December 12, 2017

Lydia Barlow

'Little Me London' guest blogger!

December 12, 2017

Lydia Barlow

When Tiffany Wright from the parenting blog 'Little me London' www.littlemelondon.com got in contact to find out my reasons why I chose to have my baby at home I was up for the challenge to put together my Top 10 reasons, and I struggled to keep it under ten to be honest!

A home birth may not be on your list of things to do, and these reasons are not to say I’m right and you’re wrong, but just to give you a bit of insight into why so many women, like me, choose to have a home birth. And of course Hypnobirthing is not only if you are planning a home birth... a My Hypnobirth course can support you wherever and however you decide to have your baby!!

When I first told people my plans to have a home birth, some looked at me as if I was completely mad, so I started to become a bit selective about who I mentioned it to. Luckily for me I had enough people around me giving the thumbs up in support, and after all it was my choice. Home birth can get a bit of a bad press as being reckless or selfish, but that couldn’t be further from the truth…

1) Home births are less painful!!!!

Basically home births hurt less! When you are completely relaxed, free from any tension and feel safe, labour can be efficient and manageable. Like many others I’m sure, I feel at my most relaxed in my own home, probably nice and cosy on the sofa - so to give myself the best chance of a calm, swift labour that’s the room I chose to have my baby in!

Oxytocin is the love and labour hormone, and it is directly affected by your emotions. It is produced when you feel safe, relaxed and somewhere private. A warm dimly lit room, which is quiet, without lots of distraction going on, is perfect to produce tons of oxytocin. In this environment you will also maximize your endorphin production too, which is the body’s own pain relief, so the winning combination for a smooth birth!

2) It’s the best VIP care in my opinion!!

It is known that continuity of care has a huge impact on a woman’s experience of birth. Women who have the support of a doula (someone providing emotional support through pregnancy and labour) are shown to progress better, have shorter labours, less need for pain relief drugs and fewer interventions – such as episiotomies, epidurals, forceps, ventouse, and C-sections. Isn’t that just incredible, all that just because of good emotional support? It makes you think, doesn’t it?

If you have a home birth with the NHS you have two experienced midwives looking after just you, which you wouldn’t get in hospital. The famous birth expert Ina May Gaskin often talks about her observations of cases when labour progress actually reverses, so instead of dilating the cervix closes back up, and this usually happens at the presence of a stranger in the room, which interrupts labour and has an effect on the mother’s hormones. So I was happy to know that at home I wouldn’t have my midwife swapping shifts during my labour, and I would get that continuity of care!

3) No worrying about the right time to turn up at the hospital!!

There is always the worry when is the right time to get in the car and make your way through traffic to the hospital. Most first time parents are known to arrive at the hospital too early and have to go back home again, only to return later! Having a home birth, I found it incredibly comforting to know I was in for the night. I find it difficult to drag myself out for the evening at the best of times!

Any interruptions during labour slow progress down, as it’s all to do with the adrenaline you produce by changing your environment, and adrenaline is your worst enemy during labour. So by staying at home I knew I would avoid all these interruptions and added time. Of course if you are a Hypnobirthing mum you will be able to keep that adrenaline at bay and maximize oxytocin hormone even whilst waiting at a red light!

4) I wanted first dibs on the birth pool!

There’s no need to worry about who is diving into the birth pool first if you’ve hired your own! You may have heard about the hard and fast rules of when you are ‘allowed’ to get into a birth pool but this is mainly because midwives have the difficult job of juggling the resources amongst the women. So if you are in the pool and another woman comes in further dilated than you, she is going to need that pool! I decided, rather than playing the dilation lottery, I would be much more at ease knowing my pool would be waiting for me!

Being in a birth pool makes labour easier as the water supports the weight of your body, which means your circulation is good so oxygenating blood can flow to your uterine muscles, and also means more oxygen for your baby. It can be said that the pool can be too relaxing sometimes which can slow progress, but if that were the case you could just hop or clamber back out onto dry land!

5) I DIDN’T want access to an epidural!!!!

I had already been there, done that and got the t-shirt with this one …and it was a lousy fit. So I actually didn’t want an anesthetist and an epidural knocking around the place!

‘But you don’t win a medal for going without an epidural” - no you don’t, but it it’s widely accepted that efficient ‘pain relief’ doesn’t necessarily equal maternal satisfaction. It was pretty comforting knowing I would avoid all the possible complications that can go with it.

If you did decide you wanted an epidural, you would tell your midwife and she would arrange for you to transfer into hospital. Even if you were in hospital already you would have to wait for the anesthetist to be free, so depending where you live the waiting time could be about the same. In terms of ‘pain relief’ at home you would have everything available that you would find in a midwife- led unit or Birth Centre. So gas and air, and pethidine can be arranged (I would definitely do your research with the latter as it crosses the placenta, but it’s there if you wanted it).

You could use hydrotherapy and hire a birth pool, which is said to be as good as a shot of pethidine, and I believe them! Also, you would be able to use a TENS machine and of course, Hypnobirthing is the best preparation for birth in my opinion!

6) I wanted to avoid interventions!

‘Where you give birth can affect many things, from how likely you are to have a caesarean to how comfortable and confident you feel’ - Which? (Birth Choice)

For me, because I had already had a birth that was medically induced with interventions that followed, it was super important for me to give birth where the chances of medical intervention were lowest and this is shown to be at home, (Birth Place Study 2011). I was doing everything I could to prepare for a natural labour for my baby so it just made sense for me to be at home, simple.

7) But what if you have to transfer to hospital??!

The most common reason to transfer from home to hospital is for ‘failure to progress’ a couple of words that are pretty damaging for a woman in labour to hear! But anyway, ‘failure to progress’ by definition is not an emergency. Home birth midwives are always experienced and I knew I would have two caring just for me – that would mean no popping to the next room or to the neighbours to check on their progress! That meant if things were to go ‘wrong’ they would pick up on it immediately and I trusted them. When things go wrong in labour it is very often a slow build up with signs along the way, and believe me your midwives would be on it if there were any signs.

8) What about all the mess? Your place ends up slightly tidier than before!!

The assumption that birth is a messy affair is wrong! It’s really not that messy and your midwives bring plastic sheeting to cover your sofa, bed, floor or wherever! So after you’ve done your bit of giving birth, you can sit back and relax and your midwives (probably with a bit of help from your birth partner) will tidy everything away and help empty out your birth pool! I swear our place was in a bit of a better state after they had left, as if nothing had ever happened - apart from the newborn baby demanding our attention 24/7!!

9) No overnight stay on the postnatal ward (whoop … Mexican wave!)

This is a hard one to grasp if you haven’t had a baby already, but skipping a night or a week on the postnatal ward is pretty bloomin’ amazing. Even if you had your own private room on your own private ward, nothing beats the bliss of cuddling up in your own bed after you’ve given birth! It’s much nicer to be flicking through the take away leaflets than faffing around desperately trying to get someone to sign your discharge papers!!! I also had this feeling that if I was in hospital there would be something that I or the baby would be kept in for- this was probably a bit of a hang-up from my first experience.

10) Benefit for the baby

Last but definitely not least - if you are planning to have a home birth you are most likely aiming for a natural birth and all the health benefits that go with it for your baby, such as helping their breathing by clearing out the amniotic fluid from their lungs and supporting their future immune system. Also being at home meant we would both avoid the risk of picking up a hospital infection.

I knew that if I were calm and relaxed my baby would get the benefit, so entering the world calm and alert and this is what I wanted. If you were planning to breast-feed it usually goes a bit more smoothly when your baby is wide awake and not sleepy from any drugs that might have been in their system (but of course not always, and we can all struggle!). Oxytocin is again one of the main hormones behind successful breast-feeding and it flourishes in all the same circumstances as birth and conception!

“The freedom to have a homebirth – whoever you are, wherever you live and whatever your situation – is much too precious to give up as if it were nothing.”

– Ina May Gaskin

Informed consent. What you need to know!

November 21, 2017

Lydia Barlow

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.