thing to consider when employing a doula is "Do I like this woman? Can I spend time with her? Can I trust her?"
You will find there are as many different doulas as there are people, there is not a typical doula. So I would suggest interviewing two or three women, maybe first by phone and then face-to-face. Ask a doula for references or for other doulas' details in your area. At the end of the day, you need to find the right doula for you.
If you are interested in hiring a doula or would like more information please visit Doula UK http://doula.org.uk
My husband has just told me that the article below was one of the reasons he first looked into Hypnobirthing when we were having our son. Having only just read it myself I feel I must share, and who knows it may inspire another father into taking the first steps to a calm birth. Hypnobirthing : A man taking charge during childbirth? I was a bit skeptical about hypnobirthing too, but there really is a way for men to take some of the strain on the big day.
I had always believed the maternity ward delivery room was a woman’s domain. That the man’s role consisted of calling for the ambulance or rushing his partner to hospital, then waiting nervously in the hospital corridor praying for everything to be OK and over as quickly as possible. Or maybe, if my presence was absolutely demanded, stealing a drag on the laughing gas and saying patronising things such as ‘keep going, darling’.
So I prepared to be of limited use to my wife Candy: I would hold her trembling hand while absorbing her abuse. Until that is, I reluctantly agreed to miss football and spend two whole Saturdays on a hypnobirthing course.
I had no idea the man could play such a leading role in childbirth. But when, erm, push came to shove, there I was, relaxing my wife, focusing her breathing, working through the birth plan with the midwives and making informed decisions with confidence. I amazed myself. In my wife’s words, after the safe arrival of our baby Jude: ‘I was the body, you were the mind.’
Giving birth is the most natural thing a woman can do, yet many female minds are filled with horror stories. Fear leads to tension, which can restrict the body at a time when it needs to let nature take its course. Hypnobirthing offers hypnosis in labour and childbirth to women who want to be in control of a drug-free, comfortable delivery and get their men pulling their weight.
Now more popular than ever in Britain, hypnobirthing is a complete antenatal education for whatever kind of birth you’re planning. We chose a hospital birth pool – alternative, yes, but perfectly normal in the modern age; even old-school midwives are coming round to it.
Signing up to Berkshire HypnoBirthing, we joined three other couples eight weeks before their due date at a Pilates studio in Reading. The comprehensive course was split over two days and our hypnoteacher, Vanessa Turner, made learning each new topic easy, between lessons sending the group into a state of deep relaxation.
‘HypnoBirthing techniques and methods are easy to learn and apply,’ says Turner (inset left). ‘They play a vital role in making the birthing experience calmer, more peaceful and meaningful for mum, dad and baby.
‘The man’s role is crucial. He provides practical, emotional and physical support – much better than sitting in the corner wondering what he can do to help.’
Turner explained ten ways to achieve a gentle birth, the rationale for hypnosis in birth and how to block out birth nightmares. We were told to not even consider them and to leave out negative energy. The mind can only hold one thought at a time and the course places great importance on desire, belief, relaxation and visualisation.
Turner explained how thought precedes reality and how every emotion triggers a physical response. A section was devoted to big babies, a common fear, and the women were made to trust their inner knowledge or instinct, to trust that their body knows exactly what to do.
The group was then shown images illustrating the various stages of birth and a selection of calming hypnobirths on DVD. The men were in charge of relaxation-deepening exercises, helping dump negative energy and thoughts.
‘I teach a wide variety of techniques and encourage men to become fully involved,’ says Turner. ‘It builds their confidence, helps them trust themselves and means they can learn what a woman needs at different stages of labour and birth.’
During the breathing exercises I spoke in a slow, calming voice to enhance a trance-like sensation, the idea being to maintain focus and reduce discomfort. Hypnobirthing bans words such as ‘pain’ and ‘contractions’ as these are considered negative –‘discomfort’ and ‘surges’ are preferred.
‘The benefits to mum are such that a woman can feel safer, can trust and let go during the process of giving birth more instinctively when she knows her partner is taking care of everything on the outside,’ adds Turner.
‘This means birthing can be a calmer and more comfortable experience where both mum and dad feel confident and in control to make whatever choices are necessary for a healthy delivery of their baby.’
The main goal of the course is to arm prospective parents with the tools to stay in control. It doesn’t end in the classroom, either. We were told to practise the techniques for at least five minutes every day and encouraged to have conversations with the unborn baby and play him music.
I saw my job as learning the birth plan by heart before the contractions – sorry, surges – took hold, to avoid unnecessary medical intervention on the big day.
I was pumped up and ready, and not at all nervous. Two days after her due date and it was action stations – but only my wife can tell you how it went
Read more: http://www.metro.co.uk/lifestyle/836745-hypnobirthing-a-man-taking-charge-during-childbirth#ixzz25RZzZD19
I read something that made me really happy today, a midwife from Leeds has been successful in her campaign to change the guidelines on cutting the umbilical cord. In the UK currently the cord is cut within the first 60 seconds after birth, however, this practice has little or no research to back it.
Thanks to midwife Amanda Burleigh, the national body of the Royal College of Midwives (RCM) has said its latest guidelines will advise that delaying umbilical cord clamping is best practice. Fortunately much research on the effects of cord cutting has been conducted. For instance, the blood composition from a six month old baby will show whether the cord was cut instantly or whether they waited until it had finished pulsating and all the baby's blood was out of the placenta and into the baby. I also understand that newer research shows that it is even more beneficial to wait to cut the cord until the placenta has been expelled so that maximum number of stem cells are transferred to the new baby. After all, this is how it was millions of years ago or is this another "birthing design flaw"?
The image above shows the infant blood volume at the time of cord clamping and as you can see at 3-4 minutes after birth the blood volume is a staggering 33% higher. Studies have shown that this could be optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants.
Until delayed cord cutting is common practice in all hospitals within the UK, expectant parents can request that their babies cord isn't cut until it has stopped pulsating by writing it in their birth plan.
Below is what the WHO (World Health Organisation) have said on the matter:
"For centuries, people have been clamping and cutting the umbilical cord at birth. However, the timing of cord clamping continues to vary according to clinical policy and practice, and the optimal timing has not yet been defined.
Early cord clamping is generally carried out in the first 60 seconds after birth, whereas later cord clamping is carried out greater than one minute after the birth or when cord pulsation has ceased.
To reduce the risk of postpartum haemorrhage in the mother, WHO recommends clamping the cord following the observation of uterine contraction at around three minutes after birth. A 2007 review however showed no significant difference in postpartum haemorrhage rates when early and late cord clamping were compared.
For the infant, there is growing evidence that delayed cord clamping is beneficial and can improve the iron status for up to six months after birth. This may be particularly relevant for infants living in low-resource settings with less access to iron-rich foods."
If you would like to read the article on Amanda Burleighs achivment click here
If you would like to see studies on cord cutting and more, please click here
I have been reading a fantastic book by Ina May Gaskin called 'Ina May's Guide to Childbirth'. For those that don't know, Ina May Gaskin is a world renowned midwife that lives in Southern Tennessee in the US. She and her colleagues live in a small village called "The Farm" a place that women and girls have little or no fear of childbirth. Ina May and her partners have attended births of more than 2,200 babies, most being born at home within the village or at the birth center. The first half of the book has short birth stories told by these mothers and midwives. The second half is Ina Mays guild to childbirth, what happens within the body and things she has witnessed happen such as an 'Orgasmic birth' - Yes it is physiologically possible and if you’d like to know more, take a look at the YouTube clip below.
But the chapter that really caught my attention and made so much sense to me was the chapter titled 'Sphincters Law'. Sphincter refers to a ring-shaped muscle that encircles an opening or passage in the body. We have over 50 sphincters within the human body, some microscopically small. The opening and closing of the anus is controlled by contraction and relaxation of a sphincter, as is the cervical sphincter that releases during childbirth, allowing the baby to pass through the birth canal out into the world. The basics of Sphincters law are:
- Excretory, Cervical, and vaginal sphincters function best in an atmosphere of intimacy and privacy - I think we can all agree it would be very difficult to go to the toilet in a room full of people watching and that it is much easier to go in a bathroom with a locked door where interruption is unlikely or impossible.
- These Sphincters cannot be opened at will or don’t respond well to commands such as "push"
- When a person's sphincter is in the process of opening, it may suddenly close down if that person becomes upset, frightened, humiliated, or self-conscious. - This happens because high levels of adrenaline in the bloodstream prevent the sphincter from opening. As with all mammals the body will not want to release anything, especially an offspring if it feels threatened and possibly in danger. I’m sure millions of years ago this saved many lives so you can understand why we were made this way.
- The state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity. - It’s not easy to relax these muscles when you are straining and trying to “push”. If you find yourself in this situation either whilst on the toilet or when in labour, take a few deep breathes, let all the tension out of your mouth and relax those muscles. The proof is in the pudding as they say; you will see what a difference this makes.
Something that wasn’t mentioned here was how important relaxing is in order for these muscles to open. Some people like to read on the toilet or smoke a cigarette, this enables them to relax, take their mind off what’s happening and let the body get on with it whilst concentrating on something else. It is the same way when giving birth, Hypnobirthing mothers are taught visualisations and relaxation techniques to help them focus the mind so the body can do what it is designed to do, without the unnecessary straining. Instead of having elevated adrenaline levels in the bloodstream, which inhibit the body’s sphincters from opening, Hypnobirthing mothers produce endorphins, the body’s natural feel good hormone allowing the cervix to open as nature intended.
To learn more about hypnobirthing click here
I recently received a DVD showing 2 beautiful hypnobirthing births from a friend and fellow hypnobirthing practitioner, Rae Dingall (Birth Peacefully). Rae recently filmed theses births herself and made the DVD in the hope that others will see them and see for themselves the power of hypnobirthing. Both couples in the DVD birthed at home calmly and peacefully with the assistance of a midwife, one in water and the other on land so to speak. I will most certainly show these to expecting parents during my classes as they are another great example of how birth should and can be.
After watching the DVD and seeing how comfortable the woman were at home it got me thinking as to why I had never considered a home birth for my own son's birth over a year ago. I guess like many first time mothers I worried about the "what ifs" but to be honest I didn't really know too much about having a home birth and the only stories I had heard about were the ones that were unplanned home births. With only approx 3% of UK woman having a planned home birth it is no wonder I personally didn't know someone who had. Obviously that has completely changed now that I am a hypnobirthing practitioner and not only do I know many women who have given birth at home, I also know many who have attended the births or who are home birth advocated.
So with my new found knowledge I wanted to share some things I previously didn't know below. 1- Having a planned home birth is just as safe as birthing in hospital (in "low risk" pregnancies) Some people worry that having a baby at home is risky and its best to be in hospital where you have emergency services on hand in case something goes wrong, but studies show this is not true. Being pregnant and giving birth doesn't mean you are sick or in life threatening danger. In normal "low risk" circumstances a woman could give birth just as her body was designed to do so, without any medical interventions. Research has shown that woman who are relaxed and comfortable have shorter and 'easier labours'
and it goes without saying that for many woman, being at home rather than in hospital will make them feel more relaxed and comfortable. So what are the chances of things going wrong? What happens if I need to transfer to hospital?
Probably the most comprehensive study of home birth ever undertaken in the UK was by The National Birthday Trust, they found that
40% of first time mothers that birthed at home had to transfer to hospital. Some of these transfers occurred before labour actually started, whilst others occurred during labour. The single largest reason for transfer was slow or no progress, accounting for 37.2% of transfers. Premature rupture of membranes (waters releasing) accounted for 24.8% of transfers, and most of these occurred before labour had even started.
If the mother does need to go into hospital the midwife present will arrange for an ambulance or as in half the cases in the study above she can go by car (as you probably would in a planned hospital birth). The study also showed that planning a home birth halved
the chances of mothers having assisted or caesarean births. The overall rate of these events was very low. So if you add in the reduced risks of infection, ventouse, forceps, tearing and caesarean section, you may even conclude that for some woman having a home birth is safer than having a hospital birth and what deems as an "emergency" rarely happens.2 - In the 1950s home births were actively discouraged
The reason home births have been unfashionable for years, is mainly because in the 1950s it was actively discouraged by the health service which ran campaigns to persuade mothers to go into hospital to give birth. In post-war Britain, just as the NHS was being created, our housing conditions and general health were quite poor. For many poorer women at that time, it probably was safer to be in hospital. However, those campaigns convinced many people that home birth itself was unsafe and that hospital was always safer. This has been perpetuated by the media so that many, particularly older, people still believe that hospital is safer than home. This is not supported by the evidence, see point 1. 3- A home birth will be attended by one or two experienced midwivesWhether the couple have hired an independent midwife* or have chosen NHS midwives to attend their home birth, only experienced midwives will be sent out.
Almost all midwives love attending home births but it is unfortunate that at this current time, we have a shortage of midwives and very often a mother that has planned a home birth will be told to go into hospital as they are short staffed. This will also mean that many student midwives graduate without ever attending a home birth, something they are very keen to experience and may rarely ever do so.Now
It isn't against the law for a woman to refuse to go into hospital but many go in as they don't know that they have any other option. The hospital have an obligation to find a midwife to attend the birth. Even if this means they send out the head midwife on duty (as only midwives with home birth experience can attend).
AIMS** advises any woman who is told during her pregnancy that "if we have a shortage of midwives at the time of your labour you will have to come into hospital" to write a short letter back stating that they have no intention of coming into hospital and they expect a midwife to attend when called. So far, each one has had a midwife attend at home (a sample letter for women in this situation is available on the AIMS website at the address below).
If enough women exercise their right to choose their place of birth then things may start to change, the home birth rate may go up and more midwives may be employed. * Independent Midwives are fully qualified midwives who have chosen to work outside the NHS in a self employed capacity. Traditionally one midwife would look after a woman throughout her pregnancy, giving them a chance to get to know one another, attend the birth and care for them both after the birth. www.independentmidwives.org.uk** AIMS, Association for Improvements in the Maternity Services www.amins.org.uk4- You can still have pain relief during a home birth
It's important to remember that women who are in control, relaxed and in their own environment and having one to one care from a midwife are much less likely to experience severe pain and less likely to ask for pain relief. However, the midwife attending the birth will carry entonox (gas and air) and may carry pethidine. A recent study by the National Birthday Trust showed that
- 53% of women who planned a home birth used entonox compared to 72% for planned hospital birth.
- 8% of women planning a home birth used pethidine compared to 30% for planned hospital birth.
You can use self help measures like hypnobirthing, massage and complementary therapies such as aromatherapy and homeopathy. You can hire a TENS machine and also a birthing pool. Laying in a pool full of warm water is a great way to relax and for many woman its so comfortable they give birth in the water. 5- Birth at home = Birth where you like, birthing pool, bedroom, hallway, kitchen....From talking to many midwives and fellow Hypnobirthing practitioners it is my understanding that many women will give birth where they feel the safest. For some this will be in a the birthing pool after their partner lovingly fills it up with warm water
and for others it will be in a part of the house they feel safest and most secure. This usually means some small, dark, cozy area of the house, like the hallway or toilet. As was the case with a friend of mine who birthed her first child at home on the upstairs landing. She said the birthing pool was all set up downstairs in the front room, she had music playing softly and candles lit around the room to give it the "relaxed" feel she had been dreaming of. She needn't have bothered because she just didn't want to move from the tiny landing and she wasn't going to move for anyone, candles and all! She stayed up there with her husband by her side and her lovely very understanding midwife, positioned on the top step of the stairs for a good few hours until she gave birth to her beautiful son. So as much as you plan for a birth you can never be sure how you will feel at the time, and where nature may take you.
The misconception that laying flat on your back during labour is "the way to do it" came from Queen Victoria of England who had a male doctor for her 7th baby in 1853. She was also one of the first famous women in history to use chloroform during labour. The use of breathable pain relief by Queen Victoria set the scene for having a male doctor attending births which then became fashionable with upper class women (which were the only ones who could afford this)
Doctors would ease pain with medications and sometimes shorten the labour by using forceps. Both these interventions confined women to their beds, usually lying on their back most of the time. Being in bed also made it easier for the doctor to see what was happening and to intervene if necessary, which they frequently did. It wasn't long before these procedures spread routinely throughout the Western world and is often the scene you will see on TV and in films today.
We now know that laying flat on your back isn't the best position to birth your baby and we are very lucky that our healthcare providers support this in a normal birthing situation. Many hospitals and antenatal classes will advise against using this position and recommend alteratives, such a squatting (the optimum position) and being on all fours. The poster here provides some great illustrations of alternate positions.
Dr. Stuart Fischbein chuckled when he read the title of the press release: "Women with a fear of childbirth endure a longer labor."
The release was promoting a study published this week in BJOG: An International Journal of Obstetrics and Gynecology. Researchers at Akershus University Hospital in Norway found women who feared giving birth were in labor for 1 hour and 32 minutes longer, on average, than those who had no fear.
"I'm glad there's now evidence to say that," Fischbein said, "but it's obvious."
For those of us who aren't OB/GYNs, it may seem more like a cruel joke. Women who are afraid of the pain and the possible medical complications associated with giving birth have to suffer through it longer?
Study author Dr. Samantha Salvesen Adams initially thought her team would find the prolonged labor could be explained by other factors - women who feared birth the most were first time mothers, who are known to have longer labors anyway, or obstetric interventions like epidurals. But when those factors were taken into consideration, the difference in time between the fearless and the fearful was still 47 minutes.
"Mental stress is associated with physiological arousal and release of stress hormones," Adams wrote in an e-mail. "During labour, high levels of stress hormones may weaken uterine [contractions]."
In other words, the adrenaline released when a body is stressed stops the oxytocin hormone production that makes a woman's uterus contract, slowing labor. It's a natural, biological response to fear, Fischbein said.
Fischbein, who's also a co-author of "Fearless Pregnancy
," said women today are afraid of giving birth because they're surrounded by horror stories.
"We have a society where sensationalism sells. They're pounded with information [about] things that can go wrong with childbirth. Of course you develop fears."
To understand Fischbein's lack of surprise at the study results, you have to take a look at the way other mammals give birth. For example, when cats, dogs or horses are in labor, they find dark places to have their offspring in peace. They eat when they're hungry, pace if they're in pain and run if something comes near them.
Compare that to a hospital setting, where a woman is given ice chips, strapped to machines while laying in bed and surrounded by people who are constantly interrupting. Though the machines and medical personnel are sometimes necessary, Fischbein says the stress comes from being in an unfamiliar environment.
He recommends women find a doctor or midwife who will take the time to talk through their fears and dispense honest advice about the birthing process.
Post by: Jacque Wilson -- CNN.com writer/producer
Filed under: Living Well