Showing posts with label home birth. Show all posts
Showing posts with label home birth. Show all posts

Saturday, 25 February 2012

Ten really important things about birth that noone tells you



1.             Having the continuous reassuring presence in labour of another woman, who has had a positive experience of birth herself (your mum, sister, friend, midwife, doula), seriously increases your chance of having a straightforward vaginal birth.  The government recommends all women be told this.

2.             Birth is an involuntary bodily function controlled by the autonomic nervous system, which also controls your breathing, digestion, going to the loo and other automatic functions over which you have very little control, except to stop or slow it down.  Labour will be easier, quicker and less painful if you feel safe and in control enough to let go and let it happen, letting the hormones flow and the muscles work. 

3.             When you go into labour you should stop thinking about what you have learnt and simply tune in to your instincts and do what your body tells you to do. Tune out from the world.

4.             Planning a home birth triples your chance of avoiding a caesarean, or assisted birth and also improves outcomes for mother and baby across the board, inc. length of labour and amount of pain. Everyone should at least consider this option.  After all, by planning for a home birth you are maximising your options – you can still go into hospital at any time.

5.             Cocoon yourself in labour to let the birth hormones flow freely.  You need to feel secure and in control enough to let go and let it happen. Fear makes your uterine muscles contract and labour more painful; fear releases adrenaline which slows down or stops the flow of the birth hormones. Let your birth partners be your advocates and protectors – let them deal with any hassles.  Be a queen.

6.             The uterus is a muscle and so you need to apply what you know about how muscles work best – be relaxed, breathe steadily, keep hydrated and fed.  Labour can be physically demanding.

7.             ‘Breathing through contractions’ is simply breathing out through your mouth in a rhythm.  By concentrating on your out breath, you keep your breathing steady (not holding your breath, nor breathing too fast), you get oxygen to your muscles and your baby, you will be more relaxed, and it gives you something to focus on, all of which reduces the pain.

8.             In a midwife group in London almost 80% of women (not having operative deliveries) had no form of artificial pain relief.  You can reduce pain of contractions by having good support, relaxing your body (go saggy with the pain), using distraction and positive thoughts, being upright and mobile, breathing steadily, looking after your muscle, using water, massage, and making the most of the interval between contractions (pacing yourself).  Women who think they will be able to cope report less pain than women who think labour will be unbearable.

9.             Pharmacological methods of pain relief use either muscle relaxants, mind-altering drugs, or interrupters of nerve messages.  By using the methods above to relax your muscles, change your perception of the pain, or to interrupt the pain messages, you can go longer without these, or work with them to make them move effective.

10.          It is not just important to have the baby’s head down, your birth will be smoother if the baby’s back is towards your front.  In late pregnancy there are things you can do to move the baby round; in labour, keep upright and leaning forward, moving (walking, marching, whatever your body tells you) and be prepared for a longer labour.

REMEMBER: It is your body, your baby, your birth. It is the law of this land that everything is your decision.  Health professionals can only recommend an action.  This applies to everything from where you give birth to having any treatment, including being induced.

Tuesday, 30 March 2010

Midwives supporting home births

In March 2006 the Nursing and Midwifery Council issued a circular clarifying the rights of women, the responsibilities of midwifes and the obligations of Local Supervising Authorities (LSA) for home births. In brief it outlines guidelines in three areas
• As experts in normal birth midwives should be competent, and have confidence, in caring for women having home births.
• Home birth is at least as safe as hospital birth for healthy women with straightforward pregnancies. Whilst there are some clear categories of women for whom a hospital birth would be highly recommended, there are others with increased risk factors where opinion is divided. Risk is a complex issue. If a woman is legally competent to make the choice to birth at home then the midwife should support her, make a plan of care, and seek support from her supervisor. S/he should make all options and choices clear and respect the choices a woman makes.
• There should always be midwives available to cover home births. ‘Withdrawal of a home birth services is no less significant to women than withdrawal of services for a hospital birth.’ Women can contact the LSA for advice.

Hurrah! This is tremendously important for those planning homebirths. In the past six months I have known women trying to book home births who have encountered problems in all these areas: midwives who are not competent in water births, not competent in physiological third stage, not confident in normal birth and nervous about attending a home birth; there have been women with low iron, suspected big babies, previous caesarean, previous assisted birth with high blood loss; two women told no midwife was available, though one other woman was attended by a senior midwife who came out from the hospital. For all these women, and the many, many more, I am very grateful for this document. If you would like to see the full document, ask me for a copy or go to www.nmc-uk.org.uk.

Everybody should at least consider a home birth, simply because it is one of your options, and should be considered along with which hospital, what pain relief and which pram. In fact the National Institute for Health and Clinical Excellence (www.nice.org.uk - Clinical Guideline on Caesarean Section) positively recommended that you do “During their discussions about options for birth, healthy pregnant women with anticipated uncomplicated pregnancies should be informed that delivering at home reduces the likelihood of CS.”* Start at www.homebirth.org.uk or the NCT publications (home birth info sheet, £1; booklet, £2.50), or contact me


*Were you told this? The guideline also recommends that “Women should be informed that continuous support during labour from women with or without prior training reduces the likelihood of CS.”

Ref: www.nice.org.uk/CG013NICEguideline pg12