June 2004
The Parents, Babies and Children’s Expo is in June and the best annual opportunity to promote our group, Friends of the Birth Centre.
Representing FBC at the Expo is one of my favourite things to do. Women who approach us come from one of two camps. Either they already know of the Birth Centre, maybe even had their baby there. These women stop to have a chat, share their birth story and introduce their little one. The second camp are women who haven’t heard of the Birth Centre and don’t understand the model of care. They’ve generally subscribed to private health insurance and taken the private-hospital, private-obstetrician route for their pregnancy care, believing they are accessing gold standard maternity care.
A woman approaches me at the stand. She cradles a milk shake in one hand and her round belly with the other. She is accompanied by two non-pregnant friends. I estimate she is about six months along with her first baby, and maybe just a little scared that she will soon have to figure out all this birth stuff. I remember feeling like that too.
‘I’m already booked into North West Private Hospital,’ she says, ‘and love my obstetrician. I would really like to have a natural birth. How do I make that happen?’
I blink. It takes a moment to digest what she is asking of me. Two midwives from North West Private Hospital approached me earlier pouring love upon the Birth Centre and its 12% caesarean rate compared to North West Private which is pushing 43%. I’ve heard stories of beautiful natural births occurring at North West, but mostly experienced mothers who’ve given birth before.
I want to say, leave your obstetrician. But I doubt that would be helpful.
‘Well,’ I begin, ‘have you had this conversation with your care provider?’
‘What conversation?’
‘That you would prefer to have a natural birth. Have you discussed it with your doctor?’
‘Oh, he says we’ll get to that in time.’
‘Well,’ I continue, ‘there are lots of ways you can increase your chances of having a good birth. Have you heard of YogaBaby?’
‘I hate yoga,’ she replies.
‘It’s more than that. It’s a way to access childbirth education and meet other mothers.’
‘Nah-ah, not my scene.’
‘Okay,’ I continue, ‘would you consider hiring a doula?’
‘A doo-la. What’s that?’ she looks at her girlfriends and they laugh.
‘A person who is there as your companion and advocate. Birth support. Evidence shows that you have a greater chance of achieving a vaginal birth with a doula.’
‘My husband wants to do that.’
‘Has your husband given birth before?’ I snip, a little too sassy. I correct course. ‘Only joking. A doula can support your husband too.’
‘No, I meant, what can I do to be ready to give birth. I don’t want a caesarean. My sister had one and she said it was awful.’
‘Ah, I see now,’ I muster all the empathy I can. Unfortunately, I know this story too well. How much do you tell a woman when you know she is on the slippery slope to an outcome she doesn’t want? She seeks a quick fix. I lean in conspiratorially. She mirrors me and leans in, too. Her girlfriends cock their ears in my direction, not wanting to miss something juicy.
‘Here’s something to think about,’ I say in a low voice. ‘How did that baby get in there?’ I pause to check they are following my cue. They lean in closer, listening, eyes sparkling.
‘We are mammals. A physiological birth needs the same conditions to let baby out as it did to let baby in. Think about what you want while you’re making love. You want privacy, dim lights, connection with your partner. You need to feel safe. Unobserved. Birth will be easiest when you trigger all the same hormones released during love making. Think loving thoughts, move like you’re making love, play music that feels sexy.’
The women blush and I worry that I’ve crossed a line. So I pull back.
‘And when you go into labour, stay home as long as you possibly can before going to the hospital. That will give you the best chance of having a straightforward birth when you arrive at the hospital.’
‘But what about the pain?’ she asks, a look of fear in her eyes.
I reach over and touch her arm. ‘I can’t tell you it won’t hurt, but it’s not pain like an injury. It’s pain with a purpose.’ She is looking at me like maybe she is beginning to understand. ‘Pain is communication. It tells you to move and find more comfortable positions that will best let the baby out. If you can go into labour naturally, and move freely to manage your discomfort, your brain will release endorphins that soften the edges and take the worst of the pain away. I promise.’
‘How many babies have you had?’ she asks, as if to test my authority on the subject.
‘Three, actually. No epidural. No pethidine. Not even a scratch to my perineum. The midwives support you to learn as much as you can about the process of birth and to begin labour naturally as much as possible. Avoid an induction if you can.’
The three women take a step back. I can tell they’ve heard enough. They walk away deep in conversation but I can’t judge whether my over-sharing was helpful or not. And the hardest thing is I will never know how her baby’s birth will be for her. Statistically, I know the odds aren’t on her side.