What now for normal birth?

Over the last month in the UK, there has been a lot of news coverage of the Royal College of Midwives’ (RCM) decision to end their campaign for normal birth. It’s been met with a predictably mixed reception – agreement and an outpouring of emphatic support from some and confusion and worry from others. A lot of people, like me, fall somewhere in between.
The Times had it as front page news and then the RCM issued a clarifying statement a couple of days later. Since then, stories of negative birth experiences and sad outcomes have been filtering out, filling the news once again with the most popular view of birth in Western culture – that it’s the most dangerous day of our lives and that medical intervention is a requirement for most.

Full disclosure – I’m a hypnobirthing teacher and I had my baby naturally at home. I know I was extremely lucky to be able to do so. I know this. My heart also goes out to the families who didn’t receive the care they deserved and are still missing their babies who they so rightly had expected to arrive safely in the world. It’s the worst possible outcome to what should be the best day of parents’ lives. I can’t imagine what it is to live with that kind of heartbreak.

As I write this, I also hold in mind all the many, many mothers who didn’t have the kind of birth they had hoped for and still feel the effects of that today. I know full well what it is to live with the small injuries, the changes in how you feel about your body and the shift of emotions you experience – the outright shock of going through such a life changing experience in a way that you don’t feel prepared for at all. I also know how hard those first few months are and that if your early days care with your newborn isn’t as supportive as possible, how that can impact your feelings towards your baby and your new role as a mother for months to come. I understand.

I have to be honest though – I’m worried that natural birth will once again become something that isn’t encouraged and this in turn will have its own negative effect, perhaps exacerbating the problem of women feeling unsupported and steam rollered. That women will stop believing in their ability to deliver their babies and that fear of childbirth will return to previous levels. Being afraid and treating birth as a medical emergency will become normal once again. It seems like a step back in the open and ongoing conversation around finding what’s best for each and every unique case.

I’ll also make clear at this point that hypnobirthing principles hold that women should give birth where and how they feel safest, which means they make all the decisions and can give birth in exactly the way that makes them feel most secure – at home, in hospital, with drugs, without… it all makes no odds. The goal is always a healthy, happy baby and a mum who has felt she was able to do things her way and was empowered in all her choices even if she did have a birth which went off her plan. The emphasis is always on her.

When I hear the stories of births that went wrong, I’m truly shocked. Every midwife I’ve ever met seems so far from the picture built in the media reports and goes above and beyond to support the women they work with. I can also imagine how hard it would be for the mum to not feel informed and like she was able to steer the decisions made too. After all, it’s her body and her baby. She will live with the long term impact of whatever choices are made by her and the team around her.

I also find it pretty tough to swallow when I see Jeremy Hunt jumping in to the fray with a tweet that (whilst it looked like a valid, mainstream opinion) actually makes it seem like he lacks basic understanding of how the system works for most women and that he was commenting on the details of a relatively small unusual set of occurrences.

I have no crystal ball to help me see how this will play out of course. I have a suspicion that the resurfacing of difficult stories will have an impact on pregnant women for a few years to come. Whilst I don’t think we should shun hearing more negative stories (and certainly shouldn’t diminish their impact or tidy them away), we would do better to have a conversation about them to enable the birth professionals in attendance to learn from them and for the mothers to get the support they need.

After all, as Sarah Wickham so succinctly points out, stories really do make a huge difference.

We need to stop gory birth scaremongering

“Oh wow! You’re pregnant! That’s amazing? When are you due? How are you feeling about – you know – the birth….? Did I tell you about my sister in law/best friend/daughter? She was in labour for 60 hours and had a c-section in the end anyway. The she couldn’t walk for a week. But I’m sure you’ll be fine… No really you will”
Agggghhh! What’s a newly expecting mother to do? Politely smile and tell these well wishers to get lost? Or politely smile and try not to listen but secretly wonder how they will cope and if they dare wish for anything better?

There is something so British (and maybe American too) about this ritual. I suspect it has it’s roots in the whole stiff upper lip, plan for the worst, be realistic mentality that seems to be part of our culture now. I’m sure the people who share the gory stories are the same ones who watch ‘One Born Every Minute’, ‘Eastenders’ and ‘Crimewatchers’ – because it’s real life right? It’s just what happens.

And so, this poor new mum goes to all her antenatal check ups and giggles nervously when the midwives start to talk about coming in to see the hospital and planning for pain relief. She goes to her NCT group and hears the birth talk covering inductions, breech babies and c-sections. Then she goes home and watches some really dramatic birth videos on YouTube because the most popular ones are the ones which are the most sensational, with the most blood.

Is it any surprise that by the time labour starts this poor new mum to be can’t sleep, can’t eat and is so afraid that she’ll take any advice she’s given from this point on, no matter what she’d hoped for?

Why do we women do this to each other? Is it mindless continuation of the norm? Or is it passing on their tale like an old war story – it was so challenging and traumatic for them that they still need to talk about it? Or worse, a brutal way to make sure nobody has it better than them?

Well – I’m here to say I’m over it.

And that I hate it.

And that women will not begin to see more positive outcomes until we buck the trends and encourage them to think differently.

We lose nothing by being positive, by educating ourselves, by planning for the best; nothing at all.

We need to put down this idea that pessimistic thinking and scaremongering equates to grown up realism. The human mind is so powerful that all words and thoughts can have great meaning.

Fortunately, for hypnobirthing mums who are dedicated to their learning and practice, the current standard ways of thinking about birth can be gently altered and challenged. I hope that at some point soon, my teaching will become obsolete.

Once women consider childbirth to be the beautiful right of passage that it is, hypnobirthing will just become birthing.

Natural ways to bring on labour: can you and should you do it?

You’re approaching the 40 week mark and those calls from your family, friends and your mum’s best friend from school who somehow knows your due date are taking on a frenzied tone. Your best mate wants to make sure you’re the one she tells first, your mother in law has picked out her outfit for the first photo with her grandkid and your dad is postponing his holiday to make sure he can meet the little one as soon as possible. It’s enough to make you want to drop your phone into the bath on purpose. Maybe just put it on silent for a bit.

On top of all that noise, your midwife is now talking to you about engagement fractions (⅗? Is ⅗ ok for now?), sweeps and inductions. You’re wondering if every tiny bit of fluid you can feel is the start of your waters breaking, you’ve had enough of aching in bed when you try to sleep and every Braxton Hicks contraction you feel could be the start of something. In other words, the pressure is on.

Technically, there’s no ‘natural’ way to bring on labour, as even a sweep might be hurrying along a baby who’s not quite ready to make an appearance yet. Research now shows that the baby’s lungs will release a special protein that tells the mum’s body that it’s ready to go and start labour. Also, the baby’s head position is vital. The pressure of it on the cervix also kicks off and amplifies the flow of hormones needed for labour. The best advice out there is to be patient and let nature take it’s awe inspiring course.

What’s a woman to do? Wait it out and hope for the best or speed things along yourself if you can? Could your attempts make labour a painful nightmare or will they just not work? Here’s a brief roundup of options you might have seen or heard about.

Might work but might not

Pineapple – this apparently does work. The bromelain it contains is thought to act in a similar way to the human hormone prostaglandin that ripens and softens the cervix, making labour more likely to start imminently. You can try this one late in pregnancy if you like but be warned – you’ll need to eat 8 fresh pineapple cores a day to get anywhere near the volume of bromelain that you need in your body for it to be effective. That means none of the tasty flesh and no juicy canned ones either. Hot and spicy food – There’s no real evidence for this one. If you have a craving for spicy food, indulge it. Bear in mind though that the last thing you want to deal with, alongside your labour, is an upset digestive system if you overdo it. Your body will likely prepare itself with a mini clearing of the system so what goes in will come out sometime soon.

Stay away from these Castor oil – the evidence shows that this will work for some people but if it does, the outcomes aren’t normally good. Everyone who took part in studies felt nauseous, many had much more painful labours and it was likely that taking it increased the chances of a cesarean. This one doesn’t sound good to me. I’d leave it well alone.

Aloe vera juice – bottles of aloe vera juice often carry a warning that they shouldn’t be used by pregnant women. It works as a laxative and can irritate the uterus, causing strong contractions that can easily become out of control giving you a more difficult and possibly more painful labour. I’d stay well clear of this too – it doesn’t sound worth the risk.

Go for it

Nice relaxing options that make feel good hormones flow – we’re mammals and labour will categorically not start if we feel stressed or in danger. If you can relax and feel happy, you’re massively increasing your chances of going into spontaneous labour.

Lovemaking, baths, laughter and happy visualisations all fall into this category. They will produce a positive physical change in your body that might loosen things up and persuade baby that the outside word is also a pretty happy place.

Alternative remedies also work in a similar way. Being relaxed, positive and like you’re doing something to help, may just be the kick start you need. Acupuncture, reflexology and hypnotherapy are by far the most likely ‘natural’ interventions you can use to help. Just make sure you see someone who’s trusted and qualified.

Raspberry leaf tea – this one is absolutely proven to be helpful, so much so that it’s best to avoid it until you are past week 30. From that point on, you can drink one cup a day, gradually increasing up to four cups it if you have no overly strong effects. The tea works to tone the uterus, making sure that contractions (or surges in hypnobirthing talk) are as efficient as possible. I made mine into pints of iced tea each morning.

Dates – just like raspberry leaf tea, these won’t kick labour off alone but they will make your body more receptive to the hormone changes it needs to pick up on to kick of surges. In countries where women eat more than six dates a day, it’s been shown that they could expect to have a shorter first stage of labour and to go into spontaneous labour more often. The dates mimic the effects of oxytocin, making the uterus more sensitive, stimulating it’s surges and reducing the chance of postpartum hemorrhage. They are nutritious but also contain a fair amount of sugar so once you’re past week 36, replace any daily treats with six awesome dates!

Patience is still best though. As with everything to do with our amazing human bodies, we need to learn to trust in it’s knowledge and ability to get things right. Maybe your baby will come tomorrow of it’s own accord anyway; perhaps it needs a week or two more to finish up growing. Whatever your circumstance, remember this: you’re getting a blissful few extra days, with just you and your partner; the kind of alone time you might be wishing for very soon. Babies come when babies are ready.

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This post was written for and first appeared on The Natural Parent Magazine.