As soon as you announce that you’re pregnant, the stories and discussions will start rolling in. Stories about the gynaecologists who schedule caesarean sections according to golf tee-off times, who coerce women into c-sections, epidurals and episiotomies; hospitals that tell you to labour faster to fit into their procedures and timetables; and midwives who push so hard for you to birth naturally that they refuse to call the OB/GYN and cause long-term damage to you and baby. Whatever the truth behind each story, the mother is always painted as a hapless victim forced into a birth she didn’t want and is then judged for it by friends and family, society – and by herself.
According to specialist OB/GYN Dr Peter Koll, “Recent research shows that, increasingly, postnatal issues like breastfeeding difficulties, bonding problems, depression and relationship problems are related more to the birthing experience than the method of birth. In other words, if a woman considers herself an involved part of the birthing experience – whether vaginal or c-section – she’s less likely to develop postnatal problems.” So the best way to make sure that these stories do not become a reflection of your own birth story is to empower yourself, stop blaming the system or your caregiver, make the choices that are right for your child and you and be involved in your birth. Here’s how.
Choose your caregiver with care
One of the key elements to a positive birth is trust, not just trusting yourself, but also trusting your caregiver. In order to trust your caregiver, you need to believe not only that he or she has the medical expertise to carry you and your baby safely through pregnancy and birth but also that you both share the same vision or philosophy of birth.
Remember, just because your gynae has been your doctor since you were 16 years old, it doesn’t mean he or she is the right person to see you through pregnancy and birth. Do your research, ask friends and family about their caregivers and interview your own caregiver. You can ask questions such as:
- Why did you become an OB/GYN?
- If you aren't on call or are delivering another baby when I'm in labour, who will deliver my baby?
- If I call with routine questions between visits, how will you handle the phone calls?
- What is your policy on informed decision making by parents?
- How much time do you normally spend with mothers in labour?
- What views do you hold about labour assistants such as doulas?
- Which procedures (epidural, episiotomy) do you routinely employ during labour?
- For which situations do you most commonly perform a c-section?
Ask your doctor about any aspect of pregnancy and birth that’s important to you: from the use of candles and water birthing to epidurals and elective c-sections. This will give you a good sense of where he or she stands on the issues that are important to you.
If during the course of your pregnancy you realise that your relationship with your caregiver is more stressful than supportive, you should look for another one. You’re also perfectly entitled to a second, or even third and fourth opinion. A word of caution though: at some point you need to listen to the advice given. If two or more doctors say, for example ,that you’re not a suitable candidate for a VBAC (vaginal birth after a c-section), then start considering the other birthing options available to you.
Read, learn and educate yourself
Know your stuff: you can’t be involved in your birth unless you understand what ‘being involved’ entails. Go to birth education classes. Again, like caregivers, not all classes are the same, so shop around. Find a class with a childbirth educator who’s experienced, who’ll answer your questions and whose birthing philosophy matches your own. If you and your partner are city slickers, listening to whale music may put you off well before your first twinge of labour.
Read up about pain relief options and understand the risks involved with any procedures or interventions, so that you can make an informed choice yourself, and so that you can understand why an intervention is necessary, if it is. Read as many birth stories as you can, but steer clear of listening to too many horror stories (those that people will tell you as soon as they find out you are pregnant).
Do(ula) it your way
Your OB/GYN and midwife’s role in labour and birth are to provide the medical care you and your baby need, and that will be their focus. A doula or professional birth partner is someone who will care for you, the mother, during labour and birth.
This is also a person who knows your wishes for birth and will ‘fight your corner’ for you while you are focussed on labour. A doula also acts as a ‘translator’ between the medical staff and you, explaining any medical terms or procedures that are necessary, and will involve you in any decisions that need to be made, so that you can make the best choices you can in the moment.
Write a birth plan
Write it all down. A birth plan is your wishlist of what you would like to happen at your birth. It includes who you would like to be your birth partner, whether you want pain relief and what interventions, if any, you are happy with.
Most births do not go according to the plan, so your birth plan should also include your wishes should any interventions become necessary. For example, you may be aiming for a natural birth when a c-section becomes necessary, so include any steps you’d like to include at a c-section too, like skin-to-skin contact, or your partner cutting the cord.
Own it, let it go- and don't judge
Labour and birth are unpredictable. You may have done everything to ensure a smooth birth, but it still didn’t turn out like you hoped.
If your baby’s birth was traumatic and leaves you feeling empty or scared, then speak to someone about it: while friends are a good option, it may be better to talk the birth through with a professional –some midwives and doulas even offer ‘birth trauma workshops’. Then, let it go. This may be easier said than done, but try to remember that the birth of your child is not the end of a journey – it is merely the start. We are often our own worst critics, so try not to judge your birth. See it for what it is, your child’s rite of passage.
Mom Chantel Heron makes the point clear, “Each woman should own her decision and as hard as it is, try to ignore the judgment, criticism and self-righteousness. I can’t believe that women do this to each other instead of saying ‘you’re a superstar’, whichever choice is made.”