‘There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they are falling in’.
Desmond Tutu
I have recently been reflecting on why I feel so passionately about antenatal care. Even after leaving the midwifery profession, I have continued to focus on this area, and became a hypnobirthing teacher alongside a specialist community public health nurse.
When I visit a family after the birth of their baby, I ask about the birth. As a student health visitor one of my mentors once challenged me, “Why do you ask them about the birth, you don’t need to?” My response was “because its important!”
I have heard hundreds of birth stories, some positive, some traumatic. How a woman views her birth affects every part of her and her relationship with herself and her child. Women who have never previously suffered with their mental health are suddenly surrounded with depression, and anxiety.
So, what is perinatal trauma?...... It’s having experienced danger of losing life and the feeling of being out of control.
What has caused a woman to feel that her labour has spiralled out of her control?
I have heard these contributing factors over the years; A change of health care practitioner during labour, interventions, particularly those that have felt unnecessary, being told that their baby is at risk and coerced to make a quick decision based on fear, a health professional’s attitude and not being given options that are evidenced based.
1 in 5 women have been sexually abused. This trauma can resurface for a woman during labour. Health professionals need to be aware of this.
I have also witnessed incredible care and interventions by health professionals which has made positive impacts and in some cases saved the lives of women and babies!
I have been a health professional for over 10 years and know what pressures health professionals face. Litigation, policies, and procedures have led to this generic ‘care’ of women instead of it being 'individualised' women centred care. To have individualised health care there would have to be a huge injection of cash into the service. If midwives do not follow policies and procedures they are leaving themselves open to litigation. When something goes wrong in the maternity service, trust me, it’s the midwives who are held accountable. Midwives are having to protect themselves and therefore treatment for women again is based on fear, past trauma, and the experiences of the health professional.
The maternity service is in a crisis. The media are currently blaming staff, notably midwives, when things go wrong. Stating that ‘physiological’ birth is the problem. The phrase ‘cult of natural birth’ is often used. They demonise the midwives instead of using the evidence from the Ockenden report stating that focus needs to be on funding, recruitment, retainment and interprofessional training.
The birth experience is fundamental for the ongoing care of the newborn. I care deeply for children which is why I am in the career I am in. This is why I am passionate about antenatal care. A child who is nurtured will go on to nurture their own child. When I see new mothers grieving for the birth they were expecting and hear their birth stories, I find it frustrating that it is the failings of our health care system that is the main contributing factor. I would like to reiterate that I have witnessed incredible staff and equipment within the maternity service and I am in no way criticising the intentions and experience of staff. By providing a course to expectant parents my only intention is to support the NHS and provide parents with tools to work alongside their health care professionals.
So where does hypnobirthing come into this? Is it some new age hippie way of giving birth? Is it a fad. Absolutely not! It is how women used to birth. Pain relief was introduced due to interventions, not because giving birth was painful. Choices, control, confidence was taken away from women and the focus was on pain.
Before the 1700’s women would give birth in an upright position, based on instinct and comfort. This allows the sacrum to move and flex, creating the space in the pelvis for the baby to be born.
So why were women forced to give birth whilst laying their backs? King Louis XIV! He wanted to watch his wives and mistresses give birth but did not want the inconvenience of an obscure view so insisted mothers laid on their back, legs apart, so he could have a better view. Because royalty birthed in this way it soon became fashionable.
These strange traditions soon become normal. This is why I find it difficult to hear when a couple say they are going to go ‘with the flow’ in labour and trust the health professionals.
If you are not educated in the choices you have, for you, your body, and your baby, you will go with somebody else’s flow, and it may not be right for you.
Having informed choices, being able to remain in control, having a voice, is fundamental in how you will view your birth.
To quote January Harshe
“I do not care what kind of birth you have….a homebirth, a scheduled caesarean, epidural hospital birth or if you birth in the woods next to a deer.
I care that you had options, that you were supported in your choices and that you were respected.’
The Way of the Koi hypnobirthing course is designed to give you all the information you need for this to happen and reduce the fear around birth. Its about working with the health care professionals.
Women can be supported postnatally, and trauma focused work can really help women have a positive outcome but what if we can intervene antenatally and offer thorough education?
We cannot inject the much needed money into the NHS but women can make a stand, by knowing their birth rights.
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