So you’ve explored your options and found that the only one that even comes close to working for you is to birth with less than supportive care providers in a hospital you have no desire to be in. What now? How do you take these less than perfect circumstances and turn them into a beautiful and positive experience. How do you find joy in a situation that is bringing much fear and unease? And how do you turn this into a safe situation?
First and foremost it is really important to acknowledge WHY having an unsupportive care provider can be a massive issue for women. We all know that we can refuse anything our care provider recommends (no matter how hard they push us) so why does it really matter whether they “support” us or not? Well, aside from the fact that many women find that they go in saying “No thanks” only to be manipulated or coerced into consenting (dead baby card, anyone?) it has a lot to do with how our hormones work. Oxytocin is the hormone that causes and regulates uterine contractions. Oxytocin is known as “the hormone of love”. It’s awesome stuff! It’s also a bit picky about where it likes to grow. It likes intimacy and darkness; Warmth and calm. And it’s not really keen on sharing its space with adrenalin. Adrenalin, on the other hand, thrives in conditions of conflict and harsh lights. It’s at its peak when you are having an argument (say, with a care provider, over whether you are going to consent to a cannula). Having an unsupportive care provider is great for the adrenalin and scares off the oxytocin. It’s also worth noting that even women who feel that they have a supportive care provider can find that their oxytocin gets a little shy when they arrive at hospital, especially if it’s still fairly early in labour.
Oxytocin - so beautiful! Image courtesy of Wikimedia
The best way to encourage oxytocin to make a grand appearance is to feel safe, warm, cocooned, cared for and supported. Finding a care provider who can help with this is great. But unfortunately it’s not uncommon to find that your care provider is in cahoots with the adrenalin. So we need to find ways to encourage the oxytocin to come on out and shine, even though it may not want to. There are a few things that we can do to encourage this:
Find a support group: Oxytocin loves friends! And sometimes the best starting place is to simply find a group of like-minded women who get it. Facebook has a million support groups for various things and while you may have to try out a few different groups before you find the right one for you, you are bound to find some great support.
Educate yourself: Oxytocin is a nerd. It loves to be educated. Being educated can help a woman to feel safe and confident and this is what you need. I’m going to make a few recommendations about education:
Take a hospital antenatal class: OMG!! I hear you all scream. You didn’t really suggest that did you? Yep, I sure did. If you are planning to birth in a hospital I think it is really important to be prepared for what that will mean. You WILL be asked to follow their policies and, while you are under no obligation to do so, it can be useful to know what they are going to recommend. And one way to find out what they will expect of you is to do their class.
And then you can do the next step…
RESEARCH: Research everything that you learned in the hospital class. Go out and read about all their policies and how these will affect your birth. BRAIN every single piece of information they gave you and make your own choices. Read articles written by OBs, midwives, doulas and other mums. Read scholarly articles. Read blogs. Talk to people. LEARN.
Take an independent childbirth class: An independent childbirth class is a great way to gain the information you actually need about pregnancy and birth. Find a class that will provide you with a wide range of fantastic tools (I think that the Hypnobirthing Australia class is so awesome that I am presently getting my practitioner certification!) to help you cope with labour. The self-hypnosis tools taught by the Hypnobirthing Australia class can also be useful in blocking out the unsupportive people while you are at the hospital and can help you to go “into yourself”.
Hire a doula: Remember that oxytocin loves support? And that’s EXACTLY what a doula is. She is a woman who knows about how to support women through birth. Your doula will spend time building a relationship with you during your pregnancy – you’ll chat on the phone or via e-mail and will have a few face to face appointments. Your doula will help you to name your fears and develop strategies for dealing with them. Your doula can help you to write a birth plan that will find the balance between informing your care provider of your goals and maintaining a respectful relationship. A doula can be a familiar and knowledgeable presence for you throughout your labour and birth. She can remind you to use your BRAIN and ask questions. Doulas are skilled at communication and can help facilitate open and respectful communication during labour and birth. They also know a lot about oxytocin and can come up with ways to coax it out if it decides to hide. They will talk to you about drawing the blinds and dimming the lights, building a cave, hiding in the bathroom or birth pool, going for a walk and other ways you can help keep the oxytocin flowing.
Adrenalin - A little more simple. Image courtesy of Wikimedia
Take a friend: This uses the same premise as getting a doula – Oxytocin loves support and love. However, don’t just take any friend! Your friend who thinks that you should get an epidural the minute you walk in the door probably isn’t going to be terribly helpful! Neither is your friend who believes that hospital policies must always be followed to the letter. And your friend who thinks that only wusses use pain relief is probably going to leave you with major performance anxiety. None of these friends is going to be able to coax the oxytocin out! Find a friend who knows a bit about birth. A friend who is calm and assertive under pressure. A friend who believes that YOU are the source of all your birthing power and knowledge. Talk to them about what you want and how they could help you to achieve it. Then bring them along.
Get in touch with Maternity Choices Australia: See if your local Maternity Choices Australia branch has someone who can provide some support and advocacy for you. And then get involved! Become a consumer representative and get involved in campaigns to help lift maternity care choices in your area. This may not benefit you in the short term, but will benefit your community in the longer term!
Practice saying “no thank you”.: Smile and nod. Submit your birth plan with a very firm – “these are only negotiable if my health circumstances change”. Get your birth plan signed off by a senior OB. Refer your care provider to the AMA position on maternal decision making. Practice asking: Why? Why are you recommending that? Why why why! (Take a three old along if you need help with that one!). And don’t lose heart! Women still birth babies in war zones and other crappy environments, so there’s no reason why you can’t birth in sub-optimal conditions as well!
This gremlin would certainly increase your adrenalin levels! Image courtesy of Wikimedia
Birthing women ALWAYS deserve to be able to birth their babies how, where and with whom they feel is best for them. Unfortunately the choice in maternity care in Australia is all an illusion and women are being forced to choose between free birthing and birthing in an unsupportive environment. If you find yourself birthing in sub-optimal conditions following the steps above will help maximise your chances of a smooth, safe, calm and positive birth. If you have any tips you’d like to add let me know!
Love the adrenalin, HO HO, OH. Just like in labour. Brill post, women need to know the full truth about adrenalin how it 'sticks' to the cervix and stops it from opening. The labour just drags on and on and on. www.painfreelabour.blogspot.co.uk