Positive Birth News

birth stories, news and articles to encourage and inspire


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Failure to Progress or Failure to Wait?

Failure to Progress and Preparing for a VBAC

For most mammals birth seems to be fairly straightforward. They seek a safe and private place to birth in the middle of the night. Some choose to birth alone and others have ‘midwife mammals’ by their side. If there is danger they either have a speedy birth or stall labour until there is another safe opportunity.

For humans, it seems far more challenging. We have to feel safe in our environment, safe with the people around us, and safe with the physical and emotional process that is taking us over. We have learnt to fear birth with our minds and hearts, yet nature requires us to feel safe in order to give birth. Sometimes ‘failure to progress’ is the result of this struggle.

‘Failure to progress’ is one of the common reasons given for a caesarean during labour. This label is a blanket term for times where contractions have slowed or paused, dilation has gone backwards, or contractions are continuing but the baby is making no further progress towards birth. Women’s stories suggest that the label ‘failure to progress’ is often used when their labour has taken several days, or simply longer than expected or allowed by policy.

There are many variations in labour and doctors and midwives face the task of judging when medical assistance is needed and when all that is needed is patience. No one wants an adverse outcome, however in the rush to keep birth safe, some mothers and babies are hurried into treatment for an emergency that just does not exist. Some caesarean births due to failure to progress are actually caesareans due to impatience and failure to wait.

“After 50 hours of intense labour, I had a caesarean.

I haemorrhaged and my uterus collapsed requiring manual internal manipulation to contract it back down again. I had to have the caesarean under general anaesthetic because of my previous spinal surgery – I was unconscious for the birth of my baby.

My husband was allowed into surgery to be with our baby. I’m glad of that, because I wasn’t ‘there’.

The last thing I remember was being pregnant. Next thing I knew, at least a couple of hours later, I was being wheeled up a corridor past a baby in a clear plastic crib and someone was saying, “That’s your daughter.”

It was a very surreal and disjointed experience. To this day, I still feel a gap. I don’t feel like I birthed my daughter, yet she’s gorgeous and I love her like I’ve never loved anyone or anything before.

It should not have happened this way. It was an unnecessary caesarean performed due to medical impatience with my long posterior labour. Neither my precious daughter nor myself were at risk during labour except when they intervened.”

From Jo’s VBAC story “Triumphant Birth”, in Birth Journeys – positive birth stories to encourage and inspire

The alternative response to a labour that seems to be failing to progress is to ask what obstacles are there to this birth. If a mother feels frightened, threatened, nervous, embarrassed, angry, unsupported, alone, disempowered, violated, exposed, worried, overwhelmed or any other negative feeling then this can slow her labour down and even stop her labour from progressing.

Women’s birth stories show that there are many ways to help a birthing mother to move through or let go of thoughts or influences that have made her feel unsafe or threatened if this is the cause of a slowed or stalled labour:
– a change in environment (can she leave the room, open or close the curtains, change the atmosphere if not location)
– a change in activity and pace (get moving if she has been still, be still if she has been moving)
– a challenging question (eg, what is it you are frightened of? What are you avoiding? Is she intentionally avoiding the intensity of labour mentally or physically by avoiding certain movements or positions that make her contractions more intense and more effective?)
– the removal of an unwelcome person in the room (is there an uninvited or irritating presence in the room? If it is a midwife or nurse, can you ask for a different one or buffer her from this person’s impact)
– or the inclusion of a loved and longed for person (is she missing someone special?)
a few simple encouraging words (you are made to do this, you are bringing your baby into the world, positive affirmations)
– a description of what her body is doing or needs to do (open up and let your baby come down)
– a cry (release the built up stress so she can feel ready to birth her baby)
– a reminder of the skills she has learnt and the strength she has to give birth and to be a mother (has she forgotten the birth skills she has learnt? Or is she worried that she doesn’t have the ability to be a mother to this baby?)
– some time alone (maybe she needs some quiet space to reflect and gather herself. A trip to the toilet seems to work well according to women’s experiences!)

Preparing for your next birth

It is important to understand the factors that contributed to the path of your last birth and to consider the possible impact your feelings (whether you felt safe or unsafe) had on your labour. It is wise to discuss your previous birth in detail with your chosen doctor/midwife for a birth after caesarean. Pay attention to the way your chosen carers talk about your past birth as this will tell you what you can expect from them.

If your doctor seems to blame you and your body for a failure to progress, then be wary of both the doctor and the truth of what they are saying. Keep in mind that a very, very tiny percentage of women actually have a physical reason why they cannot labour and birth vaginally and statistically you are unlikely to be this woman.

If you hear words like “Your pelvis is too small and your baby got stuck. Luckily we saved your baby’s life just in time. You’ll never be able to have a vaginal birth of course” then you can thank this carer and start looking for another! They have just revealed that they are unaware of or insensitive to the emotional issues around birth and they already believe you and your body ‘failed’. You could enquire about the evidence for their verdict or you could simply put this energy into finding a more supportive and respectful doctor first. There are ways to discuss a ‘failure to progress’ that would be more supportive, caring and respectful.

One doctor or midwife’s ‘failure to progress’ will be another’s call to action: how can I help you to feel safe enough to give birth?

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Doulas and Partners

Why would women have a doula when their partner will be there to support them?

Men attending their baby’s birth is a relatively modern phenomenon. My father was not present at either my birth or my brother’s birth and in the 1970s this was the norm in Australia. Fathers are now expected to be present and to shoulder a large part of the birth support role. Now many men want to be there. They want to support their woman and they want to see their child into the world. But how prepared are today’s men for this new role when their own fathers were at work or down at the pub when they were born?

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Consider that first time partners have (most likely) never seen a birth. If it is your first birth, then the chances are you haven’t either. Your partner (most likely) hasn’t read positive birth stories, watched gentle birth DVDs and has consumed less information than you.

They have (most likely) been told sensationalised and frightening birth stories including stories from men about seeing their partner in pain, seeing blood, poo, vomit, fluids and very intense and stressful situations.

Your partner is also carrying the legacy of their own birth story and they have (most likely) not reflected on their entrance to the world and what this has taught them about birth.

They may be frightened – but they’re probably not about to let you know because they want to be a rock for you. Your partner may not have gone through the same journey of learning and transformation as you in preparation for this birth and the transition into parenthood.

If this is not your first birth, then your partner may be distressed by the memory of your last birth. Even a straightforward and uncomplicated birth may have been a shock. They will have had less opportunity and less support than you to debrief and integrate their experience.

Men don’t get to meet up with other men post-birth and swap experiences the way women do. Men don’t usually get to go to birth circles or have heart to heart discussions about their experiences and feelings. They don’t get to do prenatal yoga and meditation where they can bond with their baby and visualise the birth they want and how they want to feel. They will have had less opportunity to do the healing and growing needed to go into another birth feeling ready, open and strong.

Your partner has a huge emotional investment in this birth. It must feel like the lives of the two most precious people in the world are in a boat out at sea and your partner is waiting, hoping, and willing that they will see both you and your baby safe in the harbour at the end of birth.

A doula won’t take away from your partner’s role, nor destroy the intimacy of experiencing this rite of passage as a couple. However a doula can support and reassure your partner so he can support you throughout the birth. Your partner deserves this support as much as you do!

Some ideas and resources to help your partner feel positive, supported and ready for birth too!

Becoming Dad is a blog, a facebook page and a movement created by Darren Mattock: Connect your partner up with Darren’s community for support in the transition into fatherhood. http://becomingdad.com.au/how-can-dads-make-a-difference/

Men at Birth is a collection of men’s birth stories edited by David Vernon (also a contributor to Birth Journeys) (Scroll down the linked page to find this book)

Beer and Bubs is a childbirth class for men held in an informal, friendly pub environment. Men have the chance to talk with a father who has done Beer and Bubs before and since experienced the birth of their baby, as well as learn from childbirth educators. Available around Australia.

Cheers to Childbirth is the book that grew out of the Beer and Bubs program, written by Lucy Perry with birth stories from celebrity dads.

Birth Journeys – positive birth stories to encourage and inspire contains three stories which share men’s experiences of birth (so do pass these stories over to your partner if you have the book!). These are Lachlan and Bree’s story of their first birth, Christian’s story of his second daughter’s birth in the water (she was born in the caul!), and Chris tells the story of his second baby’s home birth. There is also a piece by David Vernon on how men can prepare themselves to support their partner during labour.


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Ten Great Reasons to Choose a Doula

  1. A doula can help you have a better experience of your baby’s birth. A 2012 review of studies showed that women with continuous non-medical support throughout labour have better birth outcomes in every way.

    “Bottom line: Continuous support in labour increased the chance of a spontaneous vaginal birth, reduced intrapartum analgesia, caused no known harm, and women were more satisfied. In addition, labours were shorter, and women were less likely to have a caesarean section or instrumental vaginal birth, regional analgesia, or a baby with a low 5-minute Apgar score. There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, or on breastfeeding… continuous support was most effective when provided by a woman who was neither part of the hospital staff nor the woman’s social network, and in settings in which epidural analgesia was not routinely available.From Continuous support for women during childbirth, Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, October 17, 2012 http://summaries.cochrane.org/CD003766/continuous-support-for-women-during-childbirth#sthash.VsvNUnvh.dpuf

     

  2. A doula is an independent, educated professional who will give plenty of time to hearing you, sharing information and helping you to identify what you need and want for your journey into parenthood. A doula has usually studied pregnancy, birth, labour, how to support couples and how to be at births. An experienced doula will have knowledge and intuition.
  3. A doula can help you and your partner to understand and communicate with health professionals. A doula can offer you suggestions for how to bring up issues or ask questions. She can support and assist you and your partner to explain what you need, want and are concerned about.This is particularly helpful if you are seeking non-standard care (eg for a VBAC) or you are planning and preparing for a natural and unhindered birth. Some might even say if you are seeking a natural birth then you are automatically seeking “non-standard” care in many hospitals in Australia and the US! If the policies and practices of your place of birth are not aligned with your birth wishes then a doula will be a very good ally.
  4. A doula can give your partner a break, work with your partner as a team, or support your partner in a practical role. A doula won’t take away from your partner’s role, nor destroy the intimacy of experiencing this rite of passage as a couple. However a doula can support and reassure your partner so he (or she) can support you throughout the birth.
  5. A doula is someone to ask you questions and help you reflect on your pregnancy, birth and motherhood. She may ask questions you wouldn’t think to ask or may avoid asking yourself. This process helps you to know yourself better and helps her to support you.
  6. A doula knows how to be around women in labour, to set the tone and protect the birth space you want. A doula is trained and practised in being with birthing couples without allowing her personal circumstances, history or other factors to affect her or you. A friend or relative may not be able to give unconditionally like this especially if they have not experienced positive births before or are bringing their own fears or negative experiences into the room.
  7. A doula is someone who knows your needs, wishes and your history in a personal and emotional way – as long as you let her in and trust her. Your partner also needs to be comfortable with her and trust her. Someone who knows you well is better able to read your needs and support you than a midwife who has only just met you and you are one of several women in her care at that time. A doula who you feel comfortable with will help you to labour well because her presence makes you feel safer, unobserved and more relaxed. This supports the hormonal processes that drive labour.
  8. A doula is someone to stay with you if your partner needs to go with your baby to the nursery, or you need some medical attention post-birth. This is not a scenario you would wish to focus on, but it is reassuring to know that in this situation you would have support.
  9. A doula is someone to visit you in the post birth days to help with breastfeeding, mothering, and your wellbeing. This may be as simple as making you a cuppa, bringing you one-handed healthy food, or holding your baby while you shower. These things are really helpful post birth especially if you do not have other people who will be there for you in this gentle, reassuring and ‘no strings attached’ way.
  10. A doula becomes someone special who has witnessed your baby’s birth in a non-medical, personal way. She will be able to share in your story, hear and understand your feelings, and affirm your memories of what happened. She will hold a special place in your heart and your family.
    Not convinced? Are there blocks to you considering a doula for birth support? Making Good Decisions for a Positive Birth examines some of the common reasons shared with me for not choosing or not needing a doula and asks you to dig deeper and examine what is behind the reasoning. Only you can know whether your reasons are based on evidence, a deep consideration of your needs and an understanding of your fears.


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Making Good Decisions for a Positive Birth – looking at reasons for not having a doula

During my first pregnancy I remember thinking: “A water birth!? What if the baby drowns?” “A doula!? I don’t want a stranger watching me in labour!” “Hypnobirthing – that sounds scary and just plain weird. I don’t think imagining I’m on a tropical island is going to help when I’m in LABOUR!”

Each of these emotional reactions prevented me from learning how these options could have helped me to have the natural birth I wanted. My decisions came from misinformation (don’t always trust what you read in magazines!) and a deep fear of surrendering to labour, letting people in and being vulnerable and exposed. (for my second birth I went on to have a doula, a water birth and listened to hypnobirthing CDs!)
Make Good Choices

The best decisions are based on a consideration of evidence and an honest and deep reflection on our feelings, fears and needs. When discussing doulas and many other choices in birth, I hear a lot of reasons why couples will NOT have a doula or choose birth preparation or labour options that could be positive and helpful like hypnosis, meditation or water birth. Just like my reasoning above, often these decisions are not based on research or a true consideration of the couple’s feelings, fears and needs. Perhaps they are based on misconceptions or fears like mine were.

When we dig deeper and look beneath the surface level reasons we have the opportunity to learn a whole lot more about what we are really frightened of, worried about, and any unspoken needs or expectations we may have. Then we are in the position to make really good decisions.

Here are four common reasons people give for deciding to not have a doula. You may find this a useful discussion if you and your partner are considering having a doula and some of these concerns have come up.

1. A doula is too expensive
Find out about student doulas who may work for free or a minimal cost because they wish to gain experience yet may be very well suited to supporting you. While they may not have as much experience, you will benefit from their passion, commitment and up to date knowledge and they will often have an experienced doula as a mentor. Find out about doulas who offer flexible payments or low fees for low-income families. Many doulas will accept payments throughout your pregnancy and post birth. So, if you have not asked several local doulas what they charge and what are their options for payment, then you can’t honestly say “it’s too expensive”. You don’t know until you ask!

If this reason is a block for you,  ask yourself:

How much is birth support during this important transition worth?

What is the value of a relaxed, safe, positive beginning for you and your baby? Or the value of feeling well supported throughout pregnancy and birth?

And a confronting question: how will you feel if a shattering, traumatic birth could have been avoided if you had a doula by your side?

2. We don’t want a stranger there
If you are birthing in a hospital maternity ward, then most of the people you come into contact with will be strangers. If you have a private obstetrician, the midwives will probably be unfamiliar and your obstetrician often won’t be there until the last few minutes of your baby’s birth. If you had a team of midwives for antenatal care, you may not get a midwife you are familiar and comfortable with during labour. You may have several midwives as their shifts change during your labour. If a paediatrician, anaesthetist or registrar is needed, they will usually be a stranger too.

You will come across a lot of strangers during your labour and the days afterwards in the maternity ward. If you don’t want strangers at your birth then think seriously about where you are giving birth and who you are allowing into your birth space. Consider adding someone familiar to your birth team who will protect you from the impact of these strangers.

A doula is someone you choose to get to know, become comfortable with, and have with you during labour and after birth. You will meet your doula many times before birth to get to know each other and feel comfortable. If you choose the right doula for you then she will not feel like a stranger. Through all the shift changes and different people you may meet, she will be a familiar and friendly support person coming along with you. Everyone else might be strangers but a doula will be one person you do know apart from your partner.

If this is a block for you, ask:

Is thinking of a doula as a “stranger” really valid? 

Am I (or is my partner) afraid of having a doula there?

What is it that makes us uncomfortable about this idea?

And what does this teach us about our needs for birth?

Are we meeting these needs in our other birth plans?

3. We don’t need support 
You deserve the best support around! The more supported, safe and comfortable you feel, the easier it will be to birth your baby. Why not have as much support and help from respectful, educated, professional, experienced people as you can get?

Even couples who have prepared as well as they could for labour can end up feeling lost, alone and overwhelmed. Chrissy Grainger (Birth Journeys contributor and doula) explains that she became a doula because “I previously coordinated a support group for pregnancy and birth and was seeing so, so many women have all the information and support during pregnancy, [only] for the birth to go pear shaped.” Continuous support during birth was what was missing for many of these women.

Unless you have continuity of care with one midwife, and you are her only birthing mother at the time, your midwife will not be there with you all the time. If you have continuous monitoring or a IV drip set up then there will be people checking up on you often – but they may be focused on measurements and machines rather than supporting you. Hours of labouring can become stressful for even the most prepared couples when you are uncertain how things are going, what is normal, what is going to happen next and how much longer it will be before your baby is here.

Also ask:
Why don’t we need support?

Are we expecting support from other people (eg, a relative, friend, midwife, doctor) and will they be able to meet our expectations?

Or, why don’t we want support and what does this teach us about what we are wanting from this birth?

Are we trying to prove we can do it by ourselves, and if so, why?

Are we are seeking an intimate, personal experience of birth, and if so could a doula help to preserve and protect this?

4. I don’t want to be told what to do or be mothered
There are many different doulas and they each have a different personality, a different age and stage in life, a different relationship to offer you. It seems very unlikely that any doula would tell you what to do, make you feel like a child, or take ownership out of your hands, especially if you tell her that you do not want to feel like that. Doulas want to support women to take ownership of their own births. It is more likely that if you choose the right doula for you, she will protect and preserve your birth space, your rights and your needs. A doula knows that birth is not about her – it is about you, your partner and your baby.

On the other hand, there may be other health professionals in a hospital, birth centre, or child health clinic who may “mother” you and make you feel as though you have been placed in the role of a child. There may be others who will tell you what to do without honouring your ownership of this birth, or your motherhood of your child. A doula can help to protect and cushion you from the impact of these interactions and reaffirm that you, your baby and your partner are at the centre of this birth.

Also ask:

What would an ideal birth support person be like for me?

Would it be beneficial to have my kind of support?

And if you want to dig deeper still, you may wish to consider:

Am I worried that letting someone in to support me will take away my power?


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What You Really Need to Know About Labour – and where you’ll find it

When we are uncertain or facing something new, we often turn to guide books and people that tell us what to do, lists of tips, books that tell us what to expect and make everything seem black and white, straightforward and under control – predictable. A predictable birth would be nice, wouldn’t it!

But how far will this knowledge really go in preparing you for your own unique labour and birth? Not far enough!

When I was preparing for my first birth I focused on learning about pregnancy and labour from experts, guide books and the hospital antenatal class. I wanted to be well prepared and give my baby the best beginning possible. I read some birth stories (in Ina May’s clasic book Spiritual Midwifery but they were a little too alternative and hippy for me at the time. Never having experienced labour I found it very hard to imagine what it would be like and these stories were hard to relate to. The women were not like me and the stories were set in a different country, a different time, and a different culture. The way of speaking about birth and the feelings these women described were too much of a leap for me! I couldn’t connect with them. (I suggest reading the newer Ina May’s guide to childbirth instead).

The information I had taken in and given highest priority was how I would know when to go into hospital. And to judge this, I needed to know what the different stages of labour were. I thought they would be clear, distinct stages based on the clear, predictable flow charts and diagrams of the antenatal classes.

Even though I had come to believe that birth should work and I was determined to have a vaginal and drug free birth, I was still scared. And very honestly, who wouldn’t have some level of fear going into the unknown? Focusing on this kind of information about birth made it seem more controllable and less unpredictable. It made me feel a bit safer but really it was false confidence.

I had expected that a first labour would begin slowly and it would take time for the contractions to reach five minutes apart and then three minutes apart and then closer and closer together until transition. I thought there would be a roughly thirty minute second stage, then the birth of my baby and a syntocinon injection in my thigh at the moment of birth. The birth of the placenta would follow in five minutes or so.

Once my labour began, I learnt that birth is not predictable and it is not black and white like the nice neat charts in the antenatal class! My contractions were immediately five minutes apart when I awoke in the morning. I couldn’t rest, ignore them and pretend it was just another day because they felt strong. Although I knew that first births could take several days, the pattern of contractions I was experiencing didn’t match the description of a slow first birth. With contractions 5 minutes apart and strong enough to need my attention, I concluded that I must already bein active labour. I thought this baby might be born before the day was over!

I went straight into “being” in labour, using my yoga and active birth positions, my meditative breathing. I stayed on my feet nearly all day because I found this position most comfortable and I knew that an active upright labour would help me give my baby a natural and drug free birth.

In fact, my contractions stayed at five minutes apart for most of my 28 hour labour, moving to three minutes apart after about ten hours of labour and then spacing out to ten minutes apart when I arrived at the hospital. I had responded to early labour as though it was active labour. And this set me up for frustration and disappointment, as well as exhaustion and weakness due to not eating or drinking enough.

When the second stage took over two hours I felt a mix of exhaustion, helplessness, fear and anxiety. Much of this stemmed from expecting a 30 minute second stage based on the charts we were shown in class. I knew my labour was pushing the boundaries of what labour in my hospital was expected to look like and I was surprised they had let me push for so long. I knew I was approaching the deadline for the second stage till the birth of the baby.

It was not only incredible fatigue, but fear of what alternatives were just around the corner (a caesarean? I was terrified of that) that prompted me to ask for a vacuum extraction. My baby was crowning but I didn’t believe I could go on and no one there could have convinced me otherwise! I imagine that continuity of care with a midwife or doula might have made all the difference because they would have known me well enough to reveal the fear behind my choice. I would have trusted their words when they told me he was really very nearly here and I could go on. Nonetheless it was my choice and at least I was in control – no one took ownership out of my hands or pressured me into the choice.

When my placenta did not arrive smoothly and easily as I had expected after the syntocinon injection (it was presented as the only way to birth the placenta and avoid a haemorrhage) the midwives pushed and pulled to get the placenta out. I was feeling frightened. I knew my placenta was not behaving in the way it was expected to. Anything outside of the norm on the charts we had been shown in our classes might mean further medical assistance was required. It wasn’t a pleasant experience, but I avoided an operative removal of the placenta that would have been the next step. Like my baby’s birth, the birth of his placenta had required patience but once the syntocinon injection was given there was another deadline to meet.

This rough birth of my baby’s placenta no doubt contributed to the uterine infection I suffered from 10 days post-birth. It landed me in the emergency ward at 3am. It was a bit scary with a newborn! On the other hand, the private room where my husband was allowed to stay, all our meals and plenty of care and baby support from the midwives and nurses actually gave me a chance to recover from my post birth exhaustion and shell shock. By the time I went home a week later I felt a little more ready for motherhood.

I share this part of my first birth story because it is just so common for women to be surprised, confused and misled like I was when their first birth does not match the descriptions, the timings and measurements given in classes and guidebooks.

In the effort to communicate clearly and simply how an average labour is expected to look in a particular hospital and when they would like you to present to the maternity ward, labour is distilled down to a series of distinct stages. Measurements of contractions and dilation and your mood are focused on as the key indicators of progress. While you may find it useful to focus on these details to distract yourself from labour, this behaviour keeps you in your head, using your thinking self. It doesn’t help you to slide into the instinctive and internal state that nature intends us to enter during labour for optimal pain relief and progress.

If there is a mismatch between your expectations of what a “well-behaved” labour looks like and the reality of your labour, it can lead to assumptions about how your labour is progressing (or not), unwarranted excitement or anxiety, fatigue, disappointment and fear. Each of these emotional states may have a negative impact on the progress of labour and the choices you make during labour as a result.

A medical, technical, scientific model of labour doesn’t teach us all we need to know, or prepare us for our own experience of labour and giving birth.

What does teach us what we need to know about birth?

Starting in childhood, we have gathered another kind of knowledge about birth. This is the knowledge we have gained from the stories we have been exposed to from family, friends, TV, books and the media.

Sadly, these stories are rarely positive, reassuring or inspiring. Many women have grown up surrounded by birth stories of frightening and dangerous emergencies, complicated births or the belief that birth doesn’t work. These stories tell us to expect pain, danger and complications and quite naturally we often respond with fear and anxiety about birth. Once pregnant, many of us are further exposed to unasked for and unwanted discouraging stories.

Personally, I remember a nutri-grain commercial which showed a mother lying on a bed, gripping the sheets and screaming in labour with a line like “raising an iron man is a mother of a job”. While amusing at the time, this gave me a powerful image of what labour would be like. Media like this made me dread giving birth. (If you can find it on YouTube please send me the link!)

If you consider, for a moment, the impact negative stories of birth have, the vivid images, the words, and the ideas they have planted in your memory and your imagination, then it isn’t so hard to see the incredible value of positive stories.

The knowledge held within positive stories is different to the information we gain from text books or instructional classes. Stories are personal, emotional and evocative. They contain a very potent kind of knowledge that has a deep impact on us because it is emotional as well as informative. Stories speak to our hearts and minds. Stories also educate us on the shades of grey that are left out when we read instructional guides.

Positive birth stories that we can relate to gently show us what is possible, let us into a woman’s deeply personal experience, and offer us the opportunity to learn from her. Stories can take us into the world of labour and birth both physically and emotionally in a way that textbook descriptions can never do. Stories give a sense of what it feels like to experience birth and give the knowledge that every labour and every birth is different.

When we read a number of stories we start to recognise how different ways that labour develops – we can see labour building and recognise changes in the woman’s feelings, thoughts, her instinctive behaviours, her needs and how she responds to these.

We hear women describing the days leading up to birth, sharing how they suddenly, urgently needed to “get things done” shortly before labour begins. Others share how they had an emotional release, crying and crying, in the days before labour – clearing their mind and body of stress and anxiety. And other women insist “No! I’m not in labour!” when their behaviour indicates that they are, even if their labour is not following the pattern they expected.

This teaches us that there are many different signs that labour is imminent and sometimes we can be caught by surprise because we are looking for signs that aren’t there or missing those that are. We also learn that sometimes early labour takes days and sometimes women are not aware of being in labour at all. Sometimes women wake in the night when they are suddenly thrust into a fast, active labour lasting only an hour!

Through positive stories we learn the thoughts, feelings, movements and actions that women find beneficial in labour. We see how they breathed, the way they walked up and down, climbed stairs, swivelled their hips, used yoga poses, knelt on all fours, bounced on a birth ball or squatted. We learn through other women when these movements were most comforting or useful. This gives us knowledge of the many different ways to labour and we learn that if one position or movement isn’t quite right, we will remember something that another woman tried and have the confidence to give it a go. We don’t feel as reliant on someone to tell us what to do because we have inherited the experience of many other women through their descriptive and detailed stories.

We see how partners, doulas, mothers, sisters, or friends support women physically and with encouraging words. And we can see how sometimes these words and actions make the woman feel amazing, and sometimes she swats them away like a fly because it just isn’t what she needs right now! This teaches us the value of having the right support people and also that we can’t predict exactly how we will be feeling and what we will want! We need support people who are completely there for us and not focused on themselves and their own feelings. We also see the powerful impact of negative or frightening words on labour and this lets us know we need to protect ourselves from the impact of these – a doula is a good choice for this role.

We get inside women’s heads and we hear the words she said, thought or remembered that were helpful. And if we find ourselves in a similar situation, her words come to us and become our own words. We learn about the sounds she made – did she roar like a lion, did she moan and sing, did she chant, or was she completely silent? We see that none of these are good or bad despite what different birth preparation methods may tell you! There are many ways to be in labour. We learn that it is important not to judge ourselves by the sounds we make or don’t make. While we may have an intention to be calm and quiet, we may find vocalising more helpful.

We learn that labour can be many different things – a wild and crazy ride, a calm, a focused meditation, a determined and demanding physical and emotional marathon, a joyful and ecstatic experience.

From reading many women’s stories, we can learn to recognise some pivotal moments in labour. The overwhelming and vulnerable moment when a woman feels she cannot go on, or she wants to give up and just have her baby in her arms by any means is a defining moment. This is a moment when she needs support, faith and sometimes to be challenged and reminded of what she is doing. This moment is one that has the potential to shape us as mothers.

Stories also take us through the caesarean birth experience and help us to appreciate how this may also be made a beautiful and powerful birth. We can also learn how other women coped with a change in plans or unexpected and frightening circumstances. These stories are very powerful. They teach us that we can’t be guaranteed a perfect birth and this is perhaps the wrong goal to set our sights on.

The reason positive stories are so informative and empowering is that they pass on the wisdom and memories of women who have had positive births and they provide us with information for all our senses. Reading positive stories builds confidence in our own ability to cope with birth because everything we read and connect with becomes part of our own knowledge, our own images and memories. Now we are able to go into labour with a whole library of helpful ideas, positive experiences, encouraging words, reassuring images and memories of how to birth – even if we have never given birth before!

Reading stories from women who have had positive and empowering journeys show how incredible birth can be and reassure that giving birth is something we too can do. They prepare us for the many possibilities in birth and help us to work out how we may have the best birth for our unique circumstances. Reading positive stories may help women to acknowledge fears and concerns and begin to move beyond these to a more confident and positive perspective.

Positive birth stories show that no matter how you choose to have your baby, and no matter how your baby needs to be born, it is possible for you to feel safe, loved, respected and honoured throughout this experience. When you feel like that, you will have ownership and a positive feeling about your baby’s birth. Your baby will have the best welcome into the world – into the arms of a healthy, whole mother.


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Estimated Due Dates – choosing to induce?

In the final weeks and days of pregnancy most women feel tired, impatient and very ready to meet their baby. The waiting time may be emotional and challenging as you edge closer and closer to the moment when labour begins but when that moment will actually be remains an unknown – a mystery – and you simply have to wait. You may also feel the pressure to have an induction if your baby has not arrived by 41 weeks.

An induction may seem like an appealing and easy choice, however induction can be “like playing with fire, and many women do end up getting burnt. The problem with an induction is that women often end up on the ‘cascade of intervention’ – a road that many women regret taking, as the final outcome is often not the birth they wanted or desired.” writes Gabrielle Targett, birth educator, doula and author.

Your pregnancy is not an hourglass. The sand does NOT run out on your estimated due date.

An induction brings risks as well as benefits and it is wise to be aware of the full picture before making any decisions. An induction changes labour from a natural process to a medically managed one, requiring increased monitoring. Further medical assistance is more likely once you begin an induction because of these risks, including an increased chance of a caesarean birth. A caesarean is the usual recommendation if the induction fails, so when you choose an induction you need to be aware that you are agreeing to a possible caesarean if your baby is not born within a safe timeframe, (this timeframe will be determined by your doctor or hospital, although you may be able to have input into this).

As a guideline, it makes sense to choose an induction when the risks of waiting have become greater than the risks of an induction and all that might follow. Ask questions and share openly and honestly your concerns and thoughts with your midwife and doctor. Ideally, you will have been able to choose the most suitable carers and place of birth in the beginning and by the time you are 37+ weeks into your pregnancy you will have a relationship of trust, respect and open communication.

If you need to, seek a second opinion. It is not too late to hire a doula for extra support or even to change place or birth and care providers if you do not feel supported and heard.

If you do need an induction, it helps to know that you are making the best choice for your unique circumstances. You may find some people will question your need for an induction, offer their advice and anecdotes, or make little of an induced birth when it may have been an enormous decision for you. You may feel sad or disappointed that your wishes for birth are no longer possible.

Read up on induction and understand the process, the possible complications and what you can do to counter these or manage them. Explore the options that may be possible (but not always offered) like turning down the artificial oxcytocin once labour is established, intermittent monitoring or using a water proof doppler so you can move more easily or labour in the shower where the warm water may help with the intensity of the contractions. If you are not able to use the shower, make use of heat packs or warmed wash clothes on your back or belly. Ask your supporter to help you breathe deeply, but not to not hyperventilate, so you can consciously keep your baby oxygenated – a lack of oxygen is one of the increased risks an induced baby faces.

A positive birth depends on the way you feel and the way you are cared for more than anything else. So gather your supporters and surround yourself with strong, encouraging and loving people. Approach your new plan for birth with as much optimism as your old plan. If it has turned out you and your baby need a different path to birth, there is no shame or failure in being wise enough and flexible enough to recognise this. You can choose to handle this change in plans beautifully and you will soon be holding your baby in your arms!

For more information on induction visit Midwife Thinking – induction

Read women’s positive experiences with induction


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The Watermelon Fallacy: why giving birth is nothing like pushing out a watermelon

Have you ever heard the line that giving birth is like pushing a watermelon out of a tiny hole? I have come across this on TV shows, blog posts and even in comments made by women who say they are supportive of natural birth and empowering women. These words certainly have a powerful impact on pregnant women but it is likely to be a negative and unhelpful one. Does the watermelon line make you look forward to greeting your baby and experiencing birth? Or does it fill you with dread and make you tense up at the thought of enduring such an ordeal?

Every pregnant woman needs to know that giving birth is actually NOTHING like forcing a watermelon through a tiny hole!

Your baby is nothing like a hard, inflexible, solid watermelon. Your baby is soft, fleshy and squishy. Even their skull is soft and flexible to help your baby through the birth passage. The older baby in the watermelon picture is still clearly smaller, softer and more flexible than a watermelon. The average watermelon is much heavier and much broader than any newborn baby. There really is no comparison.

Throughout pregnancy your body is preparing for the amazing process of birthing your baby. The ligaments around your pelvis become looser to allow your pelvis to make room for your baby. Through the process of labour (especially when undisturbed) your body is prepared for the final moments of birth. Your contractions have thinned and widened your cervix so that your baby may come through. Your contractions have pushed your baby down and into the best position. Your baby’s chin is tucked in so that the smallest part of their head will come through first. By the time your baby is ready to be born, you are not pushing your baby through a ‘tiny hole’ – the birth passage is soft and open and ready to stretch to birth your baby beautifully.

The watermelon fiction does nothing to help us prepare for birth or to understand how birth works. The anxiety this watermelon image may cause is unwarranted and unhelpful.

So disregard these throwaway lines and steer clear of people who are out to scare or shock you. Find out how the intricate process of labour really works from women and men who have witnessed or experienced natural, undisturbed birth. It is amazing what your body and your baby know how to do! Learn from the stories of women who have had positive birth experiences. Seek the support of people who will help you to feel safe, cared for and confident in your ability to birth your baby. Focus on images and descriptions of labour that help you to understand, imagine and feel positive about birthing your baby.

And forget the watermelon – it’s a fallacy.