There are often situations in a birth space where snap decisions must be made, where deviations from ‘the plan’ are recommended and interventions take place. Usually these situations feel highly fraught, the care team can appear extremely concerned and you are swept into agreeing to all of the recommendations for the sake of you, your partner or your baby.
In rarer cases people may be left feeling they have no say, no option, no control. Their care team are either incorrectly telling them what they must do or they are coercing interventions which a birthing person may not want or fully understand.
In either situation you have a wonderful tool you can use:
Ask “Am I / Is my partner or is our baby in immediate danger?”
This question is an effective way of assessing exactly how much of an emergency the situation at hand is.
There are, of course, two potential answers. Lets take the first:
In this instance its pretty clear that the health care provider deems you, your partner or your baby to be in a highly risky situation. Their medical opinion is that immediate intervention is suitable.
Regardless, you deserve to understand exactly what their concern is, why, what they are advising you do, why and what the risks & benefits are. This can be a very swift conversation but understand that you have every right to this information and that the ultimate decision on how to proceed is STILL YOURS.
Only with the appropriate information can you and your partner make an informed decision. Make no apologies for asking.
I would also suggest asking that they immediately note down the discussion which has taken place and they they sign their recommendation. You may wish to read this over to ensure it sums up the conversation. If you are unhappy with their opinion, notes or anything else you can ALWAYS request a second opinion.
The alternative is of course - No.
Feel the urgency & tension lift from your body as you realise that this situation is not the ‘life or death’ it may have felt seconds ago.
From here you can breath a little slower, feel yourself settle back down. You have time to consider all options and discuss them fully with your care team and then again with your partner.
I recommend using the acronym BRAIN to assist you in these conversations.
B - Benefits
What are you suggesting & what are the benefits to this.
R - Risks
What are ALL the risks to what you are suggesting? (Dont let them only tell you about the risks of NOT following their advice). Most interventions carry some level of risk, I would be very sceptical if my care provider were telling me something is risk free. (Consider doing your own research or calling the AIMs helpline - they’re open late and will happily chat to you even if you’re in labour).
A - Alternatives
What are all the alternatives to what you are suggesting. There are usually other pathways (e.g. Intermittent monitoring as opposed to continual. Observing maternal behaviour rather than multiple vaginal examinations) the most commonly used method isn’t always the evidence based one.
I - Intuition
What does your intuition tell you? Do you feel that all is well? Or are you concerned about something and you dont feel youre being listened to? Take time to check in with yourself and make your voice heard. Your decision is final.
N - Nothing
Is doing absolutely nothing a reasonable option? Is giving yourself a little more time with no interference, fuss, pressure something you’d welcome? If so, youre more than entitled to decline all of the offered care and proceed.
I also suggest you ask for time alone (with your own partner/s) to come to your decision on how best to proceed without any pressure or coercion.
Having the presence of a doula with you in these situations can make the communication must clearer, calmer and less tense. You have an advocate there who can communicate your decision, ask relevant questions and encourage you to speak your wishes with confidence. Usually doulas have enough knowledge in where to access reliable evidence based information that they can support you as you research your care too. You will feel the benefit of an independent professional by you and your teams side.
If you would like 121 support from Jen please email firstname.lastname@example.org
‘Sure! We will be more than happy to support your homebirth!’ (A common response to a request for a home birth! Yey!)
However, it is usually followed with:
‘Unless, of course, there are not enough staff on that day. In that case you will have to come into the unit.’ (Not so yey…)
Fortunately its very simple, repeat after me…
‘NOT MY PROBLEM.’
It is not your job to consider the staffing logistics of your local trust when you are deciding on your place of birth. Wether you are assigned to a busy city centre unit or you live rurally and your local trust is practically a long weekend trip away you simply don’t have to concern yourself with this particular issue.
Fundamentally it is your right to choose where to birth.
“All people* should have an appropriate level of choice in relation to place of birth and there are a number of choices that should be available to all people in Scotland including birth at home, birth in an alongside or freestanding midwifery unit, and hospital birth.” (Gov.Scot - https://www.gov.scot/publications/best-start-five-year-forward-plan-maternity-neonatal-care-scotland-9781786527646/)
The factors you take into consideration as you make this decision are yours to choose. You are free to research as much or as little as you wish. My personal belief is that knowledge is power and the more you understand your rights and choices in birth the more confident you will feel in your interactions with your care team. However, in short - you are always in control.
If during your care you are told that you ‘will not be allowed’ a home birth due to staffing levels you are well within your rights to contest this. To support your case you may firstly like to draw your trust’s attention to their National Institute for Health and Care Excellence (NICE) guidelines which state:
“they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice of setting wherever they choose to give birth”
(NICE - https://www.nice.org.uk/guidance/cg190/chapter/recommendations)
You may then consider highlighting the complaint of Mrs Jane Reeve. Mrs Reeve was forced to hire independent care when her trust refused to provide home birth services to her. Her complaint was upheld and it was found that the suspension of home birth services was unreasonable.
It is also helpful to understand that the NMC code itself states
“You put the interests of people using or needing nursing or midwifery services first. You make their care and safety your main concern and make sure that their dignity is preserved and their needs are recognised, assessed and responded to. You make sure that those receiving care are treated with respect, that their rights are upheld and that any discriminatory attitudes and behaviours towards those receiving care are challenged.”
(NMC - https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf)
Is refusing home birth support a breach of the NMC code? When multiple contingency possibilities are ignored then I believe that it is indeed a breach & grounds for a complaint.
Ultimately though this is not your concern, you are simply not the one being paid to consider staffing logistics. We have people in our system with the means to do this.
I would strongly urge anyone who is currently experiencing issues with home birth provision to contact the following people/organisations:
*I have amended this for inclusivity reasons.
JK Rowling’s Tweet and why it’s A) Repulsive and B) A pile of shit....
JK Rowling tweeted her support for a woman who recently lost an employment tribunal over transphobic comments she made on Twitter...
To understand why JK is a massive TERF and why her tweet is a perfect example of smoke screen transphobia we must first understand who she was defending...
Who is Maya Forstater and what did she say…
Maya was working in her capacity as a tax expert for a think-tank. During this time she posted a series of tweets which questioned the governments plans to allow people to self-identify as another gender.
Maya stated “men cannot change into women”, she stated that she is concerned about expanding the definition of “woman” to include both males and females.
Maya lost her tribunal, the judge stated that her views were “incompatible with human dignity and fundamental rights of others”
In response to the ‘freedom of speech’ argument that so many trans exclusionary people use the judge stated “Even paying due regard to the qualified right to freedom of expression, people cannot expect to be protected if their core belief involves violating others’ dignity and creating an intimidating, hostile, degrading, humiliating, or offensive environment for them” in short… you cant just spout damaging rhetoric and claim that its protected under freedom of speech.
Following the judgement - JK tweeted -
“Dress however you please.
Call yourself whatever you like.
Sleep with any consenting adult who’ll have you.
Live your best life in peace and security.
But force women out of their jobs for stating that sex is real? #IStandWithMaya #ThisIsNotADrill”
Now - there is a lot to break down here. But lets start with the big juicy one that a lot of trans exclusionary feminists like to tout…
Vernix, Vernix, We 💖 You!
Have you ever come across a raw image of a newborn baby and found yourself recoiling at the creamy 'goo' coating her/him?! Please please recoil no more! Let me explain why that divine substance, also known as Vernix is one of the most awe inspiring creations of nature. Once you've read this you'll know that keeping baby coated in Vernix is one of the most important parts of any birth plan.
It a Kickass Bodyguard 💪🏼- Along with the mucus plug and amniotic sac, Vernix forms part of a bacteria fighting trio. It's thick waterproof consistency protects your baby inside the womb, on the journey through the birth canal (which can expose newborns to a number of bacteria, viruses and fungi) and continues its protection once baby emerges earthside. 💡
It is natures most effective moisturiser 😍 - and we humans are the only animal on the planet who can benefit from it (it's completely unique to us). Rubbing Vernix into your newborns skin rather than wiping all that incredible goodness off is so beneficial. It has moisture locking qualities which have kept baby's skin protected from amniotic fluid during pregnancy. 💡
It acts as lubrication! 💦 - and let's face it, when birthing a baby, lube is exactly what we want! It's slick consistency assists in allowing baby to move through the birth canal. It can also reduce the risk of vaginal trauma (meaning reduction in need for stitches - Yey! 👍🏼) 💡
It helps to keep baby toasty - Vernix acts as a natural insulator. It provides a thick, waterproof coating of waxy warmth which can ease the transition from womb to world 🌍. ✨
So next time you see a beautiful Vernix coated baby, please tag me and we can 😍😍 together!
Ever since finding out I was pregnant with my second child I have been knee deep in anxiety. Not because of what happened to me previously when I gave birth to my daughter (story to follow) I wanted to forgive my body for what had happened. I wanted to believe I could birth another child without worrying about the repercussions.
Preparing for the birth of your first child is, for many, the most intense period of their life so far. The melting pot of emotions includes the extremes of blind excitement and complete terror, plus everything in between. One minute you find yourself daydreaming about chubby toes and how much you can’t wait to smooch and nibble them and the next, you’re plunged into the icy chill of fear that you’re making a huge mistake, life is never going to be the same again and you just know you’re not and never will be ready to birth a human being out your vagina or belly.
Then we have to navigate our views and ‘readiness’ for childbirth. Many outside factors feed into this, including:
• Practical Organisation- is the birth bag/box all packed etc, Do you know who you are calling and when, is travel, pet care, postnatal support arranged?
• Health & Clinical Experiences- how supportive are the professionals you have? How is your pregnancy progressing clinically?
• Emotions - How excited, frightened, calm are you? How mentally prepared are you? Have you targeted this area and worked to turn worries into mental power?
• Birth Partners - again, how supportive & prepared are your team? Are they confident in advocating your birth plan? Do they help or hinder your preparation?
It can be a lonely time, perhaps your friends haven’t began to have their babies yet or you could be geographically isolated from your support network. I wanted to put together a post to help your prepare yourself practically and emotionally for birth. The following suggestions are not exhaustive but they are doorways and tools you can use as you progress in your pregnancy.
By understanding topics such as consent & coercion and how they translate in the birth space you are arming yourself with the most effective tool you could have in your quest for a smooth, respected and positive birth experience.
KNOW YOUR RIGHTS
This is always the first piece of advice I give any pregnant person/ couple & their birth team (if they ask).
It’s imperative that you know your fundamental human rights before you begin to discuss your care in pregnancy & birth. By understanding topics such as consent & coercion and how they translate in the birth space you are arming yourself with the most effective tool you could have in your quest for a smooth, respected and positive birth experience.
With this knowledge you can navigate your options for birth while understanding that you are in complete control over each decision. You decide where you birth, when others can and cannot touch/examine you, which positions you want to be in (and stay in) and who you want with you etc. The list really is endless but the overarching rule is YOU ARE IN CHARGE.
There are many resources which discuss this very topic but my absolute favourite is the book Human Rights in Childbirth by Rebecca Schiller. This book can be downloaded onto your smartphone or kindle as well as ordered in paper copy. Another book that details the topic of autonomy and your birth rights is Am I Allowed by Beverley A Lawrence Beech.
A really easy to digest list of factsheets are available on Birthrights website. They can even be printed and popped into your notes.
It may seem that I am preparing you for a human rights war here, it really isn’t quite as dramatic as that. However the reality is that we are still quite a bit away from providing autonomous care within our maternity system. There is still a lot of language such as ‘you’d have to’, ‘we wouldn’t allow’, ‘we need you to’ used during antenatal appointments and on our labour wards. This is an environmental issue where care givers, who should be aware of a pregnant persons right to decline interventions or request certain care, consciously or unconsciously use coercive language. This could be happening for a number of reasons but that’s not a can of worms I intend to open today. Knowing that it happens and how you can prepare for it is enough for now.
Please get in touch if you have any questions or are currently experiencing some issues around this point
Forget Everything You Know
As Nicola Mahdiya Goodall discusses in her wonderful Ted Talk ‘Reframing Birth’, our media and society have taught us to fear birth. Many approach birth in complete terror due to the dramatic and frightening portrayals they’ve seen in movies, tv shows and books.
It’s so important to recognise that these images of birth were created with the sole purpose of getting a reaction from the viewer. We love a bit of drama! Knowing that the reality of birth couldn’t be in such stark contrast is the first step to reprogramming your brain. You (and probably your birth partner) are gonna have to completely rewire the way you react to the thought of birth. To do this you’re going to flood yourself with real positive birth stories, watch real birth videos (NOT ONE BORN EVERY MINUTE) and visualise the smooth, positive birth you’re going to have.
Get following positive birth Instagram accounts with real birth images, desensitise yourself to pictures of crowning baby heads bulging through stretched, taught labia and newborn gooey goodness with vernix, blood and amniotic fluid covering the pink/blue/purple (all normal) bundles.
Yes birth is intense, yes birth can be messy but my goodness it’s fantastic when you’re prepared, when you’re excited and when you understand what’s really coming.
To flood yourself with birth stories head to your local Positive Birth Movement meet-up. Search for ‘positive birth video’, ‘gentle birth’, ‘hypno birth’ and even ‘homebirth’ on YouTube to find a treasure trove of real birth videos which demonstrate how beautiful, calm and powerful it really can be.
My fave Instagram accounts are:
Empowered Birth Project
Badass Mother Birther
And, of course, my own Jen Muir Badass Birth
some great hashtags to search are #childbirthwithoutfear & #stopcensoringbirth (be aware that the latter does contain graphic birth images)
Assemble Your Birth Team
A birth team that’s prepared, knowledgable and supportive are among the most important things you can have with you as you birth. Way more important than the handheld fan, the lip balm, the freshly washed nightshirt or the snacks (which are bloody important too btw).
When you have a confident birth partner/s you can relax into your zone safe in the knowledge that your needs with be attended, the right environment will be created and your birth plan will be respected. This does mean that your birth team require more than a basic knowledge of the birthing process and, as discussed above, your rights. They should be able to comfortably discuss your wishes and worries with your care provider. This does mean that many women are opting to have a Doula/independent birth professional with them as they birth their babies. A doula brings a plethora of techniques, knowledge and experience meaning they are there should you need practical, emotional or informational support throughout your pregnancy and labour. The magical bonus here is that your birth partner is then able to focus on you and that the weight of being the only ‘go-to’ is lifted.
Many people opt to take a parent in along with their partner. Mums, sisters and/or Dads can be wonderful birth partners but please remember that at least one of your birth partners should be well versed in your birth plan, why you’ve made these decisions, what you will and won’t compromise on and what your contingency plans are should you need them.
In a homebirth setting you can have as many birth attendants as you wish, however in most hospitals you are usually limited to two. You may still be able to swap people over, for example Mum and a partner, Mum swaps with doula when required, partner swaps with mum etc. Your extras can be in the waiting area or can head home for rest and shower etc.
Get Your Head Out The Sand
A common preparation method for soon to be first time parents is to adopt the Ostrich Approach. Head is buried in the sand and the famous last words of ‘we will just see how it goes’ are dished out to anyone who enquires how ‘are you feeling about the birth?’.
I cannot tell you how many people I have spoken with people who lament that their choice to not appropriately prepare physically, mentally and informationally for their birth resulted in an experience lacking in autonomy, knowledge and power.
Enroll in local birth prep classes, there are lots to choose from. Join in some pregnancy yoga, you’ll be amazed at how much you learn and how much they build your confidence.
You can also attend couples hypnobirthing workshops!
Yes this does all sound like a bit of money but truly this investment will pay dividends and many educators etc will accept payment plans.
Believe me your birth experience is more important than any of the fancy baby clothes, faddy gadgets and mega travel systems you can buy. #soznotsoz
Below I have included my ultimate birth prep list to help you in the packing of your homebirth box or hospital bag. I’ve tried to ensure this list is as extensive as you’ll get but if I have missed anything please comment below.
I hope this posts helps in your prep. If you have any questions please get in touch either in the comments below, via my contact page or through any of my social media.
Positive Birth Story
I had spent much of my pregnancy refusing to think about this birth due to fear of a repeat of my first traumatic birth four years ago. I was seeing a different midwife at each appointment and was not going to write a birth. I couldnt even read about giving birth. Looking back I can see my state of mind and the fear that consumed me could have led to a self fulfilling prophecy. Luckily deep down I must have known something within me needed to change. I just didn't know then what an amazing journey I was embarking on. One that has changed me so much as a person. Firstly I forced myself to start reading The Positive Birth Book by Milli Hill and what a turning point this was.
A few years previously someone on Facebook mentioned they had a doula supporting them with their birth. The idea of someone I knew being there, advocating for me (I felt the midwife didn't listen to me or respect me first time around) resonated with me.
The Birth of Reuben
A day before I turned 37 weeks pregnant I was due into the hospital for a scan, to see if Reuben had turned yet as he was lying breech throughout my whole pregnancy. I’d already prepared an argument in my head about not wanting an ECV (they sounded painful, distressing for Mum and Baby, and not always successful) so I lay on the sonographers bed that afternoon in hope that he’d turned. But of course, he hadn’t! So we went down to the consultant to discuss my options, and that’s where things escalated a lot quicker than I’d expected.
The Birth of Robyn
I found out I was pregnant in October 2017 and I knew from the very start that I wanted to to have a natural birth. Unfortunately from the point that we announced our pregnancy at the end of December, all of my mummy friends and colleagues had already started to fill my head with horror gory birthing stories and i knew i needed to hear some positive words if I was going to achieve my goal. I did some online searching and followed some links on positive birthing and birthing without fear. Through my online searches I found the Scottish Doula Jen Muir of 'Badass Birthing' and after a short email chat with her, I signed myself and my husband up to a workshop she was leading in March 2018, Glasgow.