What Is The Secret To A Good Birth?

 

Tempting question, right? It is something many people plan for, and many people get, but what can you do to guarantee that you get a positive birth? What is it that some people are doing that means that they have a good experience when other people don’t?

First, we need to start with your personal meaning of the word “good” when paired with “birth”. When I spend time with families, getting to know them before birth, we talk about this question in depth (if they want to) and the answers – even from the self-selecting group who have chosen to hire a doula – are hugely wide ranging. 

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So, what is good for you? Here are some ideas that I have taken from my antenatal meeting notes with clients…

-       Physiological / Natural / Normal

-       Planned caesarean birth 

-       Other children cared for

-       Partner there or not there

-       Everyone alive

-       Everyone healthy

-       Not agony

-       Calm 

-       Not painful 

-       Easy

-       Not alone

-       Not ignored

-       Quick

-       Not scary

-       Beautiful

-       In a specific setting, e.g. home, birth centre, labour ward

-       Using specific tools, e.g. hypnobirthing, water, TENS, massage, aromatherapy 

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What are your thoughts on reading this list? Do some things surprise you and others seem obvious? I often find that families have a new thing to add to the list that I would not have thought of. It reminds me again and again that when we talk to one another using qualitative words like “good” and “bad” we are using our own stories of judgement and experience and not necessarily understanding each other as well as we think we are. One person’s idea of good might be someone else’s idea of not good enough or just plain terrible. 

So, now that I’ve undermined my original question by not knowing what “good” is, I’d like to ask you to look at your own list (lets assume you made one a minute ago) and ask yourself “why is that thing a good thing?”. I ask this because we all have experiences and stories that lead us to make the decisions that we do, sometimes we can get lost in those stories and not even realise it. I know that I do this daily and I’m sure there are some things that I still cannot see, even when looking for them. It is very hard for us to see our own context, just as a fish does not see the water it swims through and whether that is fresh water or salt. A fish will (in my extremely limited marine expertise) have no idea that it is swimming through water and there is another environment that is not water, and even if perhaps they were aware of it – they may think us mad for living in such a harmful environment. They don’t taste it or see it or feel it on their scales. Do we know what water we are swimming in? And what the hell does this have to do with birth? 

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Birth is a transformative experience and one that, whether “good” or “bad” will no doubt last with you a lifetime. It imprints on your mind and body and stays with you. There is lots more to say on this for a future article… But for now, let’s stay with the idea that birth and the transition to parenthood (whether for the first or third time) is important. If we allow pervasive negative birth culture – and the mainstream story of birth in the UK is overwhelmingly negative – to affect the choices we make without our say so, I think we will be poorer for it.

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Here’s an example to explain what I mean. Perhaps you have on your list for a Good Birth: mother and baby alive at the end of everything. If I think about that quietly, does it scream “best case scenario” to me? It is hugely important, but is it the best that you could or should hope for? We don’t seem to have these low standards for other areas of our lives. When you chose your GCSE’s did you say to your teacher, “I don’t really care, I just want to stay alive”? what about when you picked your jobs, houses, maybe planned your wedding? 

If you read the list above and cannot connect to it or aren’t sure what might be good by your standards, you might like to consider the review of the study below. This study looked at the affects of having a doula present with you during birth. If you have researched doulas at all, then you have likely come across these statistics; my apologies for rehashing old ground. The reason I want to highlight them here is that, this was a huge contributing factor into why I became a doula; I saw that it was making a quantifiable and qualitative difference in birth experiences andoutcomes. In my eyes, creating “good” birth, or at least better birth.

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There are some qualifiers to that statement. These are the criteria that were measured in the review; having them or not having them does not make for a better birth in general, except for the first one of “negative feelings”. I think we can all agree that fewer negative feelings is a good thing, even if all feelings do have their place. I genuinely have no feelings about how anyone else chooses to give birth, so long as they were respected and treated well in their decision – that is where my passion lies; not in reducing caesarean rates. In my opinion, it is hard to judge whether fewer epidurals is a good thing unless we know if a birthing person wanted that epidural or not. However, my experience is that people want to know that the option of an intervention is there but would prefer not to take it if they don’t feel they have to. This leads me to think that most people believe that fewer interventions are preferred if medically possible. 

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“The Bohren 2017 intervention review measured the effectiveness of continuous support during labour, from 26 studies involving 15,858 women in 17 different countries. 

Women allocated to continuous support were more likely to have a spontaneous vaginal birth; 

and less likely to:

1.    report negative ratings of or feelings about their childbirth experience;

2.    use any intrapartum analgesia;

3.    have a caesarean birth;

4.    have an instrumental vaginal birth;

5.    have regional analgesia; and

6.    have a baby with a low five‐minute Apgar score 

In addition, their labours were shorter.”

Cochrane Database of Systematic Reviews, Perceptions and experiences of labour companionship: a qualitative evidence synthesis, 18 March 2019.

I would be so interested to know if you, as a reader of this and perhaps a parent or parent to be, have any thoughts over which of the above measurements are positive or negative. 

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I’ve just shown this to my husband and he is far from impressed (he told me in a kind way, but I could tell); he thinks this is two topics merged together and that I’m not being as funny as I usually am. Rather flattered to have been thought funny at any point, so I’ll take that. And sometimes, things just aren’t funny. I’m not finding this funny right now. I don’t want people to have a traumatic birth and I think often that involves us unpicking what we are expecting and planning how to get something better. 

I want you to strive for Good Birth, whatever that looks like to you, even if that is what I have dismissed above as not the “best case scenario”. I want you to become parents in a way that does not leave you traumatised and depleted.  The secret to a good birth? I think starting with what “good” means to you and why is an excellent place to start. I will be writing 5 more articles, (hopefully much better than this, of course) over the next few weeks and I plan to tease out some more analysis as well as really practical support and information for you. Hope to see you there. 

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I’m going to recommend a (or some if I get carried away…) book at the end of each of these articles, for more, take a look at my whole client library. Book Recommendation: How to Have a Baby by Natalie Meddings. If you enjoyed this you might like to read You Deserve A Doula

Ruth is a birth and postnatal doula supporting families across Kent and South London. Come and learn more about Ruth and doulas by exploring these links: Mother Mother Doula,Instagram,Doula UKFacebook, Kent Doula Collective