There are many ways that a woman can prepare for birth and there is no one right way. Just as every birth is unique, so is every woman. Feeling empowered can mean something very different to each person. It’s important not to attach labels to things such as natural birth is empowering, whereas a Caesarean-section birth is disempowering. Or a woman who managed throughout labour without using pain medication had an empowered birth versus a woman who had an epidural did not…
We know from a great deal of research that the factors that affect whether or not a woman had a positive and empowering birth experience have little to do with whether she had a vaginal birth or a Caesarean birth, whether she had pain medication or no medication, whether she gave birth at home, or in a hospital… It does, however, have everything to do with how a woman felt during her labour and birth. Was she supported continuously? Did she feel protected, safe and loved throughout her labour? Did she feel listened to and part of the decision-making process? These are the critical factors that really influence how a woman will perceive her birth experience for many, many years after the birth of her child.
There are a number of things that a woman and her partner can do though to really increase her chances of having a positive and empowering birth experience. Here is my Top 10.
- Choose your care provider and place of birth very carefully.
There are a number of great options available; for example you can hire a private independent midwife who will provide exceptional continuity of care throughout pregnancy and through the early postpartum period. A midwife’s appointment will typically last about an hour, whereas an appointment with your obstetrician will usually be over in about 15 minutes. The world’s largest clinical trial that compared standard maternity care with the primary midwife approach confirmed the hypothesis of La Trobe University researchers that being cared for by one main midwife and a small back-up team improves the experience of childbirth.Don’t just make a decision based on what your best friend did, or because a certain doctor was recommended to you. Learn about your options and make a decision about your care that is best for you and your baby.
You can also do shared care with your GP and a midwife, or an obstetrician and a midwife.
Another alternative is that you can try to be placed in a caseload program at your local hospital, which means that you will be seen by a small team of midwives throughout your pregnancy and one of them will be there to support you during labour.
You can give birth in a standard maternity unit, a natural birthing centre (some hospitals have this option and you might be lucky enough to live in an area that has a free-standing independent birthing centre), in a public hospital or a private hospital, or at home.
While you might not think that where and with whom you give birth makes all that much difference, it’s important to know that these are critical decisions that must be made early on in your pregnancy because these are the people and environments that will, to a very large extent, influence the direction that your pregnancy care goes as well as the birth you will have. For example, if you are hoping for a low-intervention, natural birth, wouldn’t you want to know that the private obstetrician you have hired has a 70% Caesarean rate?
- Surround yourself with positive images and stories about birth during your pregnancy.
Thanks to technology and social media, we live in an era of information overload. When we find out we are pregnant, one of the first things we do is start to Google a million things about pregnancy and childbirth. It can be very hard to determine if the information we are accessing is accurate, unbiased and very importantly, evidence-based.
Hearing horror stories from friends and relatives, or watching anxiety-inducing reality television shows do nothing to positively prepare us for labour and birth and in fact, can actually do real harm. Instead, women should surround themselves with positive images and stories about birth, which help to remind women that birth is a normal, physiological process and not a pathological emergency waiting to happen!
Here are my top recommendations!
Ina May’s Guide to Childbirth – by Ina May Gaskin
Gentle Birth, Gentle Mothering – by Dr Sarah Buckley
The Official Lamaze Guide: Giving Birth With Confidence – by Judith Lothian & Charlotte DeVries
New Active Birth – by Janet Balaskas
A Modern Woman’s Guide to a Natural Empowering Birth – by Katrina Zaslavsky
Mindful Birthing – by Nancy Bardacke CNM
Websites (great resources that are full of positive empowering messages and evidence-based information)
- Take a great childbirth class – preferably with an independent childbirth educator.
One of the best ways you can prepare for the birth of your child is to take a great childbirth class. A private, independent childbirth educator is preferable to a hospital course in many ways. Being independent means that they are not representing the policies of any given hospital, but instead will present ALL your options in a balanced, unbiased way. You and your partner will also enjoy a much smaller class that is focused on normal birth and that will give you the information and tools you need to help you achieve the birth you want. Remember – knowledge is power!
- Hire a doula.
A doula comes from the ancient Greek word meaning “to serve”. A doula is a woman who is trained to emotionally and physically support a woman (and her partner) throughout labour. They are not medically trained, and their role is not to replace your professional health care providers, but instead to provide you with the all-important continuity of care that we know is so vitally important. Research recently published in the American Journal of Managed Care identified another great reason for hiring a doula. Having a doula’s support during childbirth was linked to an almost 60% reduction in the likelihood of a woman giving birth by caesarean section. This figure rises to 80% for non-medically indicated caesarean sections. One obstetrician in the United States famously once said, “if doulas were a drug, it would be unethical not to use them.”
- Manage the stress in your life.
Keep communication open with your partner. Build your support system. Learn and practice meditation. Take a prenatal yoga class. Learn stress management techniques such as slow, deep breathing and other relaxation strategies, such as mindfulness. These techniques will significantly help you during your labour by enabling you to stay calm and focused and preventing your stress hormones from elevating which cause anxiety, fear and which also make you feel more pain. Renowned childbirth educator and doula, Penny Simkin, talks about The 3 R’s – Rhythm, Relaxation & Ritual. Focusing on these three elements during labour can really help a woman to find comfort and reduce pain perception. Check out the fantastic app, Mind The Bump, developed by the same team who created the extremely popular mindfulness meditation app, Smiling Mind.
- Remember the Lamaze 6 Healthy Birth Practices!
For most women, birth is normal, natural, and healthy. Learn as much as possible about what birth is like in the location you have chosen.
Lamaze have developed six Healthy Birth Practices which are evidence-based and proven to promote natural, safe and healthy birth.
- Let labour begin on its own.
- Walk, move around and change positions throughout labour.
- Bring a loved one, friend or doula for continuous support.
- Avoid interventions that are not medically necessary.
- Avoid giving birth on your back, and follow your body’s urge to push.
- Keep mother and baby together – it’s best for mother, baby and breastfeeding.
For more information visit: http://www.lamaze.org/HealthyBirthPractices
- Be your own best advocate!
We all know that birth can be unpredictable, and there may very well be times during your labour that will require you to make a decision that could potentially change the course of your labour. Informed decision-making is crucial and plays a very big part in your overall birth experience. Women who play an active role in making decisions about their care will feel empowered and in control, even when the birth doesn’t go the way they had hoped or planned.
A great way to get answers to the questions you may have is to remember the BRAIN acronym;
B – Benefits. What benefits are associated with this procedure/medication/intervention?
R – Risks. What risks are associated with this procedure/medication/intervention?
A – Alternatives. What alternatives can we consider?
I – Intuition. What’s your gut instinct telling you? Trust it – don’t ignore it.
N – Nothing, or Not Now. What happens if we do nothing – or what happens if we wait an hour/a day?
- Prep your birth partner!
Support is a key element to a woman having a positive birth and postpartum experience. As you learn more about the process of birth, you will discover your strengths in offering support, and you can decide how you want to contribute to the birth of this child. Will you be the primary support, work more with the other team members or be by the mother’s side with your full love and support while others do the hands-on work? A birth partner can serve in any manner that helps the labouring woman, so be comfortable, even joyful, in whatever role you both agree upon.
It’s important to know that simply being present makes a difference. The birth partner is usually the one member of the team who best knows her desires and can interpret her cues and express her wishes to others.
In order to care for a mother in labour, her partner must also care for themselves. Eating and drinking during labour will give you the energy you need, so pack some good healthy snacks for both of you! Wear comfortable clothes (and pack a spare change of clothes too) and let the doula or midwife care for your partner while you take an occasional break.
Ask questions. Unless you are birthing at home, you are in an unfamiliar setting surrounded by unfamiliar people. Remember your BRAIN questions and be confident in discussing your options with your care provider.
Be prepared to experience some strong emotions. Often, a birth partner is so absorbed in supporting the mother and remaining strong that he or she is surprised by the powerful feelings of love and awe that accompany seeing this incredible woman go through birth.
- Communicate your birth preferences.
Sometimes called a “Birth Plan” or a “Birth Preference list”, it can be a very helpful exercise to write down your most important preferences in order to discuss these with your health care provider during pregnancy, as well as during the labour itself. Be sure to give it to your care provider before you go in to hospital to have your baby so that it is a part of your medical records. Some hospitals will even try to “match” you with a midwife who shares your own philosophy of birth.
Creating a birth plan helps you make decisions early on and build confidence before labour and birth. Your plan is a source of strength and inspiration, not a rigid list of what must be done (or not done!). It isn’t about checklists or completing a form. Every pregnancy and birth is unique, and one plan does not fit all. Keep an open mind and a peaceful, positive outlook. A plan isn’t any guarantee that your birth will go just as you envision it. Plan for the unexpected and try to see your birth plan like a road map. Sometimes we need to change direction, but we get to our final destination in the end!
- Your body is NOT a lemon.
We are the only mammal on earth who doubts in their body’s ability to give birth. While on the one hand, it can be very reassuring to know that we have access to the very best medical backup available; the downside of this is that many of us believe that we can’t give birth without it.
Ina May Gaskin, probably the world’s most famous midwife once said, “Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth as well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.”
Your body is amazing. It created new life and grew and nourished a human being for nine months. Remember this, celebrate this and know that your body was designed to birth your baby.
Tanya Strusberg is a Lamaze Certified Childbirth Educator (LCCE) and founder of birthwell birthright, an independent childbirth education practice based in Melbourne. In 2015, Tanya was inducted as an FACCE (Fellow of the Academy of Certified Childbirth Educators) in recognition of her significant contribution to childbirth education. Through her internationally accredited Lamaze Educator Training program, she is very excited to be training a new generation of Australian Lamaze educators.
Last, but absolutely not least, she is also the mum of two beautiful children, her son Liev and daughter Amalia.