Wednesday, August 14th, 2013
The Birth Women Want

Listening to this week’s Woman’s Hour hosted by Kirsty Allsopp, had challenged me to reflect on the work that I do with pregnant women and their partners. My personal belief is that women are designed to birth babies and how they do this can have a profound impact on their postnatal health – physical and mental – as well as their future fertility and birthing options. The assertion that the only thing that matters is healthy babies and healthy mothers is, for me, too simplistic and talking to women who have experienced birth trauma confirms this view for me. Towards the end of the broadcast it was words spoken by Rebecca Schiller from Birthrights who summarised this best for me as she stated that women wanted ‘positive experiences that set them up for motherhood’. I couldn’t agree more.

Ms Allsopp, on the other hand, is following a ‘personal journey’ which seems to be driven by her own experience of having an unplanned caesarean, rather than the straightforward vaginal birth she had ‘hoped for’. Perhaps this experience was less than positive and has left her with some unfinished business which she now seems to want to take up with the National Childbirth Trust (NCT). Her perception seems to be that NCT classes do not prepare women adequately for complications during labour and birth which led to a programme that tried to be balanced but, perhaps due to her interviewing inexperience, to me felt clumsy and unsatisfying.

As an NCT teacher of 20 years experience I can quite honestly say that I have never taught an antenatal course that has not given parents an opportunity to explore the challenges and complications that they may face. These may be during pregnancy, during labour and birth, or indeed after their babies have been born. How much time is spent on these topics and how they are discussed depends primarily on the group needs. It may be that there is a focus on recovery after difficult births, or how a partner may experience the birth of their baby by caesarean/forceps/ventouse or how a woman may feel after having an unexpected assisted birth. Some groups like facts and figures, others prefer birth stories or visual images. Sometimes it is the risks and benefits that are uppermost in people’s minds and on other occasions they just want to talk about how to avoid complications. I take my lead from them as they are adult learners who will learn best if they are able to take ownership of their learning. It may be that they engage fully in these topics or that they switch off because they just don’t want to hear it. All I can do is give them the opportunities to explore and the rest is up to them.

Even during my NCT Yoga for Pregnancy classes there can be the opportunity to explore complex situations either through the birth stories women themselves tell or by way of a discussion topic at the start of a session. Women and their partners can also contact me between sessions or after a course is over to ask more questions or explore their options should their circumstances change. So understandably I feel a little affronted at the suggestion that ‘we’ are not doing our job properly!

Having said this it could also be argued that by talking about interventions and caesareans we are making them more likely to happen – they are becoming to be seen as ‘normal’ (whatever that means) and therefore they are more easily accepted than physiology would suggest is necessary. According to the World Health Organisation (WHO) the caesarean section rate should be between 10-15% and it could be argued that in the developed world this figure should be even lower. In the UK it is currently hovering around 25% of all births.

So for me there is also room for courses that don’t focus on the things that ‘might go wrong’ and instead enable women, and their partners, to prepare in a more positive way for their births. With my Natal Hypnotherapy Workshops we focus on the outcome that couples would like to achieve. This does not mean whether they want a waterbirth or a homebirth, but rather how they want to be feeling about the way their baby enters the world. It might be that they are aiming for ‘a calm, confident birth experience’ or ‘a relaxed and positive birth’. With this shift in focus it is possible to prepare for anything that happens. There is no plan, just a whole range of skills and techniques, using breathing and birth hypnosis as the core preparation, working towards the desired outcome. Sometimes nature has very different ideas about the arrival of a baby, caesarean births and other assistance is there for these situations. My hope is that whatever happens the woman is left with a positive experience that does indeed set her up for motherhood.

I am not suggesting that this works for everyone I have worked with but I can honestly say that it does more times than not and the birth stories bear this out.
I want women to enter motherhood feeling empowered, confident and positive. Yes, healthy babies and healthy mothers matter – but there is so much more to good postnatal mental and physical health than that. This is what some of the speakers on Woman’s Hour were trying to say – I am just not sure that Kirsty Allsopp was ready to hear it.

(The views expressed in this blog are my own personal views)