I was at an event last month - well, it’s probably more like a good few months ago, (who am I kidding that I actually go out the house in the evening that much?) and I got the chance to chat to some confident and super savvy women about their experience of giving birth.

When I say that I’m now a trained Hypnobirthing teacher, women open up about their own birth experience to me, which is great. Unfortunately these stories are usually pretty traumatic and you can see the tears building up in the woman’s eyes as she’s telling it and by the end I’m holding back my tears also. I do empathize, as I know that old feeling of not being able to talk about your birth story without a lump in your throat. But birth doesn’t have to be traumatic and it shouldn’t.

Something has clearly gone wrong somewhere along the line. Why is it now in the modern world that traumatic birth experience seems a pretty normal event and so many of us are left feeling traumatised by birth?

As Beverly Turner and Pam Wild sum up in their introduction to ‘The Happy Birth Book’:

“It has never been harder to get the birth you want, there has never been so much fear surrounding labour and such high rates of unnecessary medical tinkering with female bodies. Reports of traumatic births are at an all-time high and post-natal depression continues to rise”

These negative birth stories always have a running theme with similar phrases popping up throughout - ‘I wasn’t allowed’, ‘they wouldn’t let me’, ‘I would have loved to, but they said no’. It’s how women speak about birth that tells us what has ‘gone wrong’. The decisions made about your birth are solely yours to make, no one else has this power, and this is often very misunderstood. If someone does tell you what you can and can’t do, then they are misinformed about their position.

This brings up the concept of ‘informed consent’. This isn’t just nodding and going along with what is suggested , still feeling a bit unsure of it all- it is about fully understanding what you are agreeing to. Informed consent means finding out the benefits of doing something and the risks that go with it. And also the benefits and risks of actually not doing anything – and that’s the bit you might need to ask.

You may be thinking, ‘but why the hell would anyone suggest anything that is not in my and my baby’s best interest?’ Of course absolutely no one in his or her right mind wants harm to come to you or your baby, you don’t need to panic! But it is good to keep in mind that we live in a society that increasingly practises ‘defensive medicine’ where responses are made firstly to avoid liability rather than to benefit the patient - and who can blame them when litigation claims continue to rise?

Obstetricians and midwives do an incredible job and in certain medical situations you wouldn’t object to any procedures, I’m sure. But it is the things that have generally become routine without looking at the individual where problems can stem. Hospital policies are a blanket, ‘one-size fits all’ approach to care and this is where you need to get clued up and ask the question- ‘but how does this apply specifically to me?’. There are pretty much always alternatives to anything offered to you, but YOU often have to ask. If you don’t question things you are likely to be popped neatly onto the conveyor belt of births and at the end you might have come off feeling okay, but if not -it’s then a bit too late to ask.

If you are reading this and expecting your first baby you might be thinking ‘what on earth is she going on about?’ but those expecting their second will likely be nodding along. If there is anything suggested to you that doesn’t quite feel right always ask to speak to the consultant midwife at your hospital, or refer to an experienced independent midwife who will be free from the ties of hospital protocol and will be able to speak openly. Most midwives are always women’s biggest champions and are driven to support women to get the birth they want.

So, for example, if you were told to book in for an induction –you now know that the decision to have an induction is yours to make, no one else has the authority to tell you to do it. Find out about the risks alongside the benefits and what alternatives are available, so you can fully consider everything. You would most likely be told that you have the option of twice weekly foetal monitoring so you could then explore that further. But again YOU would have to ask.

For many different reasons it may be suggested to have continuous Electronic Foetal Monitoring (EFM) during labour. Again as with everything you have the right to decline or agree to this. Continuous EFM limits your movement during labour as you have straps around your stomach, which tether you to a recording machine. Because you can’t move about freely it can be pretty stressful. Imagine when your mobile has run out of battery, so you are having a phone call or sending a text hanging off the side of the bed as the charger cord isn’t quite long enough – it’s that feeling, but obviously you’re in labour as well!

It is also worth considering that the Cochrane review (Alfirevic, Devane et al.2006) found that the outcomes for women who received continuous EFM monitoring and those that received intermittent monitoring were no different. Each case is individual, if it gives you comfort, go for it, but if it makes you feel restricted or tense as lots of women report then don’t, it’s simply up to you. If you decline you should never be made to feel guilty about your decision and keeping yourself relaxed during labour is so important for your baby.

Another time when it’s good to do your homework is deciding whether you would like to have an epidural. Lots of women decide to have an epidural and have a great, positive experience. But it is a fact that with an epidural you are more likely to have a longer second stage (when you are pushing) and may need an assisted delivery. I knew this when I decided to have an epidural after my first labour was induced, but I didn’t really think about what emotional effect this might have on me. If you think about all this before you are already clued up and able to feel in control if further interventions were needed. When you are in labour you are not going to be in the right frame of mind to be reading articles, so do all this research well before!

Many women take the approach to birth preparation that they will ‘just go with the flow’ and I’m sure I said something along the lines of this myself with my first birth, but it was just another way to say I wasn’t doing any research or thinking how I might mentally prepare for labour. This isn’t a great idea as if you go in with this approach you will probably end up feeling a little lost and considering how birth is generally treated today… you really need to do your homework first!

So as the woman telling her traumatic story comes to the end, she usually gives a little shrug of her shoulders and says something like ‘Well, the baby was healthy so it all worked out in the end’.

But did it really ‘all work out in the end’ if the woman is left feeling so clearly traumatised? I’m not saying birth has to be picture perfect to be positive. A positive birth story may take any twists, turns and interventions but the woman feels in control and able to make informed decisions.

Milli Hill, founder of the Positive Birth Movement beautifully sums up what positive birth means:

“A positive birth means a birth in which a woman feels she has freedom of choice, access to accurate information, and that she is in control, powerful and respected. A birth that she approaches, perhaps with some trepidation, but without fear or dread, and that she then goes on to enjoy, and later remember with warmth and pride.

A positive birth does not have to be ‘natural’ or ‘drug free’ – it simply has to be informed from a place of positivity as opposed to fear. The Positive Birth Movement is woman-centred and as such respects a woman’s human right to choose where and how she has her baby.

You can birth with positivity in hospital or at home, with or without medical intervention. You can have a positive caesarean, or a positive home water birth. Positive Birth is about approaching birth realistically, having genuine choice, and feeling empowered by your experience”

Let’s help birth move forward to empower all women, let’s aim to stamp out using submissive language around birth and realize that it is always the woman’s choice.

Informed consent. What you need to know!

Lydia Barlow