Monthly Archives: December 2011

The Joy of birth

Has anyone ever told you that birth can be pleasurable or even pain free? It may be a very strange concept to women bombarded with stories of painful or traumatic birth. As an Independent midwife I rarely see women needing pharmacological pain relief, the main reasons being that they feel safe, loved and respected. They know and trust their midwife and know the sensations of labour are not to be feared. When a woman feels safe and supported throughout childbirth her biological functions can work as they were designed to. Her body produces complex coctails of hormones, endorphins and oxytocin to bring forth her baby in joy and triumph.

The strong sensations of childbirth are actually signs that our body is working well. The discomfort alerts us to the start of labour so we can move to a place of safety and gather our birth supporters around us. As the baby moves through our body it instructs us how, and when to move, to paricipate in the intimate dance of birth. As sensations change they let us know that we are making progress, and to assume a birthing position. The sensations of the expulsive stage enable us to work with our body and baby to give birth. These signals are more likely to be perceived as painful if the birthing woman is unsupported, scared, disturbed, or interferred with. Most women with good support manage labour with self-help techniques, love and their own determination.

I am of course referring to healthy women, experiencing full-term spontaneous labour, with a baby in the optimum position. If a labour is induced or augmented with artificial drugs, if a baby is in a really unusual position, or if an instrumental or surgical birth is necessary, then pain can be more difficult to manage.

The secret to an enjoyable birth experience is preparation, good labour support, and Oxytocin. Oxytocin has been called the love hormone as it is produced when we fall in love, or make love. It is very important in childbirth as it makes the uterus contract, enhances maternal behaviour and enables the letdown reflex in breastfeeding. Oxytocin is a very shy hormone though. It is hard to produce oxytocin in stressful situations.

The same environment which is conducive to making love is also advantageous in childbirth. Can you imagine having to make love in hospital, with bright lights, little or no privacy, unfamiliar staff wanting to watch, examine, time and chart every move? It would be very hard to mainain that loving feeling, let alone reach orgasm.

Oxytocin production is enhanced in an environment of trust, privacy, love, tenderness, darkness and emotional and physical comfort. As normal labour progresses it is normal for a woman to become more inwardly focussed, and less inclined to commumicate. The thinking parts of her brain need to not be stimulated as she enters a different state, sometimes referred to as being in “labourland.” If a woman is disturbed during active labour the flow of oxytocin can be interrupted.

According to wikipedia “The word oxytocin was derived from Greek  oxys, and tokos, meaning “quick birth,” so you can see its advantages!

Of course, if medical management is really necessary it is still possible to give birth in joy. Loving support, being in charge of the decision making process and sending love to your baby throughout, can make all the difference.

See the films below to see how joyful birth can be.

 

French woman enjoying giving birth – one of the best films of enjoyable birth I’ve ever seen.

Ecstatic birth –  shows the heights of pleasure some women can experience in labour.

Elephant birth – rather dramatic but worth watching just to see the power of birth and maternal instinct. Continue reading The Joy of birth

Copyright and the sharing of information

After an awkward issue arose between some midwifery colleagues over use of each other’s materials without consent I was prompted to write this page.

I believe all information is knowledge, knowledge is power and therefore should be shared to empower women. All information contained in this blog is my original work, from knowledge amassed throughout my midwifery career. I have worked very hard and am proud of the work I have done, so have marked photos, artwork and text as copyright Birth Joy Ltd(c). When I have used someone else’s material I will credit them in the text. I respectfully request that you do likewise. Please pass on information from my website but please remember to quote the origins of your information out of respect.

Photos are copyright to the photographer. I am very lucky that when I’ve taken birth photos, some women have given me permission to use these for teaching purposes, others have let me use their photos on my website. Some have allowed me to share with other midwives and one allowed publication in a midwifery text book. Many women have not, and I respect their right to do so.

For more information on copyright see this useful website.

“Am I allowed?”

A woman this week asked me one of the things that make me want to get on my soapbox about assertiveness and women’s rights.  What she said was “are you allowed to give birth to a breech baby?” My response, as ever, to this type of question is “it you who allows or disallows your care providers to do anything to you or your baby. Nothing can be done to you or your baby at home or in a hospital setting, without your consent. You are a mentally competent adult making rational decisions about your care, and you, more than anyone, has the best interests of your baby at the foremost in your mind”.

The Nursing and Midwifery Council (NMC), that govern all practicing midwives, provide information to midwives and nurses on the issue of consent:

“Legally, a competent adult can either give or refuse consent to treatment, even if that refusal may result in harm or death to him or herself. Nurses and midwives must respect their refusal just as much as they would their consent”.

The problem may lie with the allocation of power and responsibility in maternity care. Midwives and doctors are in a uniquely privileged position to be able to serve women at such a vulnerable time in their lives. We train long and hard to amass knowledge to help those we care for, but we should not use this to control or coerce women into what we think they should do. We are after all “Professional Servants” (Mary Cronk). We are there to serve the families we care for, but it is also our professional duty to inform them of any risks associated with their choices. The Nursing and Midwifery council (which regulates all midwives and nurses) has rules and codes of conduct advising us how to support our clients such as:

1. You must treat people as individuals and respect their dignity

2. You must not discriminate in any way against those in your care

3. You must treat people kindly and considerately

4. You must act as an advocate for those in your care, helping them to access relevant health and social care, information and support

5. You must respect people’s right to confidentiality.

6. You must ensure people are informed about how and why information is shared by those who will be providing their care.

7. You must disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising.

8. You must listen to the people in your care and respond to their concerns and preferences.

9. You must support people in caring for themselves to improve and maintain their health

10. You must recognise and respect the contribution that people make to their own care and wellbeing.

11. You must make arrangements to meet people’s language and communication needs.

12. You must share with people, in a way they can understand, the information they want or need to know about their health.

Point number 2 was obviously not read or understood by midwives who attended a woman’s home birth. The woman was from a particular religious group and her partner was from a different ethnic group. The woman phoned me as a result of midwife harassment in her current pregnancy, and in telling me her previous birth experiences said the midwives at one of her previous births had made racist remarks! I was livid and asked if she had complained – no she hadn’t! this is so wrong on so many levels I don’t know where to start! Harassing heavily pregnant women, and going against their wishes in labour is not acceptable but racism from a so called professional is a disciplinary offence. I gave the woman information and advice to make written complaints about current and previous problems, and gave her AIMS contact details.

Another part of our rules concerns consent:

13. You must ensure that you gain consent before you begin any treatment or care.

14. You must respect and support people’s rights to accept or decline treatment and care.

15. You must uphold people’s rights to be fully involved in decisions about their care. 

16. You must be aware of the legislation regarding mental capacity, ensuring that people who lack capacity remain at the centre of decision making and are fully safeguarded.

17. You must be able to demonstrate that you have acted in someone’s best interests if you have provided care in an emergency.

Whether your care provider will like or dislike your choices should be no concern of yours. I personally don’t like junk food, but understand that some people know the risks of consuming it, and still chose to do so. I may offer education about the risks, but wouldn’t dream of telling people not to do it just because I don’t like it myself. This applies to many areas of midwifery care, for example if you are told you are not allowed to give birth at home it would be good to ask if there are specific risks you need to be aware of, before thanking your health professional for their opinion, informing them that you will consider what they’ve said very carefully and let them know you will let them know your decision in due course (Taken from Mary Cronk’s assertiveness phrases). Consider how your care provider would actually be able to force you to do anything against your will (sadly, women have informed me of social services being used as a threat in some circumstances!).

REMEMBER: You do not have to ask permission to do anything which concerns your own body or your baby. Politely question your caregivers, do your own research then take responsibility for your choices! Your body, your baby, your choice!

See also:

Mary Cronk’s assertiveness comments on Angela Horn’s great homebirth website

AIMS the Association for the Improvement in Marternity Services has a great website and provides telephone support for anyone having trouble finding good maternity care. Please consider becoming a member or making a donation to their good work. x

All rights reserved. Copyright Birth Joy 2011 (C)