Modern Birth in Ireland

national | consumer issues | opinion/analysis Saturday January 08, 2011 17:15 by Tracy Donegan tracydonegan at doulaireland dot com

Prepare for a Positive Birth

As the baby boom continues in the Irish maternity hospitals are literally bursting at the seams. With more Mums labouring in corridors on trolleys is there anything you can do to stack the odds in your favour of having a healthy baby and a positive birth?

You’ll never forget your experience of giving birth, so it makes sense to do all you can to make sure the experience is as positive as possible – and no, that doesn’t necessarily mean an incense waving whale-song home birth. Despite what some well meaning friends will tell you it is more than possible to have a positive experience AND a healthy baby – you don’t have to trade one for the other. With a little preparation ahead of time a positive experience isn't just possible - it's probable.

It used to be that a first time Mum’s biggest fear was whether she would get the epidural when she wanted it but these days in Irish maternity care a bigger concern is whether Mum will get to give birth in a private room supported by her Midwife and partner or in a public hallway – this is the reality of a growing population and an overstretched overstressed maternity system.

After Colette Fitzpatrick of TV3's shocking article was printed last week and did the rounds on every Irish pregnancy forum I started to receive emails and calls from panicked Mums wanting to know what they could do to avoid the situation Colette found herself in which is sadly not an uncommon one. There are no guarantees – public, private or celebrity.

Here’s the article if you haven’t read it –

http://www.herald.ie/entertainment/around-town/i-paid-e....html

How will you remember your baby’s birth…..in 10 weeks…...in 10 years? We never forget our babies births....even when you're 85 and can't remember what you had for dinner the day before you'll always remember how you were treated during this very special time. The day of your baby's birth is so much more than just another day.... and it's memory - positive or negative will stay with you forever. I found it so sad that the memories that this celebrity first time Mum remembers forever will be of emotional and well as physical pain, an avoidable loss of dignity and policy centred care instead of Mother centered care.

What will your memories of your baby’s birth consist of?
Did you feel listened to? Did you feel respected? Were you treated kindly? Did you feel like you were the most important woman in the world during your labour? Did your partner feel involved, respected and supported? In our busy maternity units you won't always have a calm supportive presence.

Preserving a positive birth memory is the goal of a Doula – not whether you have an epidural or not....whether you have interventions or not. It is about you looking back on the birth of your baby with a sense of satisfaction. Feeling that you had the best birth experience for you - whatever path it takes. Having additional support in labour can also help you avoid post natal depression afterwards and increases breastfeeding success. Research suggests that the women who come through birth feeling good about it aren’t necessarily those who escape without stitches: in fact, the actual method of birth seems to have very little to do with it.

Instead, being included in the process – feeling that you were part of the decision-making, that you were well supported and had established a good, trusting relationship with those caring for you – is the most important factor.

After reading Colette’s birth story it’s obvious that whether public or private… all the yoga, Ina May books, GentleBirth, aromatherapy or celebrity status can’t ‘magic’ up extra rooms but when you’ve prepared a comprehensive labour ‘tool kit’ there’s a lot you and your partner can do to stay more in control and feel more confident on the day. The more confident you feel the longer you’ll stay home and labour in the comfort of your own home and not be subjected to labouring on a trolley in full view of the general public – any Mother’s worst nightmare.

Despite the bed shortages in hospitals there are lots of things that are within your control that can make the experience a much more positive one so start adding to your labour toolkit today.

Home Sweet Home

At home you have one of the most basic and most important elements of a positive birth experience - privacy. You also have access to your own shower or bath, your bed (no trolley) and all of your home comforts. Consider organising support at home from a Doula, friend or family member who has given birth naturally (whether your plans include having an epidural or not). A Doula provides emotional and informational support to you and your partner in your home before going to hospital. Your Doula is trained in labour support and non clinical ways of assessing your progress without needing any clinical examinations so you’re more likely to arrive into the hospital in advanced labour – spending less time on a trolley. If this is your first baby - having a knowledgeable supportive woman with you at home can make you and your partner much more confident in staying at home comfortably. The use of a birth Doula is shown to shorten labour, reduce the need for epidurals and is associated with less caesareans, more breastfeeding and less PND. Your Doula will accompany you to the hospital to make the journey in less stressful and depending on the hospital’s policy will stay with you or will leave you at the hospital.

• Make use of gravity! Labour is more effective when you’re upright, walking, sitting or standing. Walking and even belly dancing can be really helpful or sitting on a birth ball.

• Change positions regularly. Try standing and swaying, squatting, lying on one side, the other side, walking, etc – in other words get off the bed/trolley!

Do Your Homework So You Can Navigate the System Confidently

What struck me most from Colette’s article was her description of having her ‘waters broken’ on the corridor. Of course in an emergency situation most of us wouldn’t care if the Postman was standing looking at us as long as we were getting the care we needed but this is not the case with routine interventions that are part of every Mother’s care – whether she needs it or not.

Learn as much as you can about the policies of your hospital – routine breaking the waters whether in the reception area or a private suite is outdated practice and not based on best international practice. The reasoning of some hospitals that ‘we have to see the colour of waters to see how every baby is coping’ is not a clinically valid reason for this routine procedure and has been outdated in the UK for years. The least invasive way to determine how well your baby is doing is intermittent monitoring. Attending your maternity unit’s classes will give you a chance to ask questions about their routine procedures. If you are unsure whether you’re being offered a necessary interruption to your labour or a routine one to speed up your labour to free up the delivery suite for someone else you can ask two questions that will give you a definitive answer:

Is my partner ok?
Is our baby ok?

If the answers to both of these questions are YES – then the next logical question is “why do anything?” Can we wait a while? These 5 simple words can make a huge difference in how your labour progresses and how well you cope. The vast majority of the time the answer will be YES.

Once you’ve learned about the routine policies of your hospital write out your birth preferences and bring several copies along with you. Your partner is in the best position to facilitate for you. But in the event of you ending up on a trolley – how confident are you that your partner will be able to support you? Is your partner confident he can help you make the most of whatever circumstances you’re faced with on the big day or will you end up worrying about him too instead of focusing on giving birth to your baby? If you’re not 100% confident that he is well prepared then consider private birth preparation classes at home at a time to suit you to help him get there.

Preparing Mind & Body

Prepare for your baby’s birth with psychological coping strategies as well as physical comfort strategies. The more emotionally relaxed you are the less intense the sensations and the more in control you’ll feel. Hypnosis is associated with less pain and shorter labours.

Read positive birth stories – focus on having the best experience possible no matter what happens on the day.

Acupressure points are easy to learn in a short class and gives your partner a very useful tool for at home and at the hospital.

Talk to women who have had positive births

We can’t really say exactly how any birth will go. But if we take the time to prepare ourselves, doing our homework and finding good support, we can maximize our chances of having a positive birth experience, while still ensuring that both Mum and baby are safe and healthy.

For more information on private antenatal classes or Doula services contact Tracy Donegan

Author of The Better Birth Book (Liffey Press 2006) and The Irish Caesarean and VBAC Guide (2010)