Thinking about birth can bring up a whole host of emotions. Looking toward your baby’s entry into the world might incite hope, excitement, anticipation, worry, fear; most likely a combination of these. Reflecting on a past birth may stir up feelings of joy, love and connection, but often blended with pain, fear, guilt, confusion and failure.

Despite what you hear around town, the biggest contributors to a positive birth experience are not, in fact, the type of birth, the amount of pain relief used or how long labour lasted. It’s how we feel during the process that has the most impact. Did we know what was happening or was nobody explaining? Did we feel in control or was someone dictating what we should do? Were we empowered or powerless?

There is a pre-conceived notion about healthcare which, in the context of birth, is threatening women’s voices: ‘a good patient will do as they are told’. Surely the professionals know best? Yet there are flaws to this approach…

Policies, guidelines and standard operating procedures have been introduced in their hundreds. The goal? To create a practice that was standardised and evidence-based, to reduce risk and improve safety. The difficulty here is that every mother, every pregnancy and every baby are different; what is right for one may not be right for another. What is recommended might not seem to apply to our particular situation. If we don’t discuss our thoughts, feelings and opinions, care can become a series of alien procedures which are not tailored to us as individuals. This is compounded by the pressures faced by the NHS: antenatal classes, clinic times and support groups have been cut to the bone. There is less opportunity to ask, less time to explain and thereby less understanding. On both sides.

What can we do?

Care workers – always speak in a way that is respectful of women’s right to informed choice. Simple adjustments in language ensure women know that it is their decision to accept or refuse any aspect of care. We should be asking “are you happy for me to take blood from you to test for…” not “I’m going to take blood”. “It wouldn’t be recommended because…” over “you’re not allowed”. This seems basic yet it is powerful, and many still get it wrong. Be respectful of whatever they decide. Call out your colleagues who aren’t.

Mothers and fathers – ask questions. Ask more questions. Ask for alternative options. Ask for compromise. Read and research wherever possible. It is your basic right to be informed and make decisions, and nothing can be done without your consent. Family and friends are incredible essential support networks for mothers and fathers; there is no doubt. Just remember that you are your own person, and your story will be different to your sister’s. You might not choose the same pain relief as your mother did or feed your baby like your friend does.

Birth experiences can have a lifelong impact on women’s emotional, physical and mental health. It can be life-affirming or self-esteem crippling. There is so much more to it than “at least mum and baby are fine”. Understanding options, and being supported to make decisions about care as individuals, regardless of the outcome, is the key to empowerment in pregnancy and birth.

 

 By Sophie Adams , NHS Midwife(@mythbusting_midwife)